Sample records for policy direction responding

  1. Message Received How to Bridge the Communication Gap and Save Lives

    DTIC Science & Technology

    2004-03-01

    safety during an emergency depend on the ability of first responders to talk via radio, directly, without dispatch and in real time. Many technologies are...Words interoperability Coast Guard first responders procedures interagency communications policies 18...communication interoperability for public safety first responders entails far more than finding and emplacing a technology and training the operators. The

  2. Responding to Poverty through Education and Teacher Education Initiatives: A Critical Evaluation of Key Trends in Government Policy in England 1997-2015

    ERIC Educational Resources Information Center

    Burn, Katharine; Childs, Ann

    2016-01-01

    This paper presents a comparative critique of key education and teacher education policies in England adopted by New Labour (1997-2010) and the Coalition government (2010-2015). It focuses on direct measures intended to alleviate the effects of poverty on young people's educational outcomes, and on teacher education policies with implications for…

  3. Wildland fire management policy: Learning from the past and present and responding to future challenges

    Treesearch

    Tom Zimmerman

    2009-01-01

    Wildland fire is one of the most important vegetation- shaping factors that land managers deal with. It is our highest risk, most complex, and potentially highest consequence program. Wildland fire management policy is the most important element in defining the direction, scope, and focus of the program. What is policy? If we look it up in Merriam-Webster's...

  4. Making Educational Reform Work: Stories of School Improvement in Urban China

    ERIC Educational Resources Information Center

    Hamilton, Doug

    2014-01-01

    The latest national educational policy in the People's Republic of China calls for comprehensive educational reforms aimed at building the foundation for a modern learning society throughout China over the next 10 years. This research examines school leaders' efforts to implement school improvement initiatives that directly respond to the policy's…

  5. Financial Adequacy, Retirement, and Public Policy: A Study of the Perceptions of Older Americans.

    ERIC Educational Resources Information Center

    Peterson, David Alan

    This study examined the perceptions of older Americans on the financial aspects of retirement and on policy matters which directly bear on their income maintenance positions. A descriptive survey was made of older persons participating in senior citizen multipurpose centers and clubs. The findings showed that 57% of the respondents perceived their…

  6. Conflict of interest policies among institutions and organizations offering chiropractic continuing education.

    PubMed

    Funk, Matthew F; Lisi, Anthony J

    2009-05-01

    The purpose of this study is to document and describe the policies governing conflict of interest (COI) among select organizations and institutions offering chiropractic continuing education. Surveys were sent to the following: all North American chiropractic colleges; major national chiropractic organizations; and state chiropractic organizations in states with more than 3500 licensed Doctors of Chiropractic. Each organization or institution was surveyed regarding written and verbal COI policies. Half of the respondents in this survey indicated that they had written policies for management of COI, whereas half did not. None included most of the common elements typically outlined in continuing medical education COI policies. Content varied among the policies available for review. Relevant financial interest is the issue most often defined, and respondents generally prohibit presenters from selling products or services directly during presentations. Overall, these results suggest that processes for managing COI in chiropractic CE are less robust than those previously described for continuing medical education. This study provides preliminary insight into the status of COI management in chiropractic CE.

  7. 32 CFR 701.5 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... FOIA Directives 5400.7 and 5400.7-R, and this instruction in this part in both letter and spirit..., when responding to FOIA requests for electronic data where creation of a record, programming, or...

  8. [Priorities for health policy and systems research focused on human resources in health].

    PubMed

    Reveiz, Ludovic; Chapman, Evelina; Flórez, Carlos E Pinzón; Torres, Rubén

    2013-11-01

    Identify priorities for health policy and systems research related to human resources in Latin America and Caribbean countries. An online survey was designed based on a search in PubMed, Cochrane Library, and LILACS that contributed previously prioritized research questions. Respondents, mainly researchers and decision-makers, were identified through various sources. The first round, directed at researchers, aimed at refining and adding research questions and prioritizing questions that researchers regarded as relevant or very relevant. The second round was directed at researchers and decision-makers. A question was considered a priority when 50% (or more) of respondents described it as "relevant" or "very relevant." The first round included 20 questions on human resources and 33/66 researchers responded. Questions suggested by the researchers were added, resulting in 26 questions for the second round, which were sent to 121 researchers and decision-makers. Respondent representation by country was uniform in both rounds. In the second round, 14/26 (54%) questions were described as very relevant. Priority issues related to regulation of the market, integration of education and health care needs, and distribution of human resources. The response rate was 50% in the first round (33/66), and 34% in the second round (41/121). The results of this exercise provide a starting point for mobilization of resources for health policy and systems research. Identification of health systems research priorities is an effective and efficient strategy for reorienting political, financial, management, and social organization efforts for attaining universal health coverage.

  9. Evaluation of a medication order writing standards policy in a regional health authority.

    PubMed

    Raymond, Colette B; Sproll, Barbara; Coates, Jan; Woloschuk, Donna M M

    2013-09-01

    The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented. We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance. Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) (p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) (p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers. Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers. Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers. Plans include continued advertising, MOWS summaries in all charts, all-staff education, reminders and exploration of sustainable interventions for targeted feedback for prescribers.

  10. Another Link in the Chain: State Policies and Practices for Case Management and Environmental Investigation for Lead-Poisoned Children.

    ERIC Educational Resources Information Center

    Guthrie, Anne M.; McLaine, Pat

    Policy and practice for screening children for lead poisoning have dominated the dialogue about the health care system's role in lead poisoning prevention, with little attention directed to how the health care system responds to a lead-poisoned child once identified. This report details a study of the case management and environmental…

  11. State Policy Directives and Middle-Tier Translation in a Swedish Example

    ERIC Educational Resources Information Center

    Nordholm, Daniel

    2016-01-01

    Purpose: The purpose of this paper is to analyse the Swedish National Agency for Education's launch of the nationwide Lgr11 curriculum reform and how local education authorities (LEAs) in one municipality translated and responded to the National Agency's directives. Design/methodology/approach: This paper presents empirical data from a qualitative…

  12. Charting a Democratic Course for Global Citizenship Education: Research Directions and Current Challenges

    ERIC Educational Resources Information Center

    Myers, John P.

    2016-01-01

    This article outlines research directions for global citizenship education, by emphasizing the centrality of democratic goals for schools in the 21st century. Despite a significant shift in educational policies and practices towards addressing education that respond to the conditions of globalization, there is not a clear vision regarding its role…

  13. 78 FR 66288 - An Inquiry Into the Commission's Policies and Rules Regarding AM Radio Service Directional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... respond to pending formal tower complaints, and (2) employ language to ``deal with existing situations... the Commission does not grant reconsideration for the purpose of debating matters on which it has...

  14. The social construction of illness: key insights and policy implications.

    PubMed

    Conrad, Peter; Barker, Kristin K

    2010-01-01

    The social construction of illness is a major research perspective in medical sociology. This article traces the roots of this perspective and presents three overarching constructionist findings. First, some illnesses are particularly embedded with cultural meaning--which is not directly derived from the nature of the condition--that shapes how society responds to those afflicted and influences the experience of that illness. Second, all illnesses are socially constructed at the experiential level, based on how individuals come to understand and live with their illness. Third, medical knowledge about illness and disease is not necessarily given by nature but is constructed and developed by claims-makers and interested parties. We address central policy implications of each of these findings and discuss fruitful directions for policy-relevant research in a social constructionist tradition. Social constructionism provides an important counterpoint to medicine's largely deterministic approaches to disease and illness, and it can help us broaden policy deliberations and decisions.

  15. 76 FR 77541 - Proposed Information Collection Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... managers in formulating policies for the future direction of the Refugee Resettlement Program. Respondents... of origin, State of resettlement, and number of months since arrival. From the responses, the Office...-9). OMB No.: 0970-0033. Description: The Annual Survey of Refugees collects information on the...

  16. 32 CFR 299.5 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICE (NSA/CSS) FREEDOM OF INFORMATION ACT PROGRAM § 299.5 Procedures. (a) Requests for copies of records of the NSA/CSS shall be delivered to the Director... Director of Policy, if so designated, shall endeavor to respond to a direct request to NSA/CSS within 20...

  17. 32 CFR 299.5 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICE (NSA/CSS) FREEDOM OF INFORMATION ACT PROGRAM § 299.5 Procedures. (a) Requests for copies of records of the NSA/CSS shall be delivered to the Director... Director of Policy, if so designated, shall endeavor to respond to a direct request to NSA/CSS within 20...

  18. Orthopaedic Resident Practice Management and Health Policy Education: Evaluation of Experience and Expectations.

    PubMed

    Stautberg Iii, Eugene F; Romero, Jose; Bender, Sean; DeHart, Marc

    2018-04-11

    Introduction Practice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents' current experience and knowledge, formal training, and desire for further education in practice management and health policy. Methods We developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident's current experience and knowledge, formal training, and interest in further education. The survey was distributed at the end of the academic year through an Internet-based survey tool (www.surveymonkey.com) to orthopaedic residents representing multiple programs and all postgraduate years. Results The survey was distributed to 121 residents representing eight residency programs. Of those, 87 residents responded, resulting in a 72% response rate. All postgraduate years were represented. Regarding practice management, 66% had "no confidence" or "some confidence" in coding clinical encounters. When asked if practice models, finance management, and coding should be taught in residency, 95%, 93%, and 97% responded "yes," respectively. When evaluating first employment opportunities, the three most important factors were location, operating room block time, and call. Regarding health policy, 28% were "moderately familiar" or "very familiar" with the Physician Payments Sunshine Act, and 72% were "not familiar" or "somewhat familiar" with bundled payments for arthroplasty. Finally, when asked if yearly lectures in political activities would enhance resident education, 90% responded "yes." Discussion and conclusion Regarding practice management, the survey suggests that current orthopaedic residents are not familiar with basic topics, do not receive formal training, and want further education. The survey suggests that residents also receive minimal training in health policy. Residents feel that health policy will be important in their careers, and they would benefit from formal training in residency.

  19. The Use of Mathematical Models of Chlamydia Transmission to Address Public Health Policy Questions: A Systematic Review.

    PubMed

    Rönn, Minttu M; Wolf, Emory E; Chesson, Harrell; Menzies, Nicolas A; Galer, Kara; Gorwitz, Rachel; Gift, Thomas; Hsu, Katherine; Salomon, Joshua A

    2017-05-01

    Mathematical models of chlamydia transmission can help inform disease control policy decisions when direct empirical evaluation of alternatives is impractical. We reviewed published chlamydia models to understand the range of approaches used for policy analyses and how the studies have responded to developments in the field. We performed a literature review by searching Medline and Google Scholar (up to October 2015) to identify publications describing dynamic chlamydia transmission models used to address public health policy questions. We extracted information on modeling methodology, interventions, and key findings. We identified 47 publications (including two model comparison studies), which reported collectively on 29 distinct mathematical models. Nine models were individual-based, and 20 were deterministic compartmental models. The earliest studies evaluated the benefits of national-level screening programs and predicted potentially large benefits from increased screening. Subsequent trials and further modeling analyses suggested the impact might have been overestimated. Partner notification has been increasingly evaluated in mathematical modeling, whereas behavioral interventions have received relatively limited attention. Our review provides an overview of chlamydia transmission models and gives a perspective on how mathematical modeling has responded to increasing empirical evidence and addressed policy questions related to prevention of chlamydia infection and sequelae.

  20. Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities - a qualitative study.

    PubMed

    Rosenkötter, Nicole; Clemens, Timo; Sørensen, Kristine; Brand, Helmut

    2013-11-14

    The European Union (EU) health mandate was initially defined in the Maastricht Treaty in 1992. The twentieth anniversary of the Treaty offers a unique opportunity to take stock of EU health actions by giving an overview of influential public health related EU-level policy outputs and a summary of policy outputs or actions perceived as an achievement, a failure or a missed opportunity. Semi-structured expert interviews (N = 20) were conducted focusing on EU-level actions that were relevant for health. Respondents were asked to name EU policies or actions that they perceived as an achievement, a failure or a missed opportunity. A directed content analysis approach was used to identify expert perceptions on achievements, failures and missed opportunities in the interviews. Additionally, a nominal group technique was applied to identify influential and public health relevant EU-level policy outputs. The ranking of influential policy outputs resulted in top positions of adjudications and legislations, agencies, European Commission (EC) programmes and strategies, official networks, cooperative structures and exchange efforts, the work on health determinants and uptake of scientific knowledge. The assessment of EU health policies as being an achievement, a failure or a missed opportunity was often characterized by diverging respondent views. Recurring topics that emerged were the Directorate General for Health and Consumers (DG SANCO), EU agencies, life style factors, internal market provisions as well as the EU Directive on patients' rights in cross-border healthcare. Among these recurring topics, expert perceptions on the establishment of DG SANCO, EU public health agencies, and successes in tobacco control were dominated by aspects of achievements. The implementation status of the Health in All Policy approach was perceived as a missed opportunity. When comparing the emerging themes from the interviews conducted with the responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development.

  1. Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities – a qualitative study

    PubMed Central

    2013-01-01

    Background The European Union (EU) health mandate was initially defined in the Maastricht Treaty in 1992. The twentieth anniversary of the Treaty offers a unique opportunity to take stock of EU health actions by giving an overview of influential public health related EU-level policy outputs and a summary of policy outputs or actions perceived as an achievement, a failure or a missed opportunity. Methods Semi-structured expert interviews (N = 20) were conducted focusing on EU-level actions that were relevant for health. Respondents were asked to name EU policies or actions that they perceived as an achievement, a failure or a missed opportunity. A directed content analysis approach was used to identify expert perceptions on achievements, failures and missed opportunities in the interviews. Additionally, a nominal group technique was applied to identify influential and public health relevant EU-level policy outputs. Results The ranking of influential policy outputs resulted in top positions of adjudications and legislations, agencies, European Commission (EC) programmes and strategies, official networks, cooperative structures and exchange efforts, the work on health determinants and uptake of scientific knowledge. The assessment of EU health policies as being an achievement, a failure or a missed opportunity was often characterized by diverging respondent views. Recurring topics that emerged were the Directorate General for Health and Consumers (DG SANCO), EU agencies, life style factors, internal market provisions as well as the EU Directive on patients’ rights in cross-border healthcare. Among these recurring topics, expert perceptions on the establishment of DG SANCO, EU public health agencies, and successes in tobacco control were dominated by aspects of achievements. The implementation status of the Health in All Policy approach was perceived as a missed opportunity. Conclusions When comparing the emerging themes from the interviews conducted with the responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development. PMID:24225055

  2. Climate Change: Could It Help Develop "Adaptive Expertise"?

    ERIC Educational Resources Information Center

    Bell, Erica; Horton, Graeme; Blashki, Grant; Seidel, Bastian M.

    2012-01-01

    Preparing health practitioners to respond to the rising burden of disease from climate change is emerging as a priority in health workforce policy and planning. However, this issue is hardly represented in the medical education research. The rapidly evolving wide range of direct and indirect consequences of climate change will require health…

  3. Organizational Responses to Death in the Military.

    ERIC Educational Resources Information Center

    Bartone, Paul T.; Ender, Morten G.

    1994-01-01

    Notes that how organizations respond to a death can influence coping in either positive or negative directions for friends and co-workers of the deceased. Reviews how casualty policies have developed in U.S. Army, and draws on Army's casualty experience to suggest ways in which organizational responses to death might facilitate healthy adjustment…

  4. Sunshine Laws in Higher Education. State Policy Brief

    ERIC Educational Resources Information Center

    Hearn, James C.

    2017-01-01

    Public higher education is a major recipient of state funding and resources. As such, public colleges and universities directly respond to state needs for higher education and are required to provide transparency in decision-making, which is codified in state open-meeting and record laws. These laws, often termed "sunshine laws," present…

  5. A Study of Factors Affecting University Professors' Research Output: Perspectives of Taiwanese Professors

    ERIC Educational Resources Information Center

    Yang, Jason Cheng-Cheng

    2017-01-01

    Higher education in Taiwan is facing competition and challenges from the macro environment of globalization. Taiwan's key policy direction is enhancing university quality in order to respond to these future trends. Universities' international competitiveness relies on not only faculty members' teaching quality, but also their research performance.…

  6. The Incident: It's 2pm on a Friday Afternoon...

    ERIC Educational Resources Information Center

    Grant, Frank

    2002-01-01

    A false allegation of sexual abuse at a residential outdoor education facility demonstrates why programs should have written policies and procedures directing staff how to respond to infatuations and "come-on" traps of young people; how to avoid bodily contact, being alone with a group, or dealing emotionally and physically with…

  7. The Colorado Crisis Education and Response Network: an analysis of policy and practices.

    PubMed

    Crepeau-Hobson, Franci; Drennen, Curt

    2011-01-01

    The Federal government has recognized the importance of including behavioral health in disaster response plans and policies. Many states have responded to these directives with the development and implementation of disaster behavioral health response teams. The Colorado Crisis Education and Response Network (CoCERN) is a statewide asset that is based in community partnerships formed to deliver effective, efficient, and professional disaster behavioral health services to communities impacted by a disaster Using the K. McInnis-Dittrich model of policy analysis, this paper analyzes this approach to disaster behavioral health response. Strengths and weaknesses of the program, as well as implications for practice are discussed.

  8. Introduction of direct-to-consumer advertising of prescription drugs in Canada: an opinion survey on regulatory policy.

    PubMed

    Mintzes, Barbara; Barer, Morris; Lexchin, Joel; Bassett, Ken L

    2005-06-01

    Canada is strongly influenced by US cross-border direct-to-consumer advertising (DTCA) and has held consultations to discuss introduction of DTCA since 1996. This article describes a survey of Canadian drug policy experts carried out in 2001, during one such legislative review. The survey results are compared to more recent DTCA policy developments. We recruited key informants on pharmaceutical policy to complete a faxed questionnaire that queried their opinions on DTCA information quality, effects on drug and health care use, and regulatory issues. Respondents were asked about the evidence they had used to back their opinions. Analysis was descriptive. Of 79 identified potential participants, 60 (76%) participated, 40% of whom were from federal and provincial government; 3% were private insurers; 18%, 15%, and 8% were from health professional groups, consumer groups, and patient groups, respectively; 8% and 7% were from pharmaceutical and advertising industries, respectively. Opinions were highly polarized on the effects of DTCA on drug and health care use. Advertising and pharmaceutical industry respondents were generally positive, public sector, health professional and consumer groups generally negative. Over 80% believed DTCA leads to higher private and public drug costs and more frequent physician visits. Fewer judged billboards or television to be appropriate media for DTCA than magazines or the Internet, and most believed that children and adolescents should not be targeted. Given the polarization observed within this survey, we examined how DTCA policy has evolved in Canada since 2001. The federal government has legislative authority over DTCA, but bears few of the additional costs potentially incurred through policy change. These fall to the provinces, which provide an eroding patchwork of public coverage for prescription drugs in the face of rapidly increasing costs. No new federal legislation has been tabled since 2001. However, considerable shifts in administrative policy have occurred, all supportive of expanded advertising. Thus, the law continues to be restrictive but its application less so.

  9. Receptivity to transformative change in the Dutch urban water management sector.

    PubMed

    de Graaf, R E; Dahm, R J; Icke, J; Goetgeluk, R W; Jansen, S J T; van de Ven, F H M

    2009-01-01

    Worldwide, the need for transformative change in urban water management is acknowledged by scientists and policy makers. The effects of climate change and developments such as urbanization, the European Water Framework Directive, and societal concerns about the sustainability of urban water system force the sector to adapt. In The Netherlands, a shift towards integration of spatial planning and water management can be observed. Despite major changes in water management policy and approach, changes in the physical urban water management infrastructure remain limited to incremental solutions and demonstration projects. Policy studies show that institutional factors and professional perceptions are important factors for application of innovations in urban water management. An online survey among Dutch urban water management professionals demonstrates that according to most respondents, optimization of the current system is sufficient to achieve both European and national objectives for sustainable urban water management. The respondents are most concerned with the effects of climate change on urban water systems. In contrast to current policy of the national government, priority factors that should be addressed to achieve a more sustainable urban water system are improving knowledge of local urban water systems, capacity building, developing trust between stakeholders, and improving involvement of elected officials and citizens.

  10. Handbook of Health Professions Education. Responding to New Realities in Medicine, Dentistry, Pharmacy, Nursing, Allied Health, and Public Health.

    ERIC Educational Resources Information Center

    McGuire, Christine H.; And Others

    The evolution, present status, future directions, and external forces affecting health professions education are reviewed in this 25 chapter book. Guidelines are set forth for sound practices and policies for innovative and responsive health care. The authors assess how major economic, social, political, demographic, and technological changes are…

  11. "You Need to Let Your Voice Be Heard": Research Participants' Views on Research

    ERIC Educational Resources Information Center

    McDonald, K. E.; Kidney, C. A.; Patka, M.

    2013-01-01

    Background: Persons with intellectual and developmental disabilities have had regrettably few opportunities to voice their opinions on aspects of research with which they have had direct experience. Understanding and responding to these views can contribute to policies and practices that increasingly treat people as they desire to be treated.…

  12. 31 CFR 560.417 - Facilitation; change of policies and procedures; referral of business opportunities offshore.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... foreign affiliate to accept or perform a specific contract, engagement or transaction involving Iran or the Government of Iran without the approval of the United States person, where such transaction... involving Iran or the Government of Iran to which the United States person could not directly respond as a...

  13. 31 CFR 560.417 - Facilitation; change of policies and procedures; referral of business opportunities offshore.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... foreign affiliate to accept or perform a specific contract, engagement or transaction involving Iran or the Government of Iran without the approval of the United States person, where such transaction... involving Iran or the Government of Iran to which the United States person could not directly respond as a...

  14. 31 CFR 560.417 - Facilitation; change of policies and procedures; referral of business opportunities offshore.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... foreign affiliate to accept or perform a specific contract, engagement or transaction involving Iran or the Government of Iran without the approval of the United States person, where such transaction... involving Iran or the Government of Iran to which the United States person could not directly respond as a...

  15. Survey of Academic Field Experiences (SAFE): Trainees Report Harassment and Assault

    PubMed Central

    Clancy, Kathryn B. H.; Nelson, Robin G.; Rutherford, Julienne N.; Hinde, Katie

    2014-01-01

    Little is known about the climate of the scientific fieldwork setting as it relates to gendered experiences, sexual harassment, and sexual assault. We conducted an internet-based survey of field scientists (N = 666) to characterize these experiences. Codes of conduct and sexual harassment policies were not regularly encountered by respondents, while harassment and assault were commonly experienced by respondents during trainee career stages. Women trainees were the primary targets; their perpetrators were predominantly senior to them professionally within the research team. Male trainees were more often targeted by their peers at the research site. Few respondents were aware of mechanisms to report incidents; most who did report were unsatisfied with the outcome. These findings suggest that policies emphasizing safety, inclusivity, and collegiality have the potential to improve field experiences of a diversity of researchers, especially during early career stages. These include better awareness of mechanisms for direct and oblique reporting of harassment and assault and, the implementation of productive response mechanisms when such behaviors are reported. Principal investigators are particularly well positioned to influence workplace culture at their field sites. PMID:25028932

  16. Survey of academic field experiences (SAFE): trainees report harassment and assault.

    PubMed

    Clancy, Kathryn B H; Nelson, Robin G; Rutherford, Julienne N; Hinde, Katie

    2014-01-01

    Little is known about the climate of the scientific fieldwork setting as it relates to gendered experiences, sexual harassment, and sexual assault. We conducted an internet-based survey of field scientists (N = 666) to characterize these experiences. Codes of conduct and sexual harassment policies were not regularly encountered by respondents, while harassment and assault were commonly experienced by respondents during trainee career stages. Women trainees were the primary targets; their perpetrators were predominantly senior to them professionally within the research team. Male trainees were more often targeted by their peers at the research site. Few respondents were aware of mechanisms to report incidents; most who did report were unsatisfied with the outcome. These findings suggest that policies emphasizing safety, inclusivity, and collegiality have the potential to improve field experiences of a diversity of researchers, especially during early career stages. These include better awareness of mechanisms for direct and oblique reporting of harassment and assault and, the implementation of productive response mechanisms when such behaviors are reported. Principal investigators are particularly well positioned to influence workplace culture at their field sites.

  17. Research and its governance in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey.

    PubMed

    Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

    2014-05-01

    Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions' participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. © The Royal Society of Medicine.

  18. Research and its governance in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey

    PubMed Central

    Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

    2014-01-01

    Summary Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions’ participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. PMID:24914129

  19. Parent perspectives on school food allergy policy.

    PubMed

    Mustafa, S Shahzad; Russell, Anne F; Kagan, Olga; Kao, Lauren M; Houdek, Diane V; Smith, Bridget M; Wang, Julie; Gupta, Ruchi S

    2018-05-12

    Food allergy affects up to 8% of children in the U.S. There is minimal research to date on food allergy policies that are currently in place in schools and the opinions of parents of children with food allergy on the effectiveness of or need for these policies. An electronic survey was disseminated to parents of children with food allergy. Frequencies were calculated to describe respondent characteristics and responses. Chi-square tests were performed to examine associations between school and child characteristics and outcomes. Of the 289 parent respondents, 27.4% were unsure or felt school was unsafe for their child with food allergy. While the majority felt that the polices in their child's school were helpful, most also believed that implementation of additional polices was necessary, including availability of stock epinephrine (94.2%), lunch menus with allergen information (86%), ingredient labels on food items (81%), and direct food allergy education for students (86%). There were significant differences in school food allergy policy depending on the age of the student body, private versus public school, and geographic location. While most schools reportedly have one or more food allergy policies in place, many parents have concerns over the safety of their child at school and feel that additional policies are necessary to improve the safety of the school environment for children with food allergy. The availability of stock epinephrine, improved allergen labeling of food and menus and increased food allergy education may be key policy areas on which to focus.

  20. Maternity and parental leave policies at COTH hospitals: an update. Council of Teaching Hospitals.

    PubMed

    Philibert, I; Bickel, J

    1995-11-01

    Because residents' demands for parental leave are increasing, updated information about maternity and paternity leave policies was solicited from hospitals that are members of the Council of Teaching Hospitals (COTH) of the AAMC. A 20-item questionnaire, combining forced-choice categories and open-ended questions, was faxed to 405 COTH hospitals in October 1994; 45% responded. A total of 77% of the respondents reported having written policies for maternity and/or parental leave; in 1989, only 52% of COTH hospitals had reported having such policies. Forty-one percent of the 1994 responding hospitals offered dedicated paid maternity leave, with a mean of 42 days allowed. Twenty-five percent of the respondents offered paternity leave, and 15% offered adoption leave. It is encouraging that the majority of the teaching hospitals that responded to the survey had adopted written policies, but the 23% without written policies remain a source of concern. Well-defined policies for maternity, paternity, and adoption leave can reduce stress and foster equity both for trainees requiring leave and for their colleagues.

  1. Patient and provider perspectives on quality and health system effectiveness in a transition economy: evidence from Ukraine.

    PubMed

    Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R

    2014-08-01

    Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies would align the incentives of physicians with the desires of the population they serve. Copyright © 2014. Published by Elsevier Ltd.

  2. Direct-to-consumer prescription drug advertising and the public.

    PubMed

    Bell, R A; Kravitz, R L; Wilkes, M S

    1999-11-01

    Drug manufacturers are intensely promoting their products directly to consumers, but the impact has not been widely studied. Consumers' awareness and understanding of, attitudes toward, and susceptibility to direct-to-consumer (DTC) drug advertising were examined. Random-digit dialing telephone survey with a random household member selection procedure (completion and response rates, 58% and 69%, respectively). Respondents were interviewed while they were at their residences. Complete data were obtained from 329 adults in Sacramento County, California. Outcome measures included awareness of advertisements for 10 selected drugs, misconceptions about DTC advertising, attitudes toward DTC ads, and behavioral responses to such promotions. The influence of demographic characteristics, health status, attitudes, beliefs, and media exposure on awareness and behaviors was examined. On average, respondents were aware of advertisements for 3.7 of the 10 drugs; awareness varied from 8% for Buspar (buspirone) to 72% for Claritin (loratadine). Awareness was associated with prescription drug use, media exposure, positive attitudes toward DTC advertising, poorer health, and insurance status. Substantial misconceptions were revealed; e.g., 43% thought that only "completely safe" drugs could be advertised. Direct-to-consumer advertisements had led one third of respondents to ask their physicians for drug information and one fifth to request a prescription. Direct-to-consumer advertisements are reaching the public, but selectively so, and affecting their behaviors. Implications for public policy are examined.

  3. Direct-to-Consumer Prescription Drug Advertising and the Public

    PubMed Central

    Bell, Robert A; Kravitz, Richard L; Wilkes, Michael S

    1999-01-01

    OBJECTIVE Drug manufacturers are intensely promoting their products directly to consumers, but the impact has not been widely studied. Consumers' awareness and understanding of, attitudes toward, and susceptibility to direct-to-consumer (DTC) drug advertising were examined. DESIGN Random-digit dialing telephone survey with a random household member selection procedure (completion and response rates, 58% and 69%, respectively). SETTING Respondents were interviewed while they were at their residences. PARTICIPANTS Complete data were obtained from 329 adults in Sacramento County, California. MEASUREMENTS AND MAIN RESULTS Outcome measures included awareness of advertisements for 10 selected drugs, misconceptions about DTC advertising, attitudes toward DTC ads, and behavioral responses to such promotions. The influence of demographic characteristics, health status, attitudes, beliefs, and media exposure on awareness and behaviors was examined. On average, respondents were aware of advertisements for 3.7 of the 10 drugs; awareness varied from 8% for Buspar (buspirone) to 72% for Claritin (loratadine). Awareness was associated with prescription drug use, media exposure, positive attitudes toward DTC advertising, poorer health, and insurance status. Substantial misconceptions were revealed; e.g., 43% thought that only “completely safe” drugs could be advertised. Direct-to-consumer advertisements had led one third of respondents to ask their physicians for drug information and one fifth to request a prescription. CONCLUSIONS Direct-to-consumer advertisements are reaching the public, but selectively so, and affecting their behaviors. Implications for public policy are examined. PMID:10571712

  4. Energizing Government Decision-Makers with the Facts on Solar Technology, Policy, and Integration

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

    The Solar Technical Assistance Team (STAT) is a network of solar technology and implementation experts who provide timely, unbiased expertise to assist policymakers and regulators in making informed decisions about solar programs and policies. Government officials can submit requests directly to the STAT for technical assistance. STAT then partners with experts in solar policy, regulation, finance, technology, and other areas to deliver accurate, up-to-date information to state and local decision makers. The STAT responds to requests on a wide range of issues -- including, but not limited to, feed-in tariffs, renewable portfolio standards, rate design, program design, workforce and economicmore » impacts of solar on jurisdictions, and project financing.« less

  5. Teachers' perceptions and actions in carrying out communication policies in a public school for the deaf.

    PubMed

    Hsing, M H; Lowenbraun, S

    1997-03-01

    The purpose of this study was to investigate teachers' opinions on school communication policies in a public school for the Deaf in Taipei, Taiwan. Specifically, the authors examined how teachers carried out communication policies, and examined possible discrepancies between teachers' perceptions of their communication methods and the methods they actually used in the classroom. Questionnaires were distributed to all 120 teachers at Taipei Municipal School for the Deaf. Thirteen of the 85 respondents were selected as subjects for personal interviews followed by direct classroom observation and videotaping. Sixteen deaf high school seniors at the school were interviewed concerning their opinions about the teachers' communication modes and abilities, and about the communication modes the students experienced.

  6. Invest in Experience: New Directions for an Aging Workforce. An Analysis of Issues and Options for Business.

    ERIC Educational Resources Information Center

    National Alliance of Business, Inc., Washington, DC.

    As demographic changes and new labor supply requirements develop in the years ahead, older workers are sure to become even more important to employers and to society as a whole. To date, most employers have just begun to formulate policies to manage an aging work force in a changing economy. Some firms, however, have begun to respond pragmatically…

  7. Protecting Defense Technologies: DOD Assessment Needed to Determine Requirement for Critical Technologies List

    DTIC Science & Technology

    2013-01-01

    Service DTSA Defense Technology Security Administration MCTL Militarily Critical Technologies List This is a work of the U.S. government and is not...Respond to MCTL Weaknesses Page 8 GAO-13-157 Protecting Defense Technologies Administration ( DTSA ), military services, and DOD...implementation of technology security policies on international transfers of defense- related goods, services, and technologies; • directed DTSA to

  8. The Roles of Science in Local Resilience Policy Development: A Case Study of Three U.S. Cities

    NASA Astrophysics Data System (ADS)

    Clavin, C.; Gupta, N.

    2015-12-01

    The development and deployment of resilience policies within communities in the United States often respond to the place-based, hazard-specific nature of disasters. Prior to the onset of a disaster, municipal and regional decision makers establish long-term development policies, such as land use planning, infrastructure investment, and economic development policies. Despite the importance of incorporating disaster risk within community decision making, resilience and disaster risk are only one consideration community decision makers weigh when choosing how and whether to establish resilience policy. Using a case study approach, we examine the governance, organizational, management, and policy making processes and the involvement of scientific advice in designing and implementing resilience policy in three U.S. communities: Los Angeles, CA; Norfolk, VA; and Flagstaff, AZ. Disaster mitigation or resilience initiatives were developed and deployed in each community with differing levels and types of scientific engagement. Engagement spanned from providing technical support with traditional risk assessment to direct engagement with community decision makers and design of community resilience outreach. Best practices observed include embedding trusted, independent scientific advisors with strong community credibility within local government agencies, use of interdisciplinary and interdepartmental expert teams with management and technical skillsets, and establishing scientifically-informed disaster and hazard scenarios to enable community outreach. Case study evidence suggest science communication and engagement within and across municipal government agencies and scientifically-informed direct engagement with community stakeholders are effective approaches and roles that disaster risk scientists can fill to support resilience policy development.

  9. An exploration of older Hong Kong residents' willingness to make copayments toward vouchers for community care.

    PubMed

    Fu, Yuan Yuan; Chui, Ernest Wing-Tak; Law, Chi Kin; Zhao, XinYi; Lou, Vivian W Q

    2018-05-10

    Because of its rapidly aging population, Hong Kong faces great challenges in the provision and financing of long-term care (LTC) and needs to explore sustainable funding mechanisms. However, there is a paucity of research on older people's willingness to pay (WTP) for LTC services in Hong Kong. This study utilizes data collected in Hong Kong in 2011 (N = 536) to investigate older people's receptivity to this financing mode by assessing their co-payments for a community care service voucher scheme and then testing how potential factors affect respondents' amount of co-payment. Results show that respondents' WTP was positively associated with family financial support, financial condition, and positive attitudes toward this novel policy and negatively associated with family caregiving support. Direct and moderating effects of family financial support on WTP were found. The policy-related implications of LTC financing to improve older people's acceptance of co-payment mechanisms, financial condition, and shared responsibility of care are discussed.

  10. Workplace smoking restrictions in China: results from a six county survey.

    PubMed

    Ma, Jiemin; Apelberg, Benjamin J; Avila-Tang, Erika; Yang, Gonghuan; Ma, Shaojun; Samet, Jonathan M; Stillman, Frances A

    2010-10-01

    To determine the coverage of smoking restriction policies in indoor workplaces in China and to assess the relationships between these restrictive policies and secondhand smoke (SHS) exposure and smoking behaviours. A cross-sectional household survey was conducted in six counties in Sichuan, Jiangxi and Henan provinces in 2004. Using a standardised questionnaire, information on demographic characteristics, knowledge, attitudes and behaviours related to smoking and SHS exposure was collected through face-to-face interviews by trained local investigators among 12 036 respondents. Of respondents, 2698 individuals worked mainly indoors and were included in data analysis. Only 28.5% of respondents reported that indoor workplaces had a smoke-free policy. Even when respondents reported smoke-free policies, 41.1% smokers reported that they were non-compliant with policies and smoked at work. In addition, 32.0% of non-smokers reported being exposed to SHS at work despite smoke-free policies. Non-smokers who reported no smoking restriction policies were 3.7 times more likely to be exposed to SHS than those working in smoke-free workplaces (adjusted OR 3.7, 95% CI 1.3 to 10.1). On average, respondents complying with smoke-free policies smoked 3.8 fewer cigarettes than those reporting no policies in their workplaces at a marginally non-significant level (p=0.06) (adjusted mean difference -3.8, 95% CI -8.0 to 0.5). In China, few workplaces have implemented policies to restrict smoking, and, even in workplaces that have policies, workers report exposure to SHS while at their places of employment. Many workers report a lack of compliance with smoke-free policies. China needs better implementation of SHS policies to promote compliance. Working to improve implementation of smoke-free policies would promote cessation since Chinese smokers who were compliant with these efforts reported smoking fewer cigarettes per day.

  11. National health policy-makers’ views on the clarity and utility of Countdown to 2015 country profiles and reports: findings from two exploratory qualitative studies

    PubMed Central

    2014-01-01

    Background The use of sets of indicators to assess progress has become commonplace in the global health arena. Exploratory research has suggested that indicators used for global monitoring purposes can play a role in national policy-making, however, the mechanisms through which this occurs are poorly understood. This article reports findings from two qualitative studies that aimed to explore national policy-makers’ interpretation and use of indicators from country profiles and reports developed by Countdown to 2015. Methods An initial study aimed at exploring comprehension of Countdown data was conducted at the 2010 joint Women Deliver/Countdown conference. A second study was conducted at the 64th World Health Assembly in 2011, specifically targeting national policy-makers. Semi-structured interviews were carried out with 29 and 22 participants, respectively, at each event. Participants were asked about their understanding of specific graphs and indicators used or proposed for use in Countdown country profiles, and their perception of how such data can inform national policy-making. Responses were categorised using a framework analysis. Results Respondents in both studies acknowledged the importance of the profiles for tracking progress on key health indicators in and across countries, noting that they could be used to highlight changes in coverage, possible directions for future policy, for lobbying finance ministers to increase resources for health, and to stimulate competition between neighbouring or socioeconomically similar countries. However, some respondents raised questions about discrepancies between global estimates and data produced by national governments, and some struggled to understand the profile graphs shown in the absence of explanatory text. Some respondents reported that use of Countdown data in national policy-making was constrained by limited awareness of the initiative, insufficient detail in the country profiles to inform policy, and the absence of indicators felt to be more appropriate to their own country contexts. Conclusions The two studies emphasise the need for country consultations to ensure that national policy-makers understand how to interpret and use tools like the Countdown profile for planning purposes. They make clear the value of qualitative research for refining tools used to promote accountability, and the need for country level Countdown-like processes. PMID:25128385

  12. Assessment of Direct-to-Consumer Genetic Testing Policy in Korea Based on Consumer Preference.

    PubMed

    Jeong, Gicheol

    2017-01-01

    In June 2016, Korea permitted direct-to-consumer genetic testing (DTC-GT) on 42 genes. However, both the market and industry have not yet been fully activated. Considering the aforementioned context, this study provides important insights. The Korean DTC-GT policy assessment is based on consumer preference analysis using a discrete choice experiment. In August 2016, a web-based survey was conducted to collect data from 1,200 respondents. The estimation results show that consumers prefer a DTC-GT product that is cheap, tests various items or genes, offers accurate test results, and guarantees the confidentiality of all information. However, consumers are not entirely satisfied by current DTC-GT products due to the existence of insufficient and/or inadequate policies. First, the permitted testing of 42 genes is insufficient to satisfy consumers' curiosity regarding their genes. Second, the accuracy of the DTC-GT products has not been fully verified, assessed, and communicated to consumers. Finally, regulatory loopholes that allow information leaks in the DTC-GT process can occur. These findings imply that DTC-GT requires an improvement in government policy-making criteria and the implementation of practical measures to guarantee test accuracy and genetic information. © 2017 S. Karger AG, Basel.

  13. Awareness and use of direct-to-consumer nutrigenomic tests, United States, 2006.

    PubMed

    Goddard, Katrina A B; Moore, Cynthia; Ottman, Denae; Szegda, Kathleen L; Bradley, Linda; Khoury, Muin J

    2007-08-01

    Direct-to-consumer genetic tests are increasingly available and may improve confidentiality, convenience, and accessibility. Amid ethical concerns and an uncertain regulatory landscape, the future of this mode of delivery is unclear. One class of products, nutrigenomic tests, is used to analyze DNA and lifestyle habits to assess health risks. Little information is available regarding awareness or use of such tests among consumers or physicians. We assessed consumers' awareness and use of nutrigenomic tests in the 2006 HealthStyles national survey (5250 respondents) and awareness among physicians in the 2006 DocStyles national survey (1250 respondents). In the HealthStyles survey, 14% of respondents were aware of nutrigenomic tests, and 0.6% overall had used these tests. Respondents who were aware of nutrigenomic tests tended to be young and educated with a high income. Many physicians (44%) were aware of nutrigenomic tests, although 41% of these physicians had never had a patient ask about such tests, and most (74%) had never discussed the results of a nutrigenomic test with a patient. These results provide insight into current trends in public demand and interest in nutrigenomic tests and will aid in assessing the impact of policies, efforts at public or provider education, and the evolution of the availability and demand for such tests.

  14. Getting an evidence-based post-partum haemorrhage policy into practice.

    PubMed

    Cameron, Carolyn A; Roberts, Christine L; Bell, Jane; Fischer, Wendy

    2007-06-01

    Post-partum haemorrhage (PPH) is a potentially life-threatening complication of childbirth occurring in up to 10% of births. The NSW Department of Health (DoH) issued a new evidence-based policy (Framework for Prevention, Early Recognition and Management of Post-partum Haemorrhage) in November 2002. Feedback from maternity units indicated that there were deficiencies in the skills and experience is needed to develop the written protocols and local plans of action required by the Framework. All 96 hospitals in NSW that provide care for childbirth were surveyed. A senior midwife completed a semistructured telephone interview. Ninety four per cent of hospitals had PPH policies. Among hospitals that provided a copy of their policy, 83% were dated after the release of the DoH's Framework, but 22% contained an incorrect definition of PPH. Only 71% of respondents in small rural and urban district hospitals recalled receiving a copy of the Framework. There was considerable variation in the frequency of postnatal observations. Key factors that impede local policy development were resources, entrenched practices and centralised policy development. Enabling factors were effective relationships, the DoH policy directive (Framework), education and organisational issues/time. Greater assistance is needed to ensure that hospitals have the capacity to develop a policy applicable to local needs. Maternity hospitals throughout the state provide different levels of care and NSW DoH policy directives should not be 'one size fits all' documents. Earlier recognition of PPH may be facilitated by routine post-partum monitoring of all women and should be consistent throughout the state, regardless of hospital level.

  15. Desire or Disease? Framing Obesity to Influence Attributions of Responsibility and Policy Support.

    PubMed

    McGlynn, Joseph; McGlone, Matthew S

    2018-02-01

    The way we describe health threats affects perceptions of severity and preferred solutions to reduce risk. Most people agree obesity is a problem, but differ in how they attribute responsibility for development and decline of the disease. We explored effects of message framing on attributions of responsibility and support for public obesity policies using a 3 × 2 factorial design. Participants read one of six versions of a health message describing the negative effects of obesity. Message frames influenced respondent attributions and their support for policies to reduce obesity. Those who read a message that assigned agency to the disease (e.g., Obesity causes health problems) endorsed genetics as the cause to a greater degree than those who read a semantically equivalent message that instead assigned agency to people (e.g., Obese people develop health problems). In contrast, assigning agency to people rather than to the disease prompted higher attributions of individual responsibility and support for public policies. Explicit message frames that directly connected responsibility for obesity to either individual or societal factors had no effect on respondent perceptions. Findings suggest explicit arguments may be less effective in shifting perceptions of health threats than arguments embedded in agentic message frames. The results demonstrate specific message features that influence how people attribute responsibility for the onset and solution of obesity.

  16. Sex differences in nicotine self-administration in rats during progressive unit dose reduction: implications for nicotine regulation policy.

    PubMed

    Grebenstein, Patricia; Burroughs, Danielle; Zhang, Yan; LeSage, Mark G

    2013-12-01

    Reducing the nicotine content in tobacco products is being considered by the FDA as a policy to reduce the addictiveness of tobacco products. Understanding individual differences in response to nicotine reduction will be critical to developing safe and effective policy. Animal and human research demonstrating sex differences in the reinforcing effects of nicotine suggests that males and females may respond differently to nicotine-reduction policies. However, no studies have directly examined sex differences in the effects of nicotine unit-dose reduction on nicotine self-administration (NSA) in animals. The purpose of the present study was to examine this issue in a rodent self-administration model. Male and female rats were trained to self-administer nicotine (0.06mg/kg) under an FR 3 schedule during daily 23h sessions. Rats were then exposed to saline extinction and reacquisition of NSA, followed by weekly reductions in the unit dose (0.03 to 0.00025mg/kg) until extinction levels of responding were achieved. Males and females were compared with respect to baseline levels of intake, resistance to extinction, degree of compensatory increases in responding during dose reduction, and the threshold reinforcing unit dose of nicotine. Exponential demand-curve analysis was also conducted to compare the sensitivity of males and females to increases in the unit price (FR/unit dose) of nicotine (i.e., elasticity of demand or reinforcing efficacy). Females exhibited significantly higher baseline intake and less compensation than males. However, there were no sex differences in the reinforcement threshold or elasticity of demand. Dose-response relationships were very well described by the exponential demand function (r(2) values>0.96 for individual subjects). These findings suggest that females may exhibit less compensatory smoking in response to nicotine reduction policies, even though their nicotine reinforcement threshold and elasticity of demand may not differ from males. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Sex differences in nicotine self-administration in rats during progressive unit dose reduction: Implications for nicotine regulation policy

    PubMed Central

    Grebenstein, Patricia; Burroughs, Danielle; Zhang, Yan; LeSage, Mark G.

    2013-01-01

    Reducing the nicotine content in tobacco products is being considered by the FDA as a policy to reduce the addictiveness of tobacco products. Understanding individual differences in response to nicotine reduction will be critical to developing safe and effective policy. Animal and human research demonstrating sex differences in the reinforcing effects of nicotine suggests that males and females may respond differently to nicotine-reduction policies. However, no studies have directly examined sex differences in the effects of nicotine unit-dose reduction on nicotine self-administration (NSA) in animals. The purpose of the present study was to examine this issue in a rodent self-administration model. Male and female rats were trained to self-administer nicotine (0.06 mg/kg) under an FR 3 schedule during daily 23 h sessions. Rats were then exposed to saline extinction and reacquisition of NSA, followed by weekly reductions in the unit dose (0.03 to 0.00025 mg/kg) until extinction levels of responding were achieved. Males and females were compared with respect to baseline levels of intake, resistance to extinction, degree of compensatory increases in responding during dose reduction, and the threshold reinforcing unit dose of nicotine. Exponential demand-curve analysis was also conducted to compare the sensitivity of males and females to increases in the unit price (FR/unit dose) of nicotine (i.e., elasticity of demand or reinforcing efficacy). Females exhibited significantly higher baseline intake and less compensation than males. However, there were no sex differences in the reinforcement threshold or elasticity of demand. Dose–response relationships were very well described by the exponential demand function (r2 values > 0.96 for individual subjects). These findings suggest that females may exhibit less compensatory smoking in response to nicotine reduction policies, even though their nicotine reinforcement threshold and elasticity of demand may not differ from males. PMID:24201048

  18. One Policy, Disparate Reactions: Institutional Responses in Florida's Developmental Education Reform

    ERIC Educational Resources Information Center

    Park, Toby J.; Tandberg, David A.; Hu, Shouping; Hankerson, Dava

    2016-01-01

    This paper seeks to better understand how community colleges in Florida planned to implement a new sweeping state policy pertaining to developmental education. Via a cluster analysis, we identify three distinct patterns in the ways in which the colleges responded to the policy: reformers, responders, and resisters. Further, we find that these…

  19. Mandatory Psychiatric Withdrawal of Severely Disturbed Students: A Study and Policy Recommendations.

    ERIC Educational Resources Information Center

    Dannells, Michael; Stuber, Donna

    1992-01-01

    Assessed frequency and nature of mandatory psychiatric withdrawal policies at Kansas colleges and universities. Forty-five of 52 colleges and universities responded to survey; of those, only 5 had specific policy for dismissing students for psychological reasons. Most respondents relied exclusively on their behavioral codes of conduct and their…

  20. Antibiotic Policies and Utilization in Oregon Hospice Programs.

    PubMed

    Novak, Rachel L; Noble, Brie N; Fromme, Erik K; Tice, Michael O; McGregor, Jessina C; Furuno, Jon P

    2016-09-01

    Antibiotics are frequently used in hospice care, despite limited data on safety and effectiveness in this patient population. We surveyed Oregon hospice programs on antibiotic policies and prescribing practices. Among 39 responding hospice programs, the median reported proportion of current census using antibiotics was 10% (interquartile range = 3.5%-20.0%). Approximately 31% of responding hospice programs had policies for antibiotic initiation, 17% of hospice programs had policies for antibiotic discontinuation, and 95% of hospice programs had policies for managing drug interactions. Diarrhea, nausea/vomiting, and yeast infections were the most frequently reported antibiotic-associated adverse events, occurring "sometimes" or "often" among 62%, 47%, and 62% of respondents, respectively. In conclusion, less than a third of participating hospice programs reported having a policy for antibiotic initiation and even less frequently a policy for discontinuation. More data are needed on the risks and benefits of antibiotic use in hospice care to inform these policies and optimize outcomes in this vulnerable patient population. © The Author(s) 2015.

  1. An Assessment of Perceptions of United States Army Provost Marshals Pertaining to Counterterrorism Policy and Programs on Army Installations.

    DTIC Science & Technology

    1981-01-01

    incidents of terrorism directed against Army installations; the availability and adequacy of intelligence concerning local terrorist activities; the degree of...current counterterrorism intelli- gence is available and adequate. A further conclusion is that many survey respondents expect acts of terrorism to...responsihility arr not ade- quately protected. INDEX WORDS: Terrorism , Military, Defense, Army, Counterterrorir:.n DEDICATION To Beverly, my wife and best

  2. Demographic indicators of trust in federal, state and local government: implications for Australian health policy makers.

    PubMed

    Meyer, Samantha B; Mamerow, Loreen; Taylor, Anne W; Henderson, Julie; Ward, Paul R; Coveney, John

    2013-02-01

    To provide baseline findings regarding Australians' trust in federal, state and local government. A computer-assisted telephone interviewing (CATI) survey was administrated during October to December 2009 to a random sample (n=1109) across Australia (response rate 41.2%). Binary logistic regression analyses were carried out by means of SPSS. Age, household size, household income, IRSD and ARIA were found to be significant indicators for trust in federal, state and local government. Trust in state government is lower for older respondents and respondents living in inner and outer regional areas. Trust in local council is lower in respondents living in inner regional areas, respondents living in disadvantaged areas, and respondents in the income bracket of $60001 to $100000. Trust in federal government is lower for older respondents and respondents living in disadvantaged areas. Of note is diminished trust in government among older, regional and lower income ($30001-$60000) respondents. Trust in all levels of government was found to be the lowest in population groups that are identified by empirical research and media to have the poorest access to government services. As a consequence, improved access to services for these populations may increase trust in health policy. Increased trust in health governance may in turn, ensure effective dissemination and implementation of health policies and that existing inequities are not perpetuated through distrust of health information and policy initiatives.

  3. Physical Therapist, Physical Therapist Assistant, and Student Response to Inappropriate Patient Sexual Behavior: Results of a National Survey.

    PubMed

    Cambier, Ziádee; Boissonnault, Jill S; Hetzel, Scott J; Plack, Margaret M

    2018-06-08

    A recent survey found that 84% of physical therapist, physical therapist assistant, and student respondents experienced inappropriate patient sexual behavior (IPSB) over their careers and 47% over the prior 12 months. Prevalence data justify consideration of how to address IPSB. The objective was to determine how physical therapist clinicians (used here to mean physical therapists, physical therapist assistants, and students) address IPSB and examine strategy impact. The design was observational and cross-sectional. Several sections of the American Physical Therapy Association and selected education programs fielded the electronic survey. Respondents reported on IPSB strategy frequency and effect. Response-strategy impact was tested for statistical significance. Open-ended comments were analyzed using qualitative methods. Of 1027 respondents, 396 had experienced IPSB over the prior 12 months; 391 provided data on the frequency and effect of response strategies used. Common informal responses included distraction, ignoring IPSB, and altering treatment to avoid physical contact or being alone. Common formal responses included reporting the behavior within the facility and documenting the behavior. Successful strategies included distraction, avoidance, direct confrontation, behavioral contracts, transfer of care, and chaperone use. Experienced clinicians were more likely to be direct, whereas novice clinicians were more likely to engage in unsuccessful actions of ignoring and joking. Limitations included self-report, clinician memory, and convenience sampling. The first findings in 20 years on physical therapist, physical therapist assistant, and student response to IPSB provide direction for the profession. Results indicate a need for clear workplace policies coupled with training for managers and supervisors to support clinicians in resolving IPSB. Policies on using behavioral contracts, chaperones, and transfer of care could empower staff to consider these successful options. Professional education and training for all physical therapy professionals on assertive communication and redirection strategies with IPSB appears warranted.

  4. [Use of evidence in heath policies and programs contributions of the instituto nacional de salud].

    PubMed

    Gutierrez, Ericson L; Piazza, Marina; Gutierrez-Aguado, Alfonso; Hijar, Gisely; Carmona, Gloria; Caballero, Patricia; Reyes, Nora; Canelo, Carlos; Aparco, Juan Pablo; Tejada, Romina A; Bolaños-Díaz, Rafael; Saravia, Silvia; Gozzer, Ernesto

    2016-01-01

    This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.

  5. Direct-to-consumer advertising (DTCA) for prescription drugs: consumers' attitudes and preferences concerning its regulation in South Korea.

    PubMed

    Suh, Hae Sun; Lee, Donghyun; Kim, Sang Yong; Chee, Dong Hyun; Kang, Hye-Young

    2011-08-01

    To examine consumers' attitudes toward direct-to-consumer advertising (DTCA) for prescription drugs in Korea. We conducted a survey of 350 patients visiting community pharmacies to fill their prescriptions. Consumers' attitudes toward DTCA were assessed in terms of whether they felt DTCA was necessary, their trust in the information provided by DTCA, and their intention to use the information provided by DTCA. We examined consumers' preferences regarding the regulation of DTCA and their expectations of the effects of DTCA. About 60% of the respondents responded that DTCA is necessary and that they intended to use the information from DTCA. Less than half of the respondents reported that they would trust DTCA information. About 70% of the participants expressed the need for prior vetting of the DTCA content. Respondents had the highest expectation on the effect of DTCA as an information source for patients. Positive consumer expectations regarding the effects of DTCA were significantly associated with positive consumer attitudes toward DTCA (odds ratio=4.70, 95% confidence interval: 2.25-9.82). This study provides evidence that consumers in South Korea generally have positive attitudes toward DTCA. However, most of the respondents wanted a prior examination system of DTCA content to ensure that the information conveyed to them via DTCA was trustworthy. Policy-makers should be cautious and well-prepared if they decide to introduce DTCA in Korea. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  6. Cannabis policies and user practices: market separation, price, potency, and accessibility in Amsterdam and San Francisco.

    PubMed

    Reinarman, Craig

    2009-01-01

    This paper explores user perceptions and practices in contrasting legal-policy milieux-Amsterdam (de facto decriminalization) and San Francisco (de jure criminalization) on four policy issues: sources of cannabis and separation of markets for it and other drugs; user perceptions of effects of price on consumption; effects of potency on consumption; and perceived risk of arrest and accessibility of cannabis. Questions on these issues were added to surveys on career use patterns amongst representative samples of experienced cannabis users using comparable methods. Most San Francisco respondents obtained cannabis through friends who knew dealers, whereas most Amsterdam respondents obtained it from regulated shops. Only one in seven Amsterdam respondents but half the San Francisco respondents could obtain other drugs from their cannabis sources. Majorities under both systems had never found cannabis "too expensive." Amsterdam respondents preferred milder cannabis whilst San Francisco respondents preferred stronger; majorities in both cities reported self-titrating with potent cannabis. Risk and fear of arrest were higher in San Francisco, but most in both cities perceived arrest as unlikely. Estimated search times were somewhat longer in San Francisco, but a majority reported being able to access it within half a day. There is substantial separation of markets in the Dutch system. Policies designed to increase cannabis prices appear unlikely to impact consumption. Decriminalization was associated with a preference for milder cannabis, but under both policy regimes most respondents self-titrated when using more potent strains. Criminalization was associated with somewhat higher risk and fear of arrest and somewhat longer search times, but these did not appear to significantly impede access for most respondents.

  7. Science, policy advocacy, and marine protected areas.

    PubMed

    Gray, Noella J; Campbell, Lisa M

    2009-04-01

    Much has been written in recent years regarding whether and to what extent scientists should engage in the policy process, and the focus has been primarily on the issue of advocacy. Despite extensive theoretical discussions, little has been done to study attitudes toward and consequences of such advocacy in particular cases. We assessed attitudes toward science and policy advocacy in the case of marine protected areas (MPAs) on the basis of a survey of delegates at the First International Marine Protected Areas Congress. Delegates were all members of the international marine conservation community and represented academic, government, and nongovernmental organizations. A majority of respondents believed science is objective but only a minority believed that values can be eliminated from science. Respondents showed only partial support of positivist principles of science. Almost all respondents supported scientists being integrated into MPA policy making, whereas half of the respondents agreed that scientists should actively advocate for particular MPA policies. Scientists with a positivist view of science supported a minimal role for scientists in policy, whereas government staff with positivist beliefs supported an advocacy or decision-making role for scientists. Policy-making processes for MPAs need to account for these divergent attitudes toward science and advocacy if science-driven and participatory approaches are to be reconciled.

  8. A global view of direct access and patient self-referral to physical therapy: implications for the profession.

    PubMed

    Bury, Tracy J; Stokes, Emma K

    2013-04-01

    International policy advocates for direct access, but the extent to which it exists worldwide was unknown. The purpose of this study was to map the presence of direct access to physical therapy services in the member organizations of the World Confederation for Physical Therapy (WCPT) in the context of physical therapist practice and health systems. A 2-stage, mixed-method, descriptive study was conducted. A purposive sample of member organizations of WCPT in Europe was used to refine the survey instrument, followed by an online survey sent to all WCPT member organizations. Data were analyzed using descriptive statistics, and content analysis was used to analyze open-ended responses to identify themes. A response rate of 68% (72/106) was achieved. Direct access to physical therapy was reported by 58% of the respondents, with greater prevalence in private settings. Organizations reported that professional (entry-level) education equipped physical therapists for direct access in 69% of the countries. National physical therapy associations (89%) and the public (84%) were thought to be in support of direct access, with less support perceived from policy makers (35%) and physicians (16%). Physical therapists' ability to assess, diagnose, and refer patients on to specialists was more prevalent in the presence of direct access. The findings may not be representative of the Asia Western Pacific (AWP) region, where there was a lower response rate. Professional legislation, the medical profession, politicians, and policy makers are perceived to act as both barriers to and facilitators of direct access. Evidence for clinical effectiveness and cost-effectiveness and examples of good practice are seen as vital resources that could be shared internationally, and professional leadership has an important role to play in facilitating change and advocacy.

  9. Post-9/11 Civil-Military Relations: Room for Improvement

    DTIC Science & Technology

    2015-01-01

    directly to Congress or the American people in lobbying for their causes.7 At worst, such behaviors can force a presi- dent’s choice or leave him feeling...responded by publicly challenging Presi- dent Clinton’s policies, particularly on the question of homosexuals in the military, and few in the American...including Vice President Joe Biden. McChrystal does not seem to have personally participated in this behavior , but he made no effort to quash it

  10. The policy and practices of New South Wales drug treatment providers in responding to the possession of illicit substances on premises.

    PubMed

    Stirling, Robert; Day, Carolyn

    2016-09-01

    Responding to possession of illicit substances on the premises of drug treatment services is a complex issue. Providers are challenged by balancing duty-of-care and staff safety while attempting to provide a therapeutic environment. This study assessed the current policy and practice of non-government drug treatment services in New South Wales, Australia in responding to possession of illicit substances on their premises. Non-government drug treatment services were invited to participate in a survey that aimed to elicit information about existing policy and practices and how often it occurred. Analysis explored the differences between services that had a written policy and those that did not against service setting, accreditation status, reporting of an illicit drug possession in the last 12 months and having a sharps disposal unit. Fifty-one responses were included in the analysis, 29 (57%) of which reported having a policy and/or procedure. There was no statistically discernible difference between inpatient and outpatient settings, accreditation status of services or availability of a sharps disposal unit on the premises. However, services that reported a possession incident in the previous 12 months were more likely to report having a written policy than those that did not (37% vs. 12%; odds ratio: 4.75, 95% confidence interval 1.32-17.11, P = 0.014). The policy and practice in these settings vary greatly, with many services reporting no documented policy to guide staff. The findings suggest the need to develop organisational policy to support service providers in responding to possession of illicit substances on premises. [Stirling R, Day C. The policy and practices of New South Wales drug treatment providers in responding to the possession of illicit substances on premises. Drug Alcohol Rev 2016;35:644-649]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  11. The Trans-Pacific Partnership: Should We "Fear the Fear"?

    PubMed Central

    Walls, Helen L.; Hanefeld, Johanna; Smith, Richard D.

    2017-01-01

    RLabonté et al entitle their paper in this issue of the International Journal of Health Policy and Management "The Trans-Pacific Partnership: Is It Everything We Feared for Health?" Tantalisingly, they do not directly answer the question they pose, and in this commentary, we suggest that it is the wrong question; we should not ‘fear’ the Trans-Pacific Partnership (TPP) at all, rather we should ask how we are to respond. The public health community is right to be concerned with the potential implications of trade and investment agreements (TIAs) for health, particularly with shifts from multilateral to regional/bilateral agreements including provisions with greater risk to public health. But it is critical to understand also the potential health benefits, and especially the mitigating policy and governance mechanisms to respond to adverse TIA implications. Given entrenched and divergent sectoral worldviews and perspectives between trade and health communities on these issues, achieving the requisite understanding will also likely require characterisation of these perspectives and identification of areas of common understanding and agreed solutions. PMID:28812829

  12. Lowering the barriers to consumer-directed health care: responding to concerns.

    PubMed

    Baicker, Katherine; Dow, William H; Wolfson, Jonathan

    2007-01-01

    Consumer-directed health care is a potentially promising tool for moving toward more efficient use of health care resources. Tax policy has long been biased against health plans with significant patient cost sharing. Tax advantages created by health savings accounts (HSAs) began to change that, and proposed tax reforms could go even further. We assess various critiques of these plans, focusing on why they benefit not just the healthy and wealthy. Lower costs and more efficient health spending would help all patients and reduce uninsurance. Potential negative distributional effects are important but can be remedied more efficiently without distorting insurance design.

  13. Parental Leave Policies and Pediatric Trainees in the United States.

    PubMed

    Dixit, Avika; Feldman-Winter, Lori; Szucs, Kinga A

    2015-08-01

    The American Academy of Pediatrics (AAP) states that each residency program should have a clearly delineated, written policy for parental leave. Parental leave has important implications for trainees' ability to achieve their breastfeeding goals. This study aimed to measure the knowledge and awareness among members of the AAP Section on Medical Students, Residents, and Fellowship Trainees (SOMSRFT) regarding parental leave. An online survey was emailed to SOMSRFT members in June 2013. Quantitative data are presented as percentage of respondents. Awareness of leave policies was analyzed based on having children and the sex of respondents. Nine hundred twenty-seven members responded to the survey. Among those with children, 40% needed to extend the duration of their training in order to have longer maternity leave, 44% of whom did so in order to breastfeed longer. Thirty percent of respondents did not know if their program had a written, accessible policy for parental leave. Trainees without children and men were more unaware of specific aspects of parental leave such as eligibility for the Family Medical Leave Act as compared to women and those with children. Despite the fact that United States national policies support parental leave during pediatrics training, and a majority of programs comply, trainees' awareness regarding these policies needs improvement. © The Author(s) 2015.

  14. Supporting the labor force participation of older adults: an international survey of policy options.

    PubMed

    Barusch, Amanda S; Luptak, Marilyn; Hurtado, Marcella

    2009-01-01

    The unprecedented aging of the world's population challenges many institutions, including labor markets and public pension programs. This study was conducted to survey expert opinions regarding conditions and policies that affect employment of older adults. Eighty-nine respondents from 26 nations responded to an Internet survey regarding their own experiences with the aging labor force; factors that encouraged or discouraged labor force participation of older adults; and government responses to these issues. Respondents identified barriers to employment of older adults and described their governments' responses. Findings illuminate a range of current policy options and suggest possible opportunities for innovation.

  15. The impact of tobacco control research on policy: 20 years of progress.

    PubMed

    Warner, Kenneth E; Tam, Jamie

    2012-03-01

    To assess progress in tobacco control policy research and the relevance of research to policy making. Over 100 experts were surveyed about their opinions on the body of research existing in 1992 and 2011 concerning 11 areas of tobacco control policy, the state of policy implementation in both years, the extent to which research has affected policy adoption and how experience with policy has influenced research. Case studies of how research and policy implementation have interacted were developed. The body of research was not judged 'substantial' in any of the policy areas in 1992. In 2011, 6 of the 11 areas were evaluated as substantial. None ranked as substantial regarding policy implementation in 1992, but by 2011 half were so ranked for developed countries; in low-income and middle-income countries policy implementation moved from very low to moderate. Respondents judged the role of research in actual policy making as 'substantial' regarding clean indoor air, taxation and cessation treatment policy. Case studies illustrate how research can directly affect policy (taxation), how policy and research can have iterative effects (clean indoor air), and how research and policy interact in the case of novel policies (graphic cigarette pack warnings). The role of research in the formulation of the Framework Convention on Tobacco Control is also examined. Policy research goals established in 1992 have been largely realised. For select tobacco control policies, research has made truly important contributions to saving lives. Evidence-based policy adoption will continue to be essential to minimising the toll of tobacco, especially in the world's poorer countries.

  16. Clinician-scientist MB/PhD training in the UK: a nationwide survey of medical school policy.

    PubMed

    Barnett-Vanes, Ashton; Ho, Guiyi; Cox, Timothy M

    2015-12-30

    This study surveyed all UK medical schools regarding their Bachelor of Medicine (MB), Doctor of Philosophy (PhD) (MB/PhD) training policy in order to map the current training landscape and to provide evidence for further research and policy development. Deans of all UK medical schools registered with the Medical Schools Council were invited to participate in this survey electronically. The number of medical schools that operate institutional MB/PhD programmes or permit self-directed student PhD intercalation. Medical school recruitment procedures and attitudes to policy guidance. 27 of 33 (81%) registered UK medical schools responded. Four (14%) offer an institutional MB/PhD programme. However, of those without institutional programmes, 17 (73%) permit study interruption and PhD intercalation: two do not (one of whom had discontinued their programme in 2013), three were unsure and one failed to answer the question. Regarding student eligibility, respondents cited high academic achievement in medical studies and a bachelor's or master's degree. Of the Medical schools without institutional MB/PhD programmes, 5 (21%) have intentions to establish a programme, 8 (34%) do not and 3 were unsure, seven did not answer. 19 medical schools (70%) considered national guidelines are needed for future MB/PhD programme development. We report the first national survey of MB/PhD training in the UK. Four medical schools have operational institutional MB/PhD programmes, with a further five intending to establish one. Most medical schools permit study interruption and PhD intercalation. The total number MB/PhD students yet to graduate from medical school could exceed 150, with 30 graduating per year. A majority of medical school respondents to this survey believe national guidelines are required for MB/PhD programme development and implementation. Further research should focus on the MB/PhD student experience. Discussion regarding local and national MB/PhD policies between medical schools and academic stakeholders are needed. 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/

  17. Dental Student Academic Integrity in U.S. Dental Schools: Current Status and Recommendations for Enhancement.

    PubMed

    Graham, Bruce S; Knight, G William; Graham, Linda

    2016-01-01

    Cheating incidents in 2006-07 led U.S. dental schools to heighten their efforts to enhance the environment of academic integrity in their institutions. The aims of this study were to document the measures being used by U.S. dental schools to discourage student cheating, determine the current incidence of reported cheating, and make recommendations for enhancing a culture of integrity in dental education. In late 2014-early 2015, an online survey was distributed to academic deans of all 61 accredited U.S. dental schools that had four classes of dental students enrolled; 50 (82%) responded. Among measures used, 98% of respondents reported having policy statements regarding student academic integrity, 92% had an Honor Code, 96% provided student orientation to integrity policies, and most used proctoring of final exams (91%) and tests (93%). Regarding disciplinary processes, 27% reported their faculty members only rarely reported suspected cheating (though required in 76% of the schools), and 40% disseminated anonymous results of disciplinary hearings. A smaller number of schools (n=36) responded to the question about student cheating than to other questions; those results suggested that reported cheating had increased almost threefold since 1998. The authors recommend that schools add cheating case scenarios to professional ethics curricula; disseminate outcomes of cheating enforcement actions; have students sign a statement attesting to compliance with academic integrity policies at every testing activity; add curricular content on correct writing techniques to avoid plagiarism; require faculty to distribute retired test items; acquire examination-authoring software programs to enable faculty to generate new multiple-choice items and different versions of the same multiple-choice tests; avoid take-home exams when assessing independent student knowledge; and utilize student assessment methods directly relevant to clinical practice.

  18. Placebo Trends across the Border: US versus Canada.

    PubMed

    Harris, Cory S; Campbell, Natasha K J; Raz, Amir

    2015-01-01

    Physicians around the world report to using placebos in a variety of situations and with varying degrees of frequency. Inconsistent methodologies, however, complicate interpretation and prevent direct comparisons across studies. While US- and Canada-based physicians share similar professional standards, Canada harbours a less-litigious universal healthcare model with no formal placebo-related policy-factors that may impact how physicians view and use placebos. To compare American and Canadian data, we circulated an online survey to academic physicians practicing in Canada, collected anonymous responses, and extracted those of internists and rheumatologists for comparison to US data obtained through parallel methodologies. Whereas our data show overall concordance across the border-from definitions to ethical limitations and therapeutic potential-differences between American- and Canadian-based placebo practices merit acknowledgement. For example, compared to 45%-80% among US-based respondents, only 23±7% of Canada-based respondents reported using placebos in clinical practice. However, 79±7% of Canada-respondents-a figure comparable to US data-professed to prescribing at least one form of treatment without proven or expected efficacy. Placebo interventions including unwarranted vitamins and herbal supplements (impure placebos) as well as sugar pills and saline injections (pure placebos) appear more common in Canada, where more doctors described placebos as "placebos" (rather than "medications") and used them as a "diagnostic" tool (rather than a means of placating patient demands for treatment). Cross-border variation in the use of clinical placebos appears minor despite substantial differences in health care delivery system, malpractice climate, and placebo-related policy. The prevalence of impure placebos in both Canadian and US clinics raises ethical and practical questions currently unaddressed by policy and warranting investigation.

  19. The Future of Higher Education. LSDA Responds.

    ERIC Educational Resources Information Center

    Learning and Skills Development Agency, London (England).

    The Learning and Skills Development Agency (LSDA), a national resource for policy and practice development in post-16 education and training, responds to a government White Paper on higher education's (HE's) future. LSDA believes that policy development across further education (FE) and HE sectors should be coordinated and that the government has…

  20. Valuation of crop genetic resources in Kaski, Nepal: farmers' willingness to pay for rice landraces conservation.

    PubMed

    Poudel, Diwakar; Johnsen, Fred H

    2009-01-01

    Crop genetic resources constitute an important aspect of biodiversity conservation, both because of their direct value to the farmers and due to their indirect global value. This study uses the contingent valuation method to document the economic value of crop genetic resources based on the farmers' willingness to pay for conservation. A total of 107 households in Kaski, Nepal were surveyed in November 2003. Their mean willingness to pay was USD 4.18 for in situ and USD 2.20 for ex situ conservation per annum. Landholding size, household size, education level, socio-economic status, sex of respondent, number of crop landraces grown, and knowledge on biodiversity influenced the willingness to pay for in situ conservation, whereas only landholding size and household size influenced the willingness to pay for ex situ conservation. The respondents were willing to contribute more for in situ than ex situ conservation because of the additional effect of direct use and direct involvement of the farmers in in situ conservation. This study supports the view that economic valuation of crop genetic resources can assist the policy makers in setting conservation priorities.

  1. “Moving forward: a cross sectional baseline study of staff and student attitudes towards a totally smoke free university campus”

    PubMed Central

    2013-01-01

    Background Baseline data were collected to inform the adoption, implementation and institutionalisation phases of a completely smoke free campus policy at a large Western Australian university with a diverse student and staff community. Methods An online survey was randomly emailed to staff and students to measure the attitudes towards and the acceptability and enforcement of the policy prior to implementation. In total, 969 respondents completed the survey. Results General attitudes towards smoking were negative. While smokers, ex-smokers and non-smokers were supportive of smoke free policy on campus, 65.7% of respondents felt the campus should be completely smoke free. Respondents indicated a smoke free policy should be stringently enforced. The majority of respondents reported that they had been exposed to second-hand smoke on campus (n = 768; 79.5%). Conclusion Theory of Organisational Change provides a useful framework to support the implementation of the completely smoke free policy in the University setting. The implementation process needs to consider the broad range of issues associated with implementing a completely smoke free policy and address issues such as safety of smokers, ensuring smokers are not marginalised and ensuring a comprehensive program is implemented. These baseline findings can be used to advocate for the implementation of a comprehensive range of strategies that recognise the addictive nature of tobacco smoking and address attitude and behaviour change, environmental adaptations and effective implementation of the policy. Administration should consider smokers and non-smokers when policy is implemented. PMID:23924040

  2. Analysis of user cost and service trade-offs in transit and paratransit services

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

    Louviere, J.; Kocur, G.

    1979-08-01

    The Xenia Model Transit Service served as a test of several alternative transit services operated in a small city setting. Research was designed to test a new method for assessing user tradeoffs in costs and service based on attitudinal methods. Termed direct response assessment, the methods were developed in psychology and have been extended to application in utility assessment. A tradeoff survey was administered as part of a home interview survey. Data from the tradeoff survey were used to develop separate equations for each sample respondent to explain and describe their tradeoffs over transit fare, travel time, walk distance, typemore » of service, and headway. An aggregate equation was also developed, assuming that all respondents shared common tradeoffs. These equations were employed to retrospectively predict changes in transit system patronage since system inception in 1974. Both sets of models performed well, producing forecasts that were in the same direction and range of experience, although magnitudes were somewhat different. Coefficients of the individual tradeoff equations were then analyzed to see if they could be predicted on the basis of interpersonal characteristics of the respondents. Results indicated that differences in coefficients could be attributed to some differences in individuals such as income and auto ownership. Overall results were promising for policy evaluation and forecasting.« less

  3. Gifts and Corporate Influence in Doctor of Pharmacy Education

    PubMed Central

    Piascik, Peggy; Bernard, Daphne; Madhavan, Suresh; Stoner, Steve C.; TenHoeve, Tom

    2007-01-01

    Objectives To explore the nature of corporate gifts directed at PharmD programs and pharmacy student activities and the perceptions of administrators about the potential influences of such gifts. Methods A verbally administered survey of administrative officials at 11 US colleges and schools of pharmacy was conducted and responses were analyzed. Results All respondents indicated accepting corporate gifts or sponsorships for student-related activities in the form of money, grants, scholarships, meals, trinkets, and support for special events, and cited many advantages to corporate partner relationships. Approximately half of the respondents believed that real or potential problems could occur from accepting corporate gifts. Forty-four percent of respondents agreed or strongly agreed that corporate contributions could influence college or school administration. Sixty-one percent agreed or strongly agreed that donations were likely to influence students. Conclusions Corporate gifts do influence college and school of administration and students. Policies should be in place to manage this influence appropriately. PMID:17786255

  4. Understanding Effects of Flexible Spending Accounts on People with Disabilities: The Case of a Consumer-Directed Care Program.

    PubMed

    Lombe, Margaret; Inoue, Megumi; Mahoney, Kevin; Chu, Yoosun; Putnam, Michelle

    2016-01-01

    This study set out to explore the saving behavior, barriers, and facilitators along with effects of participating in a consumer-directed care program among people with disabilities in the state of West Virginia (N = 29). Results suggest that respondents were able to save money through the program to enable them to purchase goods and services they needed to enhance their welfare and quality of life. Generally, items saved for fell into 3 broad categories: household equipment, individual functioning, and home modification. Facilitators and barriers to saving were also indicated and so were the benefits of program participation. Program and policy implications are presented.

  5. Stakeholder attitudes toward influenza vaccination policy in the United States.

    PubMed

    Berman, Pamela Protzel; Orenstein, Walter A; Hinman, Alan R; Gazmararian, Julie

    2010-11-01

    There is growing interest in simplifying recommendations to vaccinate Americans against influenza. The article discusses interviews with 35 stakeholders from the medical, public health, educational, insurance, and vaccine industry sectors to assess the potential for policy change, and discusses questions posed to the interviewees on current and future influenza vaccination policy and barriers to policy change. About 97% of respondents support the expansion of vaccination for all school-age children, and about 95% support universal vaccination, but there are reservations expressed by the respondents, despite the support for this policy change. Barriers to influenza vaccination recommendations include access, supply, confusing recommendations, and public perceptions. Barriers to universal vaccination include lack of infrastructure, cost, need for education, and vaccine supply. Issues concerning resources and education are challenges that impede policy change. The study findings can be useful to policy makers and practitioners for reviewing U.S. vaccination policy and changes to the policy.

  6. E-Cigarette Policies on College Campuses: Student Use Behaviors, Awareness, and Policy Support.

    PubMed

    Brown, Elizabeth M; Henes, Amy L; Olson, Lindsay T

    2016-12-01

    This study examined e-cigarette use and attitudes toward e-cigarette policies among students at colleges and universities with and without policies prohibiting e-cigarette use on campus. In April 2015, we fielded an online survey with a convenience sample of 930 students at 14 North Dakota colleges and universities. The survey included questions about e-cigarette use, observed e-cigarette use on campus, awareness of school e-cigarette policy, and support for policies prohibiting e-cigarette use on campus. Over 40 % of respondents had used e-cigarettes at least once, and most current users reported using them rarely (36 %). Nearly 29 % of respondents reported observing e-cigarette use on campus, and more than half of these reported seeing e-cigarette use indoors. More than 42 % did not know whether their school's policy prohibited e-cigarette use on campus, and students at schools with a policy were more likely to identify their campus policy correctly. Sixty-six percent of respondents were in favor of policies prohibiting e-cigarette use on campus, and those at schools with policies prohibiting e-cigarette use were more likely to support a campus e-cigarette policy. Policies prohibiting e-cigarette use on campus intend to restrict use, reduce prevalence, and shape social norms. This study indicates that support for campus e-cigarette policies is high, although awareness of whether e-cigarettes are included in college and university policies is low. These findings demonstrate the need for coordinated policy education efforts and may guide college administrators and student health services personnel as they consider how to implement and evaluate campus e-cigarette policies.

  7. Attitudes About Regulation Among Direct-to-Consumer Genetic Testing Customers

    PubMed Central

    Green, Robert C.; Kaufman, David

    2013-01-01

    Introduction: The first regulatory rulings by the U.S. Food and Drug Administration on direct-to-consumer (DTC) genetic testing services are expected soon. As the process of regulating these and other genetic tests moves ahead, it is important to understand the preferences of DTC genetic testing customers about the regulation of these products. Methods: An online survey of customers of three DTC genetic testing companies was conducted 2–8 months after they had received their results. Participants were asked about the importance of regulating the companies selling DTC genetic tests. Results: Most of the 1,046 respondents responded that it would be important to have a nongovernmental (84%) or governmental agency (73%) monitor DTC companies' claims to ensure the consistency with scientific evidence. However, 66% also felt that it was important that DTC tests be available without governmental oversight. Nearly, all customers favored a policy to ensure that insurers and law enforcement officials could not access their information. Discussion: Although many DTC customers want access to genetic testing services without restrictions imposed by the government regulation, most also favor an organization operating alongside DTC companies that will ensure that the claims made by the companies are consistent with sound scientific evidence. This seeming contradiction may indicate that DTC customers want to ensure that they have unfettered access to high-quality information. Additionally, policies to help ensure privacy of data would be welcomed by customers, despite relatively high confidence in the companies. PMID:23560882

  8. Attitudes about regulation among direct-to-consumer genetic testing customers.

    PubMed

    Bollinger, Juli Murphy; Green, Robert C; Kaufman, David

    2013-05-01

    The first regulatory rulings by the U.S. Food and Drug Administration on direct-to-consumer (DTC) genetic testing services are expected soon. As the process of regulating these and other genetic tests moves ahead, it is important to understand the preferences of DTC genetic testing customers about the regulation of these products. An online survey of customers of three DTC genetic testing companies was conducted 2-8 months after they had received their results. Participants were asked about the importance of regulating the companies selling DTC genetic tests. Most of the 1,046 respondents responded that it would be important to have a nongovernmental (84%) or governmental agency (73%) monitor DTC companies' claims to ensure the consistency with scientific evidence. However, 66% also felt that it was important that DTC tests be available without governmental oversight. Nearly, all customers favored a policy to ensure that insurers and law enforcement officials could not access their information. Although many DTC customers want access to genetic testing services without restrictions imposed by the government regulation, most also favor an organization operating alongside DTC companies that will ensure that the claims made by the companies are consistent with sound scientific evidence. This seeming contradiction may indicate that DTC customers want to ensure that they have unfettered access to high-quality information. Additionally, policies to help ensure privacy of data would be welcomed by customers, despite relatively high confidence in the companies.

  9. Australian governments' spending on preventing and responding to drug abuse should target the main sources of drug-related harm and the most cost-effective interventions.

    PubMed

    McDonald, David

    2011-01-01

    A notable feature of Australian drug policy is the limited public and professional attention given to the financial costs of drug abuse and to the levels and patterns of government expenditures incurred in preventing and responding to this. Since 1991, Collins and Lapsley have published scholarly reports documenting the social costs of drug abuse in Australia and their reports also contain estimates of governments' drug budgets: revenue and expenditures. They show that, in 2004-2005, Australian governments expended at least $5288 million on drug abuse, with 50% of the expenditure directed to preventing and dealing with alcohol-related problems, 45% to illicit drugs and just 5% to tobacco. Some 60% of the expenditure was directed at drug crime and 37% at health interventions. This pattern of resource allocation does not adequately reflect an evidence-informed policy orientation in that it largely fails to focus on the drug types that are the sources of the most harm (tobacco and alcohol rather than illicit drugs), and the sectors for which we have the strongest evidence of the cost-effectiveness of the available interventions (treatment and harm reduction rather than legislation and law enforcement). The 2010-2014 phase of Australia's National Drug Strategy should include incremental changes to the resource allocation mix, and not simply maintain the historical resource allocation formulae. © 2010 Australasian Professional Society on Alcohol and other Drugs.

  10. Escape and evade control policies for ensuring the physical security of nonholonomic, ground-based, unattended mobile sensor nodes

    NASA Astrophysics Data System (ADS)

    Mascarenas, David; Stull, Christopher; Farrar, Charles

    2011-06-01

    In order to realize the wide-scale deployment of high-endurance, unattended mobile sensing technologies, it is vital to ensure the self-preservation of the sensing assets. Deployed mobile sensor nodes face a variety of physical security threats including theft, vandalism and physical damage. Unattended mobile sensor nodes must be able to respond to these threats with control policies that facilitate escape and evasion to a low-risk state. In this work the Precision Immobilization Technique (PIT) problem has been considered. The PIT maneuver is a technique that a pursuing, car-like vehicle can use to force a fleeing vehicle to abruptly turn ninety degrees to the direction of travel. The abrupt change in direction generally causes the fleeing driver to lose control and stop. The PIT maneuver was originally developed by law enforcement to end vehicular pursuits in a manner that minimizes damage to the persons and property involved. It is easy to imagine that unattended autonomous convoys could be targets of this type of action by adversarial agents. This effort focused on developing control policies unattended mobile sensor nodes could employ to escape, evade and recover from PIT-maneuver-like attacks. The development of these control policies involved both simulation as well as small-scale experimental testing. The goal of this work is to be a step toward ensuring the physical security of unattended sensor node assets.

  11. Stigma, discrimination, treatment effectiveness, and policy: public views about drug addiction and mental illness.

    PubMed

    Barry, Colleen L; McGinty, Emma E; Pescosolido, Bernice A; Goldman, Howard H

    2014-10-01

    Public attitudes about drug addiction and mental illness were compared. A Web-based national survey (N=709) was conducted to compare attitudes about stigma, discrimination, treatment effectiveness, and policy support in regard to drug addiction and mental illness. Respondents held significantly more negative views toward persons with drug addiction. More respondents were unwilling to have a person with drug addiction marry into their family or work closely with them. Respondents were more willing to accept discriminatory practices against persons with drug addiction, more skeptical about the effectiveness of treatments, and more likely to oppose policies aimed at helping them. Drug addiction is often treated as a subcategory of mental illness, and insurance plans group them together under the rubric of "behavioral health." Given starkly different public views about drug addiction and mental illness, advocates may need to adopt differing approaches to reducing stigma and advancing public policy.

  12. Policies on documentation and disciplinary action in hospital pharmacies after a medication error.

    PubMed

    Bauman, A N; Pedersen, C A; Schommer, J C; Griffith, N L

    2001-06-15

    Hospital pharmacies were surveyed about policies on medication error documentation and actions taken against pharmacists involved in an error. The survey was mailed to 500 randomly selected hospital pharmacy directors in the United States. Data were collected on the existence of medication error reporting policies, what types of errors were documented and how, and hospital demographics. The response rate was 28%. Virtually all of the hospitals had policies and procedures for medication error reporting. Most commonly, documentation of oral and written reprimand was placed in the personnel file of a pharmacist involved in an error. One sixth of respondents had no policy on documentation or disciplinary action in the event of an error. Approximately one fourth of respondents reported that suspension or termination had been used as a form of disciplinary action; legal action was rarely used. Many respondents said errors that caused harm (42%) or death (40%) to the patient were documented in the personnel file, but 34% of hospitals did not document errors in the personnel file regardless of error type. Nearly three fourths of respondents differentiated between errors caught and not caught before a medication leaves the pharmacy and between errors caught and not caught before administration to the patient. More emphasis is needed on documentation of medication errors in hospital pharmacies.

  13. A history of drug advertising: the evolving roles of consumers and consumer protection.

    PubMed

    Donohue, Julie

    2006-01-01

    Direct-to-consumer advertising (DTCA) of prescription drugs in the United States is controversial. Underlying the debate are disagreements over the role of consumers in medical decision making, the appropriateness of consumers engaging in self-diagnosis, and the ethics of an industry promoting potentially dangerous drugs. Drug advertising and federal policy governing drug advertising have both responded to and reinforced changes in the consumer's role in health care and in the doctor-patient relationship over time. This article discusses the history of DTCA in the context of social movements to secure rights for health care patients and consumers, the modern trend toward consumer-oriented medicine, and the implications of DTCA and consumer-oriented medicine for contemporary health policy debates about improving the health care system.

  14. A History of Drug Advertising: The Evolving Roles of Consumers and Consumer Protection

    PubMed Central

    Donohue, Julie

    2006-01-01

    Direct-to-consumer advertising (DTCA) of prescription drugs in the United States is controversial. Underlying the debate are disagreements over the role of consumers in medical decision making, the appropriateness of consumers engaging in self-diagnosis, and the ethics of an industry promoting potentially dangerous drugs. Drug advertising and federal policy governing drug advertising have both responded to and reinforced changes in the consumer's role in health care and in the doctor-patient relationship over time. This article discusses the history of DTCA in the context of social movements to secure rights for health care patients and consumers, the modern trend toward consumer-oriented medicine, and the implications of DTCA and consumer-oriented medicine for contemporary health policy debates about improving the health care system. PMID:17096638

  15. How Institutional and University Counselor Policies Effectively Respond to Victims of Cyber Violent Acts: A Multisite Case Study

    ERIC Educational Resources Information Center

    Richards, Gretchen M.

    2012-01-01

    This multisite case study examined how institutional and university counselor policies effectively respond to cyber violent acts. Stake's (2006) multisite case study methodology was used to identify seven themes from current literature. Two sites with four participants were selected. The participants included two counseling directors and the…

  16. Perceptions of College Financial Aid among California Latino Youth. Policy Brief

    ERIC Educational Resources Information Center

    Zarate, Maria Estela; Pachon, Harry P.

    2006-01-01

    The Tomas Rivera Policy Institute (TRPI) survey of California Latino youth perceptions of college financial aid reveals: (1) Ninety-eight percent of respondents felt it was important to have a college education; (2) Thirty-eight percent of respondents did not feel the benefits of college outweigh the costs; (3) Not being able to work and incurring…

  17. Surgeon-industry conflict of interest: survey of North Americans' opinions regarding surgeons consulting with industry.

    PubMed

    DiPaola, Christian P; Dea, Nicolas; Noonan, Vanessa K; Bailey, Christopher S; Dvorak, Marcel F S; Fisher, Charles G

    2014-04-01

    Surgeon-industry conflict of interest (COI) has become a source of considerable interest. Professional medical societies, industry, and policy makers have attempted to regulate potential COI without consideration for public opinion. The objective of this study was to report on the opinions of individuals representing the general public regarding surgeon-industry consulting relationships. Web-based survey. Survey was administered using a "spine Web site," and opinions are collected on surgeon-industry consulting and regulation. Associations among responses to similar questions were assessed to ensure validity and subgroup analysis performed for respondent age, sex, education, insurance, employment, and patient status. Six hundred ten of 642 surveys had complete data. The sample population comprised more females and was older and more educated than the American population. About 80% of respondents felt it was ethical and either beneficial or of no influence to the quality of health care if surgeons were consultants for surgical device companies. Most felt disclosure of an industry relationship was important and paying surgeons royalties for devices, other than those they directly implant, would not affect quality of care. Respondents support multidisciplinary surgeon-industry COI regulation and trust doctors and their professional societies to head this effort. Despite the known potential negative impact of surgeon-industry COI on patient care, this study revealed that this does not seem to be reflected in the opinion of the general public. The respondents felt that disclosure is deemed one of the most important means of self-regulation and COI management, which is in agreement with current trends of most spine societies and journals that are increasing the stringency of disclosure policies. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. 21 CFR 1404.1000 - Respondent.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Respondent. 1404.1000 Section 1404.1000 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.1000 Respondent. Respondent means a person against whom an agency has initiated a debarment...

  19. Psychological research and global climate change

    NASA Astrophysics Data System (ADS)

    Clayton, Susan; Devine-Wright, Patrick; Stern, Paul C.; Whitmarsh, Lorraine; Carrico, Amanda; Steg, Linda; Swim, Janet; Bonnes, Mirilia

    2015-07-01

    Human behaviour is integral not only to causing global climate change but also to responding and adapting to it. Here, we argue that psychological research should inform efforts to address climate change, to avoid misunderstandings about human behaviour and motivations that can lead to ineffective or misguided policies. We review three key research areas: describing human perceptions of climate change; understanding and changing individual and household behaviour that drives climate change; and examining the human impacts of climate change and adaptation responses. Although much has been learned in these areas, we suggest important directions for further research.

  20. Depression in the workplace: the role of the corporate medical director.

    PubMed

    Burton, Wayne N; Conti, Daniel J

    2008-04-01

    Depressive disorders are a major health issue in the US workplace. They are responsible for significant direct and indirect costs to the employer in terms of medical and pharmaceutical costs, time absent from work and decreased productivity while on the job (presenteeism). The Corporate Medical Director (CMD) or occupational health physician must be equipped to respond to this health problem just as they must be able to respond to the more "traditional" workplace issues such as communicable disease, occupational exposures, and work-related ergonomic injuries. An integrated response by the CMD includes forming partnerships with relevant departments such as the Employee Assistance Program, Human Resources, Corporate Benefits, and others; measuring the impact of the disease; and providing leadership with regard to interventions in health plan design, disability management, workplace policy, and education aimed at increasing awareness and destigmatization.

  1. Mapping public policy options responding to obesity: the case of Spain.

    PubMed

    González-Zapata, L I; Ortiz-Moncada, R; Alvarez-Dardet, C

    2007-05-01

    This study assesses the opinions of the main Spanish stakeholders from food and physical exercise policy networks on public policy options for responding to obesity. We followed the multi-criteria mapping methodology in the framework of the European project 'Policy options in responding to obesity' (PorGrow), through a structured interview to 21 stakeholders. A four-step approach was taken: options, criteria, scoring and weighting, obtaining in this way a measure of the performance of each option which integrates qualitative and quantitative information. In an overall analysis, the more popular policy options where those grouped as educational initiatives: include food and health in the school curriculum, improve health education to the general public, improve the training of health professionals in obesity care and prevention, incentives to caterers to provide healthier menus and improve community sports facilities. Fiscal measures as subsidies and taxes had the lowest support. The criteria assessed as priorities were grouped as efficacy and societal benefits. Obesity in Spain can be approached through public policies, although the process will not be easy or immediate. The feasibility of changes requires concerned public policymakers developing long-term actions taking into account the map of prioritized options by the stakeholders.

  2. 14 CFR 415.23 - Policy review.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Policy review. 415.23 Section 415.23... TRANSPORTATION LICENSING LAUNCH LICENSE Policy Review and Approval § 415.23 Policy review. (a) The FAA reviews a... raised during a policy review that would impede issuance of a policy approval. The applicant may respond...

  3. Curriculum Policy Implementation: How Schools Respond to Government's "Soft" Policy in the Curriculum Reform

    ERIC Educational Resources Information Center

    Chan, Jacqueline K. S.

    2012-01-01

    "Soft" policy has newly emerged as a policy implementation concept in relation to governance. Non-binding in character, "soft" policy is designed for multi-level systems of governance in which there is relative autonomy at different levels of collective decision-making. "Soft" policy has gained attention since the…

  4. E-learning policies, practices and challenges in two Norwegian organizations.

    PubMed

    Welle-Strand, Anne; Thune, Taran

    2003-05-01

    This article reports a pilot study on the uses of technology to enable learning within a formal educational setting in a higher education institution and within a corporation. These two Norwegian cases were selected due to their commitment to technology-enabled learning, as expressed in policy and strategy documents. The aim was to investigate the commitment and actual use of information and communications technology (ICT) for learning as well as what key actors think are the major challenges for successful large scale implementation of ICT for learning. The findings indicate that there is insufficient follow-up on e-learning policies and that there is a general lack of strategic direction and leadership in this area. The key challenges respondents highlight relate to the need for a systematic and pedagogical approach to e-learning in which three equally important considerations must be balanced: organization, pedagogy and technology. Key perspectives of a coherent pedagogical and organizational framework for planning e-learning are discussed.

  5. Main-streaming NFP into the Department of Health of the Philippines: opportunities and challenges.

    PubMed

    Infantado, R B

    1997-01-01

    In 1994, the Department of Health (DOH) of the Philippines issued a circular which reaffirmed natural family planning (NFP) as one of the basic services to be offered in all government family planning service sites and urged family planning workers to develop competence in teaching NFP methods. Although the circular represented a major policy breakthrough for the main-streaming of NFP it found the department without the capability or experience to directly provide NFP services. The two approaches the department is taking to respond to this new policy initiative are described in this paper. The selection of these approaches was influenced by the devolution of central government authority to local government units. The approaches include developing department capability in NFP training, service provision and service installation and creating a supportive program and policy environment. DOH partnership with an NFP non-government organization (NGO) has been critical in developing NFP capability within the government sector, particularly in NFP training and service installation.

  6. Factors Associated With Occupational Sun-Protection Policies in Local Government Organizations in Colorado.

    PubMed

    Walkosz, Barbara J; Buller, David B; Andersen, Peter A; Wallis, Allan; Buller, Mary Klein; Scott, Michael D

    2015-09-01

    Skin cancer prevention remains a national priority. Reducing chronic UV radiation exposure for outdoor workers through sun-safety practices is an important step to help reduce the incidence of skin cancer. To determine the presence of occupational sun-safety policies at local government organizations in a single state. Of 571 potentially eligible local government organizations of Colorado cities, counties, and special tax districts, we enrolled 98 in a randomized pretest-posttest controlled experiment starting August 15, 2010, that evaluated an intervention to promote the adoption of sun-safety policies. We used a policy-coding protocol to evaluate personal sun-protection practices, environmental and administrative controls, and policy directives for sun safety starting February 10, 2011. We report the baseline assessment of the occupational sun-protection policies of these organizations. The presence of an occupational sun-safety policy. Overall, 85 local government organizations (87%) had policies that required personal sun-protection practices, including the use of eyewear, hats, and protective clothing. However, of the 98 responding organizations, only 8 hat policies (8%), 10 eyewear policies (10%), and 7 clothing policies (7%) mentioned sun protection as the intent of the policy. Only cosmopoliteness, operationalized as proximity to an urban area, was associated with the presence of a sun-safety policy (odds ratio, 0.99 [95% CI, 0.98-1.00]; P = .02). Outdoor workers are at increased risk for skin cancer because of long-term exposure to solar UV radiation. Although organizational policies have the potential to increase sun protection in occupational settings, occupational sun-safety policies were uncommon among local governments. Opportunities exist for dermatologists and other physicians to influence occupational sun-safety practices and policies, which are consistent with other safety procedures and could easily be integrated into existing workplace practices.

  7. Are life-extending treatments for terminal illnesses a special case? Exploring choices and societal viewpoints.

    PubMed

    McHugh, Neil; van Exel, Job; Mason, Helen; Godwin, Jon; Collins, Marissa; Donaldson, Cam; Baker, Rachel

    2018-02-01

    Criteria used by the National Institute for Health and Care Excellence (NICE) to assess life-extending, end-of-life (EoL) treatments imply that health gains from such treatments are valued more than other health gains. Despite claims that the policy is supported by societal values, evidence from preference elicitation studies is mixed and in-depth research has shown there are different societal viewpoints. Few studies elicit preferences for policies directly or combine different approaches to understand preferences. Survey questions were designed to investigate support for NICE EoL guidance at national and regional levels. These 'Decision Rule' and 'Treatment Choice' questions were administered to an online sample of 1496 UK respondents in May 2014. The same respondents answered questions designed to elicit their agreement with three viewpoints (previously identified and described) in relation to provision of EoL treatments for terminally ill patients. We report the findings of these choice questions and examine how they relate to each other and respondents' viewpoints. The Decision Rule questions described three policies: DA - a standard 'value for money' test, applied to all health technologies; DB - giving special consideration to all treatments for terminal illnesses; and DC - giving special consideration to specific categories of treatments for terminal illnesses e.g. life extension (as in NICE EoL guidance) or those that improve quality-of-life (QoL). Three Treatment Choices were presented: TA - improving QoL for patients with a non-terminal illness; TB - extending life for EoL patients; and TC - improving QoL at the EoL. DC received most support (45%) with most respondents giving special consideration to EoL only when treatments improved QoL. The most commonly preferred treatment choices were TA (51%) and TC (43%). Overall, this study challenges claims about public support for NICE's EoL guidance and the focus on life extension at EoL and substantiates existing evidence of plurality in societal values. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. State of Infection Prevention in US Hospitals Enrolled in NHSN

    PubMed Central

    Pogorzelska-Maziarz, Monika; Herzig, Carolyn T. A.; Weiner, Lindsey M.; Furuya, E. Yoko; Dick, Andrew; Larson, Elaine

    2014-01-01

    Background This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent healthcare associated infections (HAI) in intensive care units (ICUs). Methods All hospitals, except for Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation included: 1) completion of a survey that assessed presence of evidence-based prevention policies and clinician adherence, and 2) joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and non-respondents. Results Of the 3,374 eligible hospitals, 975 hospitals provided data (29% response rate) on 1,653 ICUs; and, there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions and the average hours per week of data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and non-respondents. Conclusions Guidelines around IP staffing in acute care hospitals should be updated. In future publications we will analyze the associations between HAI rates and infection prevention and control program characteristics, presence of and clinician adherence to evidence-based policies. PMID:24485365

  9. Assessing patient and caregiver understanding of and satisfaction with the use of contact isolation.

    PubMed

    Chittick, Paul; Koppisetty, Shalini; Lombardo, Lia; Vadhavana, Akash; Solanki, Ashish; Cumming, Kristi; Agboto, Vincent; Karl, Cindy; Band, Jeffrey

    2016-06-01

    Contact isolation is a method used for limiting the spread of antimicrobial-resistant organisms when caring for patients. This policy has been linked to several adverse outcomes and less patient satisfaction. We assessed patient and caregiver understanding and satisfaction with the use of contact isolation. A prospective survey of >500 patients in contact isolation at our institution was performed during 2014. Participants responded to a series of statements relating to contact isolation, using a 5-point Likert scale. Responses were assessed for overall positivity or negativity and further compared according to floor type or designation. Of the patients, 48.7% responded to the survey; 70 caregivers also responded. Patient and caregiver responses were similar and were positive overall. Most respondents felt safer because of the use of contact isolation and because it prevented infections. A smaller majority of respondents also thought the policy was adequately explained to them and adhered to by staff. In the largest collection of respondents surveyed to date about contact isolation and its impact on them, the policy was viewed positively, both by patients and caregivers. There is still room for improvement in the area of patient education regarding the use of contact isolation. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Mental health and substance abuse insurance parity for federal employees: how did health plans respond?

    PubMed

    Barry, Colleen L; Ridgely, M Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than coverage for general medical services. While mental health advocates view insurance limits as evidence of discrimination, adverse selection and moral hazard can also explain these differences in coverage. The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, we examine how health plans responded to the parity directive. Results show that in comparison with a set of unaffected health plans, federal employee plans were significantly more likely to augment managed care through contracts with managed behavioral health "carve-out" firms after parity. This finding helps to explain the absence of an effect of the FEHB Program directive on total spending, and is relevant to the policy debate in Congress over federal parity.

  11. Attitudes and beliefs about secondhand smoke and smoke-free policies in four countries: findings from the International Tobacco Control Four Country Survey.

    PubMed

    Hyland, Andrew; Higbee, Cheryl; Borland, Ron; Travers, Mark; Hastings, Gerard; Fong, Geoffrey T; Cummings, K Michael

    2009-06-01

    This paper describes the varying levels of smoking policies in nationally representative samples of smokers in four countries and examines how these policies are associated with changes in attitudes and beliefs about secondhand smoke over time. We report data on 5,788 respondents to Wave 1 of the International Tobacco Control Four Country Survey who were employed at the time of the survey. A cohort of these respondents was followed up with two additional survey waves approximately 12 months apart. Respondents' attitudes and beliefs about secondhand smoke as well as self-reported policies in their workplace and in bars and restaurants in their community were assessed at all waves. The level of comprehensive smoke-free policies in workplaces, restaurants, and bars increased over the study period for all countries combined and was highest in Canada (30%) and lowest in the United Kingdom (0%) in 2004. In both cross-sectional and longitudinal analyses, stronger secondhand smoke policies were associated with more favorable attitudes and support for comprehensive regulations. The associations were the strongest for smokers who reported comprehensive policies in restaurants, bars, and their workplace for all three survey waves. Comprehensive smoke-free policies are increasing over time, and stronger policies and the public education opportunities surrounding their passage are associated with more favorable attitudes toward secondhand smoke regulations. The implication for policy makers is that, although the initial debate over smoke-free policies may be tumultuous, once people understand the rationale for implementing smoke-free policies and experience their benefits, public support increases even among smokers, and compliance with smoke-free regulations increases over time.

  12. Study protocol of the German Study on Tobacco Use (DEBRA): a national household survey of smoking behaviour and cessation.

    PubMed

    Kastaun, Sabrina; Brown, Jamie; Brose, Leonie S; Ratschen, Elena; Raupach, Tobias; Nowak, Dennis; Cholmakow-Bodechtel, Constanze; Shahab, Lion; West, Robert; Kotz, Daniel

    2017-05-02

    The prevalence of tobacco smoking in Germany is high (~27%). Monitoring of national patterns of smoking behaviour and data on the "real-world" effectiveness of cessation methods are needed to inform policies and develop campaigns aimed at reducing tobacco-related harm. In England, the Smoking Toolkit Study (STS) has been tracking such indicators since 2006, resulting in the adaptation of tobacco control policies. However, findings cannot be directly transferred into the German health policy context. The German Study on Tobacco Use (DEBRA: "Deutsche Befragung zum Rauchverhalten") aims to provide such nationally representative data. In June 2016, the study started collecting data from computer-assisted, face-to-face household interviews in people aged 14 years and older. Over a period of 3 years, a total of ~36,000 respondents will complete the survey with a new sample of ~2000 respondents every 2 months (=18 waves). This sample will report data on demographics and the use of tobacco and electronic (e-)cigarettes. Per wave, about 500-600 people are expected to be current or recent ex-smokers (<12 months since quitting). This sample will answer detailed questions about smoking behaviour, quit attempts, exposure to health professionals' advice on quitting, and use of cessation aids. Six-month follow-up data will be collected by telephone. The DEBRA study will be an important source of data for tobacco control policies, health strategies, and future research. The methodology is closely aligned to the STS, which will allow comparisons with data from England, a country with one of the lowest smoking prevalence rates in Europe (18%). This study has been registered at the German Clinical Trials Register ( DRKS00011322 ) on 25th November 2016.

  13. The economic burden of HIV/AIDS on individuals and households in Nepal: a quantitative study.

    PubMed

    Poudel, Ak Narayan; Newlands, David; Simkhada, Padam

    2017-01-24

    There have been only limited studies assessing the economic burden of HIV/AIDS in terms of direct costs, and there has been no published study related to productivity costs in Nepal. Therefore, this study explores in detail the economic burden of HIV/AIDS, including direct costs and productivity costs. This paper focuses on the direct costs of seeking treatment, productivity costs, and related factors affecting direct costs, and productivity costs. This study was a cross-sectional, quantitative study. The primary data were collected through a structured face-to-face survey from 415 people living with HIV/AIDS (PLHIV). The study was conducted in six representative treatment centres of six districts of Nepal. The data analysis regarding the economic burden (direct costs and productivity costs) was performed from the household's perspective. Descriptive statistics have been used, and regression analyses were applied to examine the extent, nature and determinants of the burden of the disease, and its correlations. Average total costs due to HIV/AIDS (the sum of average total direct and average productivity costs before adjustment for coping strategies) were Nepalese Rupees (NRs) 2233 per month (US$ 30.2/month), which was 28.5% of the sample households' average monthly income. The average total direct costs for seeking HIV/AIDS treatment were NRs 1512 (US$ 20.4), and average productivity costs (before adjustment for coping strategies) were NRs 721 (US$ 9.7). The average monthly productivity losses (before adjustment for coping strategies) were 5.05 days per person. The major determinants for the direct costs were household income, occupation, health status of respondents, respondents accompanied or not, and study district. Health status of respondents, ethnicity, sexual orientation and study district were important determinants for productivity costs. The study concluded that HIV/AIDS has caused a significant economic burden for PLHIV and their families in Nepal. The study has a number of policy implications for different stakeholders. Provision of social support and income generating programmes to HIV-affected individuals and their families, and decentralising treatment services in each district seem to be viable solutions to reduce the economic burden of HIV-affected individuals and households.

  14. Patient Advocacy Organizations, Industry Funding, and Conflicts of Interest.

    PubMed

    Rose, Susannah L; Highland, Janelle; Karafa, Matthew T; Joffe, Steven

    2017-03-01

    Patient advocacy organizations (PAOs) are influential health care stakeholders that provide direct counseling and education for patients, engage in policy advocacy, and shape research agendas. Many PAOs report having financial relationships with for-profit industry, yet little is known about the nature of these relationships. To describe the nature of industry funding and partnerships between PAOs and for-profit companies in the United States. A survey was conducted from September 1, 2013, to June 30, 2014, of a nationally representative random sample of 439 PAO leaders, representing 5.6% of 7865 PAOs identified in the United States. Survey questions addressed the nature of their activities, their financial relationships with industry, and the perceived effectiveness of their conflict of interest policies. Amount and sources of revenue as well as organizational experiences with and policies regarding financial conflict of interest. Of the 439 surveys mailed to PAO leaders, 289 (65.8%) were returned with at least 80% of the questions answered. The PAOs varied widely in terms of size, funding, activities, and disease focus. The median total revenue among responding organizations was $299 140 (interquartile range, $70 000-$1 200 000). A total of 165 of 245 PAOs (67.3%) reported receiving industry funding, with 19 of 160 PAOs (11.9%) receiving more than half of their funding from industry. Among the subset of PAOs that received industry funding, the median amount was $50 000 (interquartile range, $15 000-$200 000); the median proportion of industry support derived from the pharmaceutical, device, and/or biotechnology sectors was 45% (interquartile range, 0%-100%). A total of 220 of 269 respondents (81.8%) indicated that conflicts of interest are very or moderately relevant to PAOs, and 94 of 171 (55.0%) believed that their organizations' conflict of interest policies were very good. A total of 22 of 285 PAO leaders (7.7%) perceived pressure to conform their positions to the interests of corporate donors. Patient advocacy organizations engage in wide-ranging health activities. Although most PAOs receive modest funding from industry, a minority receive substantial industry support, raising added concerns about independence. Many respondents report a need to improve their conflict of interest policies to help maintain public trust.

  15. Stigma, Discrimination, Treatment Effectiveness and Policy Support: Comparing Public Views about Drug Addiction with Mental Illness

    PubMed Central

    Barry, Colleen L; McGinty, Emma Elizabeth; Pescosolido, Bernice; Goldman, Howard H.

    2014-01-01

    Objective This study compares current public attitudes about drug addiction with attitudes about mental illness. Methods A web-based national public opinion survey (N=709) was conducted to compare attitudes about stigma, discrimination, treatment effectiveness, and policy support. Results Respondents hold significantly more negative views toward persons with drug addiction compared to those with mental illness. More respondents were unwilling to have a person with drug addiction marry into their family or work closely with them on a job. Respondents were more willing to accept discriminatory practices, more skeptical about the effectiveness of available treatments, and more likely to oppose public policies aimed at helping persons with drug addiction. Conclusions Drug addiction is often treated as a sub-category of mental illness, and health insurance benefits group these conditions together under the rubric of behavioral health. Given starkly different public views about drug addiction and mental illness, advocates may need to adopt differing approaches for advancing stigma reduction and public policy. PMID:25270497

  16. A direct healthcare cost analysis of the cryopreserved versus fresh transfer policy at the blastocyst stage.

    PubMed

    Papaleo, Enrico; Pagliardini, Luca; Vanni, Valeria Stella; Delprato, Diana; Rubino, Patrizia; Candiani, Massimo; Viganò, Paola

    2017-01-01

    A cost analysis covering direct healthcare costs relating to IVF freeze-all policy was conducted. Normal- and high- responder patients treated with a freeze-all policy (n = 63) compared with fresh transfer IVF (n = 189) matched by age, body mass index, duration and cause of infertility, predictive factors for IVF (number of oocytes used for fertilization) and study period, according to a 1:3 ratio were included. Total costs per patient (€6952 versus €6863) and mean costs per live birth were similar between the freeze-all strategy (€13,101, 95% CI 10,686 to 17,041) and fresh transfer IVF (€15,279, 95% CI 13,212 to 18,030). A mean per live birth cost-saving of €2178 (95% CI -1810 to 6165) resulted in a freeze-all strategy owing to fewer embryo transfer procedures (1.29 ± 0.5 versus 1.41 ± 0.7); differences were not significant. Sensitivity analysis revealed that the freeze-all strategy remained cost-effective until the live birth rate is either higher or only slightly lower (≥-0.59%) in the freeze-all group compared with fresh cycles. A freeze-all policy does not increase costs compared with fresh transfer, owing to negligible additional expenses, i.e. vitrification, endometrial priming and monitoring, against fewer embryo transfer procedures required to achieve pregnancy. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Direct access: factors that affect physical therapist practice in the state of Ohio.

    PubMed

    McCallum, Christine A; DiAngelis, Tom

    2012-05-01

    Direct access to physical therapist services is permitted by law in the majority of states and across all practice settings. Ohio enacted such legislation in 2004; however, it was unknown how direct access had affected actual clinical practice. The purpose of this study was to describe physical therapist and physical therapist practice environment factors that affect direct access practice. A 2-phase, mixed-method descriptive study was conducted. In the first phase, focus group interviews with 32 purposively selected physical therapists were completed, which resulted in 8 themes for an electronically distributed questionnaire. In the second phase, survey questionnaires were distributed to physical therapists with an e-mail address on file with the Ohio licensing board. An adjusted return rate of 23% was achieved. Data were analyzed for descriptive statistics. A constant comparative method assessed open-ended questions for common themes and patterns. Thirty-one percent of the respondents reported using direct access in physical therapist practice; however, 80% reported they would practice direct access if provided the opportunity. Physical therapists who practiced direct access were more likely to be in practice 6 years or more and hold advanced degrees beyond the entry level, were American Physical Therapy Association members, and had supportive management and organizational practice policies. The direct access physical therapist practice was generally a locally owned suburban private practice or a school-based clinic that saw approximately 6% to 10% of its patients by direct access. The majority of patients treated were adults with musculoskeletal or neuromuscular impairments. Nonresponse from e-mail may be associated with sample frame bias. Implementation of a direct access physical therapist practice model is evident in Ohio. Factors related to reimbursement and organizational policy appear to impede the process.

  18. Perspectives on three issues facing the transportation manager in the nineties. Research report

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

    Lewis, C.A.; Marzette, D.; McCoy, B.

    1999-03-01

    The nineties have been a period of tremendous change for the transportation industry. The Intermodal Surface Transportation Efficiency Act, Clean Air Act Amendments, Americans with Disabilities Act, and increasing gender and ethnic diversity have caused agencies to reassess their standard operating procedures. Greater knowledge has been sought by senior level transportation officials in an effort to prepare agencies for the changing policy, including, seminars and workshops, revisions to policy manuals, and strengthened procedures regarding how issues will be resolved. This research examines the level and nature of direct impacts on the transportation organization. Major legislative changes and mandates have imposedmore » the need for changes in how transportation systems operate. Transportation professionals continue to be challenged to develop plans and implement services that respond to mandates within the framework of the legislation.« less

  19. Optimal management of a stochastically varying population when policy adjustment is costly.

    PubMed

    Boettiger, Carl; Bode, Michael; Sanchirico, James N; Lariviere, Jacob; Hastings, Alan; Armsworth, Paul R

    2016-04-01

    Ecological systems are dynamic and policies to manage them need to respond to that variation. However, policy adjustments will sometimes be costly, which means that fine-tuning a policy to track variability in the environment very tightly will only sometimes be worthwhile. We use a classic fisheries management problem, how to manage a stochastically varying population using annually varying quotas in order to maximize profit, to examine how costs of policy adjustment change optimal management recommendations. Costs of policy adjustment (changes in fishing quotas through time) could take different forms. For example, these costs may respond to the size of the change being implemented, or there could be a fixed cost any time a quota change is made. We show how different forms of policy costs have contrasting implications for optimal policies. Though it is frequently assumed that costs to adjusting policies will dampen variation in the policy, we show that certain cost structures can actually increase variation through time. We further show that failing to account for adjustment costs has a consistently worse economic impact than would assuming these costs are present when they are not.

  20. Assessing public policies and assets that affect obesity risk while building new public health partnerships, New Hampshire, 2011.

    PubMed

    Anderson, Ludmila; Foster, Scot; Flynn, Regina; Fitterman, Mindy

    2013-08-08

    The New Hampshire Obesity Prevention Program and the 9 New Hampshire regional planning commissions assessed the state's obesity-related policies and assets by using community measures recommended by the Centers for Disease Control and Prevention. A self-administered questionnaire that focused on policies and assets that promote healthful eating, physical activity, and breast-feeding was sent to 234 municipalities; 59% responded (representing 73% of the state's population). Of the municipalities that responded, 52% had sidewalks, 22% had bicycle lanes, none had nutrition standards, and 4% had a policy supporting breastfeeding. Through collaboration, we gathered baseline information that can be used to set priorities and assess progress over time.

  1. 12 CFR 741.12 - Liquidity and contingency funding plans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .../liability policy, a funds management policy, or a business continuity policy. The CFP must address, at a...; (3) Policies to manage a range of stress environments, identification of some possible stress events... the institution to respond to liquidity events; (5) Management processes that include clear...

  2. The effect of changing state health policy on hospital uncompensated care.

    PubMed

    Davidoff, A J; LoSasso, A T; Bazzoli, G J; Zuckerman, S

    2000-01-01

    This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals' uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.

  3. Political ideologies and health-oriented beliefs and behaviors: an empirical examination of strategic issues.

    PubMed

    Murrow, J J; Coulter, R L; Coulter, M K

    2000-01-01

    The area of health care has been called the most important political issue of the 1990s. Attitudes toward health care reform, increasing health costs, and defensive medical practices have been examined in the public press and by academicians. In addition, a substantial amount of research has been directed toward the improvement of individual personal health due to changes in personal health-related habits and behaviors. To date, there are relatively few studies which have attempted to examine the political tendencies of a nationwide sample of respondents as they relate to personal health-related beliefs and behaviors. This article explores the consumer's views on critical questions relating to health orientations and political tendencies. The results indicate a divergence between the political orientations of respondents and their beliefs and behaviors associated with health and wellness. Implications for policy-makers are discussed.

  4. The interplay between gender, race and weight status: self perceptions and social consequences.

    PubMed

    Fletcher, Jason M

    2014-07-01

    This paper uses data from nearly 15,000 young adult respondents to the Add Health survey to examine racial and gender differences in the perceptions and social rewards to weight. The data include information on several typically unmeasured domains: self-perceptions of ideal weight, attractiveness ratings, and measured weight information, along with ties to a series of adult outcomes. Results show important gender and racial differences in ideal weight as well as differences for both self-perceived attractiveness and interviewer rated attractiveness. Findings also suggest the existence of large differences in socio-cultural rewards and sanctions for weight status. Black respondents, particularly women, appear to receive lower "obesity penalties" in both their self-perceived and interviewer accessed attractiveness ratings than other groups. These findings suggest the need to consider new classes of policies directed at shifting relative social benefits and consequences to weight status. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Infection Control Practice in the Operating Room: Staff Adherence to Existing Policies in a Developing Country

    PubMed Central

    Cawich, Shamir O; Tennant, Ingrid A; McGaw, Clarence D; Harding, Hyacinth; Walters, Christine A; Crandon, Ivor W

    2013-01-01

    Context: Infection control interventions are important for containing surgery-related infections. For this reason, the modern operating room (OR) should have well-developed infection control policies. The efficacy of these policies depends on how well the OR staff adhere to them. There is a lack of available data documenting adherence to infection control policies. Objective: To evaluate OR staff adherence to existing infection control policies in Jamaica. Methods: We administered a questionnaire to all OR staff to assess their training, knowledge of local infection control protocols, and practice with regard to 8 randomly selected guidelines. Adherence to each guideline was rated with fixed-choice items on a 4-point Likert scale. The sum of points determined the adherence score. Two respondent groups were defined: adherent (score > 26) and nonadherent (score ≤ 26). We evaluated the relationship between respondent group and age, sex, occupational rank, and time since completion of basic medical training. We used χ2 and Fisher exact tests to assess associations and t tests to compare means between variables of interest. Results: The sample comprised 132 participants (90 physicians and 42 nurses) with a mean age of 36 (standard deviation ± 9.5) years. Overall, 40.1% were adherent to existing protocols. There was no significant association between the distribution of adherence scores and sex (p = 0.319), time since completion of basic training (p = 0.595), occupational rank (p = 0.461), or age (p = 0.949). Overall, 19% felt their knowledge of infection control practices was inadequate. Those with working knowledge of infection control practices attained it mostly through informal communication (80.4%) and self-directed research (62.6%). Conclusion: New approaches to the problem of nonadherence to infection control guidelines are needed in the Caribbean. Several unique cultural, financial, and environmental factors influence adherence in this region, in contrast to conditions in developed countries. PMID:24355900

  6. Vehicle emissions during children's school commuting: impacts of education policy.

    PubMed

    Marshall, Julian D; Wilson, Ryan D; Meyer, Katie L; Rajangam, Santhosh K; McDonald, Noreen C; Wilson, Elizabeth J

    2010-03-01

    We explore how school policies influence the environmental impacts of school commutes. Our research is motivated by increased interest in school choice policies (in part because of the U.S. "No Child Left Behind" Act) and in reducing bus service to address recent budget shortfalls. Our analysis employs two samples of elementary-age children, age 5-12: a travel survey (n = 1246 respondents) and a school enrollment data set (n = 19,655 students). Multinomial logistic regression modeled the determinants of travel mode (automobile, school bus, and walking; n = 803 students meeting selection criteria). Travel distance has the single greatest effect on travel mode, though school choice, trip direction (to- or from-school), and grade play a role. Several policies were investigated quantitatively to predict the impact on school travel, vehicle emissions, and costs. We find that eliminating district-wide school choice (i.e., returning to a system with neighborhood schools only) would have significant impacts on transport modes and emissions, whereas in many cases proposed shifts in school choice and bus-provision policies would have only modest impacts. Policies such as school choice and school siting may conflict with the goal of increasing rates of active (i.e., nonmotorized) school commuting. Policies that curtail bus usage may reduce bus emissions but yield even larger increases in private-vehicle emissions. Our findings underscore the need to critically evaluate transportation-related environmental and health impacts of currently proposed changes in school policy.

  7. Weight Control Belief and Its Impact on the Effectiveness of Tobacco Control Policies on Quit Attempts: Findings from the ITC 4 Country

    PubMed Central

    Shang, Ce; Chaloupka, Frank J.; Fong, Geoffrey T.; Thompson, Mary; Siahpush, Mohammad; Ridgeway, William

    2015-01-01

    Background Weight concerns are widely documented as one of the major barriers for girls and young adult women to quit smoking. Therefore, it is important to investigate whether smokers who have weight concerns respond to tobacco control policies differently than smokers who do not in terms of quit attempts, and how this difference varies by gender and country. Objective This study aims to investigate, by gender and country, whether smokers who believe that smoking helps control weight are less responsive to tobacco control policies with regards to quit attempts than those who do not. Methods We use longitudinal data from the International Tobacco Control Policy (ITC) Evaluation Project in the US, Canada, the UK, and Australia to conduct the analysis. We first constructed a dichotomous indicator for smokers who have the weight control belief and then the disparity in policy responsiveness in terms of quit attempts by directly estimating the interaction terms of policies and the weight control belief indicator using generalized estimating equations. Findings We find that weight control belief significantly attenuates the policy impact of tobacco control measures on quit attempts among US female smokers and among UK smokers. This pattern was not found among smokers in Canada and Australia. Conclusions Although our results vary by gender and country, the findings suggest that weight concerns do alter policy responsiveness in quit attempts in certain populations. Policy makers should take this into account and alleviate weight concerns to enhance the effectiveness of existing tobacco control policies on promoting quitting smoking. PMID:25646173

  8. CMHC practices related to tardive dyskinesia screening and informed consent for neuroleptic drugs.

    PubMed

    Benjamin, S; Munetz, M R

    1994-04-01

    The authors conducted a national survey of community mental health centers to determine their policies and practices about screening patients for tardive dyskinesia and obtaining informed consent for use of neuroleptic drugs. Clinical directors of 235 centers in the United States, selected by geographic region and population, were surveyed through a nine-item questionnaire. Although nearly all the 160 respondents reported that they screened patients for tardive dyskinesia, only about two-fifths had formal screening policies, and about two-fifths had screening programs. The Abnormal Involuntary Movement Scale examination was used by almost two-thirds of respondents who screened patients, and about one-fifth relied on unstructured observation. Slightly more than half of respondents specified a frequency for screening examinations, at a modal interval of six months. Seventy percent used nonpsychiatric clinicians for screening. Almost three-quarters of the respondents had informed consent policies for use of neuroleptics. Urban centers tended to be more aware than rural centers of the American Psychiatric Association's tardive dyskinesia screening guidelines. They also used fewer nonmedical practitioners for screening and were more likely to obtain informed consent for neuroleptics. Despite the existence of APA guidelines and state policies and regulations about tardive dyskinesia screening, a national effort to educate clinicians about prevention of tardive dyskinesia is still needed.

  9. Institutional Admissions Policies in Higher Education: A Widening Participation Perspective

    ERIC Educational Resources Information Center

    Greenbank, Paul

    2006-01-01

    Purpose: This article analyses how higher education institutions (HEIs) have responded to government policy to increase the participation rates of students from lower social classes through their admissions policies. Design/methodology/approach: The article uses documentary evidence and interviews with institutional policy makers to examine HEI…

  10. Health insurance in Ghana: evaluation of policy holders’ perceptions and factors influencing policy renewal in the Volta region

    PubMed Central

    2013-01-01

    Background Health insurance is an important mechanism that succors individuals, states and the nation at large. The purpose of this study was to assess individual’s attitude towards health insurance policy and the factors that influence respondents’ decision to renew their health insurance policy when it expires. Methods This cross sectional study was conducted in the Volta region of Ghana. A total of 300 respondents were randomly sampled and interviewed for the study. Data was collected at the household level and analyzed with STATA software. Descriptive statistics was used to assess the demographic characteristics of the respondents while Logistic regression model was used to assess factors that influence respondents’ decision to take up health insurance policy and renew it. Results The study results indicate that 61.1% of respondents are currently being enrolled in the NHIS, 23.9% had not renewed their insurance after enrollment and 15% had never enrolled. Reasons cited for non-renewal of insurance included poor service quality (58%), lack of money (49%) and taste of other sources of care (23%). The gender, marital status, religion and perception of health status of respondents significantly influenced their decision to enroll and remain in NHIS. Conclusion NHIS has come to stay with clients testifying to its benefits in keeping them strong and healthy. Efforts therefore must be put in by all stakeholders including the community to educate the individuals on the benefits of health insurance to ensure all have optimal access. PMID:23822579

  11. WMD first response: requirements, emerging technologies, and policy implications

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

    Vergino, E S; Hoehn, W E

    2000-06-19

    In the US today, efforts are underway to defend against the possible terrorist use of weapons of mass destruction (WMD) against US cities. These efforts include the development and adaptation of technologies to support prevention and detection, to defend against a possible attack, and, if these fail, to provide both mitigation responses and attribution for a WMD incident. Technologies under development span a range of systems, from early detection and identification of an agent or explosive, to diagnostic and systems analysis tools; and to forensic analysis for law enforcement. Also, many techniques and tools that have been developed for othermore » applications are being examined to determine whether, with some modification, they could be of use by the emergency preparedness, public health, and law enforcement communities. However, anecdotal evidence suggests the existence of a serious disconnect between the technology development communities and these user communities. This disconnect arises because funding for technology development is derived primarily from sources (principally federal agencies) distant from the emergency response communities, which are predominantly state, county, or local entities. Moreover, the first responders with whom we have worked candidly admit that their jurisdictions have been given, or have purchased for them, a variety of technological devices, typically without consulting the emergency responders about their utility. In private discussions, emergency responders derisively refer to these as a closet full of useless toys. Technology developers have many new and relevant technologies currently in the development pipeline, but most have not been adequately vetted against the field needs or validated for field use. The Center for Global Security Research at the Lawrence Livermore National Laboratory and the Sam Nunn School of International Affairs at the Georgia Institute of Technology recently sponsored a two-day workshop to bring together some 50 representatives of the emergency response, technology development, and policy communities. Participating in this workshop were first responders (representing law enforcement, public health, and emergency response personnel from Los Angeles County, Salt Lake City, Atlanta, and London, England), technology developers from US government laboratories and universities, and policymakers from both the executive and legislative branches of the federal government. The workshop had several objectives. First, we wanted the emergency responders to define the utility of various technologies and tools currently available for first response to a WMD event. Second, we expected the workshop to provide input to the technologists directly from the field users, regarding their special requirements for, and constraints on the use of, new emergency response technologies. Third, we planned to expose the first responders to the types of new technologies under development and allow them the opportunity to ask questions and voice their needs. Finally, we planned to provide recommendations to policymakers for new directions for development and investment of technology.« less

  12. Understanding Standards and Assessment Policy in Science Education: Relating and Exploring Variations in Policy Implementation by Districts and Teachers in Wisconsin

    NASA Astrophysics Data System (ADS)

    Anderson, Kevin John Boyett

    Current literature shows that many science teachers view policies of standards-based and test-based accountability as conflicting with research-based instruction in science education. With societal goals of improving scientific literacy and using science to spur economic growth, improving science education policy becomes especially important. To understand perceived influences of science education policy, this study looked at three questions: 1) How do teachers perceive state science standards and assessment and their influence on curriculum and instruction? 2) How do these policy perspectives vary by district and teacher level demographic and contextual differences? 3) How do district leaders' interpretations of and efforts within these policy realms relate to teachers' perceptions of the policies? To answer these questions, this study used a stratified sample of 53 districts across Wisconsin, with 343 middle school science teachers responding to an online survey; science instructional leaders from each district were also interviewed. Survey results were analyzed using multiple regression modeling, with models generally predicting 8-14% of variance in teacher perceptions. Open-ended survey and interview responses were analyzed using a constant comparative approach. Results suggested that many teachers saw state testing as limiting use of hands-on pedagogy, while standards were seen more positively. Teachers generally held similar views of the degree of influence of standards and testing regardless of their experience, background in science, credentials, or grade level taught. District SES, size and past WKCE scores had some limited correlations to teachers' views of policy, but teachers' perceptions of district policies and leadership consistently had the largest correlation to their views. District leadership views of these state policies correlated with teachers' views. Implications and future research directions are provided. Keywords: science education, policy, accountability, standards, assessment, district leadership

  13. The Privatization of Industrial Policy: Public Responses to the Rise of Photonic Technology in the United States.

    NASA Astrophysics Data System (ADS)

    Sternberg, Ernest

    1990-01-01

    Photonics arose in the 1980s as a revolutionary technological development encompassing lasers, fiber optics, sensing devices, imaging systems, and optical applications in computing. It achieved worldwide commercial significance, affecting the productive activities of numerous industries. Despite considerable domestic investment, US industrial performance in the technology deteriorated in comparison to that of other nations, particularly Japan. This study examines the US public policy response to photonics. Photonics exemplifies a technological paradigm with integral properties: it comprises a body of knowledge and skill, systems of technical devices, and sets of technological interrelationships among industrial sectors. This study argues that private firms in themselves respond inefficiently to such technological interdependencies. Firms would operate more efficiently in the presence of industrial policies that recognize the integral properties of technology and plan for massive technological changes in the economy. Amid a widespread rejection of industrial policy as faulty economics, the US response to photonics occurred not through explicit policy but through a privatization of policy making. This privatization relegated technology policy making to private and unaccountable realms. Privatization took three forms. First, through disaggregation, government dispersed assets to interested parties through pork-barrel appropriations, business participation in agency operations, and review committees representing eventual beneficiaries. Second, through collaboration, committees of university faculty and corporate affiliates made technology policy decisions. Third, through sheltering, technological research was conducted under the military establishment. Privatization made for debilitating policy. Operating in the absence of vision, strategy, or plan, it failed to respond to the integral characteristics of photonics understood as a technological paradigm. US industrial retrogression in photonics reflected the domestic policy making inability to respond coherently to technological change.

  14. Assessing Public Policies and Assets That Affect Obesity Risk While Building New Public Health Partnerships, New Hampshire, 2011

    PubMed Central

    Foster, Scot; Flynn, Regina; Fitterman, Mindy

    2013-01-01

    The New Hampshire Obesity Prevention Program and the 9 New Hampshire regional planning commissions assessed the state’s obesity-related policies and assets by using community measures recommended by the Centers for Disease Control and Prevention. A self-administered questionnaire that focused on policies and assets that promote healthful eating, physical activity, and breast-feeding was sent to 234 municipalities; 59% responded (representing 73% of the state’s population). Of the municipalities that responded, 52% had sidewalks, 22% had bicycle lanes, none had nutrition standards, and 4% had a policy supporting breastfeeding. Through collaboration, we gathered baseline information that can be used to set priorities and assess progress over time. PMID:23928459

  15. 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.

  16. Pharmacists' views and reported practices in relation to a new generic drug substitution policy in Lebanon: a mixed methods study.

    PubMed

    El-Jardali, Fadi; Fadlallah, Racha; Morsi, Rami Z; Hemadi, Nour; Al-Gibbawi, Mounir; Haj, Magda; Khalil, Suzan; Saklawi, Youssef; Jamal, Diana; Akl, Elie A

    2017-02-17

    Governments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy. We used a cross-sectional mixed methods approach composed of self-administered questionnaires and semi-structured interviews. The study population consisted of community pharmacists in Lebanon. We randomly approached one pharmacy personnel from each selected community pharmacy. We conducted descriptive analyses to assess responses to questionnaire and regression analyses to understand associations between responses and respondent demographics. We analyzed qualitative data thematically. Out of 204 invited community pharmacies, 153 pharmacies participated (75% response rate). The majority of respondents (64%) were in favor of generic drug substitution; however, less than half (40%) indicated they have substituted brand drugs for generic equivalents. Moreover, 57% indicated that the existing pricing system discourages them from performing generic drug substitution. Most respondents indicated that physicians are overusing the "non-substitutable" option (84%) and that there are technical problems with processing the new prescription form (78%). Less than half (47%) reported that the MOPH is performing regular audits on the forms collected by the pharmacy. While 45% of the respondents indicated that consumers have accepted most of the generic substitutions, 21% perceived the increase in generic drug dispensing to be significant. Findings suggested a potentially significant association between being informed about generic drugs and respondents' support of the policy. Suggested strategies to address implementation challenges included strengthening stewardship function of MOPH, securing full commitment of health care providers, conducting educational and awareness campaigns about generic drugs and generic drug substitution, and aligning incentive systems of the key stakeholders. The majority of community pharmacists were supportive of generic drug substitution in general but not of the current implementation of the policy in Lebanon. Findings revealed implementation challenges at the provider, patient, and system level which are hindering attainment of the policy objectives. The key lessons derived from this study can be used for continuous improvement of the policy and its implementation.

  17. Laboratory Directed Research and Development annual report, fiscal year 1997

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

    NONE

    1998-03-01

    The Department of Energy Order 413.2(a) establishes DOE`s policy and guidelines regarding Laboratory Directed Research and Development (LDRD) at its multiprogram laboratories. As described in 413.2, LDRD is research and development of a creative and innovative nature which is selected by the Laboratory Director or his or her designee, for the purpose of maintaining the scientific and technological vitality of the Laboratory and to respond to scientific and technological opportunities in conformance with the guidelines in this Order. DOE Order 413.2 requires that each laboratory submit an annual report on its LDRD activities to the cognizant Secretarial Officer through themore » appropriate Operations Office Manager. The report provided in this document represents Pacific Northwest National Laboratory`s LDRD report for FY 1997.« less

  18. EPA Policy for the Administration of Environmental Programs on Indian Reservations (1984 Indian Policy)

    EPA Pesticide Factsheets

    1984 policy by William D. Ruckelshaus outlining EPA's dealing with Tribal Governments and in responding to the problems of environmental management on America Indian reservations in order to protect human health and the environment.

  19. Institutional policies of U.S. medical schools regarding tenure, promotion, and benefits for part-time faculty.

    PubMed

    Socolar, R R; Kelman, L S; Lannon, C M; Lohr, J A

    2000-08-01

    To collect data on institutional policies regarding tenure, promotions, and benefits for part-time faculty at U.S. medical schools and determine the extent to which part-time work is a feasible or attractive option for academic physicians. In July 1996, the authors sent a 29-item questionnaire regarding tenure, promotions, and benefit policies for part-time faculty to respondents identified by the deans' offices of medical schools in the United States and Puerto Rico. Responses were analyzed using descriptive statistics and chi-square analyses. Respondents from 104 of 126 medical schools (83%) completed the questionnaire; 58 responded that their schools had written policies about tenure, promotion, or benefits for part-time faculty. Tenure. Of the 95 medical schools with tenure systems, 25 allowed part-time faculty to get tenure and 76 allowed for extending the time to tenure. Allowable reasons to slow the tenure clock included medical leave (65), maternity leave (65), paternity leave (54), other leave of absence (59). Only 23 allowed part-time status as a reason to slow the tenure clock. Policies written by the dean's office and from schools in the midwest or west were more favorable to part-time faculty's being allowed to get tenure. Promotions. The majority of respondents reported that it was possible for part-time faculty to serve as clinical assistant, assistant, associate, and full professors. Benefits. The majority of schools offered retirement benefits and health, dental, disability, and life insurance to part-time faculty, although in many cases part-time faculty had to buy additional coverage to match that of full-time faculty. Most medical schools do not have policies that foster tenure for part-time faculty, although many allow for promotion and offer a variety of benefits to part-time faculty.

  20. The impact of a primetime cancer storyline: from individual knowledge and behavioral intentions to policy-level changes.

    PubMed

    Marcus, Pamela M; Huang, Grace C; Beck, Vicki; Miller, Michael J

    2010-12-01

    We assessed the educational impact of a primetime network TV storyline that addressed cancer patient navigators. An online survey was administered after the episode aired. Exposed respondents saw the episode (n = 336); unexposed respondents did not (n = 211). Exposed respondents were more likely to report they would recommend a patient navigator (61% vs. 48%, p = 0.01). Clips of the episode were shown to raise awareness of patient navigators in a Congressional Committee meeting before the Patient Navigator Act was signed into law (2005). Entertainment education can have a positive impact on cancer knowledge and can contribute to policy-level decisions.

  1. Truth Disclosure Practices of Physicians in Jordan.

    PubMed

    Borgan, Saif M; Amarin, Justin Z; Othman, Areej K; Suradi, Haya H; Qwaider, Yasmeen Z

    2018-03-01

    Disclosure of health information is a sensitive matter, particularly in the context of serious illness. In conservative societies-those which predominate in the developing world-direct truth disclosure undoubtedly presents an ethical conundrum to the modern physician. The aim of this study is to explore the truth disclosure practices of physicians in Jordan, a developing country. In this descriptive, cross-sectional study, 240 physicians were initially selected by stratified random sampling. The sample was drawn from four major hospitals in Amman, Jordan. A closed-ended questionnaire was distributed and completed by self-report. A total of 164 physicians completed the questionnaire. Thirty-seven physicians (23 per cent) usually withheld the diagnosis of "serious illness" from patients, while 127 physicians (77 per cent) usually divulged the information directly. Among the latter, 108 physicians (86 per cent) made exceptions to their disclosure policy. Specialists were more likely to withhold health information (p = 0.04998). Non-disclosure was primarily motivated by request from the patient's family (seventy-one participants, 54 per cent). In twenty cases (15 per cent), non-disclosure was undertaken independently. In conclusion, most respondents opt to disclose the truth; however, the vast majority of these respondents make exceptions. Instances of non-disclosure are primarily motivated by sociocultural constructs.

  2. Doubly illegal: Qualitative accounts of underage alcohol access through theft

    PubMed Central

    Jennings, Vanessa K.; Friese, Bettina; Moore, Roland S.; Grube, Joel W.

    2012-01-01

    This study investigated sources of alcohol for underage drinkers. In-depth, semi-structured interviews were individually conducted with 47 youths, ages 15–18, who reported drinking within the last 12 months, to explore alcohol access. Theft was one method that some youths reported using to obtain alcohol. In addition to 9% of respondents who reported stealing alcohol from commercial outlets themselves, a total of 26% respondents reported occasions when their close friends stole alcohol. Our findings unveiled that teens had a body of knowledge that some drew upon for stealing alcohol. Youths revealed detailed knowledge about store layout, theft protection devices and store policies. In particular, respondents disclosed knowledge about which aisles have blind spots, how to remove security tops on bottles, and no-chase policies. Theft of alcohol from commercial sources may be reduced by examining the weaknesses of existing theft prevention practices, and revising store policies. PMID:22303285

  3. A survey of social media policies in U.S. dental schools.

    PubMed

    Henry, Rachel K; Webb, Chadleo

    2014-06-01

    Since social media sites began to appear in the 1990s, their popularity has increased dramatically, especially among younger individuals. With this widespread use of social media, institutions of higher education are finding the need to implement social media policies. The purpose of this study was to gather information from accredited U.S. dental schools on their social media policies. A survey sent to academic deans asked questions related to social media policies and violations of policies. The survey yielded a 35.9 percent (n=23) response rate. Social media policies at the university level were reported by 47.8 percent (n=11) of respondents, and 34.8 percent (n=8) had social media policies specifically in the dental school. Schools that had an institutional social media policy were more likely to have a social media policy in the dental school (p=0.01), and dental schools were more likely to have a policy if the academic dean had been in the position less than five years (p=0.01). All twenty-three responding dental schools have official social media pages. Dental educators and administrators may want to look for opportunities to raise awareness of social media professionalism in their dental schools.

  4. Responding to "Crisis": Education Policy Research in Europe

    ERIC Educational Resources Information Center

    Alexiadou, Nafsika

    2016-01-01

    This paper discusses the significance of international and transnational developments for education policy research, with a focus on the European Union. The rise of policy projects at the EU level since 2000, has altered the relationships between the state, EU institutions and education policy, in terms of the definition of values, purposes, and…

  5. Support for Climate Change Policy: Social Psychological and Social Structural Influences

    ERIC Educational Resources Information Center

    Dietz, Thomas; Dan, Amy; Shwom, Rachael

    2007-01-01

    We investigated preferences for climate change mitigation policies and factors contributing to higher levels of policy support. The sample was comprised of 316 Michigan and Virginia residents, all of whom completed mail surveys. Of the eight policies proposed to reduce the burning of fossil fuels, respondents overwhelmingly indicated they would…

  6. School Principals Speaking Back to Widening Participation Policies in Higher Education

    ERIC Educational Resources Information Center

    Blackmore, Jill; Hutchison, Kirsten; Keary, Anne

    2017-01-01

    This paper examines school principal responses to the policy discourse of widening participation in higher education. As a critical analysis of how policy is produced, read and responded to by principals [Bacchi, C., 2009. "Analysing policy: what's the problem represented to be?" New York: Pearson], the paper questions the assumptions…

  7. Responding to Policy Challenges with Research Evidence: Introduction to Special Issue

    ERIC Educational Resources Information Center

    Aydarova, Elena; Berliner, David C.

    2018-01-01

    In a policy climate where various actors claim to have solutions for the enduring challenges of teacher education, policy deliberations sideline certain voices and omit important perspectives. This special issue brings together scholars who attend to the voices, perspectives, and issues overlooked by teacher education policy debates dominated by…

  8. U.S. Virtual School Trial Period and Course Completion Policy Study

    ERIC Educational Resources Information Center

    Hawkins, Abigail; Barbour, Michael K.

    2010-01-01

    Variation in policies virtual schools use to calculate course completion and retention rates impacts the comparability of these quality metrics. This study surveyed 159 U.S. virtual schools examining the variability in trial period and course completion policies--two policies that affect course completion rates. Of the 86 respondents, almost 70%…

  9. Information in medical decision making: how consistent is our management?

    PubMed

    Lorence, Daniel P; Spink, Amanda; Jameson, Robert

    2002-01-01

    The use of outcomes data in clinical environments requires a correspondingly greater variety of information used in decision making, the measurement of quality, and clinical performance. As information becomes integral in the decision-making process, trustworthy decision support data are required. Using data from a national census of certified health information managers, variation in automated data quality management practices was examined. Relatively low overall adoption of automated data management exists in health care organizations, with significant geographic and practice setting variation. Nonuniform regional adoption of computerized data management exists, despite national mandates that promote and in some cases require uniform adoption. Overall, a significant number of respondents (42.7%) indicated that they had not adopted policies and procedures to direct the timeliness of data capture, with 57.3% having adopted such practices. The inconsistency of patient data policy suggests that provider organizations do not use uniform information management methods, despite growing federal mandates to do so.

  10. Pulmonary embolism in pediatric patients survey of CT pulmonary angiography practices and policies.

    PubMed

    Lee, Edward Y; Zurakowski, David; Boiselle, Phillip M

    2010-12-01

    To determine the current policies and practices of Society for Pediatric Radiology (SPR) members regarding the evaluation of pediatric patients with suspected pulmonary embolism (PE) with an emphasis on use of computed tomography pulmonary angiography (CTPA). Institutional review board exemption was granted for this study. Surveys were mailed electronically to the 1575 members of the SPR representing 416 institutions. Information gathered included the existence of written policies, the imaging study of choice for suspected PE, routine acquisition of chest radiographs before CTPA, currently used CTPA techniques, modifications of protocols for radiation dose reduction, typical DLP (dose-length-product) for CTPA, and estimated annual frequency of performing CTPA for evaluating PE in children. Survey items pertaining to policies and practices were compared between practice settings and populations using chi-square analysis. One hundred and sixty members representing 118 institutions responded, which resulted in a response rate of 28% (118/416), on an institutional basis. Of these 118 respondents, 104 (88%) perform CTPA in children with clinical suspicion of PE. Of the 104 respondents who perform CTPA, 26 (25%) have a written policy for CTPA, 93 (89%) perform CTPA as the first study choice, and 67 (64%) routinely obtain chest radiographs before CTPA. The most commonly used CTPA techniques in children with clinical suspicion of PE include intravenous contrast amount of 2 mL/kg, mechanical injection of intravenous contrast, and tailored bolus tracking method for CTPA scan initiation by observing the Hounsfield units of contrast in the central pulmonary artery on the monitoring scan. Sixty respondents (58%) modify CTPA imaging protocols for evaluating PE in children in order to decrease radiation dose. The two most common modifications for radiation dose reduction were reduced mAs in 41 (68%) and automatic exposure control in 38 (63%). The majority of respondents (88%) did not know the typical DLP for a 20-kg child during CTPA study performed to evaluate for PE. A significantly greater percentage of radiation dose-reduction techniques are performed within academic institutions compared with private institutions (P = .03). Most survey respondents perform CTPA as the study of choice for evaluating PE in children, but there is considerable variability in their policies and practices. Respondents from academic medical centers are more likely to employ radiation dose-reduction techniques for CTPA than those in private practice settings. Copyright © 2010 AUR. Published by Elsevier Inc. All rights reserved.

  11. What criteria guide national entrepreneurs' policy decisions on user fee removal for maternal health care services? Use of a best-worst scaling choice experiment in West Africa.

    PubMed

    Torbica, Aleksandra; De Allegri, Manuela; Belemsaga, Danielle; Medina-Lara, Antonieta; Ridde, Valery

    2014-10-01

    Several countries in sub-Saharan Africa have implemented policies to remove or reduce user fees. Our aim was to identify criteria guiding such decisions among national policy entrepreneurs, those who link up problem definition, solution development and political processes. We administered a best-worst scaling (BWS) experiment to 89 policy entrepreneurs, asking them to identify the most and the least important criteria on a series of predefined sets. Sets were compiled using a Balance Incomplete Block Design which generated random combinations of all 11 criteria included in the experiment. In turn, those had emerged from a prior set of focus group discussions organized among policy entrepreneurs. Ordered logit models were used to investigate the value of single criteria as well as heterogeneity of preferences. Political commitment was identified as the most important criterion guiding policy decisions on user fee abolition or reduction to the overall sample, but particularly so for more experienced respondents aged over 50 years. International pressure and donor money were identified as least important while equity and institutional capacity were deemed of relatively little importance. Respondents more involved in advising on policy than on formulating policy rated economic issues such as financial sustainability and cost-effectiveness as less important. It is feasible to apply BWS experiments in low-income countries, although whether the technique can be adjusted to elicit preferences among non-literate respondents in these settings is unclear. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. Social Stigma Toward Persons With Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health-Oriented Policies.

    PubMed

    Kennedy-Hendricks, Alene; Barry, Colleen L; Gollust, Sarah E; Ensminger, Margaret E; Chisolm, Margaret S; McGinty, Emma E

    2017-05-01

    Prescription opioid use disorder and overdose have emerged as significant public health challenges in the past 15 years. Little is known about public attitudes toward individuals who have developed a prescription opioid use disorder and whether these attitudes affect support for policy interventions. This study examined social stigma toward individuals with prescription opioid use disorder and tested whether stigma was associated with support for various policy interventions. A nationally representative Web-based survey was conducted from January 31 to February 28, 2014. The 1,071 respondents reported on their beliefs about and attitudes toward persons affected by prescription opioid use disorder and rated their support for various policy interventions. Ordered logistic regression models estimated the association between stigma and public support for punitive and public health-oriented policies. Most respondents viewed this disorder as affecting all groups-racial and ethnic, income, and geographic area of residence groups-fairly equally, despite epidemiological data demonstrating that certain populations have been disproportionately burdened. Respondents expressed high levels of stigma toward individuals with prescription opioid use disorder. Levels of stigma were generally similar among those with and without experience with prescription opioid use disorder, either one's own or that of a relative or close friend. Higher levels of stigma were associated with greater support for punitive policies and lower support for public health-oriented policies. Reframing the issue to emphasize the structural factors contributing to prescription opioid use disorder and the barriers to accessing evidence-based treatment might improve support for policies that benefit affected individuals.

  13. Mass and Elite Views on Nuclear Security: US National Security Surveys 1993-1999

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

    HERRON,KERRY G.; JENKINS-SMITH,HANK C.; HUGHES,SCOTT D.

    This is the fourth report in an ongoing series of studies examining how US perspectives about nuclear security are evolving in the post-Cold War era. In Volume 1 the authors present findings from a nationwide telephone survey of randomly selected members of the US general public conducted from 13 September to 14 October 1999. Results are compared to findings from previous surveys in this series conducted in 1993, 1995, and 1997, and trends are analyzed. Key areas of investigation reported in Volume 1 include evolving perceptions of nuclear weapons risks and benefits, preferences for related policy and spending issues, andmore » views about three emerging issue areas: deterrent utility of precision guided munitions; response options to attacks in which mass casualty weapons are used; and expectations about national missile defenses. In this volume they relate respondent beliefs about nuclear security to perceptions of nuclear risks and benefits and to policy preferences. They develop causal models to partially explain key preferences, and they employ cluster analysis to group respondents into four policy relevant clusters characterized by similar views and preferences about nuclear security within each cluster. Systematic links are found among respondent demographic characteristics, perceptions of nuclear risks and benefits, policy beliefs, and security policy and spending preferences. In Volume 2 they provide analysis of in-depth interviews with fifty members of the US security policy community.« less

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

    PubMed

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

    2017-07-01

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

  15. Attitudes and beliefs of sports medicine providers to sickle cell trait screening of student athletes.

    PubMed

    Acharya, Kruti; Benjamin, Holly J; Clayton, Ellen W; Ross, Lainie F

    2011-11-01

    To describe the attitudes of members of the American Medical Society for Sports Medicine (AMSSM) toward the new National Collegiate Athletic Association (NCAA) policy to require all Division I student athletes be screened for sickle cell trait (SCT), have prior evidence of testing, or sign a waiver. Cross-sectional survey of members of the AMSSM electronic mailing list was conducted. Descriptive, McNemar, and χ2 statistics were performed. Internet survey. Of the 1765 AMSSM e-mail list members, 370 returned partial or completed surveys. Dependent variables included familiarity with the NCAA policy, support of universal or targeted screening programs, preferences regarding screening methodologies, and athletic restrictions or modifications for student athletes identified with SCT. Respondents' gender, race/ethnicity, and involvement as an NCAA team physician were independent variables. Of the respondents, 76% were men, 85% were whites, and 53% served as NCAA Division I team physicians. Ninety percent were aware of the policy. There was greater support for targeted (76%, 267 of 353) compared with universal (39%, 137 of 353; P < 0.01) screening, with targeting based on race/ethnicity and sport. Respondents supported targeted screening of varsity and freshman athletes in all NCAA divisions, but most (88%) also supported waivers. Respondents favored using existing medical records (73%) or Sickledex screening (71%) methodologies despite concerns about inaccuracies (16% for each methodology). Most respondents agreed that there is discrimination in athletic participation and obtaining insurance. There is lack of consensus within the AMSSM regarding the current NCAA SCT screening policy. Implementation must take into consideration potential discrimination.

  16. Visitor restriction policies and practices in children's hospitals in North America: results of an Emerging Infections Network Survey.

    PubMed

    Pong, Alice L; Beekmann, Susan E; Faltamo, Mekleet M; Polgreen, Philip M; Shane, Andi L

    2018-06-21

    To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities. An electronic survey to characterize VRPP in pediatric healthcare facilities. The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed. A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate. Of the 104 respondents (61%) familiar with their VRPP, 92 (88%) had VRPP in all inpatient units. The respondents reported age-based VRPP (74%) symptom-based VRPP (97%), and outbreak-specific VRPP (75%). Symptom-based VRPP were reported to be seasonal by 24% of respondents and to be implemented year-round according to 70% of respondents. According to the respondents, communication of VRPP to families occurred at admission (87%) and through signage in care areas (64%), while communication of VRPP to staff occurred by email (77%), by meetings (55%), and by signage in staff-only areas (49%). Respondents reported that enforcement of VRPP was the responsibility of nursing (80%), registration clerks (58%), unit clerks (53%), the infection prevention team (31%), or clinicians 16 (16%). They also reported that the effectiveness of VRPP was assessed through active surveillance of hospital acquired respiratory infections (62%), through active surveillance of healthcare worker exposures (28%) and through patient/family satisfaction assessments (29%). Visitor restriction policies and practices vary in scope, implementation, enforcement, and physician awareness in pediatric facilities. A prospective multisite evaluation of outcomes would facilitate the adoption of uniform guidance.

  17. [Laws and policies on illicit drugs in Brazil and the perspective of drug users' family members and acquaintances: a study in the City of Ribeirão Preto, São Paulo, Brazil].

    PubMed

    Ventura, Carla Aparecida Arena; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto; Ferreira, Paulo Sérgio

    2009-01-01

    Brazilian drugs legislation has evolved from a prohibitionist system to a less repressive one in terms of drug users. The objective of this study was to identify the perception of relatives and acquaintances of drug users living in Ribeirão Preto, São Paulo, Brazil, about the country's laws and policies on drugs. Data collection was performed using a structured questionnaire. The sample consisted of 100 drug users' relatives or acquaintances, selected at a public health service. Respondents' relationships with the drug user were as follows: 31% friend, 23% sibling, 15% child and 7% spouse. Most users (78%) were men, with an average age of 26 years. Results confirm that national laws and policies have a direct effect on individuals' attitude and behaviors. There is a lack of trust in the police and a general perception that, despite recent chances that favor user rehabilitation, the laws on drugs do not respect users' human rights.

  18. Stakeholders' perspectives on health workforce policy reform.

    PubMed

    Hepburn, Valerie A; Healy, Judith

    2007-08-01

    We administered an electronic survey in October-November 2006 to gauge stakeholder perspectives on Australia's recently adopted health workforce policies. Nearly all of the 41 survey respondents (65% response rate) ranked workforce as very important to overall health policy. Respondents identified decreasing health disparities and rates of disease and mortality as top goals, and identified improved quality and safety and more professionals in rural areas as priority measures for success. Lack of coordination between the governments and insufficient long-range planning were seen as threats to the success of the new workforce initiatives. The survey results suggest the need for clear goals and measurable outcomes. Although they represented different organisations and perspectives, the health workforce policy opinion leaders that participated in this survey reflected remarkable commonality in goals, measures, alternatives, and potential threats.

  19. Public support for bicycling and transport policies in inner Sydney, Australia: a cross-sectional survey.

    PubMed

    Rissel, Chris; Crane, Melanie; Standen, Chris; Wen, Li Ming; Ellison, Richard; Greaves, Stephen

    2018-06-01

    To describe the degree of community support - and factors associated with this support - for a number of potential transport policy options among an inner-city sample of residents in Sydney, Australia. This study analysed data collected from a cross-sectional online survey: Wave 3 of the Sydney Transport and Health Study, conducted in September-October 2015 (n=418). There was a high level of overall support for policies to make public transport cheaper (85%), have more bicycle paths separated from motor vehicles (82%) and have a public bike-share program (72%), with similar levels of support across usual commute mode, age and sex. Despite a natural tendency for respondents to support transport policies that were of most relevance to themselves, it appeared that, in this sample, public support for public transport and bicycling policies remained strong across all respondents. Implications for public health: Policies that support public transport and active travel and achieve positive health outcomes would be well received by inner-Sydney residents. © 2018 The Authors.

  20. Factors Associated With Occupational Sun-Protection Policies in Local Government Organizations in Colorado

    PubMed Central

    Walkosz, Barbara J.; Buller, David B.; Andersen, Peter A.; Wallis, Allan; Buller, Mary Klein; Scott, Michael D.

    2015-01-01

    IMPORTANCE Skin cancer prevention remains a national priority. Reducing chronic UV radiation exposure for outdoor workers through sun-safety practices is an important step to help reduce the incidence of skin cancer. OBJECTIVE To determine the presence of occupational sun-safety policies at local government organizations in a single state. DESIGN, SETTING, AND PARTICIPANTS Of 571 potentially eligible local government organizations of Colorado cities, counties, and special tax districts, we enrolled 98 in a randomized pretest-posttest controlled experiment starting August 15, 2010, that evaluated an intervention to promote the adoption of sun-safety policies. We used a policy-coding protocol to evaluate personal sun-protection practices, environmental and administrative controls, and policy directives for sun safety starting February 10, 2011. We report the baseline assessment of the occupational sun-protection policies of these organizations. MAIN OUTCOMES AND MEASURES The presence of an occupational sun-safety policy. RESULTS Overall, 85 local government organizations (87%) had policies that required personal sun-protection practices, including the use of eyewear, hats, and protective clothing. However, of the 98 responding organizations, only 8 hat policies (8%), 10 eyewear policies (10%), and 7 clothing policies (7%) mentioned sun protection as the intent of the policy. Only cosmopoliteness, operationalized as proximity to an urban area, was associated with the presence of a sun-safety policy (odds ratio, 0.99 [95% CI, 0.98–1.00]; P = .02). CONCLUSIONS AND RELEVANCE Outdoor workers are at increased risk for skin cancer because of long-term exposure to solar UV radiation. Although organizational policies have the potential to increase sun protection in occupational settings, occupational sun-safety policies were uncommon among local governments. Opportunities exist for dermatologists and other physicians to influence occupational sun-safety practices and policies, which are consistent with other safety procedures and could easily be integrated into existing workplace practices. PMID:25993051

  1. Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals.

    PubMed

    Peicius, Eimantas; Blazeviciene, Aurelija; Kaminskas, Raimondas

    2017-06-05

    This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union (EU) where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health professionals' understanding and preferences related to advance directives. In addition, the study sought to explore the views of health care professionals of the application of Advance Directives (AD) in clinical practice in Lithuania. A cross-sectional survey was conducted by interviewing 478 health professionals based at major health care centers in Kaunas district, Lithuania. The design of the study included the use of a questionnaire developed for this study and validated by a pilot study. The collected data were analyzed using standard descriptive statistical methods. The analysis of knowledge about AD revealed some statistically significant differences when comparing the respondents' profession and gender. The analysis also indicated key emerging themes among respondents including tranquility of mind, the longest possible life expectancy and freedom of choice. Further, the study findings revealed that more than half of the study participants preferred to express their will while alive by using advance directives. The study findings revealed a low level of knowledge on advance directives among health professionals. Most health professionals agreed that AD's improved end-of-life decision making while the majority of physicians appreciated AD as the best tool for sharing responsibilities in clinical practice in Lithuania. More physicians than nurses preferred the presence of advance directives to support their decision making in end-of-life situations.

  2. Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

    PubMed

    Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L

    2018-03-06

    In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.

  3. Policy and political advocacy: Comparison study of nursing faculty to determine current practices, perceptions, and barriers to teaching health policy.

    PubMed

    Staebler, Suzanne; Campbell, Jane; Cornelius, Patsy; Fallin-Bennett, Amanda; Fry-Bowers, Eileen; Kung, Ying Mai; LaFevers, David; Miller, Janice

    To better understand policy/advocacy concepts and methodology utilized in all levels of nursing educational programs and develop clarity concerning structure of policy content and integration across all levels of education. Cross-sectional analysis of data obtained from a survey sent to 19,043 nursing faculty in the United States; 598 total responses; 514 complete responses. Quantitative data points were analyzed using SPSS and qualitative data was grouped and analyzed by theme. Barriers and perceptions of student engagement and student learning outcomes along with institutional and faculty development barriers were explored in baccalaureate, masters, and doctoral level nursing programs. Thirty-six percent of respondents reported having experience in development and implementation of policy, ranging from local to international spheres and 21% reported active involvement in current state and federal policy development. Seventy percent of respondents have advocated for the nursing profession through professional organizations while 44% report current activity in legislative advocacy. The value of nursing policy education, advocacy, and analysis must be valued in higher education. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Food as a reward in the classroom: school district policies are associated with practices in US public elementary schools.

    PubMed

    Turner, Lindsey; Chriqui, Jamie F; Chaloupka, Frank J

    2012-09-01

    The use of food as a reward for good student behavior or academic performance is discouraged by many national organizations, yet this practice continues to occur in schools. Our multiyear cross-sectional study examined the use of food as a reward in elementary schools and evaluated the association between district policies and school practices. School data were gathered during the 2007-2008, 2008-2009, and 2009-2010 school years via mail-back surveys (N=2,069) from respondents at nationally representative samples of US public elementary schools (1,525 unique schools, 544 of which also participated for a second year). During every year, the corresponding district policy for each school was gathered and coded for provisions pertaining to the use of food as a reward. School practices did not change over time and as of the 2009-2010 school year, respondents in 42.1% and 40.7% of schools, respectively, indicated that food was not used as a reward for academic performance or for good student behavior. In multivariate logistic regression analyses controlling for school characteristics and year, having a district policy that prohibited the use of food as a reward was significantly associated with school respondents reporting that food was not used as a reward for academic performance (P<0.05) or for good student behavior (P<0.05). School-level respondents in the West and the Midwest were less likely to report that food was not used as a reward than were respondents in the South and Northeast. As of 2009-2010, only 11.9% of the districts in our study prohibited the use of food as a reward. Strengthening district policies may reduce the use of food rewards in elementary schools. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  5. 22 CFR 1423.11 - Settlement or adjustment of issues.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... respondent, and the Regional Director concludes that the offered settlement will effectuate the policies of... effectuate the policies of the Foreign Service Labor-Management Relations Statute, the Regional Director may... Regional Director concludes that the offered settlement will effectuate the policies of the Foreign Service...

  6. 22 CFR 1423.11 - Settlement or adjustment of issues.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... respondent, and the Regional Director concludes that the offered settlement will effectuate the policies of... effectuate the policies of the Foreign Service Labor-Management Relations Statute, the Regional Director may... Regional Director concludes that the offered settlement will effectuate the policies of the Foreign Service...

  7. Policies and protocols for preventing transmission of HIV infection in oral health care in South Africa.

    PubMed

    Ogunbodede, E O; Rudolph, M J

    2002-12-01

    Human immunodeficiency virus (HIV) infection constitutes an unparalleled public health challenge. The unique nature of most oral health procedures, instrumentation and patient-care settings requires specific strategies and protocols aimed at preventing the transmission of HIV/AIDS between oral health care providers and patients, as well as between patients themselves. The present study investigated the level of information and training about protocols and policies for preventing the transmission of HIV/AIDS in oral health care settings in South Africa. The data collection techniques utilised available information, in-depth interviews and an open-ended questionnaire. The respondents were 20 purposively selected key informants who were senior officers for HIV/AIDS programmes and/or oral health organisations. Sixteen (80%) of the respondents reported that there were no existing oral health policies on HIV/AIDS in their health care institutions or organisations. None of the interviewees knew of any specific protocols on HIV/AIDS in the oral health care setting that emanated from South Africa. In addition, none of the dental professional associations had established an infection control committee or a support system for members who might become infected with HIV and develop AIDS. Territorial boundaries existed between sectors within the medical disciplines, as well as between the medical and oral health disciplines. Numerous general impediments were identified, such as prejudice, denial and fear, inadequate training and/or information about the infection, lack of representation and resources for policy planning, a lack of interest from the business sector, and approaching HIV/AIDS in the workplace as a 'one-time issue' Other obstacles identified included unemployment, poverty, illiteracy, disempowerment of women and inadequate communication of policies to service providers. Additional issues raised included the migrant labour systeM, complexities of language and culture, the large unstructured sex industry, high prevalence of sexually transmitted infections and lack of funding. All of these have an impact on oral health. Future policy directions identified included 'increasing access to HIV information and postexposure prophylaxis' 'shift towards care and support for those living with HIV/AIDS with emphasis on community and home-based care' and 'improving intersectoral co-ordination and collaboration'. The study demonstrated gaps in availability and access to policies and protocols on HIV/AIDS by managers and health workers. Specific strategic recommendations are made for oral health.

  8. Perceived impact and feasibility of strategies to improve access to healthy foods in Washington State, USA.

    PubMed

    Johnson, Donna B; Quinn, Emilee L; Podrabsky, Mary; Beckwith-Stanley, Nadia; Chan, Nadine; Ellings, Amy; Kovacs, Tricia; Lane, Claire

    2013-12-01

    The present study measured the perceived impact and political and implementation feasibility of state-level policy strategies related to increasing access to healthy foods and limiting unhealthy foods. Potential state-level policy strategies to improve access to healthy foods were identified through a review of evidence-based literature and policy recommendations. Respondents rated the perceived impact and political and implementation feasibility of each policy on a five-point scale using online surveys. Washington State policy process. Forty-nine content experts (national researchers and subject experts), forty policy experts (state elected officials or their staff, gubernatorial or legislative policy analysts) and forty-five other stakeholders (state-level advocates, programme administrators, food producers). In aggregate, respondents rated policy impact and implementation feasibility higher than political feasibility. Policy experts rated policy strategies as less politically feasible compared with content experts (P < 0·02) or other stakeholders (P < 0·001). Eight policy strategies were rated above the median for impact and political and implementation feasibility. These included policies related to nutrition standards in schools and child-care facilities, food distribution systems, urban planning projects, water availability, joint use agreements and breast-feeding supports. Although they may be perceived as potentially impactful, some policies will be more difficult to enact than others. Information about the potential feasibility of policies to improve access to healthy foods can be used to focus limited policy process resources on strategies with the highest potential for enactment, implementation and impact.

  9. 7 CFR 1.2 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 1 2013-01-01 2013-01-01 false Policy. 1.2 Section 1.2 Agriculture Office of the Secretary of Agriculture ADMINISTRATIVE REGULATIONS Official Records § 1.2 Policy. (a) Agencies of USDA shall comply with the time limits set forth in the FOIA and in this subpart for responding to and...

  10. From "Ritual" to "Mindfulness": Policy and Pedagogic Positioning

    ERIC Educational Resources Information Center

    Adams, Paul

    2011-01-01

    Schools and professionals respond to statute in different ways. However, professional activity is more than mediated response to policy. Versions of pedagogy are not simply envisaged on high and enacted in the workplace. This paper examines how professional views formulate policy imperatives. It proposes that to understand pedagogy requires an…

  11. Stories of Compliance and Subversion in a Prescriptive Policy Environment

    ERIC Educational Resources Information Center

    MacBeath, John

    2008-01-01

    In their commitment to raising standards successive Conservative and Labour governments have moved progressively to tighter prescription of school policy and more far reaching proscription of practices deemed unacceptable. This article examines how 12 headteachers construct the policy environment and how they respond to it in the schools they…

  12. Behavior intentions of the public after bans on smoking in restaurants and bars.

    PubMed Central

    Biener, L; Siegel, M

    1997-01-01

    OBJECTIVES: This study assessed the potential effect of smoke-free policies on bar and restaurant patronage. METHODS: Random-digit dialing techniques were used in surveying a representative sample of Massachusetts adults (n = 2356) by telephone. RESULTS: Approximately 61% of the respondents predicted no change in their use of restaurants in response to smoke-free policies, 30% predicted increased use, and 8% predicted decreased use. In turn, 69% of the respondents predicted no change in their patronage of bars, while 20% predicted increased use and 11% predicted decreased use. CONCLUSIONS: These results suggest that smoke-free policies are likely to increase overall patronage of bars and restaurants. PMID:9431301

  13. The history and future of nursing labor research in a cost-control environment.

    PubMed

    Brewer, C S

    1998-04-01

    For the first time in nursing's history, the downsizing of hospitals, the increased use of managed care, reduced use of registered nurses and other factors may result in significant unemployment in nursing, with resulting downward adjustments in the wage. Understanding the labor supply response of nurses to changes in the wage is critical to predicting accurately how nurses will respond to changes in the market demand as it influences wages, and determining rational policy responses to the labor market. In this article, three generations of nursing labor research are summarized and critiqued. Methodological issues are discussed and specific directions for future studies are suggested.

  14. Analysis of Student Satisfaction in The Process of Teaching and Learning Using Importance Performance Analysis

    NASA Astrophysics Data System (ADS)

    Sembiring, P.; Sembiring, S.; Tarigan, G.; Sembiring, OD

    2017-12-01

    This study aims to determine the level of student satisfaction in the learning process at the University of Sumatra Utara, Indonesia. The sample size of the study consisted 1204 students. Students’ response measured through questionnaires an adapted on a 5-point likert scale and interviews directly to the respondent. SERVQUAL method used to measure the quality of service with five dimensions of service characteristics, namely, physical evidence, reliability, responsiveness, assurance and concern. The result of Importance Performance Analysis reveals that six services attributes must be corrected by policy maker of University Sumatera Utara. The quality of service is still considered low by students.

  15. A complex systems approach to constructing better models for managing financial markets and the economy

    NASA Astrophysics Data System (ADS)

    Farmer, J. Doyne; Gallegati, M.; Hommes, C.; Kirman, A.; Ormerod, P.; Cincotti, S.; Sanchez, A.; Helbing, D.

    2012-11-01

    We outline a vision for an ambitious program to understand the economy and financial markets as a complex evolving system of coupled networks of interacting agents. This is a completely different vision from that currently used in most economic models. This view implies new challenges and opportunities for policy and managing economic crises. The dynamics of such models inherently involve sudden and sometimes dramatic changes of state. Further, the tools and approaches we use emphasize the analysis of crises rather than of calm periods. In this they respond directly to the calls of Governors Bernanke and Trichet for new approaches to macroeconomic modelling.

  16. Veterinary public health activities at FAO: echinococcosis/hydatid disease.

    PubMed

    Eddi, C; de Balogh, K; Lubroth, J; Amanfu, W; Speedy, A; Battaglia, D

    2004-12-01

    Cystic hydatidosis is a zoonotic disease that remain as a significant cause of human morbidity and mortality in many parts of the world. The disease has veterinary public health implications. FAO is involved with some activities in the control of echinococcosis/hydatid disease: within the Animal Production and Health Division the Veterinary Public Health (VHP) Programme is constituted by members of the different Services (Animal Health, Animal Production, and Livestock Policy) within the Division. FAO regular programme has also established a global network of professionals directly involved in VPH. Furthermore FAO's Technical Cooperation Projects (TCP) is a tool to assist member countries in responding to urgent and unforeseen demands.

  17. Policy Dispute and Paradigm Evaluation: A Response to Rowland.

    ERIC Educational Resources Information Center

    Lichtman, Allan J.; Rohrer, Daniel M.

    1982-01-01

    Responds to Rowland's article, (CS 705 841). Contends that policy systems analysis emerges as the only acceptable paradigm for competitive debate and that it satisfies the criteria for paradigm evaluation. (PD)

  18. Physician and stakeholder perceptions of conflict of interest policies in oncology.

    PubMed

    Lockhart, A Craig; Brose, Marcia S; Kim, Edward S; Johnson, David H; Peppercorn, Jeffrey M; Michels, Dina L; Storm, Courtney D; Schuchter, Lynn M; Rathmell, W Kimryn

    2013-05-01

    The landscape of managing potential conflicts of interest (COIs) has evolved substantially across many disciplines in recent years, but rarely are the issues more intertwined with financial and ethical implications than in the health care setting. Cancer care is a highly technologic arena, with numerous physician-industry interactions. The American Society of Clinical Oncology (ASCO) recognizes the role of a professional organization to facilitate management of these interactions and the need for periodic review of its COI policy (Policy). To gauge the sentiments of ASCO members and nonphysician stakeholders, two surveys were performed. The first asked ASCO members to estimate opinions of the Policy as it relates to presentation of industry-sponsored research. Respondents were classified as consumers or producers of research material based on demographic responses. A similar survey solicited opinions of nonphysician stakeholders, including patients with cancer, survivors, family members, and advocates. The ASCO survey was responded to by 1,967 members (1% of those solicited); 80% were producers, and 20% were consumers. Most respondents (93% of producers; 66% of consumers) reported familiarity with the Policy. Only a small proportion regularly evaluated COIs for presented research. Members favored increased transparency about relationships over restrictions on presentations of research. Stakeholders (n = 264) indicated that disclosure was "very important" to "extremely important" and preferred written disclosure (77%) over other methods. COI policies are an important and relevant topic among physicians and patient advocates. Methods to simplify the disclosure process, improve transparency, and facilitate responsiveness are critical for COI management.

  19. Preferred conservation policies of shark researchers.

    PubMed

    Shiffman, David S; Hammerschlag, Neil

    2016-08-01

    There is increasing concern about the conservation status of sharks. However, the presence of numerous different (and potentially mutually exclusive) policies complicates management implementation and public understanding of the process. We distributed an online survey to members of the largest professional shark and ray research societies to assess member knowledge of and attitudes toward different conservation policies. Questions covered society member opinions on conservation and management policies, personal histories of involvement in advocacy and management, and perceptions of the approach of conservation nongovernmental organizations (NGOs) to shark conservation. One hundred and two surveys were completed (overall response rate 21%). Respondents considered themselves knowledgeable about and actively involved in conservation and management policy; a majority believed scientists have a responsibility to advocate for conservation (75%), and majorities have sent formal public comments to policymakers (54%) and included policy suggestions in their papers (53%). They believe sustainable shark fisheries are possible, are currently happening today (in a few places), and should be the goal instead of banning fisheries. Respondents were generally less supportive of newer limit-based (i.e., policies that ban exploitation entirely without a species-specific focus) conservation policy tools, such as shark sanctuaries and bans on the sale of shark fins, than of target-based fisheries management tools (i.e., policies that allow for sustainable harvest of species whose populations can withstand it), such as fishing quotas. Respondents were generally supportive of environmental NGO efforts to conserve sharks but raised concerns about some NGOs that they perceived as using incorrect information and focusing on the wrong problems. Our results show there is an ongoing debate in shark conservation and management circles relative to environmental policy on target-based natural resources management tools versus limit-based conservation tools. They also suggest that closer communication between the scientific and environmental NGO communities may be needed to recognize and reconcile differing values and objectives between these groups. © 2016 Society for Conservation Biology.

  20. Framing the Consequences of Childhood Obesity to Increase Public Support for Obesity Prevention Policy

    PubMed Central

    Niederdeppe, Jeff; Barry, Colleen L.

    2013-01-01

    Objectives. We examined the effects of messages describing consequences of childhood obesity on public attitudes about obesity prevention policy. Methods. We collected data from 2 nationally representative Internet-based surveys. First, respondents (n = 444) evaluated the strength of 11 messages about obesity’s consequences as reasons for government action. Second, we randomly assigned respondents (n = 2494) to a control group or to treatment groups shown messages about obesity consequences. We compared groups’ attitudes toward obesity prevention, stratified by political ideology. Results. Respondents perceived a message about the health consequences of childhood obesity as the strongest rationale for government action; messages about military readiness, bullying, and health care costs were rated particularly strong by conservatives, moderates, and liberals, respectively. A message identifying the consequences of obesity on military readiness increased conservatives’ perceptions of seriousness, endorsement of responsibility beyond the individual, and policy support, compared with a control condition. Conclusions. The public considers several consequences of childhood obesity as strong justification for obesity prevention policy. Activating new or unexpected values in framing a health message could raise the health issue’s salience for particular subgroups of the public. PMID:24028237

  1. Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study.

    PubMed

    Rose, Shyanika W; Emery, Sherry L; Ennett, Susan; McNaughton Reyes, Heath Luz; Scott, John C; Ribisl, Kurt M

    2015-10-01

    We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act. We surveyed a US nationally representative sample of 17, 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors' access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%). Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment.

  2. Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study

    PubMed Central

    Emery, Sherry L.; Ennett, Susan; McNaughton Reyes, Heath Luz; Scott, John C.; Ribisl, Kurt M.

    2015-01-01

    Objectives. We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act. Methods. We surveyed a US nationally representative sample of 17 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers. Results. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors’ access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%). Conclusions. Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment. PMID:26270303

  3. The road maintenance funding models in Indonesia use earmarked tax

    NASA Astrophysics Data System (ADS)

    Gultom, Tiopan Henry M.; Tamin, Ofyar Z.; Sjafruddin, Ade; Pradono

    2017-11-01

    One of the solutions to get a sustainable road maintenance fund is to separate road sector revenue from other accounts, afterward, form a specific account for road maintenance. In 2001, Antameng and the Ministry of Public Works proposed a road fund model in Indonesia. Sources of the road funds proposal was a tariff formed on the nominal total tax. The policy of road funds was proposed to finance the road network maintenance of districts and provincials. This research aims to create a policy model of road maintenance funds in Indonesia using an earmarked tax mechanism. The research method is qualitative research, with data collection techniques are triangulation. Interview methods conducted were semi-structured. Strength, Weakness, Opportunities, and Threat from every part of the models were showen on the survey format. Respondents were representative of executives who involved directly against the financing of road maintenance. Validation model conducted by a discussion panel, it was called the Focus Group Discussion (FGD). The FGD involved all selected respondents. Road maintenance financing model that most appropriately applied in Indonesia was a model of revenue source use an earmarked PBBKB, PKB and PPnBM. Revenue collection mechanism was added tariff of registered vehicle tax (PKB), Vehicle Fuel Tax (PBBKB) and the luxury vehicle sales tax (PPnBM). The funds are managed at the provincial level by a public service agency.

  4. Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam.

    PubMed

    Witter, Sophie; Thi Thu Ha, Bui; Shengalia, Bakhuti; Vujicic, Marko

    2011-08-17

    Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motivate doctors in particular to work in remote areas. The objective of this study was to understand the dynamics of the health labour market in Vietnam, and what might encourage doctors to accept posts and remain in-post in rural areas. This study forms part of a labour market survey which was conducted in Vietnam in November 2009 to February 2010. The study had three stages. This article describes the findings of the first stage - the qualitative research and literature review, which fed into the design of a structured survey (second stage) and contingent valuation (third stage). For the qualitative research, three tools were used - key informant interviews at national and provincial level (6 respondents); in-depth interviews of doctors at district and commune levels (11 respondents); and focus group discussions with medical students (15 participants). The study reports on the perception of the problem by national level stakeholders; the motivation for joining the profession by doctors; their views on the different factors affecting their willingness to work in rural areas (including different income streams, working conditions, workload, equipment, support and supervision, relationships with colleagues, career development, training, and living conditions). It presents findings on their overall satisfaction, their ranking of different attributes, and willingness to accept different kinds of work. Finally, it discusses recent and possible policy interventions to address the distribution problem. Four typical 'directions of travel' are identified for Vietnamese doctors - from lower to higher levels of the system, from rural to urban areas, from preventive to curative health and from public to private practice. Substantial differences in income from formal and informal sources all reinforce these preferences. While non-financial attributes are also important for Vietnamese doctors, the scale of the difference of opportunities presents a considerable policy challenge. Significant salary increases for doctors in hard-to-staff areas are likely to have some impact. However, addressing the differentials is likely to require broader market reforms and regulatory measures.

  5. Street-level workers' inadequate knowledge and application of exemption policies in Burkina Faso jeopardize the achievement of universal health coverage: evidence from a cross-sectional survey.

    PubMed

    Ridde, Valéry; Leppert, Gerald; Hien, Hervé; Robyn, Paul Jacob; De Allegri, Manuela

    2018-01-08

    Street-level workers play a key role in public health policies in Africa, as they are often the ones to ensure their implementation. In Burkina Faso, the State formulated two different user-fee exemption policies for indigents, one for deliveries (2007), and one for primary healthcare (2009). The objective of this study was to measure and understand the determinants of street-level workers' knowledge and application of these exemption measures. We used cross-sectional data collected between October 2013 and March 2014. The survey targeted 1521 health workers distributed in 498 first-line centres, 18 district hospitals, 5 regional hospitals, and 11 private or other facilities across 24 districts. We used four different random effects models to identify factors associated with knowledge and application of each of the above-mentioned exemption policies. Only 9.2% of workers surveyed knew of the directive exempting the worst-off, and only 5% implemented it. Knowledge and application of the delivery exemption were higher, with 27% of all health workers being aware of the delivery exemption directive and 24.2% applying it. Mobile health workers were found to be consistently more likely to apply both exemptions. Health workers who were facility heads were significantly more likely to know about the indigent exemption for primary health care and to apply it. Health workers in districts with higher proportions of very poor people were significantly more likely to know about and apply the delivery exemption. Nearly 60% of respondents indicated either 5% or 10% as the percentage of people they would deem adequate to target for exemption. This quantitative study confirmed earlier qualitative results on the importance of training and informing health workers and monitoring the measures targeting equity, to ensure compliance with government directives. The local context (e.g., hierarchy, health system, interventions) and the ideas that street-level workers have about the policy instruments can influence their effective implementation. Methods for remunerating health workers and health centres also need to be adapted to ensure equity measures are applied to achieve universal healthcare.

  6. Policy-Relevant Behaviors Predict Heavier Drinking in Both On and Off Premises and Mediate the Relationship Between Heavier Alcohol Consumption and Age, Gender, and Socioeconomic Status-Analysis from the International Alcohol Control Study.

    PubMed

    Casswell, Sally; Huckle, Taisia; Wall, Martin; Parker, Karl

    2016-02-01

    Our goal was to investigate the role of behaviors amenable to policy change in mediating the relationship between alcohol consumption in off and on premises, age, and 2 measures of socioeconomic status (education and income). A cross-sectional general population survey was analyzed by using Bayesian path analysis to understand direct and mediating pathways. A total of 1,900 drinkers (past 6 months), aged 18 to 65 years, living in households with landline phones participated in the study. Measures were as follows: typical quantities of alcohol consumed per occasion, frequency of drinking, both off and on premise; gender, age groups; and years of education, personal income, prices paid, time of purchase, and liking for alcohol advertisements. Later times of purchase predicted larger quantities consumed (on and off premise) and more frequent drinking (on premise only). Younger people and males purchased later, and this mediated their heavier consumption. Lower prices paid predicted larger quantities consumed (on premise) and higher frequency of drinking (off premise). Younger and male respondents paid lower prices, and this mediated larger quantities consumed on premise and more frequent drinking off premise. Less well educated paid lower prices, and this mediated drinking more frequently off premise among this group. Liking for alcohol ads predicted drinking larger quantities and higher frequency both off and on premise. Younger and male respondents reported greater liking for ads, and this mediated their consumption of larger quantities and more frequent drinking both on and off premise. Those with higher income drank larger amounts on premise and more frequently on and off, but there were no mediating effects from the policy-relevant variables. Heavier drinking patterns by young people and those less well educated could be ameliorated by attention to alcohol policy. Copyright © 2016 by the Research Society on Alcoholism.

  7. Policies and Procedures That Facilitate Implementation of Evidence-Based Clinical Guidelines in U.S. Dental Schools.

    PubMed

    Polk, Deborah E; Nolan, Beth A D; Shah, Nilesh H; Weyant, Robert J

    2016-01-01

    The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed.

  8. The Unintended Consequences of an Algebra-for-All Policy on High-Skill Students: Effects on Instructional Organization and Students' Academic Outcomes

    ERIC Educational Resources Information Center

    Nomi, Takako

    2012-01-01

    In 1997, Chicago implemented a policy that required algebra for all ninth-grade students, eliminating all remedial coursework. This policy increased opportunities to take algebra for low-skill students who had previously enrolled in remedial math. However, little is known about how schools respond to the policy in terms of organizing math…

  9. Change management in an environment of ongoing primary health care system reform: A case study of Australian primary health care services.

    PubMed

    Javanparast, Sara; Maddern, Janny; Baum, Fran; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Sanders, David

    2018-01-01

    Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers. As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services. Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services. Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Tablets: A Survey of Circulation Policies at Academic Libraries

    ERIC Educational Resources Information Center

    Derr, Janice; Tolppanen, Bradley P.

    2015-01-01

    This article presents the results of a Web-based survey regarding the circulation of tablets in academic libraries. The survey, which was completed by 61 respondents, identifies the most common circulation policies and procedures used. These results will help other academic institutions develop their own policy or update existing ones. Areas of…

  11. National Testing: Gains or Strains? School Leaders' Responses to Policy Demands

    ERIC Educational Resources Information Center

    Gunnulfsen, Ann Elisabeth; Møller, Jorunn

    2017-01-01

    Studies have shown that principals are essential in successfully implementing large-scale policy reforms in schools. However, the issue of how school leaders interpret and transform reforms is understudied. This article explores how twelve Norwegian school leaders respond to external demands in a new policy context emphasizing national test…

  12. Constructing Teacher Agency in Response to the Constraints of Education Policy: Adoption and Adaptation

    ERIC Educational Resources Information Center

    Robinson, Sarah

    2012-01-01

    Drawing on agency literature, this paper demonstrates how teachers' professional agency emerged when seemingly conflicting strategies were imposed on them in policy reform. Policy discourse is often linked to performance and accountability measures, which teachers respond to in a number of ways. Some education researchers identify tensions caused…

  13. 25 CFR 161.701 - What is BIA's trespass policy?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is BIA's trespass policy? 161.701 Section 161.701... GRAZING PERMITS Trespass § 161.701 What is BIA's trespass policy? BIA will: (a) Investigate accidental, willful, and/or incidental trespass on Navajo Partitioned Lands; (b) Respond to alleged trespass in a...

  14. 25 CFR 161.701 - What is BIA's trespass policy?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What is BIA's trespass policy? 161.701 Section 161.701... GRAZING PERMITS Trespass § 161.701 What is BIA's trespass policy? BIA will: (a) Investigate accidental, willful, and/or incidental trespass on Navajo Partitioned Lands; (b) Respond to alleged trespass in a...

  15. 25 CFR 166.801 - What is the BIA's trespass policy?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What is the BIA's trespass policy? 166.801 Section 166... Trespass § 166.801 What is the BIA's trespass policy? We will: (a) Investigate accidental, willful, and/or incidental trespass on Indian agricultural land; (b) Respond to alleged trespass in a prompt, efficient...

  16. 25 CFR 166.801 - What is the BIA's trespass policy?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What is the BIA's trespass policy? 166.801 Section 166... Trespass § 166.801 What is the BIA's trespass policy? We will: (a) Investigate accidental, willful, and/or incidental trespass on Indian agricultural land; (b) Respond to alleged trespass in a prompt, efficient...

  17. 25 CFR 166.801 - What is the BIA's trespass policy?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is the BIA's trespass policy? 166.801 Section 166... Trespass § 166.801 What is the BIA's trespass policy? We will: (a) Investigate accidental, willful, and/or incidental trespass on Indian agricultural land; (b) Respond to alleged trespass in a prompt, efficient...

  18. 25 CFR 166.801 - What is the BIA's trespass policy?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What is the BIA's trespass policy? 166.801 Section 166... Trespass § 166.801 What is the BIA's trespass policy? We will: (a) Investigate accidental, willful, and/or incidental trespass on Indian agricultural land; (b) Respond to alleged trespass in a prompt, efficient...

  19. 25 CFR 161.701 - What is BIA's trespass policy?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What is BIA's trespass policy? 161.701 Section 161.701... GRAZING PERMITS Trespass § 161.701 What is BIA's trespass policy? BIA will: (a) Investigate accidental, willful, and/or incidental trespass on Navajo Partitioned Lands; (b) Respond to alleged trespass in a...

  20. 25 CFR 161.701 - What is BIA's trespass policy?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What is BIA's trespass policy? 161.701 Section 161.701... GRAZING PERMITS Trespass § 161.701 What is BIA's trespass policy? BIA will: (a) Investigate accidental, willful, and/or incidental trespass on Navajo Partitioned Lands; (b) Respond to alleged trespass in a...

  1. 25 CFR 161.701 - What is BIA's trespass policy?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What is BIA's trespass policy? 161.701 Section 161.701... GRAZING PERMITS Trespass § 161.701 What is BIA's trespass policy? BIA will: (a) Investigate accidental, willful, and/or incidental trespass on Navajo Partitioned Lands; (b) Respond to alleged trespass in a...

  2. Developing a Policy to Address Nonsuicidal Self-Injury in Schools

    ERIC Educational Resources Information Center

    Berger, Emily; Hasking, Penelope; Reupert, Andrea

    2015-01-01

    Background: Nonsuicidal self-injury (NSSI) is an increasing and serious concern in schools. The purpose of this study was to determine the suitability of a new policy for responding to NSSI in schools. Methods: Teachers and other school staff, including year level coordinators, psychologists, and counselors, N?=?48, reviewed a policy for…

  3. Assessment of Selected Energy Efficiency Policies

    EIA Publications

    2005-01-01

    This report responds to a request from Senator Byron L. Dorgan, asking the Energy Information Administration (EIA) to undertake a quantitative analysis of a variety of energy efficiency policies using assumptions provided by the Alliance to Save Energy (ASE).

  4. Learn About Science Policy at the 2013 AGU Fall Meeting

    NASA Astrophysics Data System (ADS)

    Gilley, Meg

    2013-11-01

    The 2013 AGU Fall Meeting offers many opportunities to explore current science policy issues. Sequestration and the recent government shutdown showed us the connection between science and policy and the impact that policy can have on researchers' work. This year's Fall Meeting Public Affairs events will give members the tools to communicate with Congress, respond to legal pressure about their science, and work with policy makers in Washington, D. C., as an AGU Congressional Science Fellow.

  5. Research ethics policies and practices in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey.

    PubMed

    Zielinski, Chris; Kebede, Derege; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

    2014-05-01

    To describe the state of research ethics policies and practices in health research institutions in sub-Saharan African countries. A structured questionnaire was used to solicit information on research ethics from health research institutions. Forty-two sub-Saharan African countries. Key informants from the health research institutions. Existence of institutional ethics review policies and mechanisms. About half (51%) of respondent institutions reported having policies on research ethics and 58% had written policies requiring that researchers obtain informed consent of research participants. About one-third of respondent institutions (34%) had established ethics review committees, 42% required that studies went through ethics review committees and 46% had linkages with national or regional ethics organisations. Regarding operating procedures for ethics review committees, 53% had adopted standard operating procedures. Less than one-quarter of respondent institutions reported having policies in place to monitor ongoing research. Of the institutions that monitored ongoing research, 34% did an annual ethical review and 74% required a periodic written report. Only 36% provided any type of ethics training for staff, including those conducting health research and those who were not members of the ethics review committee. There are substantial gaps in the capacity of health research institutions in the WHO African Region to undertake ethical review of studies before, during and after studies conducted. There is a need to strengthen such capacity in order to ensure the wellbeing of individuals enrolled in studies and that of communities that host these studies. © The Royal Society of Medicine.

  6. Physician and Stakeholder Perceptions of Conflict of Interest Policies in Oncology

    PubMed Central

    Lockhart, A. Craig; Brose, Marcia S.; Kim, Edward S.; Johnson, David H.; Peppercorn, Jeffrey M.; Michels, Dina L.; Storm, Courtney D.; Schuchter, Lynn M.; Rathmell, W. Kimryn

    2013-01-01

    Purpose The landscape of managing potential conflicts of interest (COIs) has evolved substantially across many disciplines in recent years, but rarely are the issues more intertwined with financial and ethical implications than in the health care setting. Cancer care is a highly technologic arena, with numerous physician-industry interactions. The American Society of Clinical Oncology (ASCO) recognizes the role of a professional organization to facilitate management of these interactions and the need for periodic review of its COI policy (Policy). Methods To gauge the sentiments of ASCO members and nonphysician stakeholders, two surveys were performed. The first asked ASCO members to estimate opinions of the Policy as it relates to presentation of industry-sponsored research. Respondents were classified as consumers or producers of research material based on demographic responses. A similar survey solicited opinions of nonphysician stakeholders, including patients with cancer, survivors, family members, and advocates. Results The ASCO survey was responded to by 1,967 members (1% of those solicited); 80% were producers, and 20% were consumers. Most respondents (93% of producers; 66% of consumers) reported familiarity with the Policy. Only a small proportion regularly evaluated COIs for presented research. Members favored increased transparency about relationships over restrictions on presentations of research. Stakeholders (n = 264) indicated that disclosure was “very important” to “extremely important” and preferred written disclosure (77%) over other methods. Conclusion COI policies are an important and relevant topic among physicians and patient advocates. Methods to simplify the disclosure process, improve transparency, and facilitate responsiveness are critical for COI management. PMID:23530092

  7. Police exposure to infectious agents: an audit of protective policies.

    PubMed

    Jessop, A B; Del Buono, F; Solomon, G; Mullen-Fortino, M; Rogers, J M

    2014-10-01

    As first responders, police officers may be exposed to infectious agents such as hepatitis viruses and human immunodeficiency virus. Their risk of infection by these viruses can be reduced with training, monitoring and, with some viruses, vaccination. To examine infection prevention policies and practices among police departments and determine provision of vaccination and infection prevention education programmes. A questionnaire sent to all police departments in five counties of south-eastern Pennsylvania to capture information about department size, immunization policies and practices, record keeping, infection prevention education and monitoring of exposures. Ninety-six of 168 departments responded (57%). Among these, policies requiring pre-employment physical examinations were almost universal (95%). Vaccination policies were less common with <15% requiring and 50% recommending hepatitis, tetanus or influenza vaccination for officers. Few departments took action to provide (2%) or cover the cost (21%) of vaccination. Fewer than 12% maintained vaccination records. Education about the risk of infectious agents was offered by 60% of the responding departments, but often just once at the start of employment. Fewer than half of the departments had systems to collect exposure information. Police departments have opportunities to improve policies and practices for infection prevention and control. Accurate documentation of vaccination status is essential to ensure provision of appropriate post-exposure assessment and treatment. Better reporting of exposure will improve understanding of the infection transmission risk, enhancing the ability to offer targeted education and services to officers. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. JPRS Report, East Europe.

    DTIC Science & Technology

    1990-02-20

    percent of teinagbdclrdhttey there are r asons (tending to be outside politics) for were satisfied with Markovic’s agricultural policy . It is...respondents than anti- Serbian nationality was 23.9. Nevertheless, even these inflation policy and agricultural policy . There, 26.4 results show that... agricultural policy of the FEC that has received many production surveyed, but of only 47 percent of those in objections during Markovic’s term, it is

  9. Tobacco control policies to promote awareness and smoke-free environments in residence and workplace to reduce passive tobacco smoking in Bangladesh and its correlates.

    PubMed

    Sultana, Papia; Rahman, Md Tahidur; Roy, Dulal Chandra; Akter, Shamima; Jung, Jenny; Rahman, Md Mizanur; Akter, Jahanara

    2018-01-01

    Bangladesh is one of the highest tobacco consuming countries in the world, with reported 21.2% of the population as daily smokers, 24.3% as smokeless tobacco users, and 36.3% as adult passive smoker. Given the high prevalence and established harmful effects of passive tobacco smoking, this study aimed to estimate of pattern of smoking policies in residential and work place, and to identify the associated socio-economic and demographic correlates in Bangladesh. Secondary data of sample size 9629 collected by the Global Adult Tobacco Survey (GATS) 2010 has been used. Along with descriptive analysis, binary logistic regression model has been used to analyze the socio-demographic and economic correlates to tobacco smoking policy. The prevalence of male and female passive tobacco smokers was 74.3% and 25.8% respectively. Among the passive tobacco smokers, 22.2% reported that smoking was allowed at their home and 29.8% reported that there was no such smoking policy at their home. Alternatively, 26.0% passive tobacco smokers reported that smoking was allowed and 27.5% reported that there was no such smoking policy at their work place. Logistic regression analysis indicated that for tobacco smokers group, the odds of allowing smoking at home was 4.85 times higher than the non-smoker respondent (OR = 4.85, 95% CI = 4.13, 5.71), 1.18 times more likely to be allowed at home in rural areas than urban areas (OR = 1.18, 95% CI = 1.06,1.32) and less for college/university completed and (or) higher educated respondent than no formal schooling (OR = 0.35, 95% CI = 0.24, 0.52). On the other hand, smoking was 1.70 times more likely to be allowed at work place for tobacco smokers than their counter part respondent (OR = 1.70, 95% CI = 1.36, 2.14) and was less likely to be allowed for college/university completed and (or) higher educated respondent (OR = 0.26, 95% CI = 0.14, 0.45) than respondent with no formal schooling. To reduce the passive smoking, lower educated people and people in urban areas should advocate more about the adverse effect of active and passive tobacco smoking. Also, smoking policy should reform introducing smoking zone at work places and residential buildings.

  10. The goal of value-based medicine analyses: comparability. The case for neovascular macular degeneration.

    PubMed

    Brown, Gary C; Brown, Melissa M; Brown, Heidi C; Kindermann, Sylvia; Sharma, Sanjay

    2007-01-01

    To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). A search was performed in the National Library of Medicine database of 16 million peer-reviewed articles using the key words cost-utility, cost-effectiveness, value, verteporfin, pegaptanib, laser photocoagulation, ranibizumab, and therapy. All articles that used an outcome of quality-adjusted life-years (QALYs) were studied in regard to (1) percent improvement in quality of life, (2) utility methodology, (3) utility respondents, (4) types of costs included (eg, direct healthcare, direct nonhealthcare, indirect), (5) cost bases (eg, Medicare, National Health Service in the United Kingdom), and (6) study cost perspective (eg, government, societal, third-party insurer). To qualify as a value-based medicine analysis, the patient value had to be measured using the outcome of the QALYs conferred by respective interventions. As with value-based medicine analyses, patient-based time tradeoff utility analysis had to be utilized, patient utility respondents were necessary, and direct medical costs were used. Among 21 cost-utility analyses performed on interventions for neovascular macular degeneration, 15 (71%) met value-based medicine criteria. The 6 others (29%) were not comparable owing to (1) varying utility methodology, (2) varying utility respondents, (3) differing costs utilized, (4) differing cost bases, and (5) varying study perspectives. Among value-based medicine studies, laser photocoagulation confers a 4.4% value gain (improvement in quality of life) for the treatment of classic subfoveal choroidal neovascularization. Intravitreal pegaptanib confers a 5.9% value gain (improvement in quality of life) for classic, minimally classic, and occult subfoveal choroidal neovascularization, and photodynamic therapy with verteporfin confers a 7.8% to 10.7% value gain for the treatment of classic subfoveal choroidal neovascularization. Intravitreal ranibizumab therapy confers greater than a 15% value gain for the treatment of subfoveal occult and minimally classic subfoveal choroidal neovascularization. The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds.

  11. THE GOAL OF VALUE-BASED MEDICINE ANALYSES: COMPARABILITY. THE CASE FOR NEOVASCULAR MACULAR DEGENERATION

    PubMed Central

    Brown, Gary C.; Brown, Melissa M.; Brown, Heidi C.; Kindermann, Sylvia; Sharma, Sanjay

    2007-01-01

    Purpose To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). Methods A search was performed in the National Library of Medicine database of 16 million peer-reviewed articles using the key words cost-utility, cost-effectiveness, value, verteporfin, pegaptanib, laser photocoagulation, ranibizumab, and therapy. All articles that used an outcome of quality-adjusted life-years (QALYs) were studied in regard to (1) percent improvement in quality of life, (2) utility methodology, (3) utility respondents, (4) types of costs included (eg, direct healthcare, direct nonhealthcare, indirect), (5) cost bases (eg, Medicare, National Health Service in the United Kingdom), and (6) study cost perspective (eg, government, societal, third-party insurer). To qualify as a value-based medicine analysis, the patient value had to be measured using the outcome of the QALYs conferred by respective interventions. As with value-based medicine analyses, patient-based time tradeoff utility analysis had to be utilized, patient utility respondents were necessary, and direct medical costs were used. Results Among 21 cost-utility analyses performed on interventions for neovascular macular degeneration, 15 (71%) met value-based medicine criteria. The 6 others (29%) were not comparable owing to (1) varying utility methodology, (2) varying utility respondents, (3) differing costs utilized, (4) differing cost bases, and (5) varying study perspectives. Among value-based medicine studies, laser photocoagulation confers a 4.4% value gain (improvement in quality of life) for the treatment of classic subfoveal choroidal neovascularization. Intravitreal pegaptanib confers a 5.9% value gain (improvement in quality of life) for classic, minimally classic, and occult subfoveal choroidal neovascularization, and photodynamic therapy with verteporfin confers a 7.8% to 10.7% value gain for the treatment of classic subfoveal choroidal neovascularization. Intravitreal ranibizumab therapy confers greater than a 15% value gain for the treatment of subfoveal occult and minimally classic subfoveal choroidal neovascularization. Conclusions The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds. PMID:18427606

  12. Teacher-Advocates Respond to ESSA: "Support the Good Parts--Resist the Bad Parts"

    ERIC Educational Resources Information Center

    Jones, Denisha; Khalil, Deena; Dixon, R. Davis

    2017-01-01

    Although researchers consider them powerful, teacher policy advocates are among the least studied stakeholders in U.S. public education reform today. Although plenty of attention has been given to the impact of policy on teachers' work, little research explores how teachers interpret or interact with policy. Drawing on the work of Spillane,…

  13. Newer Researchers in Higher Education: Policy Actors or Policy Subjects?

    ERIC Educational Resources Information Center

    Ashwin, Paul; Deem, Rosemary; McAlpine, Lynn

    2016-01-01

    In this article, we explore the extent to which 42 newer researchers, in the academic sub-field of higher education, were aware of, responded to and negotiated their careers in relation to higher education policies. Participants, who were mainly from European countries, tended to divide into two similarly sized groups: one that engaged with and…

  14. Household Location and Schools in Metropolitan Areas with Heterogeneous Suburbs; Tiebout, Alonso, and Government Policy. NBER Working Paper No. 15915

    ERIC Educational Resources Information Center

    Hanushek, Eric A.; Yilmaz, Kuzey

    2010-01-01

    An important element in considering school finance policies is that households are not passive but instead respond to policies. Household behavior is especially important in considering how households affect the spatial structure of metropolitan areas where different jurisdictions incorporate bundles of advantages and disadvantages. This paper…

  15. Examining the use of health systems and policy research in the health policymaking process in Israel: views of researchers.

    PubMed

    Ellen, Moriah E; Lavis, John N; Shemer, Joshua

    2016-09-01

    All too often, health policy and management decisions are made without making use of or consulting with the best available research evidence, which can lead to ineffective and inefficient health systems. One of the main actors that can ensure the use of evidence to inform policymaking is researchers. The objective of this study is to explore Israeli health systems and policy researchers' views and perceptions regarding the role of health systems and policy research (HSPR) in health policymaking and the barriers and facilitators to the use of evidence in the policymaking process. A survey of researchers who have conducted HSPR in Israel was developed. The survey consisted of a demographics section and closed questions, which focused on support both within the researchers' organisations and the broader environment for KTE activities, perceptions on the policymaking process, and the potential influencing factors on the process. The survey was sent to all health systems and policy researchers in Israel from academic institutions, hospital settings, government agencies, the four health insurance funds, and research institutes (n = 107). All responses were analyzed using descriptive statistics. For close-ended questions about level of agreement we combined together the two highest categories (agree or strongly agree) for analysis. Thirty-seven respondents participated in the survey. While many respondents felt that the use of HSPR may help raise awareness on policy issues, the majority of respondents felt that the actual use of HSPR was hindered for many reasons. While facilitators do exist to support the use of research evidence in policymaking, numerous barriers hinder the process such as challenges in government/provider relations, policymakers lacking the expertise for acquiring, assessing, and applying HSPR and priorities in the health system drawing attention away from HSPR. Furthermore, it is perceived by a majority of respondents that the health insurance funds and the physician organisations exert a strong influence in the policymaking process. Health system and policy researchers in Israel need to be introduced to the benefits and potential advantages of evidence-informed policy in an organised and systematic way. Future research should examine the perceptions of policymakers in Israel and thus we can gain a broader perspective on where the actual issues lie.

  16. A national survey of the infrastructure and IT policies required to deliver computerised cognitive behavioural therapy in the English NHS

    PubMed Central

    Andrewes, Holly; Kenicer, David; McClay, Carrie-Anne; Williams, Christopher

    2013-01-01

    Objective This study aimed to identify if patients have adequate access to Computerised Cognitive Behavioural Therapy (cCBT) programmes in all mental health trusts across England. Design The primary researcher contacted a targeted sample of information technology (IT) leads in each mental health trust in England to complete the survey. Setting Telephone, email and postal mail were used to contact an IT lead or nominated expert from each mental health trust. Participants 48 of the 56 IT experts from each mental health trust in England responded. The experts who were chosen had sufficient knowledge of the infrastructure, technology, policies and regulations to answer all survey questions. Results 77% of trusts provided computers for direct patient use, with computers in all except one trust meeting the specifications to access cCBT. However, 24% of trusts acknowledged that the number of computers provided was insufficient to provide a trust-wide service. 71% stated that the bandwidth available was adequate to provide access to cCBT sites, yet for many trusts, internet speed was identified as unpredictable and variable between locations. IT policies in only 56% of the trusts allowed National Health Service (NHS) staff to directly support patients as they complete cCBT courses via emails to the patients’ personal email account. Only 37% allowed support via internet video calls, and only 9% allowed support via instant messaging services. Conclusions Patient access to cCBT in English NHS mental health trusts is limited by the inadequate number of computers provided to patients, unpredictable bandwidth speed and inconsistent IT policies, which restrict patients from receiving the support needed to maximise the success of this therapy. English NHS mental health trusts need to alter IT policy and improve resources to reduce the waiting time for psychological resources required for patients seeking this evidence-based therapy. PMID:23377995

  17. Toward a consistent modeling framework to assess multi-sectoral climate impacts.

    PubMed

    Monier, Erwan; Paltsev, Sergey; Sokolov, Andrei; Chen, Y-H Henry; Gao, Xiang; Ejaz, Qudsia; Couzo, Evan; Schlosser, C Adam; Dutkiewicz, Stephanie; Fant, Charles; Scott, Jeffery; Kicklighter, David; Morris, Jennifer; Jacoby, Henry; Prinn, Ronald; Haigh, Martin

    2018-02-13

    Efforts to estimate the physical and economic impacts of future climate change face substantial challenges. To enrich the currently popular approaches to impact analysis-which involve evaluation of a damage function or multi-model comparisons based on a limited number of standardized scenarios-we propose integrating a geospatially resolved physical representation of impacts into a coupled human-Earth system modeling framework. Large internationally coordinated exercises cannot easily respond to new policy targets and the implementation of standard scenarios across models, institutions and research communities can yield inconsistent estimates. Here, we argue for a shift toward the use of a self-consistent integrated modeling framework to assess climate impacts, and discuss ways the integrated assessment modeling community can move in this direction. We then demonstrate the capabilities of such a modeling framework by conducting a multi-sectoral assessment of climate impacts under a range of consistent and integrated economic and climate scenarios that are responsive to new policies and business expectations.

  18. Attitudes of First-year Medical Students Toward the Confidentiality of Computerized Patient Records

    PubMed Central

    Davis, Luke; Domm, Jennifer A.; Konikoff, Michael R.; Miller, Randolph A.

    1999-01-01

    Objectives: To investigate the attitudes of students entering medical school toward the confidentiality of computerized medical records. Design: First-year medical students at the Vanderbilt University School of Medicine responded to a series of questions about a hypothetic breach of patient's privacy through a computerized patient record system. Measurements: The individual authors independently grouped the blinded responses according to whether they were consistent with then-current institutional policy. These preliminary groupings were discussed, and final categorizations were made by consensus. Results: While most students had a sense of what was right and wrong in absolute terms, half the class suggested at least one course of action that was deemed to be inconsistent with institutional policies. Conclusions: The authors believe that medical schools should directly address ethical and legal issues related to the use of computers in clinical practice as an integral part of medical school curricula. Several teaching approaches can facilitate a greater awareness of the issues surrounding technology and medicine. PMID:9925228

  19. Perioperative management of obstructive sleep apnea: a survey of Veterans Affairs health care providers.

    PubMed

    Dhanda Patil, Reena; Patil, Yash J

    2012-01-01

    (1) To determine the presence of Veterans Affairs (VA) institutional guidelines for the perioperative management of obstructive sleep apnea (OSA); (2) to examine current use of preoperative screening tools for OSA in the VA; and (3) to understand current VA practice patterns regarding postoperative disposition of patients with OSA. Survey study. Veterans Affairs hospitals with surgical services; sample size 102 facilities. Veterans Affairs health care providers. The authors surveyed health care providers at VA hospitals using a survey tool developed by the authors. The response rate was 80%. A variety of preoperative screening tools for OSA were used by respondents, most commonly American Society of Anesthesiologists guidelines (53%). A policy for postoperative disposition of known and presumed OSA was present in 26% and 19% of responses, respectively. Of those respondents reporting a formal postoperative care policy, 48% and 30% admitted patients to a monitored ward bed and surgical intensive care unit, respectively. Of the 74% of respondents unaware of an institutional policy, Anesthesia and Surgery worked together to dictate postoperative disposition of patients with known OSA 73% of the time. The degree of OSA was ranked as the most important factor (58%) influencing postoperative disposition. Ten percent of respondents reported a major perioperative complication attributable to OSA in the past year. This survey study elucidates the heterogeneity of preoperative screening for and postoperative care of veterans with OSA. Future investigators may use these data to formalize institutional policies with regard to patients with OSA, with potentially significant impacts on patient care and usage of financial resources.

  20. 77 FR 46805 - Small Business Innovation Research Program Policy Directive

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ... Small Business Innovation Research Program Policy Directive; Small Business Technology Transfer Program Policy Directive; Small Business Innovation Research (SBIR) Program and Small Business Technology... ADMINISTRATION 13 CFR Chapter I RIN 3245-AF84 Small Business Innovation Research Program Policy Directive AGENCY...

  1. Tobacco related knowledge and support for smoke-free policies among community pharmacists in Lagos state, Nigeria

    PubMed Central

    Poluyi, Edward O.; Odukoya, Oluwakemi O.; Aina, Bolajoko; Faseru, Babalola

    2014-01-01

    Background: There are no safe levels of exposure to second hand smoke and smoke-free policies are effective in reducing the burden of tobacco-related diseases and death. Pharmacists, as a unique group of health professionals, might be able to play a role in the promotion of smoke-free policies. Objective: To determine the tobacco-related knowledge of community pharmacists and assess their support for smoke-free policies in Lagos state, Nigeria. Methods: A cross-sectional descriptive study design using both quantitative and qualitative methods was employed. Two hundred and twelve randomly selected community pharmacists were surveyed using a pre-tested self-administered questionnaire. In addition, one focus group discussion was conducted with ten members of the Lagos state branch of the Association of Community Pharmacists of Nigeria. Results: The quantitative survey revealed that the majority (72.1%) of the respondents were aged between 20 and 40 years, predominantly male (60.8%), Yoruba (50.2%) or Igbo (40.3%) ethnicity and had been practicing pharmacy for ten years or less (72.2%). A majority (90.1%) of respondents were aware that tobacco is harmful to health. Slightly less (75.8%) were aware that second hand smoke is harmful to health. Among the listed diseases, pharmacists responded that lung (84.4%) and esophageal (68.9%) cancers were the most common diseases associated with tobacco use. Less than half of those surveyed associated tobacco use with heart disease (46.9%), chronic obstructive pulmonary disease (27.8%), bladder cancer (47.2%), peripheral vascular disease (35.8%) and sudden death (31.1%). Only 51.9% had heard of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). A little over half of the respondents (53.8%) were aware of any law in Nigeria controlling tobacco use. The majority of respondents supported a ban on smoking in homes (83.5%), in public places (79.2%), and in restaurants, nightclubs and bars (73.6%). For every additional client attended to daily, knowledge scores increased by 0.022 points. Current smokers were 1.3 times less likely to support smoke-free policies compared with non-smokers. The findings emanating from the focus group discussion reinforced the fact that the pharmacists were in support of smoke-free policies particularly in homes and public places. It also demonstrated that most of them were aware of the health risks associated with tobacco use and second hand smoke however some misconceptions seemed to exist. Conclusion: The pharmacists surveyed expressed support of smoke-free policies and most of them were aware of the health risks associated with tobacco use. However, awareness of WHO FCTC and country-level tobacco legislation was low. Current smokers were less likely to support smoke-free policies. Community pharmacists should therefore be considered worth engaging for the promotion of smoke-free policies. Efforts should also be made to educate pharmacists about country level smoke-free laws. PMID:25883686

  2. Responding to obesity in Brazil: understanding the international and domestic politics of policy reform through a nested analytic approach to comparative analysis.

    PubMed

    Gómez, Eduardo J

    2015-02-01

    Why do governments pursue obesity legislation? And is the case of Brazil unique compared with other nations when considering the politics of policy reform? Using a nested analytic approach to comparative research, I found that theoretical frameworks accounting for why nations implement obesity legislation were not supported with cross-national statistical evidence. I then turned to the case of Brazil's response to obesity at three levels of government, national, urban, and rural, to propose alternative hypotheses for why nations pursue obesity policy. The case of Brazil suggests that the reasons that governments respond are different at these three levels. International forces, historical institutions, and social health movements were factors that prompted national government responses. At the urban and rural government levels, receiving federal financial assistance and human resource support appeared to be more important. The case of Brazil suggests that the international and domestic politics of responding to obesity are highly complex and that national and subnational political actors have different perceptions and interests when pursuing obesity legislation. Copyright © 2015 by Duke University Press.

  3. The Maricopa Colleges.

    ERIC Educational Resources Information Center

    Bush, Ronald W.; Ames, W. Clark

    1984-01-01

    A college personnel policy developed to respond to changing conditions has 10 elements: establishment of a master planning process, policy and procedures review, early retirement, extended leave, recruitment and hiring of new faculty, flexible benefits, productivity and career development, internship opportunities, faculty renewal opportunities,…

  4. Responding to Political, Social, and Ethical Issues.

    ERIC Educational Resources Information Center

    Ylvisaker, Paul N.

    1994-01-01

    In responding to political, social, and ethical issues, college trustees have three essential responsibilities: (1) to examine critical trends and influences outside the institution; (2) to translate this knowledge into institutional policy; and (3) to monitor the institution's social, political, and ethical performance through recurrent…

  5. Do attitudes, intentions and actions of school food coordinators regarding public organic food procurement policy improve the eating environment at school? Results from the iPOPY study.

    PubMed

    He, Chen; Perez-Cueto, Federico J A; Mikkelsen, Bent E

    2014-06-01

    The present study investigates whether public organic food procurement policies have the potential to induce changes in the school food service environment. A comparative cross-national survey was conducted in public primary and/or secondary schools in Finland, Germany and Italy. The school food coordinators completed a web-based questionnaire on their attitudes, intentions and actions towards organic school food provision. In Germany, 122 out of 2050 schools in the state of Hesse responded. In Finland, 250 out of 998 schools across the country responded. In Italy, 215 out of 940 schools from eight provinces responded. School food coordinators in the sample of schools in the three countries. The German and Finnish school food coordinators separately most agreed with the promotion of healthy eating habits (P < 0·001) and organic food (P < 0·001) by schools. The Finnish schools were most likely to adopt a food and nutrition policy (P < 0·001), a health-promoting school policy according to WHO principles (P < 0·001), to have a playground (P < 0·001), to involve physical activity themes in teaching (P = 0·012) and to have a canteen (P < 0·001). The Italian schools were most likely to involve the food and nutrition policy in pedagogical activities (P = 0·004), to serve nutritional school meals (P < 0·001) and to recommend children to eat healthily (P < 0·001). In the three countries, the non-organic schools were less likely to adopt a food and nutrition policy (P < 0·001), a WHO health-promoting policy (P < 0·001) and have a canteen (P = 0·017) than the organic schools. The study suggests that there is a gap in the effects of public organic food procurement policy on building a healthier school food environment.

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

    Mwangi, A.M.

    This study focuses on wood-energy production and consumption strategies among small-scale farm households in central Kenya. The specific objective were: (1) to determine how households had responded to specific wood-energy policies; (2) to identify factors associated with household adoption or non-adoption of the strategies. Different programs aimed at addressing wood-energy shortages in Kenya were initiated or strengthened during the 1980s: fuelwood or multipurpose tree planting; development and dissemination of improved stoves and fireplaces; promotion of increased accessibility to wood-energy substitutes. Household adoption levels for policy-supported strategies have remained low despite promotion. Survey data from two villages in Nyeri district weremore » collected to determine the factors associated with adoption of the Kenya Ceramic Jiko, the [open quotes]Kuni Mbili[close quotes] stove/fireplace, kerosene stoves, electric cookers, and fuelwood or multipurpose tree planting. Adoption rates varied from as low as 1 percent for electricity to 43 percent for the Kenya Ceramic Jiko. Important policy variables included extension visits per year, income levels, years of formal education received by head of household, access to different fuels, area of farm-land owned, household size, and locational characteristics of the villages. Policy recommendations included: use of research results to direct policy; improvement of information flows between policy makers, extension agents, and technology-users; increased support of agroforestry; and better program coordination. Recommendations for further research included: examining more areas where efficiency gains in energy production and consumption can be made, extending the study to cover the drier parts of central Kenya, and conducting regular case studies in order to better understand the adoption process over time.« less

  7. Burden of disease in Japan: using national and subnational data to inform local health policy.

    PubMed

    Gilmour, Stuart; Liao, Yi; Bilano, Ver; Shibuya, Kenji

    2014-05-01

    The Global Burden of Disease (GBD) study has been instrumental in guiding global health policy development since the early 1990s. The GBD 2010 project provided rich information about the key causes of mortality, disability-adjusted life years, and their associated risk factors in Japan and provided a unique opportunity to incorporate these data into health planning. As part of the latest update of this project, GBD 2013, the Japanese GBD collaborators plan to update and refine the available burden of disease data by incorporating sub-national estimates of the burden of disease at the prefectural level. These estimates will provide health planners and policy makers at both the national and prefectural level with new, more refined tools to adapt local public health initiatives to meet the health needs of local populations. Moreover, they will enable the Japanese health system to better respond to the unique challenges in their rapidly aging population and as a complex combination of non-communicable disease risk factors begin to dominate the policy agenda. Regional collaborations will enable nations to learn from the experiences of other nations that may be at different stages of the epidemiological transition and have different exposure profiles and associated health effects. Such analyses and improvements in the data collection systems will further improve the health of the Japanese, maintain Japan's excellent record of health equity, and provide a better understanding of the direction of health policy in the region.

  8. Child mental-health policy development in sub-Saharan Africa: broadening the perspectives using Bronfenbrenner's ecological model.

    PubMed

    Atilola, Olayinka

    2017-04-01

    Despite socio-economic, demographic and epidemiological facts and realities that point to a potential risk for explosion in the prevalence of childhood mental health problems in sub-Saharan Africa, there is still a severe dearth of child and adolescent mental health (CAMH) policy or strategy to respond to the situation in the region. Unfortunately, current attempts at suggesting courses of action in this regard appear to be focused on narrow reactionary approaches. There is a need for theoretical frameworks to capture the full ramification of childhood in sub-Saharan Africa, from which multi-level, context-appropriate and holistic CAMH policy directions can be understood. In this commentary, we propose an amended version of the Bronfenbrenner's ecological model of childhood as such framework that captures proximal, intermediate and distal factors that influence the care environment of children. We then used the insights provided by the model to identify and prioritize intervention points and appropriate intervention strategies in charting a tentative course for CAMH policy development in the region. Though the ecological model provides a distinct perspective to the structure and dynamics of the care environment of children, the proposed framework using the model is still largely theoretical and need to be further integrated into future studies on CAMH policy development in the region. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District.

    PubMed

    Vyagusa, Dismas B; Mubyazi, Godfrey M; Masatu, Melchiory

    2013-10-14

    Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries. This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services. 157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required. Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents. TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs' inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal services. Thus, the authorities seeming to recognize and promote TBAs should provide support to TBAs in relation to necessary training and giving them essential working facilities, routine supportive supervision and rewarding those seeming to comply with the standard guidelines for delivering EmoC services.

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

    PubMed

    Honda, Ayako

    2015-02-04

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

  11. Awareness of pro-tobacco advertising and promotion and beliefs about tobacco use: Findings from the Tobacco Control Policy (TCP) India Pilot Survey†

    PubMed Central

    Bansal-Travers, Maansi; Fong, Geoffrey T.; Quah, Anne C.K.; Sansone, Genevieve; Pednekar, Mangesh S.; Gupta, Prakash C.; Sinha, Dhirendra N.

    2014-01-01

    Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (p<0.01). The findings from this study reiterate the need for stronger legislation and strict enforcement of bans on direct and indirect advertising and promotion of tobacco products in India. PMID:25455648

  12. Urban containment policies and the protection of natural areas: the case of Seoul's greenbelt

    Treesearch

    David N. Bengston; Yeo-Chang Youn

    2006-01-01

    Countries around the world have responded to the problems associated with rapid urban growth and increasingly land-consumptive development patterns by creating a wide range of policy instruments designed to manage urban growth. Of the array of growth management techniques, urban containment policies are considered by some to be a promising approach. This paper focuses...

  13. Responding to Self-Harm: A Documentary Analysis of Agency Policy and Procedure

    ERIC Educational Resources Information Center

    Paul, Sally; Hill, Malcolm

    2013-01-01

    This paper reports on the findings of a documentary analysis of policies and procedures relating to self-harm from a range of organisations working with young people in the UK. It identifies the extent to which policies and/or procedures relating to self-harm are available for service providers and offers a wider understanding of the concepts of…

  14. Latino Educational Opportunity in Discourse and Policy: A Critical and Policy Discourse Analysis of the White House Initiative on Educational Excellence for Hispanics

    ERIC Educational Resources Information Center

    Hernandez, Susana

    2013-01-01

    This study interrogates how federal policy discursively shapes Latino educational opportunity and equity. The White House Initiative on Educational Excellence for Hispanics (WHIEEH) represents the pre-eminent federal discourse on Latino educational opportunity, and sets the parameters by which institutions are able to be informed and respond to…

  15. Aid and Innovation: How Federal Financial Aid Policy Impacts Student Success and How States Can Respond. Policy Bulletin

    ERIC Educational Resources Information Center

    Reichert, Katrina

    2012-01-01

    From Washington to Connecticut, Arkansas to Indiana, state policymakers and community college leaders are focused on building completion pathways to ensure that more students succeed in postsecondary education and make smooth transitions to careers. Financial aid is both an effective and a necessary policy lever to promote this goal. Not only do…

  16. In-State Tuition for Undocumented Immigrants: State's Rights and Educational Opportunity. Policy Matters: A Higher Education Policy Brief

    ERIC Educational Resources Information Center

    Russell, Alene

    2007-01-01

    Concerns about higher-education access and affordability have emerged as significant issues in the immigration debates. As is true for immigration issues in general, public opinion is divided on how states should respond, and emotions run high. Passage of proposed federal legislation would clarify the states' authority over tuition policy and the…

  17. 77 FR 25610 - Statement of Agency Policy and Interpretation on the Hours of Service Laws as Amended; Delay of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-01

    ...-2009-0057, Notice No. 3] Statement of Agency Policy and Interpretation on the Hours of Service Laws as... of agency policy and interpretation on the hours of service laws that was published in the Federal... hours of service laws as amended (Final Interpretations), responding to public comments on FRA's earlier...

  18. Understanding the United States and Brazil's response to obesity: institutional conversion, policy reform, and the lessons learned.

    PubMed

    Gómez, Eduardo J

    2015-06-10

    In the United States (US) and Brazil, obesity has emerged as a health epidemic. This article is driven by the following research questions: how did the US and Brazil's federal institutions respond to obesity? And how did these responses affect policy implementation? The aim of this article is therefore to conduct a comparative case study analysis of how these nations' institutions responded in order to determine the key lessons learned. This study uses primary and secondary qualitative data to substantiate causal arguments and factual claims. Brazil shows that converting preexisting federal agencies working in primary healthcare to emphasize the provision of obesity prevention services can facilitate policy implementation, especially in rural areas. Brazil also reveals the importance of targeting federal grant support to the highest obesity prevalence areas and imposing grant conditionalities, while illustrating how the incorporation of social health movements into the bureaucracy facilitates the early adoption of nutrition and obesity policies. None of these reforms were pursued in the US. Brazil's government has engaged in innovative institutional conversion processes aiding its ability to sustain its centralized influence when implementing obesity policy. The US government's adoption of Brazil's institutional innovations may help to strengthen its policy response.

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

    PubMed

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

    2008-01-01

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

  20. Public health and public trust: Survey evidence from the Ebola Virus Disease epidemic in Liberia.

    PubMed

    Blair, Robert A; Morse, Benjamin S; Tsai, Lily L

    2017-01-01

    Trust in government has long been viewed as an important determinant of citizens' compliance with public health policies, especially in times of crisis. Yet evidence on this relationship remains scarce, particularly in the developing world. We use results from a representative survey conducted during the 2014-15 Ebola Virus Disease (EVD) epidemic in Monrovia, Liberia to assess the relationship between trust in government and compliance with EVD control interventions. We find that respondents who expressed low trust in government were much less likely to take precautions against EVD in their homes, or to abide by government-mandated social distancing mechanisms designed to contain the spread of the virus. They were also much less likely to support potentially contentious control policies, such as "safe burial" of EVD-infected bodies. Contrary to stereotypes, we find no evidence that respondents who distrusted government were any more or less likely to understand EVD's symptoms and transmission pathways. While only correlational, these results suggest that respondents who refused to comply may have done so not because they failed to understand how EVD is transmitted, but rather because they did not trust the capacity or integrity of government institutions to recommend precautions and implement policies to slow EVD's spread. We also find that respondents who experienced hardships during the epidemic expressed less trust in government than those who did not, suggesting the possibility of a vicious cycle between distrust, non-compliance, hardships and further distrust. Finally, we find that respondents who trusted international non-governmental organizations (INGOs) were no more or less likely to support or comply with EVD control policies, suggesting that while INGOs can contribute in indispensable ways to crisis response, they cannot substitute for government institutions in the eyes of citizens. We conclude by discussing the implications of our findings for future public health crises. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Implementing a province-wide mandatory vaccinate-or-mask policy at healthcare facilities in British Columbia, Canada.

    PubMed

    Nunn, Alexandra; Campbell, Audrey C; Naus, Monika; Kwong, Jeffrey C; Puddicombe, David; Quach, Susan; Henry, Bonnie

    2018-01-08

    In 2012, British Columbia (BC) became the first Canadian province to implement an influenza prevention policy requiring healthcare workers (HCW) to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season. This study describes an evaluation of influenza policy implementation processes and identifies supports and challenges related to successful policy implementation at the level of healthcare facilities, during the second policy year (2013/14). Implementation leaders from 262 long-term care (LTC) and acute care facilities, mostly in three of BC's five regional Health Authorities, were invited to participate in an online survey following the 2013/14 influenza season. Descriptive quantitative and qualitative analyses identified common and effective strategies for improving vaccination coverage and policy compliance. A total of 127 respondents completed the survey on behalf of 33 acute care and 99 LTC facilities, representing 36% of acute care and 27% of LTC facilities in BC. Respondents agreed that the policy was successfully implemented at 89% of facilities, and implementation was reported to be easy at 52% of facilities. The findings elaborate on communication and leadership strategies, campaign logistics and enforcement approaches involved in policy implementation. Implementation of a vaccinate-or-mask influenza policy is complex. This study provides insight for other jurisdictions considering implementing such a policy and offers practical recommendations for facilities and health authorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Health Benefits and Risks of Pets in Nursing Homes: A Survey of Facilities in Ohio.

    PubMed

    Stull, Jason W; Hoffman, Cydney C; Landers, Timothy

    2018-05-01

    Pets are encountered in nursing homes and although they provide health benefits to individuals, they are also a source of health risks. The current study aimed to determine the frequency and types of animals in nursing homes, perceived benefits, and content of policies addressing health risks. Ninety-five administrators from unique nursing homes in Ohio completed an online survey addressing perceived benefits and risks of animals and policies in place. Animals were permitted in 99% of nursing homes, with dogs (95%), cats (85%), birds (71%), fish (55%), and farm animals (40%) most frequently reported. Respondents perceived animal interactions resulted in high health benefits for residents. Most facilities (70/75; 93%) reported having an animal policy, yet important gaps were frequently identified in the content of policies. Most respondents (75%) did not report health and safety concerns with animals in facilities. Best practice guidelines and policies should be developed and implemented in nursing homes to address requirements for different animal ownership models, range of animal species, and staff knowledge. [Journal of Gerontological Nursing, 44(5), 39-45.]. Copyright 2018, SLACK Incorporated.

  3. 22 CFR 128.6 - Discovery.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Discovery. 128.6 Section 128.6 Foreign... Discovery. (a) Discovery by the respondent. The respondent, through the Administrative Law Judge, may... discovery if the interests of national security or foreign policy so require, or if necessary to comply with...

  4. 22 CFR 128.6 - Discovery.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Discovery. 128.6 Section 128.6 Foreign... Discovery. (a) Discovery by the respondent. The respondent, through the Administrative Law Judge, may... discovery if the interests of national security or foreign policy so require, or if necessary to comply with...

  5. 22 CFR 128.6 - Discovery.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Discovery. 128.6 Section 128.6 Foreign... Discovery. (a) Discovery by the respondent. The respondent, through the Administrative Law Judge, may... discovery if the interests of national security or foreign policy so require, or if necessary to comply with...

  6. 22 CFR 128.6 - Discovery.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Discovery. 128.6 Section 128.6 Foreign... Discovery. (a) Discovery by the respondent. The respondent, through the Administrative Law Judge, may... discovery if the interests of national security or foreign policy so require, or if necessary to comply with...

  7. 22 CFR 128.6 - Discovery.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Discovery. 128.6 Section 128.6 Foreign... Discovery. (a) Discovery by the respondent. The respondent, through the Administrative Law Judge, may... discovery if the interests of national security or foreign policy so require, or if necessary to comply with...

  8. A Policy Guide on Integrated Care (PGIC): Lessons Learned from EU Project INTEGRATE and Beyond

    PubMed Central

    Devroey, Dirk

    2017-01-01

    Efforts are underway in many European countries to channel efforts into creating improved integrated health and social care services. But most countries lack a strategic plan that is sustainable over time, and that reflects a comprehensive systems perspective. The Policy Guide on Integrated Care (PGIC) as presented in this paper resulted from experiences with the EU Project INTEGRATE and our own work with healthcare reform for patients with chronic conditions at the national and international level. This project is one of the largest EU funded projects on Integrated Care, conducted over a four-year period (2012–2016) and included partners from nine European countries. Project Integrate aimed to gain insights into the leadership, management and delivery of integrated care to support European care systems to respond to the challenges of ageing populations and the rise of people living with long-term conditions. The objective of this paper is to describe the PGIC as both a tool and a reasoning flow that aims at supporting policy makers at the national and international level with the development and implementation of integrated care. Any Policy Guide on Integrated should build upon three building blocks, being a mission, vision and a strategy that aim at capturing the large amount of factors that directly or indirectly influence the successful development of integrated care. PMID:29588631

  9. A Policy Guide on Integrated Care (PGIC): Lessons Learned from EU Project INTEGRATE and Beyond.

    PubMed

    Borgermans, Liesbeth; Devroey, Dirk

    2017-09-25

    Efforts are underway in many European countries to channel efforts into creating improved integrated health and social care services. But most countries lack a strategic plan that is sustainable over time, and that reflects a comprehensive systems perspective. The Policy Guide on Integrated Care (PGIC) as presented in this paper resulted from experiences with the EU Project INTEGRATE and our own work with healthcare reform for patients with chronic conditions at the national and international level. This project is one of the largest EU funded projects on Integrated Care, conducted over a four-year period (2012-2016) and included partners from nine European countries. Project Integrate aimed to gain insights into the leadership, management and delivery of integrated care to support European care systems to respond to the challenges of ageing populations and the rise of people living with long-term conditions. The objective of this paper is to describe the PGIC as both a tool and a reasoning flow that aims at supporting policy makers at the national and international level with the development and implementation of integrated care. Any Policy Guide on Integrated should build upon three building blocks, being a mission, vision and a strategy that aim at capturing the large amount of factors that directly or indirectly influence the successful development of integrated care.

  10. Support for e-cigarette policies: a survey of smokers and ex-smokers in Great Britain

    PubMed Central

    Brose, Leonie S; Partos, Timea R; Hitchman, Sara C; McNeill, Ann

    2017-01-01

    Introduction E-cigarette regulations are the topic of extensive debate. Approaches vary worldwide, and limited evidence is available on public support for specific policies or what influences support. The present study aimed to assess smokers' and ex-smokers' support for 3 e-cigarette policies: (1) equal or higher availability relative to cigarettes, (2) advertising, (3) use in smoke-free places, and to assess changes in support over time and associations with respondent characteristics. Methods Smokers and ex-smokers (n=1848) provided 3279 observations over 2 waves (2013 and 2014) of a longitudinal web-based survey in Great Britain. Multivariable logistic regressions fitted using generalised estimating equations assessed change in policy support over time, and associations between support and demographics (age, gender and income), smoking and e-cigarette use status, nicotine knowledge and perceived relative harm. Results Equal or higher relative availability was supported by 79% in 2013 and 76% in 2014; advertising by 66% and 56%, respectively; neither change was significant in adjusted analyses. Support for use in smoke-free places decreased significantly from 55% to 45%. Compared with ex-smokers, smokers were more likely to support advertising and use in smoke-free places. Respondents using e-cigarettes, those who perceived e-cigarettes as less harmful than cigarettes, and those with more accurate knowledge about nicotine were more likely to support all 3 policies. Conclusions Less restrictive e-cigarette policies were more likely to be supported by e-cigarette users, and respondents who perceived e-cigarettes to be less harmful than cigarettes, or knew that nicotine was not a main cause of harm to health. PMID:27312824

  11. Support for e-cigarette policies: a survey of smokers and ex-smokers in Great Britain.

    PubMed

    Brose, Leonie S; Partos, Timea R; Hitchman, Sara C; McNeill, Ann

    2017-03-01

    E-cigarette regulations are the topic of extensive debate. Approaches vary worldwide, and limited evidence is available on public support for specific policies or what influences support. The present study aimed to assess smokers' and ex-smokers' support for 3 e-cigarette policies: (1) equal or higher availability relative to cigarettes, (2) advertising, (3) use in smoke-free places, and to assess changes in support over time and associations with respondent characteristics. Smokers and ex-smokers (n=1848) provided 3279 observations over 2 waves (2013 and 2014) of a longitudinal web-based survey in Great Britain. Multivariable logistic regressions fitted using generalised estimating equations assessed change in policy support over time, and associations between support and demographics (age, gender and income), smoking and e-cigarette use status, nicotine knowledge and perceived relative harm. Equal or higher relative availability was supported by 79% in 2013 and 76% in 2014; advertising by 66% and 56%, respectively; neither change was significant in adjusted analyses. Support for use in smoke-free places decreased significantly from 55% to 45%. Compared with ex-smokers, smokers were more likely to support advertising and use in smoke-free places. Respondents using e-cigarettes, those who perceived e-cigarettes as less harmful than cigarettes, and those with more accurate knowledge about nicotine were more likely to support all 3 policies. Less restrictive e-cigarette policies were more likely to be supported by e-cigarette users, and respondents who perceived e-cigarettes to be less harmful than cigarettes, or knew that nicotine was not a main cause of harm to health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Factors influencing malaria control policy-making in Kenya, Uganda and Tanzania.

    PubMed

    Mutero, Clifford M; Kramer, Randall A; Paul, Christopher; Lesser, Adriane; Miranda, Marie Lynn; Mboera, Leonard E G; Kiptui, Rebecca; Kabatereine, Narcis; Ameneshewa, Birkinesh

    2014-08-08

    Policy decisions for malaria control are often difficult to make as decision-makers have to carefully consider an array of options and respond to the needs of a large number of stakeholders. This study assessed the factors and specific objectives that influence malaria control policy decisions, as a crucial first step towards developing an inclusive malaria decision analysis support tool (MDAST). Country-specific stakeholder engagement activities using structured questionnaires were carried out in Kenya, Uganda and Tanzania. The survey respondents were drawn from a non-random purposeful sample of stakeholders, targeting individuals in ministries and non-governmental organizations whose policy decisions and actions are likely to have an impact on the status of malaria. Summary statistics across the three countries are presented in aggregate. Important findings aggregated across countries included a belief that donor preferences and agendas were exerting too much influence on malaria policies in the countries. Respondents on average also thought that some relevant objectives such as engaging members of parliament by the agency responsible for malaria control in a particular country were not being given enough consideration in malaria decision-making. Factors found to influence decisions regarding specific malaria control strategies included donor agendas, costs, effectiveness of interventions, health and environmental impacts, compliance and/acceptance, financial sustainability, and vector resistance to insecticides. Malaria control decision-makers in Kenya, Uganda and Tanzania take into account health and environmental impacts as well as cost implications of different intervention strategies. Further engagement of government legislators and other policy makers is needed in order to increase funding from domestic sources, reduce donor dependence, sustain interventions and consolidate current gains in malaria.

  13. Distraction by smartphone use during clinical practice and opinions about smartphone restriction policies: A cross-sectional descriptive study of nursing students.

    PubMed

    Cho, Sumi; Lee, Eunjoo

    2016-05-01

    Smartphone use in healthcare settings may distract healthcare providers and disrupt patient care. Moreover, it may lead to adverse events, thereby threatening patient safety. This study assessed nursing students' smartphone use as a source of distraction in clinical practice and identified their opinions about policies restricting smartphone use during patient care. A cross-sectional descriptive design was used with convenience sampling. Third-year nursing students (n=312) from two nursing schools in the Republic of Korea completed the survey in 2012. A self-report questionnaire-based on addiction theories for problem behaviors and literature on the distraction caused by cellular phone use-was used to assess smartphone use, experiences of distraction caused by smartphone use, and opinions about restriction policies on smartphone use during clinical practice. Nearly half (46.2%) of the nursing students used smartphones at least sometimes during clinical practice and about a quarter of the respondents (24.7%) were at least sometimes distracted by smartphones during clinical practice. The majority of the respondents (83.7%) had witnessed nurses using smartphones at least sometimes during their work. A few respondents (15.7%) agreed or strongly agreed with the policy for restricting smartphone use in hospitals. Students who used smartphones more often tended to disagree with restriction policies for smartphone use in hospitals. Awareness about the risks of smartphone use, especially regarding patient safety, is necessary for nursing students in school and hospital settings. Educators and faculty of nursing schools need to develop policies that encourage intelligent and safe use of smartphones during clinical practice. Copyright © 2016. Published by Elsevier Ltd.

  14. Accrual and recruitment practices at Clinical and Translational Science Award (CTSA) institutions: a call for expectations, expertise, and evaluation.

    PubMed

    Kost, Rhonda G; Mervin-Blake, Sabrena; Hallarn, Rose; Rathmann, Charles; Kolb, H Robert; Himmelfarb, Cheryl Dennison; D'Agostino, Toni; Rubinstein, Eric P; Dozier, Ann M; Schuff, Kathryn G

    2014-08-01

    To respond to increased public and programmatic demand to address underenrollment of clinical translational research studies, the authors examined participant recruitment practices at Clinical and Translational Science Award (CTSA) sites and make recommendations for performance metrics and accountability. The CTSA Recruitment and Retention taskforce in 2010 invited representatives at 46 CTSAs to complete an online 48-question survey querying accrual and recruitment outcomes, practices, evaluation methods, policies, and perceived gaps in related knowledge/practice. Descriptive statistical and thematic analyses were conducted. Forty-six respondents representing 44 CTSAs completed the survey. Recruitment conducted by study teams was the most common practice reported (78%-91%, by study type); 39% reported their institution offered recruitment services to investigators. Respondents valued study feasibility assessment as a successful practice (39%); desired additional resources included feasibility assessments (49%) and participant registries (44%). None reported their institution systematically required justification of feasibility; some indicated relevant information was considered prior to institutional review board (IRB) review (30%) or contract approval (22%). All respondents' IRBs tracked study progress, but only 10% of respondents could report outcome data for timely accrual. Few reported written policies addressing poor accrual or provided data to support recruitment practice effectiveness. Many CTSAs lack the necessary frame work to support study accrual. Recom men dations to enhance accrual include articulating institutional expectations and policy for routine recruitment plan ning; providing recruitment expertise to inform feasibility assessment and recruit ment planning; and developing interdepartmental coordination and integrated informatics infrastructure to drive the conduct, evaluation, and improvement of recruitment practices.

  15. Conflict-of-interest disclosure at medical journals in Japan: a nationwide survey of the practices of journal secretariats.

    PubMed

    Kojima, Takako; Green, Joseph; Barron, J Patrick

    2015-08-26

    Medical journals in Japan generally have appropriate policies regarding disclosure of conflicts of interest (COI). However, COI management depends on the staff members of each journal's editorial secretariat. This study's objectives were to find out (A) whether COI disclosure and the journal's role in it are clearly understood by the journal's secretariat staff, (B) how much experience the editorial secretariat has in actually handling issues related to disclosure and (C) what kind of help or support they need. In January 2014, questionnaires were sent to the editorial secretariats of journal-publishing societies belonging to the Japanese Association of Medical Sciences (JAMS). The response rate was 100%, and the respondents represented 121 journals published by the 118 JAMS member societies (at the time of the survey). Information was collected on the history of COI policies and on how those policies were implemented. At the end of the questionnaire, there was an open-ended call for comments. Compulsory COI disclosure began between 2010 and 2013 for 60.3% of the journals (73/121). Handling of COI issues was not uniform: 17.4% (21/121) of respondents do not pursue cases of dubious disclosure, and 47.9% (58/121) do not require COI disclosures from editorial board members. Very few of the editorial secretariats had clearly-stated consequences for violations of COI-disclosure policy (33/121, 27.3%), and only 28.9% offered COI education (35/121). Respondents' comments indicated that uniform, easily-searchable guidance regarding COI policies and implementation would be welcome. Although commitment is widespread, policy implementation is inconsistent and COI experience is lacking. Clear, easy-to-use guidelines are desired by many societies. The JAMS is to be commended for supporting this country-wide investigation; other countries and regions are encouraged to perform similar investigations to respond to needs regarding COI management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. 75 FR 65484 - Federal Open Market Committee; Domestic Policy Directive of September 21, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-25

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of September 21... 271), there is set forth below the domestic policy directive issued by the Federal Open Market... Committee at its meeting held on September 21, 2010, which includes the domestic policy directive issued at...

  17. 78 FR 22880 - Federal Open Market Committee; Domestic Policy Directive of March 19-20, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of March 19-20... 271), there is set forth below the domestic policy directive issued by the Federal Open Market... Committee at its meeting held on March 19-20, 2013, which includes the domestic policy directive issued at...

  18. 77 FR 55794 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... Officer for Agriculture, Office of Information and Regulatory Affairs, Office of Management and Budget... amended, (RE Act) and as prescribed by Office of Management and Budget (OMB) Circular A- 129, Policies for.... Description of Respondents: Not-for-profit institutions; Business or other for-profit. Number of Respondents...

  19. The Farm Crisis: Who's in Trouble, How to Respond. National Issues Forum.

    ERIC Educational Resources Information Center

    Bulletin of Science, Technology & Society, 1987

    1987-01-01

    Provides a synopsis of information about the current crises in American agriculture. Addresses national farm policy, political activities, surplus crops, subsidy programs, the loss of smaller family-operated farms, and farm markets. Includes an opinion instrument that invites the reader to respond to the issues. (TW)

  20. Retraction policies of top scientific journals ranked by impact factor.

    PubMed

    Resnik, David B; Wager, Elizabeth; Kissling, Grace E

    2015-07-01

    This study gathered information about the retraction policies of the top 200 scientific journals, ranked by impact factor. Editors of the top 200 science journals for the year 2012 were contacted by email. One hundred forty-seven journals (74%) responded to a request for information. Of these, 95 (65%) had a retraction policy. Of journals with a retraction policy, 94% had a policy that allows the editors to retract articles without authors' consent. The majority of journals in this sample had a retraction policy, and almost all of them would retract an article without the authors' permission.

  1. Utilisation of eye-care services: the effect of Scotland's free eye examination policy.

    PubMed

    Dickey, Heather; Ikenwilo, Divine; Norwood, Patricia; Watson, Verity; Zangelidis, Alexandros

    2012-12-01

    To examine how the introduction of free eye examinations in Scotland affected people's use of eye care services. Particularly, to assess if more people are now having their eyes examined regularly, and whether there are differences in the way people responded to the policy across socio-economic groups. Using the British Household Panel Survey, eye test uptake and frequency in Scotland is compared to the rest of the UK pre and post policy. Propensity to have eye tests and responsiveness to the policy is compared across socio-economic groups. In addition, using data available from a chain of private ophthalmic opticians, clinical characteristics of eye examination patients are compared pre- and post-policy. There is evidence that suggests that people responded positively to the policy. In particular, a higher percentage of people in Scotland have their eyes tested after the free eye care policy was introduced. Interestingly, the response to the policy varies between the different socio-economic groups. For the highest earners and most educated groups, the proportion of people having an eye test increased more than for those groups with lower income or lower education. Although the policy succeeded in getting more people to have their eyes tested, the socio-economic differences observed suggest that the policy has not reached the more vulnerable segments in society to the same extent, in particular, those with low education and low income. As a result, eye care services utilisation inequalities have widened in Scotland after the free eye care policy was introduced. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Faculty experiences with the National Institutes of Health (NIH) public access policy, compliance issues, and copyright practices.

    PubMed

    Charbonneau, Deborah H; McGlone, Jonathan

    2013-01-01

    The research assessed faculty awareness of the National Institutes of Health (NIH) public access policy and faculty experiences with the copyright terms in their author agreements with publishers. During the fall of 2011, 198 faculty members receiving funding from NIH at a large urban academic institution were invited to participate in an anonymous online survey. A total of 94 faculty members responded to the survey, representing a response rate of 47%. Thirty percent of the survey respondents were either unaware of or not familiar with the NIH policy. Further, a significant number of faculty members (97.8%) indicated that they usually signed their copyright forms "as is." The findings show that time, confusing instructions, and unclear journal policies are challenges experienced by NIH-funded faculty in complying with the federal mandate. There is a need to educate faculty with respect to the value of retaining their copyrights and self-archiving their publications to help advance public access and open access scholarship.

  3. Misconduct Policies in High-Impact Biomedical Journals

    PubMed Central

    Bosch, Xavier; Hernández, Cristina; Pericas, Juan M.; Doti, Pamela; Marušić, Ana

    2012-01-01

    Background It is not clear which research misconduct policies are adopted by biomedical journals. This study assessed the prevalence and content policies of the most influential biomedical journals on misconduct and procedures for handling and responding to allegations of misconduct. Methods We conducted a cross-sectional study of misconduct policies of 399 high-impact biomedical journals in 27 biomedical categories of the Journal Citation Reports in December 2011. Journal websites were reviewed for information relevant to misconduct policies. Results Of 399 journals, 140 (35.1%) provided explicit definitions of misconduct. Falsification was explicitly mentioned by 113 (28.3%) journals, fabrication by 104 (26.1%), plagiarism by 224 (56.1%), duplication by 242 (60.7%) and image manipulation by 154 (38.6%). Procedures for responding to misconduct were described in 179 (44.9%) websites, including retraction, (30.8%) and expression of concern (16.3%). Plagiarism-checking services were used by 112 (28.1%) journals. The prevalences of all types of misconduct policies were higher in journals that endorsed any policy from editors’ associations, Office of Research Integrity or professional societies compared to those that did not state adherence to these policy-producing bodies. Elsevier and Wiley-Blackwell had the most journals included (22.6% and 14.8%, respectively), with Wiley journals having greater a prevalence of misconduct definition and policies on falsification, fabrication and expression of concern and Elsevier of plagiarism-checking services. Conclusions Only a third of top-ranking peer-reviewed journals had publicly-available definitions of misconduct and less than a half described procedures for handling allegations of misconduct. As endorsement of international policies from policy-producing bodies was positively associated with implementation of policies and procedures, journals and their publishers should standardize their policies globally in order to increase public trust in the integrity of the published record in biomedicine. PMID:23284820

  4. Misconduct policies in high-impact biomedical journals.

    PubMed

    Bosch, Xavier; Hernández, Cristina; Pericas, Juan M; Doti, Pamela; Marušić, Ana

    2012-01-01

    It is not clear which research misconduct policies are adopted by biomedical journals. This study assessed the prevalence and content policies of the most influential biomedical journals on misconduct and procedures for handling and responding to allegations of misconduct. We conducted a cross-sectional study of misconduct policies of 399 high-impact biomedical journals in 27 biomedical categories of the Journal Citation Reports in December 2011. Journal websites were reviewed for information relevant to misconduct policies. Of 399 journals, 140 (35.1%) provided explicit definitions of misconduct. Falsification was explicitly mentioned by 113 (28.3%) journals, fabrication by 104 (26.1%), plagiarism by 224 (56.1%), duplication by 242 (60.7%) and image manipulation by 154 (38.6%). Procedures for responding to misconduct were described in 179 (44.9%) websites, including retraction, (30.8%) and expression of concern (16.3%). Plagiarism-checking services were used by 112 (28.1%) journals. The prevalences of all types of misconduct policies were higher in journals that endorsed any policy from editors' associations, Office of Research Integrity or professional societies compared to those that did not state adherence to these policy-producing bodies. Elsevier and Wiley-Blackwell had the most journals included (22.6% and 14.8%, respectively), with Wiley journals having greater a prevalence of misconduct definition and policies on falsification, fabrication and expression of concern and Elsevier of plagiarism-checking services. Only a third of top-ranking peer-reviewed journals had publicly-available definitions of misconduct and less than a half described procedures for handling allegations of misconduct. As endorsement of international policies from policy-producing bodies was positively associated with implementation of policies and procedures, journals and their publishers should standardize their policies globally in order to increase public trust in the integrity of the published record in biomedicine.

  5. Managerial and Organizational Discourses of Workplace Bullying.

    PubMed

    Johnson, Susan L; Boutain, Doris M; Tsai, Jenny H-C; de Castro, Arnold B

    2015-09-01

    To explore how workplace bullying is addressed by hospital nursing unit managers and organizational policies. Although workplace bullying is costly to organizations, nurses report that managers do not consistently address the issue. This study used discourse analysis to analyze interview data and policy documents. There were differences in the manner in which managers and the policy documents labeled bullying-type behaviors and discussed the roles and responsibilities of staff and managers. Policies did not clearly delineate how managers should respond to workplace bullying. These differences can allow management variation, not sanctioned by policy. Unclear policy language can also offer insufficient guidance to managers, resulting in differential enforcement of policies.

  6. Differences in the Perception of Social Support Among Rural Area Seniors-A Cross-Sectional Survey of Polish Population.

    PubMed

    Chruściel, Paweł; Kulik, Teresa; Jakubowska, Klaudia; Nalepa, Dorota

    2018-06-19

    Introduction and objective : Social support constitutes an important determinant of an elderly person’s health and of functioning in his or her living environment. It depends on available support networks and the type of help received. Measurement of social support should encompass both its structure and the functions it fulfills, which enables detailed assessment of the phenomenon. The aim of the study was to compare the perception of social support among rural area seniors provided with institutional care with those living in a home setting. Material and method : Using the diagnostic survey method and the technique of the distribution of a direct questionnaire, 364 respondents from rural areas were examined: those living in an institutional environment ( n = 190) and those living in their home (natural) environment ( n = 174). The respondents were selected on the basis of a combined sampling method: proportionate, stratified, and systematic. Variables were measured with the following questionnaires: Courage Social Network Index (CSNI) and Social Support Scale (SSS). Results : The living environment has been proved to differentiate average values of support both in the structural and functional dimensions in a statistically significant way ( p < 0.001). An untypical phenomenon was higher average values pertaining to emotional bonds, frequency of direct contacts, and help received in the group of respondents living in an institutional environment. Conclusions : The living environment and demographic variables affect the perception of social support among elderly people. Full-time institutional care of a senior citizen leads to the deterioration of social support; therefore, keeping an elderly person in a home environment should be one of the primary goals of the senior policy.

  7. Good Policy, Good Practice II. Improving Outcomes and Productivity in Higher Education: A Guide for Policymakers

    ERIC Educational Resources Information Center

    Brenneman, Meghan Wilson; Callan, Patrick M.; Ewell, Peter T.; Finney, Joni E.; Jones, Dennis P.; Zis, Stacey

    2010-01-01

    This new edition of "Good Policy, Good Practice II" revises and updates the authors' 2007 publication. Like the earlier edition, it responds to one of the questions that is raised most frequently in the authors' work with public policy and education leaders as they begin to address the national and state imperatives to increase the proportion of…

  8. Policy-Impact Analysis: A Rational Method to Respond to the Challenges Faced by Higher Education in the Eighties.

    ERIC Educational Resources Information Center

    Morrison, James L.

    Policy-impact analysis is introduced as a model to aid higher education in dealing with the significant problems in the decade of the 1980s. The model provides a framework within which a variety of futures research techniques are tied to policy development, implementation, and evaluation. The utility of the model is that it structures…

  9. High Schools' Role in College and Workforce Preparation: Do College-for-All Policies Make High School Irrelevant? Spotlight on Student Success.

    ERIC Educational Resources Information Center

    Rosenbaum, James E.

    High schools have responded to the poor labor market primarily by encouraging college-for-all policies, leading the majority of seniors to plan to get college degrees, even those who perform poorly. School policies focus too narrowly on academic achievement, overlooking soft skills like motivation, dependability, attention to quality, and social…

  10. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    PubMed

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable meeting achieved its purpose (to engage stakeholders, elicit feedback, refine policy directions). Third, our decision-maker partners' expectations of the policy roundtable meeting were exceeded; they re-affirmed its value and described the refined policy directions as foundational to establishing the vocabulary, vision and framework for improving access to scheduled clinical services in Manitoba. Finally, our adaptation of key design elements was conducive to discussion of issues surrounding access to care. Our policy roundtable process was an effective tool for acquiring broad input from stakeholders, refining policy directions and forming the necessary consensus starting points to move towards evidence-informed policy.

  11. 75 FR 42444 - Federal Open Market Committee; Domestic Policy Directive of June 22 and 23, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of June 22 and 23...), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at... Committee at its meeting held on June 22 and 23, 2010, which includes the domestic policy directive issued...

  12. Using Newborn Screening Bloodspots for Research: Public Preferences for Policy Options.

    PubMed

    Hayeems, Robin Z; Miller, Fiona A; Barg, Carolyn J; Bombard, Yvonne; Cressman, Celine; Painter-Main, Michael; Wilson, Brenda; Little, Julian; Allanson, Judith; Avard, Denise; Giguere, Yves; Chakraborty, Pranesh; Carroll, June C

    2016-06-01

    Retaining residual newborn screening (NBS) bloodspots for medical research remains contentious. To inform this debate, we sought to understand public preferences for, and reasons for preferring, alternative policy options. We assessed preferences among 4 policy options for research use of residual bloodspots through a bilingual national Internet survey of a representative sample of Canadians. Fifty percent of respondents were randomly assigned to select reasons supporting these preferences. Understanding of and attitudes toward screening and research concepts, and demographics were assessed. Of 1102 respondents (94% participation rate; 47% completion rate), the overall preference among policy options was ask permission (67%); this option was also the most acceptable choice (80%). Assume permission was acceptable to 46%, no permission required was acceptable to 29%, and no research allowed was acceptable to 26%. The acceptability of the ask permission option was reduced among participants assigned to the reasoning exercise (84% vs 76%; P = .004). Compared with assume/no permission required, ordered logistic regression showed a significant reduction in preference for the ask permission option with greater understanding of concepts (odds ratio, 0.87; P < .001), greater confidence in science (odds ratio, 0.16; P < .001), and a perceived responsibility to contribute to research (odds ratio, 0.39; P < .001). Surveyed Canadians prefer that explicit permission is sought for storage and research use of NBS bloodspots. This preference was diminished when reasons supporting and opposing routine storage, and other policy options, were presented. Findings warrant consideration as NBS communities strategize to respond to shifting legislative contexts. Copyright © 2016 by the American Academy of Pediatrics.

  13. Moral dimensions of human-wildlife conflict.

    PubMed

    Lute, Michelle L; Navarrete, Carlos David; Nelson, Michael Paul; Gore, Meredith L

    2016-12-01

    Despite increasing support for conservation globally, controversy over specific conservation policies persists among diverse stakeholders. Investigating the links between morals in relation to conservation can help increase understanding about why humans support or oppose policy, especially related to human-wildlife conflict or human conflict over wildlife. Yet the moral dimension of human-wildlife conflict has mostly gone unconsidered and unmeasured; thus, policy and programmatic efforts to reduce controversy may be missing a key part of the equation. We conducted a web-based survey (n = 1239 respondents) in Michigan (U.S.A.) to investigate cognitive and emotional influences on the value-behavior relationship. Respondents were identified by their interest and involvement in Michigan wolf management. The survey consisted of questions about values, emotions, cognitions, and behaviors relative to wolves in Michigan. We used path analysis to explore whether emotions and cognitions mediated the relationship between value and behavior. Most respondents attributed intrinsic value to wolves (n = 734) and all life (n = 773) and engaged in behaviors that benefited wolf populations and ecosystems regardless of stakeholder group (e.g., environmentalist, farmer). Attributing intrinsic value to wolves was positively related to favorable emotions toward wolves and cognitive assessments that hunting and trapping of wolves is unacceptable. Despite similarities in attribution of intrinsic value, groups differed in emotions and cognitions about wolf hunting. These differences provide a useful way to predict stakeholder behavior. Our findings may inform interventions aimed at increasing support for wolf management policies and positive interactions among stakeholders and wildlife. Leveraging agreement over intrinsic value may foster cooperation among stakeholders and garner support for controversial conservation policy. © 2016 Society for Conservation Biology.

  14. School Safety Study: Phase I.

    ERIC Educational Resources Information Center

    Arora, Alka

    This report summarizes findings from a study concerned with Arizona school safety. The survey component highlights safety-related policy information across 300 schools; the interview component highlights school-safety perceptions of 64 staff across 16 schools. Various policies and programs that respond to internal and external threats to school…

  15. Responding to Postsecondary Education Financing Pressures.

    ERIC Educational Resources Information Center

    Longanecker, David A.

    Minnesota has adopted a financial policy that takes into account the increasing pressure to finance postsecondary education. The policy increases the price of college through increased tuition, while at the same time targeting sufficient financial aid to ensure educational opportunity for financially needy students. In practical terms, this…

  16. Love, money, or flexibility: what motivates people to work in consumer-directed home care?

    PubMed

    Howes, Candace

    2008-07-01

    The purpose of this study was to investigate the impact of wages and benefits (relative to other jobs available to workers), controlling for personal characteristics, on the recruitment and retention of providers working in a consumer-directed home care program. I used the results of focus groups to design a survey that was administered to 2,260 workers stratified by ethnicity and working in eight California counties that represented the range of wage and benefit packages available. I used logistic regression to measure the effect of wage and benefit levels, controlling for covariates, on home care workers' stated reason for entering and remaining in the job. Two thirds of respondents reported that commitment to their consumer was the most important reason why they took the job and flexibility was the second most important reason, regardless of wages and benefits and personal characteristics. However, in the county in which very part-time workers were eligible, health insurance was the most important reason for retention. Wage levels above $9 an hour mattered somewhat, especially where the increase was recent. Family providers responded to wage and benefit incentives similarly to non-family providers. To improve recruitment and retention of consumer-directed home care workers, jobs should be flexible and provide affordable health insurance for part-time workers. The effect of wages suggests that recruitment might be improved with higher wages, but only when they reach the $9 to $10 range (in 2004 dollars). Finally, policy must recognize that family caregivers have financial needs similar to non-family caregivers.

  17. Direct-to-consumer genetic testing: an assessment of genetic counselors' knowledge and beliefs

    PubMed Central

    Hock, Kathryn T.; Christensen, Kurt D.; Yashar, Beverly M.; Roberts, J. Scott; Gollust, Sarah E.; Uhlmann, Wendy R.

    2013-01-01

    Purpose Direct-to-consumer genetic testing is a new means of obtaining genetic testing outside of a traditional clinical setting. This study assesses genetic counselors’ experience, knowledge, and beliefs regarding direct-to-consumer genetic testing for tests that would currently be offered in genetics clinics. Methods Members of the National Society of Genetic Counselors completed a web-administered survey in February 2008. Results Response rate was 36%; the final data analysis included 312 respondents. Eighty-three percent of respondents had two or fewer inquiries about direct-to-consumer genetic testing, and 14% had received requests for test interpretation or discussion. Respondents believed that genetic counselors have a professional obligation to be knowledgeable about direct-to-consumer genetic testing (55%) and interpret results (48%). Fifty-one percent of respondents thought genetic testing should be limited to a clinical setting; 56% agreed direct-to-consumer genetic testing is acceptable if genetic counseling is provided. More than 70% of respondents would definitely or possibly consider direct-to-consumer testing for patients who (1) have concerns about genetic discrimination, (2) want anonymous testing, or (3) have geographic constraints. Conclusions Results indicate that genetic counselors have limited patient experiences with direct-to-consumer genetic testing and are cautiously considering if and under what circumstances this approach should be used PMID:21233722

  18. Long-term effects of hypnotherapy in patients with refractory irritable bowel syndrome.

    PubMed

    Lindfors, Perjohan; Unge, Peter; Nyhlin, Henry; Ljótsson, Brjánn; Björnsson, Einar S; Abrahamsson, Hasse; Simrén, Magnus

    2012-04-01

    Gut-directed hypnotherapy is considered to be an effective treatment in irritable bowel syndrome (IBS) but few studies report the long-term effects. This retrospective study aims to evaluate the long-term perceived efficacy of gut-directed hypnotherapy given outside highly specialized hypnotherapy centers. 208 patients, who all had received gut-directed hypnotherapy, were retrospectively evaluated. The Subjective Assessment Questionnaire (SAQ) was used to measure changes in IBS symptoms, and patients were classified as responders and non-responders. Patients were also asked to report changes in health-care seeking, use of drugs for IBS symptoms, use of alternative non-pharmacological treatments, and if they still actively used hypnotherapy. Immediately after hypnotherapy, 103 of 208 patients (49%) were responders and 75 of these (73%) had improved further at the follow-up 2-7 years after hypnotherapy (mean 4 years). A majority of the responders still used hypnotherapy on a regular basis at follow-up (73%), and the responders reported a greater reduction in health-care seeking than non-responders. A total of 87% of all patients reported that they considered gut-directed hypnotherapy to be worthwhile, and this differed between responders and non-responders (100% vs. 74%; p < 0.0001). This long-term follow-up study indicates that gut-directed hypnotherapy in refractory IBS is an effective treatment option with long-lasting effects, also when given outside highly specialized hypnotherapy centers. Apart from the clinical benefits, the reduction in health-care utilization has the potential to reduce the health-care costs.

  19. Analysis of selected policies towards universal health coverage in Uganda: the policy implementation barometer protocol.

    PubMed

    Hongoro, Charles; Rutebemberwa, Elizeus; Twalo, Thembinkosi; Mwendera, Chikondi; Douglas, Mbuyiselo; Mukuru, Moses; Kasasa, Simon; Ssengooba, Freddie

    2018-01-01

    Policy implementation remains an under researched area in most low and middle income countries and it is not surprising that several policies are implemented without a systematic follow up of why and how they are working or failing. This study is part of a larger project called Supporting Policy Engagement for Evidence-based Decisions (SPEED) for Universal Health Coverage in Uganda. It seeks to support policymakers monitor the implementation of vital programmes for the realisation of policy goals for Universal Health Coverage. A Policy Implementation Barometer (PIB) is proposed as a mechanism to provide feedback to the decision makers about the implementation of a selected set of policy programmes at various implementation levels (macro, meso and micro level). The main objective is to establish the extent of implementation of malaria, family planning and emergency obstetric care policies in Uganda and use these results to support stakeholder engagements for corrective action. This is the first PIB survey of the three planned surveys and its specific objectives include: assessment of the perceived appropriateness of implementation programmes to the identified policy problems; determination of enablers and constraints to implementation of the policies; comparison of on-line and face-to-face administration of the PIB questionnaire among target respondents; and documentation of stakeholder responses to PIB findings with regard to corrective actions for implementation. The PIB will be a descriptive and analytical study employing mixed methods in which both quantitative and qualitative data will be systematically collected and analysed. The first wave will focus on 10 districts and primary data will be collected through interviews. The study seeks to interview 570 respondents of which 120 will be selected at national level with 40 based on each of the three policy domains, 200 from 10 randomly selected districts, and 250 from 50 facilities. Half of the respondents at each level will be randomly assigned to either face-to-face or on-line interviews. An integrated questionnaire for these interviews will collect both quantitative data through Likert scale-type questions, and qualitative data through open-ended questions. And finally focused dialogues will be conducted with selected stakeholders for feedback on the PIB findings. Secondary data will be collected using data extraction tools for performance statistics. It is anticipated that the PIB findings and more importantly, the focused dialogues with relevant stakeholders, that will be convened to discuss the findings and establish corrective actions, will enhance uptake of results and effective health policy implementation towards universal health coverage in Uganda.

  20. Expert opinions on optimal enforcement of minimum purchase age laws for tobacco.

    PubMed

    Levy, D T; Chaloupka, F; Slater, S

    2000-05-01

    A questionnaire on how youth access laws should be enforced was sent to 20 experts who had administered and/or evaluated a youth access enforcement program. Respondents agreed on the need for a high level of retail compliance, checkers representative of the community, checks at least twice per year, a graduated penalty structure with license revocation, and bans on self-service and vending machines. Respondents indicated the need for research on the effects of ID use, frequency of checks, penalty structures, and the effects on smoking rates of youth access policies alone and in conjunction with other tobacco control policies.

  1. Conservative sharp wound debridement: an overview of Canadian education, practice, risk, and policy.

    PubMed

    Rodd-Nielsen, Elise; Harris, Connie L

    2013-01-01

    The purpose of this study was to describe the education, policy, practice, and risk management strategies of nurses performing conservative sharp wound debridement (CSWD) in Canada, prior to the release of the Canadian Association for Enterostomal Therapy Evidence-Based Recommendations for Conservative Sharp Wound Debridement. Data collection was based on a nonrandomized, nonexperimental study design and reported using descriptive statistics. Invitations for health care professionals to participate in a CSWD scan were sent to 4315 people via e-mail through the membership lists of 2 Canadian voluntary professional wound care associations. Skip logic screened out respondents who had no experience in CSWD (n = 57). The total number of professionals who participated was 487. A 26-question electronic scan addressed demographics, education, policy, practice, and risk/quality issues related to CSWD. A comment section was included for some questions. A selected subsample of 397 nurses was chosen from the original total of 487 respondents. Nonnurse respondents were excluded due to the low total number of participants in each of these other professional categories. Nurses perform CSWD in all types of care settings in Canada from outpost nursing stations to hospital wards, homes, and long-term care facilities. The wound education preparation reported varied. The most frequently reported formal wound care education was a 2-day course (59%; n = 220), followed by an enterostomal therapy course (42%; n = 155) and the International Interdisciplinary Wound Care Course (26%; n = 98), with overlapping preparation evident. Eleven percent of respondents (n = 47) reported having taken no formal wound course, and 7% (n = 27) taught themselves to perform CSWD. Twenty-eight percent of nurses (n = 112) were unclear about whether CSWD was within their scope of practice or replied that it was not, and 69% (n = 273) did not know if there was provincial legislation that restricted their practice of CSWD. Forty-eight percent of nurses (n = 181) reported that their institutions do not have policies on CSWD, and 9% (n = 35) did not know. Adverse events associated with CSWD were reported by 196 respondents, with minor bleeding reported most frequently (98% n = 192) by those who answered the question. The education, policy, practice, and risk management of nurses practicing CSWD could benefit from development and dissemination of a set of National Standards and Competencies for this high-risk wound intervention.

  2. 42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

  3. 42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

  4. 42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

  5. 42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

  6. 42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

  7. Colleges Respond to Student Binge Drinking: Reducing Student Demand or Limiting Access.

    ERIC Educational Resources Information Center

    Wechsler, Henry; Seibring, Mark; Liu, I-Chao; Ahl, Marilyn

    2004-01-01

    Administrators at 68% of 4-year colleges nationwide (N = 747) responded to a survey concerning the types of programs and policies they used in response to students" heavy drinking. Most schools conducted targeted alcohol education and invested in institutional prevention efforts; half conducted social norms campaigns; a sizeable minority…

  8. 78 FR 42073 - Proposed Agency Information Collection Activities: Submission for OMB Review; Comment Request Re...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... continuing effort to reduce paperwork and respondent burden, invites the general public and other Federal... hour. Estimated number of respondents per survey: 850. Total Annual Burden: 12,500 hours. General... change, and in some cases to simply learn how particular policies or programs are working, or are...

  9. Role and use of evidence in policymaking: an analysis of case studies from the health sector in Nigeria.

    PubMed

    Onwujekwe, Obinna; Uguru, Nkoli; Russo, Giuliano; Etiaba, Enyi; Mbachu, Chinyere; Mirzoev, Tolib; Uzochukwu, Benjamin

    2015-10-24

    Health policymaking is a complex process and analysing the role of evidence is still an evolving area in many low- and middle-income countries. Where evidence is used, it is greatly affected by cognitive and institutional features of the policy process. This paper examines the role of different types of evidence in health policy development in Nigeria. The role of evidence was compared between three case studies representing different health policies, namely the (1) integrated maternal neonatal and child health strategy (IMNCH); (2) oral health (OH) policy; and (3) human resource for health (HRH) policy. The data was collected using document reviews and 31 in-depth interviews with key policy actors. Framework Approach was used to analyse the data, aided by NVivo 10 software. Most respondents perceived evidence to be factual and concrete to support a decision. Evidence was used more if it was perceived to be context-specific, accessible and timely. Low-cost high-impact evidence, such as the Lancet series, was reported to have been used in drafting the IMNCH policy. In the OH and HRH policies, informal evidence such as experts' experiences and opinions, were reported to have been useful in the policy drafting stage. Both formal and informal evidence were mentioned in the HRH and OH policies, while the development of the IMNCH was revealed to have been informed mainly by more formal evidence. Overall, respondents suggested that formal evidence, such as survey reports and research publications, were most useful in the agenda-setting stage to identify the need for the policy and thus initiating the policy development process. International and local evidence were used to establish the need for a policy and develop policy, and less to develop policy implementation options. Recognition of the value of different evidence types, combined with structures for generating and using evidence, are likely to enhance evidence-informed health policy development in Nigeria and other similar contexts.

  10. Sensitivity of health sector indicators' response to climate change in Ghana.

    PubMed

    Dovie, Delali B K; Dzodzomenyo, Mawuli; Ogunseitan, Oladele A

    2017-01-01

    There is accumulating evidence that the emerging burden of global climate change threatens the fidelity of routine indicators for disease detection and management of risks to public health. The threat partially reflects the conservative character of the health sector and the reluctance to adopt new indicators, despite the growing awareness that existing environmental health indicators were developed to respond to risks that may no longer be relevant, and are too simplistic to also act as indicators for newer global-scale risk factors. This study sought to understand the scope of existing health indicators, while aiming to discover new indicators for building resilience against three climate sensitive diseases (cerebro spinal meningitis, malaria and diarrhea). Therefore, new potential indicators derived from human and biophysical origins were developed to complement existing health indicators, thereby creating climate-sensitive battery of robust composite indices of resilience in health planning. Using Ghana's health sector as a case study systematic international literature review, national expert consultation, and focus group outcomes yielded insights into the relevance, sensitivity and impacts of 45 indicators in 11 categories in responding to climate change. In total, 65% of the indicators were sensitive to health impacts of climate change; 24% acted directly; 31% synergistically; and 45% indirectly, with indicator relevance strongly associated with type of health response. Epidemiological indicators (e.g. morbidity) and health demographic indicators (e.g. population structure) require adjustments with external indicators (e.g. biophysical, policy) to be resilient to climate change. Therefore, selective integration of social and ecological indicators with existing public health indicators improves the fidelity of the health sector to adopt more robust planning of interdependent systems to build resilience. The study highlights growing uncertainties in translating research into protective policies when new indicators associated with non-health sources are needed to complement existing health indicators that are expected to respond to climate change. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Internationalization Policies of Jesuit Universities: A Case Study of Japan and the U.S

    ERIC Educational Resources Information Center

    Jung, Kang-Yup

    2009-01-01

    In the wake of globalization, higher education institutions almost inevitably have adopted and implemented internationalization policies as their primary strategy for responding to the challenges and opportunities brought about by globalization. This study concerns the comparison of the motivations, program strategies, and organization strategies…

  12. National Policy and the Development of Inclusive School Practices: A Case Study

    ERIC Educational Resources Information Center

    Dyson, Alan; Gallannaugh, Frances

    2007-01-01

    National education policy in England under New Labour Governments has encompassed both a "standards agenda" and an "inclusion agenda", with schools required to respond to both simultaneously. Some previous studies have seen these agendas as contradictory and have seen schools' efforts to develop inclusive practices as being…

  13. More Questions than Answers: A Response to Stephens, Reeder, and Elder.

    ERIC Educational Resources Information Center

    Bhaerman, Robert D.

    1992-01-01

    Responds to the three main articles in this issue with questions concerning the development and use of policy-impact codes (rural-urban classification systems) for specific purposes in policymaking, research, and practice. Questions the necessity for policy-impact codes to ensure equity, adequacy, responsiveness, and appropriateness of rural…

  14. Information Policy -- Distance Education: Provider and Victim Libraries.

    ERIC Educational Resources Information Center

    Heron, Peter; Dugan, Robert E.

    1997-01-01

    This discussion of information policy focuses on library services for distance education. Topics include the logistics and management of providing library services off-site and/or responding to student requests; and meeting the needs of distance education students for information and library instruction, both students from the member institution…

  15. Differential Effects of Linguistic Imperialism on Second Language Learning: Americanisation in Puerto Rico Versus Russification in Estonia.

    ERIC Educational Resources Information Center

    Clachar, Arlene

    1998-01-01

    Explores how Americanization and Russification differed in terms of their imperialist language policies and how these policies led two colonialized societies, Puerto Rico and Estonia, to respond in dramatically different ways to the pressures to learn English and Russian respectively. (Author/VWL)

  16. Content Validity in Evaluation and Policy-Relevant Research.

    ERIC Educational Resources Information Center

    Mark, Melvin M.; And Others

    1985-01-01

    The role of content validity in policy-relevant research is illustrated in a study contrasting results of surveys concerning public opinion toward gun control. Inadequate content validity threatened inferences about the overall level of support for gun control, but not about opinion difference between sexes or respondents of varying political…

  17. The Effect of Jail Reform Policies on Guard/Management Relations.

    ERIC Educational Resources Information Center

    Pogrebin, Mark

    1987-01-01

    Interviewed 60 jail corrections officers in four types of jails to examine views about working relations and judgments of institutional policy. Respondents reported feeling unappreciated by superiors and powerless in relation to inmates. Officers were caught between administration demands for safety and recently acquired rights of inmates. (NB)

  18. Beyond Standardization: State Standards and School Improvement.

    ERIC Educational Resources Information Center

    Wise, Arthur E.; Darling-Hammond, Linda

    This paper focuses on ways in which one state policy for improving education--standard-setting through testing mechanisms--affects the classroom teacher-learner relationship. That uniform policy-making is problematic is clear from observations of 43 Mid-Atlantic school district teachers. Responding to three types of standards, 45 percent found…

  19. 75 FR 30030 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... Governments; Number of Respondents: 51; Total Annual Responses: 51; Total Annual Hours: 102. (For policy... dialysis facilities are required to report. Form Number: CMS-265-94 (OMB : 0938-0236); Frequency: Yearly...,508; Total Annual Responses: 5,508; Total Annual Hours: 275,400. (For policy questions regarding this...

  20. Turkey: Reviews of National Policies for Education.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France).

    The first of three parts of this review of Turkey's educational system and national educational policies, the examiner's report, begins by singling out essential features of modern Turkey that affect the provision of education and to which the system is having to respond. These include Turkey's unique geographic situation, its continuing devotion…

  1. 10 CFR 26.27 - Written policy and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.27 Written policy and... respond to an emergency, the procedure must— (A) Require a determination of fitness by breath alcohol... require him or her to be subject to this subpart, if the results of the determination of fitness indicate...

  2. 10 CFR 26.27 - Written policy and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.27 Written policy and... respond to an emergency, the procedure must— (A) Require a determination of fitness by breath alcohol... require him or her to be subject to this subpart, if the results of the determination of fitness indicate...

  3. 78 FR 42965 - Guidance for Industry: Enforcement Policy Regarding Investigational New Drug Requirements for Use...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... Microbiota for Transplantation To Treat Clostridium difficile Infection Not Responsive to Standard Therapies... Policy Regarding IND Requirements for Use of Fecal Microbiota for Transplantation to Treat Clostridium... microbiota for transplantation (FMT) to treat C. difficile infection not responding to standard therapies...

  4. 24 CFR 107.51 - Findings of noncompliance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... shall be made in any case in which the facts establish the existence of a discriminatory practice under § 107.15(g) (c) The existence or use of a policy or practice, or any arrangement, criterion or other... business necessity or governmental purpose of the respondent; (2) The policy or practice effectively...

  5. Enforcement policy regarding unfair exclusionary conduct in the air transport industry : findings on the economic, policy, and legal issues

    DOT National Transportation Integrated Search

    2001-01-17

    This Administration has investigated whether incumbent airlines have been responding to entry by other airlines in ways that seemed intended not as legitimate competition but as a means of creating or maintaining market power. On the basis of that in...

  6. Satisfaction with Rural Services: The Policy Preferences of Leaders and Community Residents.

    ERIC Educational Resources Information Center

    Molnar, Joseph J.; Smith, John P.

    To examine ratings of satisfaction with selected community services in relation to spending preferences and to ascertain policy-relevant implications of citizen evaluations in planning and delivering rural services), a study focused on perceptions of community leaders and household respondents in eight rural Alabama counties. Research literature…

  7. US Military Presence in Latin America: Making the Manta Forward Operating Location work

    DTIC Science & Technology

    2003-09-01

    actors in the decision making process and the actors’ policy preferences and determine how they group themselves in this policy area and interact......between Peru’s growing areas and Colombia’s processing plants.22 The riverine efforts responded to concerns that drug traffickers would shift smuggling

  8. Sex Crimes, Children, and Pornography: Public Views and Public Policy

    ERIC Educational Resources Information Center

    Mears, Daniel P.; Mancini, Christina; Gertz, Marc; Bratton, Jake

    2008-01-01

    "Get tough" approaches for responding to sex crimes have proliferated during the past decade. Child pornography in particular has garnered attention in recent years. Policy makers increasingly have emphasized incarceration as a response to such crime, including accessing child pornography. Juxtaposed against such efforts is a dearth of knowledge…

  9. Child Health, Medicaid, and Welfare "Reform." Report III, Confronting the New Politics of Child and Family Policy in the United States.

    ERIC Educational Resources Information Center

    Kamerman, Sheila B., Ed.; Kahn, Alfred J., Ed.

    "Confronting the New Politics of Child and Family Policy in the United States" is an 18-month project designed to help states, local government, and the voluntary sector as they respond to the social policy debates and changes precipitated by the 104th Congress. The project's main vehicle, aside from exploratory and analytic work, is a…

  10. Public policies for managing urban growth and protecting open space: policy instruments and lessons learned in the United States

    Treesearch

    David N. Bengston; Jennifer O. Fletcher

    2003-01-01

    The public sector in the United States has responded to growing concern about the social and environmental costs of sprawling development patterns by creating a wide range of policy instruments designed to manage urban growth and protect open space. These techniques have been implemented at the local, regional, state and, to a limited extent, national levels. This...

  11. Child Welfare in the Context of Welfare "Reform." Confronting the New Politics of Child and Family Policy in the United States. Report V.

    ERIC Educational Resources Information Center

    Kamerman, Sheila B., Ed.; Kahn, Alfred J., Ed.

    "Confronting the New Politics of Child and Family Policy in the United States" is an 18-month project designed to help states, local governments, and the voluntary sector as they respond to the social policy debates and changes precipitated by the 104th Congress. The project's main vehicle, aside from exploratory and analytic work, is a…

  12. Directional responding of C57BL/6J mice in the Morris water maze is influenced by visual and vestibular cues and is dependent upon the anterior thalamic nuclei

    PubMed Central

    Stackman, Robert W.; Lora, Joan C.; Williams, Sidney B.

    2012-01-01

    Recent findings indicate that rats navigate in spatial tasks such as the Morris water maze (MWM) using a local cue-based reference frame rather than a distal cue-based reference frame. Specifically, rats swim in a particular direction to a location relative to pool-based cues, rather than to an absolute location defined by room-based cues. Neural mechanisms supporting this bias in rodents for relative responding in spatial tasks are not yet understood. Anterior thalamic neurons discharge according to the current directional heading of the animal. The contribution of head direction (HD) cell activity to navigation has been difficult to elucidate. We found that male C57BL/6J mice trained for 4 or 7 days in the MWM exhibited an overwhelming preference for swimming in a direction relative to pool-based cues over absolute responding during a platform-less probe test. Rotation of extra-maze cues caused a corresponding rotation of the direction mice swam during probe test, suggesting that both pool- and room-based reference frames guide platform search. However, disorienting the mice before the probe test disturbed relative responding. Therefore, relative responding is guided by both internal and external cue sources. Selective inactivation of anterior thalamic nuclei (ATN) by microinfusion of muscimol or fluorophore-conjugated muscimol caused a near complete shift in preference from relative to absolute responding. Interestingly, inactivation of the dorsal CA1 region of the hippocampus did not affect relative responding. These data suggest that ATN, and HD cells therein, may guide relative responding in the MWM, a task considered by most to reflect hippocampal processing. PMID:22836256

  13. Perceptions of policy and political leadership in nursing in New Zealand.

    PubMed

    Donovan, Donna J; Diers, Donna; Carryer, Jenny

    2012-07-01

    This qualitative study was focused on the landscape of nursing policy and political leadership in New Zealand. A volunteer sample (N = 18) of nurse leaders (Fellows of the College of Nurses Aotearoa (NZ) Inc) drawn from across the country was interviewed with respect to issues that affect their interest in participating in political action and policy work. The framework of stages of nursing's political development published by Cohen and colleagues (1996) was used as an interview guide. Respondents were asked to describe their own stage of political development, their perception of the political development of New Zealand nurses and nursing organisations at large, and also their thoughts on what could be done to better position nursing in healthcare policy development. In general, respondents agreed that the major nursing organisations in New Zealand (the College of Nurses-- Aotearoa and New Zealand Nurses Organisation [NZNO]) were moving toward increasing policy sophistication. Qualitative content analysis suggested five themes which, taken together, describe nursing's policy/political development in New Zealand: languaging; succession/legacy planning; Tall Poppies and Queen Bees; "it's a small country"; and speaking with one voice. Although limited by sample size, the information collected provides a beginning focus for discussion that can steer New Zealand nursing activities toward the wider involvement of nurse leaders in healthcare policy work on behalf of the discipline.

  14. Adapting to the Effects of Climate Change on Inuit Health

    PubMed Central

    Ford, James D.; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-01-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks—one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context. PMID:24754615

  15. Adapting to the effects of climate change on Inuit health.

    PubMed

    Ford, James D; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-06-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks-one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context.

  16. Protecting and Expanding the Richness and Diversity of Life, An Ethic for Astrobiology Research and Space Exploration

    NASA Technical Reports Server (NTRS)

    Randolph, Richard O.; McKay, Chris P.

    2011-01-01

    The ongoing search for life on other worlds and the prospects of eventual human exploration of the Moon and Mars indicate the need for new ethical guidelines to direct our actions as we search and how we respond if we discover microbial life on other worlds. Here we review how life on other worlds presents a novel question in environmental ethics. We propose a principle of protecting and expanding the richness and diversity of life as the basis of an ethic for astrobiology research and space exploration. There are immediate implications for the operational policies governing how we conduct the search for life on Mars and how we plan for human exploration throughout the Solar System.

  17. Multicultural health care in practice. An empirical exploration of multicultural care in The Netherlands.

    PubMed

    Olthuis, Gert; van Heteren, Godelieve

    2003-09-01

    This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive in their direct interactions with patients. On the basis of the observations of the 24 respondents five strategies were formulated to improve the delivery of care in a multicultural environment. Their findings were further evaluated by confronting the empirical data with care-ethical notions (attentiveness, responsibility, competence, and responsiveness) and intercultural communication-theory.

  18. Protecting and expanding the richness and diversity of life, an ethic for astrobiology research and space exploration

    NASA Astrophysics Data System (ADS)

    Randolph, Richard O.; McKay, Christopher P.

    2014-01-01

    The ongoing search for life on other worlds and the prospects of eventual human exploration of the Moon and Mars indicate the need for new ethical guidelines to direct our actions as we search and how we respond if we discover microbial life on other worlds. Here we review how life on other worlds presents a novel question in environmental ethics. We propose a principle of protecting and expanding the richness and diversity of life as the basis of an ethic for astrobiology research and space exploration. There are immediate implications for the operational policies governing how we conduct the search for life on Mars and how we plan for human exploration throughout the Solar System.

  19. Early onset ageing and service preparation in people with intellectual disabilities: institutional managers' perspective.

    PubMed

    Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M

    2011-01-01

    Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this population. We used purposive sampling to recruit 54 institutional managers who care for people with intellectual disabilities in Taiwan. The present study employed a cross-sectional design using a self-administrative structured questionnaire that was completed by the respondents in November 2009. The results showed that more than 90% of the respondents agreed with earlier onset aging characteristics of people with ID. However, nearly all of the respondents expressed that the government policies were inadequate and the institution is not capable of caring for aging people with ID, and more than half of them did not satisfy to their provisional care for this group of people. With regard to the service priority of government aging policy for people with ID, the respondent expressed that medical care, financial support, daily living care were the main areas in the future policy development for them. The factors of institutional type, expressed adequacy of government's service, respondent's job position, age, and working years in disability service were variables that can significantly predict the positive perceptions toward future governmental aging services for people with ID (adjusted R(2) = 0.563). We suggest that the future study strategy should underpin the aging characteristics of people with intellectual disabilities and its differences with general population to provide the useful information for the institutional caregivers. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Public attitudes towards smoking and tobacco control policy in Russia.

    PubMed

    Danishevski, K; Gilmore, A; McKee, M

    2008-08-01

    Since the political transition in 1991, Russia has been targeted intensively by the transnational tobacco industry. Already high smoking rates among men have increased further; traditionally low rates among women have more than doubled. The tobacco companies have so far faced little opposition as they shape the discourse on smoking in Russia. This paper asks what ordinary Russians really think about possible actions to reduce smoking. A representative sample of the Russian population (1600 respondents) was interviewed face to face in November 2007. Only 14% of respondents considered tobacco control in Russia adequate, while 37% thought that nothing was being done at all. There was support for prices keeping pace with or even exceeding inflation. Over 70% of all respondents favoured a ban on sales from street kiosks, while 56% believed that existing health warnings (currently 4% of front and back of packs) were inadequate. The current policy of designating a few tables in bars and restaurants as non-smoking was supported by less than 10% of respondents, while almost a third supported a total ban, with 44% supporting provision of equal space for smokers and non-smokers. Older age, non-smoking status and living in a smaller town all emerged as significantly associated with the propensity to support antismoking measures. The tobacco companies were generally viewed as behaving like most other companies in Russia, with three-quarters of respondents believing that these companies definitely or maybe bribe politicians. Knowledge of impact of smoking on health was limited with significant underestimation of dangers and addictive qualities of tobacco. A third believed that light cigarettes are safer than normal cigarettes. The majority of the Russian population would support considerable strengthening of tobacco control policies but there is also a need for effective public education campaigns.

  1. Women's postpartum maternity benefits and work experience.

    PubMed

    Gjerdingen, D K; McGovern, P M; Chaloner, K M; Street, H B

    1995-10-01

    This study was conducted to describe women's perceptions of their maternity leave policy and its implementation, maternity leave benefits, postpartum work experience, and factors that relate to returning to work. Surveys were mailed to 436 married, recently employed, first-time mothers at 1, 3, 6, 9 and 12 months postpartum. Most respondents said they had written maternity leave policies they could understand, but they were not completely satisfied with their policies. The average 11.1-week maternity leave was considerably shorter than their 8-month ideal, and only 25.5% had the option of working part-time. A minority (35.8%) were allowed to use personal days to care for a sick infant. Most women were distressed about making child care arrangements. Compared with women who remained at home, those who returned to work complained of more respiratory, gynecologic, and breast symptoms. Relatively little is known about women's postpartum work experience. In this study, return to work after delivery was related to several demographic, occupational, and social factors and was associated with health problems and concerns about child care. With a majority of new mothers now returning to work, attention has recently been directed to factors that facilitate the merger of work and parenting roles. One such important factor is women's parental or maternity leave benefits, the focus of this study.

  2. Economic incentives as a policy tool to promote safety and health at work.

    PubMed

    Kankaanpää, Eila

    2010-06-01

    Incentives are regarded as a promising policy tool for promoting occupational safety and health (OSH). This article discusses the potential of different kinds of incentives in light of economic theory and evidence from research. When incentives are used as a policy tool, it implies the existance of an institution that has both the interest and the power to apply incentives to stakeholders, usually to employers. Governments can subsidize employers' investments in OSH with subsidies and tax structures. These incentives are successful only if the demand for OSH responds to the change in the price of OSH investments and if the suppliers of OSH are able to increase their production smoothly. Otherwise, the subsidy will only lead to higher prices for OSH goods. Both public and private insurance companies can differentiate insurance premiums according to claim behavior in the past (experience rating). There is evidence that this can effectively lower the frequency of claims, but not the severity of cases. This papers concludes that incentives do not directly lead to improvement. When incentives are introduced, their objective(s) should be clear and the end result (ie what the incentive aims to promote) should be known to be effective in achieving healthy and safe workplaces.

  3. Optimizing the response to surveillance alerts in automated surveillance systems.

    PubMed

    Izadi, Masoumeh; Buckeridge, David L

    2011-02-28

    Although much research effort has been directed toward refining algorithms for disease outbreak alerting, considerably less attention has been given to the response to alerts generated from statistical detection algorithms. Given the inherent inaccuracy in alerting, it is imperative to develop methods that help public health personnel identify optimal policies in response to alerts. This study evaluates the application of dynamic decision making models to the problem of responding to outbreak detection methods, using anthrax surveillance as an example. Adaptive optimization through approximate dynamic programming is used to generate a policy for decision making following outbreak detection. We investigate the degree to which the model can tolerate noise theoretically, in order to keep near optimal behavior. We also evaluate the policy from our model empirically and compare it with current approaches in routine public health practice for investigating alerts. Timeliness of outbreak confirmation and total costs associated with the decisions made are used as performance measures. Using our approach, on average, 80 per cent of outbreaks were confirmed prior to the fifth day of post-attack with considerably less cost compared to response strategies currently in use. Experimental results are also provided to illustrate the robustness of the adaptive optimization approach and to show the realization of the derived error bounds in practice. Copyright © 2011 John Wiley & Sons, Ltd.

  4. What's in a Name? Evaluating the Effects of the "Sex Offender" Label on Public Opinions and Beliefs.

    PubMed

    Harris, Andrew J; Socia, Kelly M

    2016-10-01

    Particularly over the past two decades, the terms sex offender and juvenile sex offender (JSO) have attained increasingly common usage in media and public policy discourse. Although often applied as factual descriptors, the labels may evoke strong subconscious associations with a population commonly presumed to be compulsive, at high risk of re-offense, and resistant to rehabilitation. Such associations, in turn, may exert considerable impact on expressions of support for certain policies as well as public beliefs and opinions about adults and youth who have perpetrated sexual offenses. The current study systematically evaluated the impact of the "sex offender" and "JSO" labels through series of items administered to a nationally stratified and matched sample from across the United States. The study employed an experimental design, in which one group of participants (n = 498) ranked their levels of agreement with a series of statements utilizing these labels, and a control group (n = 502) responded to a matched set of statements substituting the labels with more neutral descriptive language. Findings support the hypothesis that use of the "sex offender" label strengthens public support for policies directed at those who have perpetrated sexual crimes, including public Internet disclosure, residency restrictions, and social networking bans. The "JSO" label is demonstrated to produce particularly robust effects, enhancing support for policies that subject youth to public Internet notification and affecting beliefs about youths' propensity to re-offend as adults. Implications for public policy, media communication, and research are explored and discussed. © The Author(s) 2014.

  5. Managerial and Organizational Discourses of Workplace Bullying

    PubMed Central

    Johnson, Susan L.; Boutain, Doris M.; Tsai, Jenny H.-C.; de Castro, Arnold B.

    2017-01-01

    OBJECTIVE To explore how workplace bullying is addressed by hospital nursing unit managers and organizational policies. BACKGROUND Although workplace bullying is costly to organizations, nurses report that managers do not consistently address the issue. METHODS This study used discourse analysis to analyze interview data and policy documents. RESULTS There were differences in the manner in which managers and the policy documents labeled bullying-type behaviors and discussed the roles and responsibilities of staff and managers. Policies did not clearly delineate how managers should respond to workplace bullying. CONCLUSIONS These differences can allow management variation, not sanctioned by policy. Unclear policy language can also offer insufficient guidance to managers, resulting in differential enforcement of policies. PMID:26301552

  6. The match between institutional elderly care management research and management challenges - a systematic literature review.

    PubMed

    Kokkonen, Kaija; Rissanen, Sari; Hujala, Anneli

    2012-11-08

    Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers' and policymakers' scientific literacy needs to be enhanced.

  7. Roles and strategies of state organizations related to school-based physical education and physical activity policies.

    PubMed

    Cradock, Angie L; Barrett, Jessica L; Carnoske, Cheryl; Chriqui, Jamie F; Evenson, Kelly R; Gustat, Jeanette; Healy, Isobel B; Heinrich, Katie M; Lemon, Stephenie C; Tompkins, Nancy Oʼhara; Reed, Hannah L; Zieff, Susan G

    2013-01-01

    School-based physical education (PE) and physical activity (PA) policies can improve PA levels of students and promote health. Studies of policy implementation, communication, monitoring, enforcement, and evaluation are lacking. To describe how states implement, communicate, monitor, enforce, and evaluate key school-based PE and PA policies, researchers interviewed 24 key informants from state-level organizations in 9 states, including representatives from state departments of health and education, state boards of education, and advocacy/professional organizations. These states educate 27% of the US student population. Key informants described their organizations' roles in addressing 14 school-based PE and PA state laws and regulations identified by the Bridging the Gap research program and the National Cancer Institute's Classification of Laws Associated with School Students (C.L.A.S.S.) system. On average, states had 4 of 14 school-based PE and PA laws and regulations, and more than one-half of respondents reported different policies in practice besides the "on the books" laws. Respondents more often reported roles implementing and communicating policies compared with monitoring, enforcing, and evaluating them. Implementation and communication strategies used included training, technical assistance, and written communication of policy to local education agency administrators and teachers. State-level organizations have varying roles in addressing school-based PE and PA policies. Opportunities exist to focus state-level efforts on compliance with existing laws and regulations and evaluation of their impact.

  8. The match between institutional elderly care management research and management challenges - a systematic literature review

    PubMed Central

    2012-01-01

    Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced. PMID:23137416

  9. Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District

    PubMed Central

    2013-01-01

    Introduction Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries. Objectives This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services. Methods 157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required. Findings Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents. Conclusion TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs’ inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal services. Thus, the authorities seeming to recognize and promote TBAs should provide support to TBAs in relation to necessary training and giving them essential working facilities, routine supportive supervision and rewarding those seeming to comply with the standard guidelines for delivering EmoC services. PMID:24124663

  10. Prison Boomers: Policy Implications of Aging Prison Populations

    PubMed Central

    Psick, Zachary; Ahalt, Cyrus; Brown, Rebecca T.; Simon, Jonathan

    2018-01-01

    Prison populations worldwide are aging at an unprecedented rate, and associated age-related medical costs have had serious consequences for jurisdictions struggling to respond to the changes. Our examination of the situation in California shows that recognizing the changing healthcare needs of aging prison populations is critical to achieving effective and efficient policies and practices that affect this medically vulnerable and costly population. Chronic prison overcrowding usually accompanies the aging trends, and there is evidence that aging is strongly correlated with desistance from criminal behavior, suggesting an opportunity to at least partially address the challenges through early release of appropriate persons. Some relevant policies do exist, but they have not achieved this goal on a sufficient scale. Drawing lessons from California and available scholarship, we conclude with recommendations for those faced with responding to the unprecedented number of older adults now in prison, most of whom will eventually be released. PMID:28299972

  11. Municipalities' Priority Problems and Prospect of Establishing Ordinance to Measures for Marginal Hamlets

    NASA Astrophysics Data System (ADS)

    Nakanishi, Mayumi; Hoshino, Satoshi; Hashimoto, Shizuka; Kuki, Yasuaki

    The problems of Marginal Hamlets are getting worse, in which more than half of the population is over 65 and community-based life is difficult. To contribute to effective policy making, we conducted a questionnaire survey to members of the National Liaison Council of ‘Suigen no Sato’ constituted to share information about problems and effective counter measures for marginal hamlets. Our study clarified that first, most of respondents had common problems such as lack of job-opportunities and animal damage on farm, and second, though most of respondents recognized the effectiveness of selecting target communities in policy implementations, it is difficult for municipal governments to establish such ordinance provided that councilors and those who were not living in areas of policy target wouldn't agree with it. Finally, we pointed out the roles of national and prefectural governments to help municipal governments effectively cope with such entangled situations.

  12. Awareness and knowledge of National School Health Policy and School Health Programme among public secondary school teachers in Ibadan metropolis

    PubMed Central

    Obembe, Taiwo A.; Osungbade, Kayode O.; Ademokun, Oluwakemi M.

    2016-01-01

    Background: The awareness, knowledge, and involvement of teachers in the implementation of School Health Programme (SHP) in secondary schools are essential in ensuring the effectiveness and overall success of the School Health Policy. This study assessed the awareness and knowledge of teachers on SHP in Ibadan metropolis. Methods: A descriptive cross-sectional study was carried out using a two-stage sampling technique to select 426 secondary school teachers across all the five Urban Local Government Areas (LGAs) in Ibadan metropolis by balloting. Pretested semi-structured questionnaires were used to collect data from 426 teachers. Quantitative data were analyzed using descriptive statistics, Chi-square, and logistics regression tests at 5% level of significance. Results: About one-third of the respondents had heard of National School Health Policy (NSHP); however, few had seen the document. About half of the respondents were aware of the SHP in their schools. Many of the respondents had a good knowledge of SHP. Age and level of education of participants significantly influenced the knowledge of SHP. Above 50 years of age and postgraduate qualification were the significant predictors for the good knowledge of SHP. Conclusions: Awareness of the NSHP was low despite the good knowledge of SHP. This could be due to the tertiary education that most of the respondents had. Concerted efforts of stakeholders are required to intensify the health education awareness campaign to improve teachers’ knowledge based on NSHP. PMID:27630385

  13. Retiree out-of-pocket healthcare spending: a study of consumer expectations and policy implications.

    PubMed

    Hoffman, Allison K; Jackson, Howell E

    2013-01-01

    Even though most American retirees benefit from Medicare coverage, a mounting body of research predicts that many will face large and increasing out-of-pocket expenditures for healthcare costs in retirement and that many already struggle to finance these costs. It is unclear, however, whether the general population understands the likely magnitude of these out-of-pocket expenditures well enough to plan for them effectively. This study is the first comprehensive examination of Americans' expectations regarding their out-of-pocket spending on healthcare in retirement. We surveyed over 1700 near retirees and retirees to assess their expectations regarding their own spending and then compared their responses to experts' estimates. Our main findings are twofold. First, overall expectations of out-of-pocket spending are mixed. While a significant proportion of respondents estimated out-of-pocket costs in retirement at or above expert estimates of what the typical retiree will spend, a disproportionate number estimated their future spending substantially below what experts view as likely. Estimates by members of some demographic subgroups, including women and younger respondents, deviated relatively further from the experts' estimates. Second, respondents consistently misjudged spending uncertainty. In particular, respondents significantly underestimated how much individual health experience and changes in government policy can affect individual out-of-pocket spending. We discuss possible policy responses, including efforts to improve financial planning and ways to reduce unanticipated financial risk through reform of health insurance regulation.

  14. Lumping and splitting: the health policy agenda in India.

    PubMed

    Peters, David H; Rao, K Sujatha; Fryatt, Robert

    2003-09-01

    India's health system was designed in a different era, when expectations of the public and private sectors were quite different. India's population is also undergoing transitions in the demographic, epidemiologic and social aspects of health. Disparities in life expectancy, disease, access to health care and protection from financial risks have increased. These factors are challenging the health system to respond in new ways. The old approach to national health policies and programmes is increasingly inappropriate. By analyzing inter- and intra-state differences in contexts and processes, we argue that the content of national health policy needs to be more diverse and accommodating to specific states and districts. More 'splitting' of India's health policy at the state level would better address their health problems, and would open the way to innovation and local accountability. States further along the health transition would be able to develop policies to deal with the emerging epidemic of non-communicable diseases and more appropriate health financing systems. States early in the transition would need to focus on improving the quality and access of essential public health services, and empowering communities to take more ownership. Better 'lumping' of policy issues at the central level is also needed, but not in ways that have been done in the past. The central government needs to focus on overcoming the large inequalities in health outcomes across India, tackle growing challenges to health such as the HIV epidemic, and provide the much needed leadership on systemic issues such as the development of systems for quality assurance and regulation of the private sector. It also needs to support and facilitate states and districts to develop critical capacities rather than directly manage programmes. As India develops a more diverse set of state health policies, there will be more opportunities to learn what works in different policy environments.

  15. Cross-Cultural Household Influence on Vaccination Decisions.

    PubMed

    Taylor, Eric; Atkins, Katherine E; Medlock, Jan; Li, Meng; Chapman, Gretchen B; Galvani, Alison P

    2016-10-01

    Uptake of vaccination against seasonal influenza is suboptimal in most countries, and campaigns to promote vaccination may be weakened by clustering of opinions and decisions not to vaccinate. This clustering can occur at myriad interacting levels: within households, social circles, and schools. Given that influenza is more likely to be transmitted to a household contact than any other contact, clustering of vaccination decisions is arguably most problematic at the household level. We conducted an international survey study to determine whether household members across different cultures offered direct advice to each other regarding influenza vaccination and whether this advice was associated with vaccination decisions. The survey revealed that household members across the world advise one another to vaccinate, although to varying degrees, and that advice correlates with an increase in vaccination uptake. In addition, respondents in Japan, China, and the United States were less likely to offer advice to older adults than to the young, despite older adults' being the target age group for vaccination in both Far Eastern countries. Furthermore, advice was not primarily directed to household members within the age groups advised to vaccinate by national health policies. In Japan, advice was offered more to ages outside of the policy guidelines than inside. Harnessing the influence of household members may offer a novel strategy to improve vaccination coverage across cultures worldwide. © The Author(s) 2015.

  16. Tobacco outlet density and tobacco knowledge, beliefs, purchasing behaviours and price among adolescents in Scotland.

    PubMed

    Tunstall, Helena; Shortt, Niamh K; Niedzwiedz, Claire L; Richardson, Elizabeth A; Mitchell, Richard J; Pearce, Jamie R

    2018-06-01

    Despite long-term falls in global adult smoking prevalence and over 50 years of tobacco control policies, adolescent smoking persists. Research suggests greater densities of tobacco retail outlets in residential neighbourhoods are associated with higher adolescent smoking rates. Policies to reduce retail outlets have therefore been identified by public health researchers as a potential 'new frontier' in tobacco control. Better understanding of the pathways linking density of tobacco retailers and smoking behaviour could support these policies. In this study we use path analysis to assess how outlet density in the home environment is related to adolescent tobacco knowledge, beliefs, retail purchases and price in Scotland. We assessed 22,049 13 and 15 year old respondents to the nationally representative cross-sectional 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Outlet density was based on Scottish Tobacco Retailers Register, 2012, data. A spatially-weighted Kernel Density Estimation measure of outlet density within 400 m of respondents' home postcode was grouped into tertiles. The analysis considered whether outlet density was associated with the number of cigarette brands adolescents could name, positive beliefs about smoking, whether smokers purchased cigarettes from shops themselves or through adult proxies and perceived cost of cigarettes. Models were stratified by adolescent smoking status. The path analyses indicated that outlet density was not associated with most outcomes, but small, significant direct effects on knowledge of cigarette brands among those who had never smoked were observed. With each increase in outlet density tertile the mean number of brands adolescents could name rose by 0.07 (mean = 1.60; SD = 1.18; range = 4). This suggests greater outlet densities may have affected adolescents' knowledge of cigarette brands but did not encourage positive attitudes to smoking, purchases from shops or lower cigarette prices. Exposure to tobacco outlets may influence adolescents' awareness of tobacco products, a potential pathway to smoking behaviour. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Second-hand smoke exposure and mitigation strategies among home visitation workers.

    PubMed

    Keske, Robyn R; Rees, Vaughan W; Behm, Ilan; Wadler, Brianna M; Geller, Alan C

    2013-07-01

    Protection of workers from second-hand smoke (SHS) in occupational settings is an important policy priority, yet little attention has been given to SHS protection for home visitation health workers, who number almost 2 million in the USA. Self-reported SHS exposure, SHS mitigation strategies and suggestions for further SHS exposure reduction approaches were obtained from home visitation health workers in Massachusetts. A cross-sectional survey was conducted among Massachusetts Early Intervention workers (N=316) at their state-wide conference in April 2010. Eighty-three per cent of respondents reported at least 1 hour per month of SHS exposure, and 16% reported at least 11 hours per month. Nevertheless, only 22% of workers counselled clients on maintaining a smoke-free home. Fewer than 30% of workers had ever voiced concerns to their employing agency, and just 12% had raised their concerns directly with clients. Only 14% stated that their agency had rules designed to protect workers from SHS. SHS exposure occurs frequently among home visitation health workers. The data point to a substantial population who are not protected from SHS exposure by formal policies.

  18. Awareness of pro-tobacco advertising and promotion and beliefs about tobacco use: findings from the Tobacco Control Policy (TCP) India Pilot Survey.

    PubMed

    Bansal-Travers, Maansi; Fong, Geoffrey T; Quah, Anne C K; Sansone, Genevieve; Pednekar, Mangesh S; Gupta, Prakash C; Sinha, Dhirendra N

    2014-12-01

    Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (p<0.01). The findings from this study reiterate the need for stronger legislation and strict enforcement of bans on direct and indirect advertising and promotion of tobacco products in India. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  19. Concussion management in United States college sports: compliance with National Collegiate Athletic Association concussion policy and areas for improvement.

    PubMed

    Baugh, Christine M; Kroshus, Emily; Daneshvar, Daniel H; Filali, Naji A; Hiscox, Michael J; Glantz, Leonard H

    2015-01-01

    In 2010, the National Collegiate Athletic Association (NCAA) adopted its Concussion Policy and Legislation, which applies to more than 450,000 collegiate athletes annually. To date, there has been no examination of school-level compliance with the NCAA Concussion Policy. To examine whether stakeholders at NCAA schools report that their school has a concussion management plan and whether existing plans are consistent with the NCAA policy. Also examined were stakeholders' perceptions regarding concussion management at their institution and possible areas for improvement. Cross-sectional study; Level of evidence, 3. Surveys were sent by e-mail to coaches, sports medicine clinicians, and compliance administrators at all 1066 NCAA member institutions. Surveys asked population-specific questions about institutional concussion management. Individuals (N=2880) from 907 unique schools participated in this survey. Most respondents (n=2607; 92.7%) indicated their school had a concussion management plan. Most schools had all (82.1%) or some (15.2%) respondents indicate a concussion management plan was present. When asked to indicate all individuals who could have final responsibility for returning athletes to play after a concussion, 83.4% selected team doctor, 72.8% athletic trainer, 31.0% specialist physician, 6.8% coach, and 6.6% athlete. Most respondents (76.1%) indicated that their institution had a process for annual athlete concussion education; 91.2% required athletes to acknowledge their responsibility to report concussion symptoms. Nearly all respondents (98.8%) thought their school's concussion management plan protected athletes "well" or "very well." Top categories suggested for improvement included better coach education (39.7%), increasing sports medicine staffing (37.2%), and better athlete education (35.2%). Although a large majority of respondents indicated that their school has a concussion management plan, improvement is needed. Compliance with specified components (eg, annual athlete education) lags behind the presence of the plan itself, and stakeholders had suggestions for areas in which improvements are needed. Increasing scientific evidence supporting the seriousness of concussion underscores the need for the NCAA to use its regulatory capabilities to ensure that athletes' brains are safe. © 2014 The Author(s).

  20. State Policies on Community College Workforce Development: Findings from a National Survey.

    ERIC Educational Resources Information Center

    Jenkins, Davis; Boswell, Katherine

    The Education Commission of the States conducted a national survey on workforce development in the community college. The research instrument was sent to the state agency responsible for oversight of the community colleges in each of the 50 states. Forty-five states responded. The five states that did not respond are Idaho, Hawaii, Maryland,…

  1. Subjective Welfare, Well-Being, and Self-Reported Food Hypersensitivity in Four European Countries: Implications for European Policy

    ERIC Educational Resources Information Center

    Voordouw, Jantine; Antonides, Gerrit; Fox, Margaret; Cerecedo, Inmaculada; Zamora, Javier; de la Hoz Caballer, Belen; Rokicka, Ewa; Cornelisse-Vermaat, Judith; Jewczak, Maciej; Starosta, Pawel; Kowalska, Marek L.; Jedrzejczak-Czechowicz, Monika; Vazquez-Cortes, Sonia; Escudero, Cano; de Blok, Bertine Flokstra; Dubois, Anthony; Mugford, Miranda; Frewer, Lynn J.

    2012-01-01

    This study estimates the effects of food hypersensitivity on individuals' perceived welfare and well-being compared to non-food hypersensitive individuals. Study respondents were recruited in the Netherlands, Poland, Spain and UK. The difference in welfare between food hypersensitive respondents and those asymptomatic to foods was estimated using…

  2. Educational Leadership and Policy Analysis Support and Encouragement Study

    ERIC Educational Resources Information Center

    Lee, Jenny; Owens, Megan; Lampley, James

    2016-01-01

    Among doctoral programs, attrition rates and student feelings of isolation are high. In an attempt to determine the current levels and sources of support and encouragement from students enrolled in a Doctor of Education program, a survey was sent to students. There were 94 respondents to the online survey. Fifty-two (65%) of the respondents were…

  3. Exit Strategies: How Low-Performing High Schools Respond to High School Exit Examination Requirements

    ERIC Educational Resources Information Center

    Holme, Jennifer Jellison

    2013-01-01

    Background: Over the past several decades, a significant number of states have either adopted or increased high school exit examination requirements. Although these policies are intended to generate improvement in schools, little is known about how high schools are responding to exit testing pressures. Purpose: This study examined how five…

  4. Thinking It Through: A Study of How Pre-Service Teachers Respond to Children Who Present with Possible Mental Health Difficulties

    ERIC Educational Resources Information Center

    Armstrong, David; Price, Deborah; Crowley, Tim

    2015-01-01

    Teachers are key professionals in responding to children and adolescents with possible mental health difficulties and who exhibit social, emotional or behavioural difficulties in the classroom. Health and education policy increasingly positions teachers as vital agents in connecting mental health services with affected young people. A growing…

  5. CE: Original Research: Exploring How Nursing Schools Handle Student Errors and Near Misses.

    PubMed

    Disch, Joanne; Barnsteiner, Jane; Connor, Susan; Brogren, Fabiana

    2017-10-01

    : Background: Little attention has been paid to how nursing students learn about quality and safety, and to the tools and policies that guide nursing schools in helping students respond to errors and near misses. This study sought to determine whether prelicensure nursing programs have a policy for reporting and following up on student clinical errors and near misses, a tool for such reporting, a tool or process (or both) for identifying trends, strategies for follow-up with students after errors and near misses, and strategies for follow-up with clinical agencies and individual faculty members. A national electronic survey of 1,667 schools of nursing with a prelicensure registered nursing program was conducted. Data from 494 responding schools (30%) were analyzed. Of the responding schools, 245 (50%) reported having no policy for managing students following a clinical error or near miss, and 272 (55%) reported having no tool for reporting student errors or near misses. Significant work is needed if the principles of a fair and just culture are to shape the response to nursing student errors and near misses. For nursing schools, some essential first steps are to understand the tools and policies a school has in place; the school's philosophy regarding errors and near misses; the resources needed to establish a fair and just culture; and how faculty can work together to create learning environments that eliminate or minimize the negative consequences of errors and near misses for patients, students, and faculty.

  6. Social impact of the 2004 Manawatu floods and the 'hollowing out' of rural New Zealand.

    PubMed

    Smith, Willie; Davies-Colley, Christian; Mackay, Alec; Bankoff, Greg

    2011-07-01

    The Manawatu floods of 2004 have had significant, long-lasting social consequences. This paper draws on findings from a series of detailed surveys of 39 farm households directly affected by the floods and 17 individuals directly involved in managing the flood recovery programme. The nature of the impact on rural families highlights how the 'hollowing out' of rural New Zealand has changed the capacity of rural communities to respond to natural hazards and increased their sense of isolation. In addition, the floods exposed the vulnerability of rural communities. This is shown to have implications for policies designed to build resilience and improve responses to adverse events, including the need to support local, community initiatives on self-reliance and mutual support. Approaches to manage better long-term flood risks should be designed within a context of ongoing rural decline that has compromised the health of both individuals and communities. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

  7. Do coverage mandates affect direct-to-consumer advertising for pharmaceuticals? Evidence from parity laws.

    PubMed

    Nathenson, Robert; Richards, Michael R

    2018-01-29

    Direct-to-consumer advertising (DTCA) for prescription drugs is a relatively unique feature of the US health care system and a source of tens of billions of dollars in annual spending. It has also garnered the attention of researchers and policymakers interested in its implications for firm and consumer behavior. However, few economic studies have explored the DTCA response to public policies, especially those mandating coverage of these products. We use detailed advertising expenditure data to assess if pharmaceutical firms increase their marketing efforts after the implementation of relevant state and federal health insurance laws. We focus on mental health parity statutes and related drug therapies-a potentially ripe setting for inducing stronger consumer demand. We find no clear indication that firms expect greater value from DTCA after these regulatory changes. DTCA appears driven by other considerations (e.g., product debut); however, it remains a possibility that firms respond to these laws through other, unobserved channels (e.g., provider detailing).

  8. Serving high-risk foods in a high-risk setting: survey of hospital food service practices after an outbreak of listeriosis in a hospital.

    PubMed

    Cokes, Carolyn; France, Anne Marie; Reddy, Vasudha; Hanson, Heather; Lee, Lillian; Kornstein, Laura; Stavinsky, Faina; Balter, Sharon

    2011-04-01

    Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies and practices after a listeriosis outbreak occurred in a NYC hospital. From August through October 2008, a listeriosis outbreak in a NYC hospital was investigated. From February through April 2009, NYC's 61 acute-care hospitals were asked to participate in a telephone survey regarding food safety practices and policies, specifically service of high-risk foods to patients at increased risk for listeriosis. Five patients with medical conditions that put them at high risk for listeriosis had laboratory-confirmed Listeria monocytogenes infection. The Listeria outbreak strain was isolated from tuna salad prepared in the hospital. Fifty-four (89%) of 61 hospitals responded to the survey. Overall, 81% of respondents reported serving ready-to-eat deli meats to patients, and 100% reported serving prepared ready-to-eat salads. Pregnant women, patients receiving immunosuppressive drugs, and patients undergoing chemotherapy were served ready-to-eat deli meats at 77%, 59%, and 49% of hospitals, respectively, and were served prepared ready-to-eat salads at 94%, 89%, and 73% of hospitals, respectively. Only 4 (25%) of 16 respondents reported having a policy that ready-to-eat deli meats must be heated until steaming hot before serving. Despite the potential for severe outcomes of Listeria infection among hospitalized patients, the majority of NYC hospitals had no food preparation policies to minimize risk. Hospitals should implement policies to avoid serving high-risk foods to patients at risk for listeriosis.

  9. Student Grading Policies: Legal Issues and Administrative Review

    ERIC Educational Resources Information Center

    Gregory, Richard A.

    2005-01-01

    This case study focuses on the legal aspects of school district grading policies. Given parental and student challenges to assigned grades, a school district and its employees must be prepared to respond appropriately to substantive and procedural claims. Moreover, when these claims cannot be resolved at the building level, administrative reviews,…

  10. "Making the Difficult Choice": Understanding Georgia's Test-Based Grade Retention Policy in Reading

    ERIC Educational Resources Information Center

    Huddleston, Andrew P.

    2015-01-01

    The author uses Bourdieu's concepts of field, capital, and habitus to analyze how students, parents, teachers, and administrators are responding to Georgia's test-based grade retention policy in reading at one Georgia elementary school. In this multiple case study, the author interviewed, observed, and collected documents regarding ten fifth…

  11. An Investigation of Selective College and University Libraries' Serial Arrangement.

    ERIC Educational Resources Information Center

    Kesler, Elizabeth Gates; Teborek, Gay

    Data from a survey on serials arrangement procedures and policies at academic libraries was used by the University of Rhode Island (URI) Library in changing current serials policies. Ten libraries, four of which have similar serial holdings and user populations to URI, responded to a questionnaire. Information was obtained on classification versus…

  12. Australia's Sustainability: A New Policy Front for Rural Education?

    ERIC Educational Resources Information Center

    Halsey, R. John

    2009-01-01

    Rural education and its policy agenda has for many decades primarily focussed upon responding to decline to "keep things going; keep things open". While this has been understandable and much has been achieved, it is now opportune--essential?--that rural education and its leaders embrace a new challenge, sustainability, and use it to…

  13. Responding to University Policies and Initiatives: The Role of Reflexivity in the Mid-Career Academic

    ERIC Educational Resources Information Center

    Brew, Angela; Boud, David; Lucas, Lisa; Crawford, Karin

    2017-01-01

    How do academics make sense of university policies and strategic initiatives and act on them? Interviews were conducted with 27 mid-career academics in different disciplines, different research-intensive university environments and two countries (England and Australia). Data were analysed iteratively utilising a critical realist perspective,…

  14. Against the Dark: Antiblackness in Education Policy and Discourse

    ERIC Educational Resources Information Center

    Dumas, Michael J.

    2016-01-01

    I argue that analyses of racial(ised) discourse and policy processes in education must grapple with cultural disregard for and disgust with blackness. This article explains how a theorization of antiblackness allows one to more precisely identify and respond to racism in education discourse and in the formation and implementation of education…

  15. Portuguese Policies Fostering International Student Mobility: A Colonial Legacy or A New Strategy?

    ERIC Educational Resources Information Center

    França, Thais; Alves, Elisa; Padilla, Beatriz

    2018-01-01

    This paper explores policies on international student mobility to Portugal from within the Lusophone space, analyzing the cases of Angola, Cape Verde and Brazil. We argue that Portuguese strategies to attract international students respond to different demands and interests embedded in its geopolitical memberships. One the one hand, they respond…

  16. Affirming Students' Right to Their Own Language: Bridging Language Policies and Pedagogical Practices

    ERIC Educational Resources Information Center

    Scott, Jerrie Cobb, Ed.; Straker, Dolores Y., Ed.; Katz, Laurie, Ed.

    2008-01-01

    How can teachers make sound pedagogical decisions and advocate for educational policies that best serve the needs of students in today's diverse classrooms? What is the pedagogical value of providing culturally and linguistically diverse students greater access to their own language and cultural orientations? This landmark volume responds to the…

  17. The Family Life Cycle and Preferred Policies for Gasoline Conservation: A Conjoint Analysis.

    ERIC Educational Resources Information Center

    Tashchian, Armen; And Others

    1983-01-01

    Used family life cycle as the basis for assessing public reaction to alternative energy-conservation measures in a sample of 367 adults. Results showed most respondents preferred some sort of energy conservation policy. Young marrieds were most concerned with conservation; middle-aged adults were least willing to adopt energy conservation…

  18. Teacher Education for Inclusive Practice--Responding to Policy

    ERIC Educational Resources Information Center

    Alexiadou, Nafsika; Essex, Jane

    2016-01-01

    This article draws on research in one teacher education course in England and examines the ways in which the programme prepares student-teachers for inclusive practice in science teaching. We frame our analysis by drawing on aspects of institutional mediation of official policy in teacher education, as well as theories around inclusion and…

  19. Opting Out: Parents Creating Contested Spaces to Challenge Standardized Tests

    ERIC Educational Resources Information Center

    Mitra, Dana; Mann, Bryan; Hlavacik, Mark

    2016-01-01

    We explore how the opt-out movement has responded to the combination of a stringent federal policy with weak and often variable implementation among the states. Gaps between federal expectations and states' understandings of just how to make NCLB's demands a reality have created policy ambiguity. Parents who oppose standardized testing have…

  20. 75 FR 38810 - National Advisory Council for Environmental Policy and Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-06

    ...: Under the Federal Advisory Committee Act, Public Law 92463, EPA gives notice of a public teleconference... advice to the EPA Administrator on a broad range of environmental policy, technology, and management... developing to respond to EPA's request for advice on workforce issues the Agency is facing and how EPA can...

  1. Internationalizing Higher Education in Singapore: Government Policies and the NUS Experience

    ERIC Educational Resources Information Center

    Daquila, Teofilo C.

    2013-01-01

    The internationalization of higher education has become an important policy and research agenda. At the national level, different countries have responded differently with some countries becoming more open than others. At the local level, universities have also reacted differently with some becoming more liberal and innovative than others. Thus,…

  2. School Choice as a Civil Right: District Responses to Competition and Equal Educational Opportunity

    ERIC Educational Resources Information Center

    Lubienski, Christopher

    2005-01-01

    Using geographic representations to examine choice policies and patterns in a major urban area, this analysis considers how districts in a metropolitan area are responding to competitive incentives in arranging options for African American students. The findings demonstrate that the distribution of districts' school choice policies exclude poorer…

  3. Tackling the Knowledge: Action Gap in Sustainable Consumption--Insights from a Participatory School Programme

    ERIC Educational Resources Information Center

    Barth, Matthias; Fischer, Daniel; Michelsen, Gerd; Nemnich, Claudia; Rode, Horst

    2012-01-01

    In the international policy discourse on sustainable consumption and production, education is acknowledged to be a powerful tool in changing unsustainable patterns of consumption. Current educational policies and programmes have responded to the consumption challenge mainly by including and addressing consumption issues in formal tuition in…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  5. The Development of ICT across the Curriculum in Irish Schools: A Historical Perspective

    ERIC Educational Resources Information Center

    McGarr, Oliver

    2009-01-01

    This literature review explores the historical development of information and communication technology (ICT) in Irish postprimary/secondary schools and examines how the education system has responded to the various ICT initiatives and policy changes. The review has found that despite national policy and significant ICT initiatives, it appears that…

  6. Is "Gender-Sensitive Education" a Useful Concept for Educational Policy?

    ERIC Educational Resources Information Center

    Forde, Christine

    2014-01-01

    This article responds to Astrid Sinnes and Marianne Løken's article "Gendered education in a gendered world: Looking beyond cosmetic solutions to the gender gap in science" by exploring the idea of "gender-sensitive" education and its usefulness in educational policy. It draws on theoretical discussions of the concept of…

  7. Towards gender-sensitivity: the Philippine POPCOM experience. How sensitive to gender issues are our family planning personnel?

    PubMed

    Danguilan, M

    1995-04-01

    The Philippine Commission on Population (POPCOM) sets and coordinates the country's population policy. POPCOM launched Gender I in early 1994 in the attempt to find out how aware and sensitive its board of commissioners, staff, and the provincial and city population officers were on gender and population issues. The assessment covered the respondents' gender relations at the workplace; gender, work, and family responsibilities; job satisfaction; their perceptions about gender-related issues in reproductive health; personal sex attitudes; and general perceptions on gender issues. The project also explored respondents' knowledge and perceptions on population growth and structure; population information generation and use; quality of life; reproductive health; law, ethics, and policy; and men's and women's roles. Having completed the institutional assessment, POPCOM has now implemented the Gender II project designed to strengthen the formulation, coordination, and implementation of gender-aware population and reproductive health policies and programs. Project activities include policy review and framework development, capability building through gender and reproductive health training and information management, and special research projects.

  8. Research support for effective state and community tobacco control programme response to electronic nicotine delivery systems

    PubMed Central

    Schmitt, Carol L; Lee, Youn Ok; Curry, Laurel E; Farrelly, Matthew C; Rogers, Todd

    2014-01-01

    Objective To identify unmet research needs of state and community tobacco control practitioners pertaining to electronic nicotine delivery systems (ENDS or e-cigarettes) that would inform policy and practice efforts at the state and community levels, and to describe ENDS-related research and dissemination activities of the National Cancer Institute-funded State and Community Tobacco Control Research Initiative. Methods To determine specific research gaps relevant to state and community tobacco control practice, we analysed survey data collected from tobacco control programmes (TCPs) in all 50 US states and the District of Columbia (N=51). Survey items covered a range of ENDS issues: direct harm to users, harm of secondhand vapour, cessation, flavours, constituents and youth access. Results There is no ENDS topic on which a majority of state TCP managers feel very informed. They feel least informed about harms of secondhand vapour while also reporting that this information is among the most important for their programme. A majority (N=31) of respondents indicated needs for research on the implications of ENDS products for existing policies. Conclusions TCP managers report that ENDS research is highly important for practice and need research-based information to inform decision making around the inclusion of ENDS in existing tobacco control policies. For optimal relevance to state and community TCPs, research on ENDS should prioritise study of the health effects of ENDS use and secondhand exposure to ENDS vapour in the context of existing tobacco control policies. PMID:24935899

  9. Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.

    PubMed

    Abrahamson, Kathleen; Miech, Edward; Davila, Heather Wood; Mueller, Christine; Cooke, Valerie; Arling, Greg

    2015-05-01

    Health systems globally and within the USA have introduced nursing home pay-for-performance (P4P) programmes in response to the need for improved nursing home quality. Central to the challenge of administering effective P4P is the availability of accurate, timely and clinically appropriate data for decision making. We aimed to explore ways in which data were collected, thought about and used as a result of participation in a P4P programme. Semistructured interviews were conducted with 232 nursing home employees from within 70 nursing homes that participated in P4P-sponsored quality improvement (QI) projects. Interview data were analysed to identify themes surrounding collecting, thinking about and using data for QI decision making. The term 'data' appeared 247 times in the interviews, and over 92% of these instances (228/247) were spontaneous references by nursing home staff. Overall, 34% of respondents (79/232) referred directly to 'data' in their interviews. Nursing home leadership more frequently discussed data use than direct care staff. Emergent themes included using data to identify a QI problem, gathering data in new ways at the local level, and measuring outcomes in response to P4P participation. Alterations in data use as a result of policy change were theoretically consistent with the revised version of the Promoting Action on Research Implementation in Health Services framework, which posits that successful implementation is a function of evidence, context and facilitation. Providing a reimbursement context that facilitates the collection and use of reliable local evidence may be an important consideration to others contemplating the adaptation of P4P policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. 75 FR 64309 - Components for Evaluation of Direct-Reading Monitors for Gases and Vapors and Addendum

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-19

    ... Direct-Reading Monitors for Gases and Vapors: Hazard Detection in First Responder Environments.'' The.../docket/review/docket220 . The document expands the 1995 method development and evaluation experimental... evaluating direct-reading monitors for hazard detection in First Responder environments. The 1995 document...

  11. Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research

    PubMed Central

    Collin, Jeff; Hill, Sarah E.; Kandlik Eltanani, Mor; Plotnikova, Evgeniya; Ralston, Rob; Smith, Katherine E.

    2017-01-01

    Background Public health’s terms of engagement with unhealthy commodity industries (alcohol, tobacco and ultra-processed food and drinks) have become increasingly contested in policy and research. We sought to identify approaches that could attract consensus support within and across policy domains. Methods Using snowball sampling, we undertook an online survey of 335 health researchers, advocates and policymakers, in 40 countries, assessing responses to stated principles, claims and recommendations for engaging with unhealthy commodity industries in relation to key policy and research initiatives. Results Most respondents identified a fundamental conflict between industry interests and public health objectives for all three industries, with agreement greatest in relation to tobacco and weakest for food. This pattern was replicated across diverse questions regarding potential forms of engagement, including in rejecting voluntarism and partnership approaches to health policy. While awareness of tobacco industry tactics to influence policy and research was higher than for alcohol and food, most respondents rejected the view that the influence of the latter was less significant for public health. Proposals that health and research organisations should divest their funds attracted less support with respect to food, while restricting publication of industry-funded research in academic journals was the issue that most divided opinion. Respondents reported most difficulty in answering questions about the food industry. Conclusions The strong consensus around restricting interactions with the tobacco industry supports increased implementation of the WHO Framework Convention on Tobacco Control’s conflict of interest provisions. There is strong support for the extension of such practices to the alcohol industry, challenging current norms. More mixed responses indicate a need for greater clarity in defining the food industry, and for research analyzing links, similarities and differences across different types of unhealthy commodity producers. Partnership approaches to addressing non-communicable diseases seem incapable of attracting widespread support across public health, challenging practice in many contexts. PMID:28886049

  12. Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research.

    PubMed

    Collin, Jeff; Hill, Sarah E; Kandlik Eltanani, Mor; Plotnikova, Evgeniya; Ralston, Rob; Smith, Katherine E

    2017-01-01

    Public health's terms of engagement with unhealthy commodity industries (alcohol, tobacco and ultra-processed food and drinks) have become increasingly contested in policy and research. We sought to identify approaches that could attract consensus support within and across policy domains. Using snowball sampling, we undertook an online survey of 335 health researchers, advocates and policymakers, in 40 countries, assessing responses to stated principles, claims and recommendations for engaging with unhealthy commodity industries in relation to key policy and research initiatives. Most respondents identified a fundamental conflict between industry interests and public health objectives for all three industries, with agreement greatest in relation to tobacco and weakest for food. This pattern was replicated across diverse questions regarding potential forms of engagement, including in rejecting voluntarism and partnership approaches to health policy. While awareness of tobacco industry tactics to influence policy and research was higher than for alcohol and food, most respondents rejected the view that the influence of the latter was less significant for public health. Proposals that health and research organisations should divest their funds attracted less support with respect to food, while restricting publication of industry-funded research in academic journals was the issue that most divided opinion. Respondents reported most difficulty in answering questions about the food industry. The strong consensus around restricting interactions with the tobacco industry supports increased implementation of the WHO Framework Convention on Tobacco Control's conflict of interest provisions. There is strong support for the extension of such practices to the alcohol industry, challenging current norms. More mixed responses indicate a need for greater clarity in defining the food industry, and for research analyzing links, similarities and differences across different types of unhealthy commodity producers. Partnership approaches to addressing non-communicable diseases seem incapable of attracting widespread support across public health, challenging practice in many contexts.

  13. Conflict-of-interest disclosure at medical journals in Japan: a nationwide survey of the practices of journal secretariats

    PubMed Central

    Kojima, Takako; Green, Joseph; Barron, J Patrick

    2015-01-01

    Objectives Medical journals in Japan generally have appropriate policies regarding disclosure of conflicts of interest (COI). However, COI management depends on the staff members of each journal's editorial secretariat. This study's objectives were to find out (A) whether COI disclosure and the journal's role in it are clearly understood by the journal’s secretariat staff, (B) how much experience the editorial secretariat has in actually handling issues related to disclosure and (C) what kind of help or support they need. Setting and design In January 2014, questionnaires were sent to the editorial secretariats of journal-publishing societies belonging to the Japanese Association of Medical Sciences (JAMS). Participants The response rate was 100%, and the respondents represented 121 journals published by the 118 JAMS member societies (at the time of the survey). Primary and secondary outcome measures Information was collected on the history of COI policies and on how those policies were implemented. At the end of the questionnaire, there was an open-ended call for comments. Results Compulsory COI disclosure began between 2010 and 2013 for 60.3% of the journals (73/121). Handling of COI issues was not uniform: 17.4% (21/121) of respondents do not pursue cases of dubious disclosure, and 47.9% (58/121) do not require COI disclosures from editorial board members. Very few of the editorial secretariats had clearly-stated consequences for violations of COI-disclosure policy (33/121, 27.3%), and only 28.9% offered COI education (35/121). Respondents’ comments indicated that uniform, easily-searchable guidance regarding COI policies and implementation would be welcome. Conclusions Although commitment is widespread, policy implementation is inconsistent and COI experience is lacking. Clear, easy-to-use guidelines are desired by many societies. The JAMS is to be commended for supporting this country-wide investigation; other countries and regions are encouraged to perform similar investigations to respond to needs regarding COI management. PMID:26310399

  14. Dietary diversity of formal and informal residents in Johannesburg, South Africa

    PubMed Central

    2013-01-01

    Background This paper considers the question of dietary diversity as a proxy for nutrition insecurity in communities living in the inner city and the urban informal periphery in Johannesburg. It argues that the issue of nutrition insecurity demands urgent and immediate attention by policy makers. Methods A cross-sectional survey was undertaken for households from urban informal (n = 195) and urban formal (n = 292) areas in Johannesburg, South Africa. Foods consumed by the respondents the previous day were used to calculate a Dietary Diversity Score; a score < 4 was considered low. Results Statistical comparisons of means between groups revealed that respondents from informal settlements consumed mostly cereals and meat/poultry/fish, while respondents in formal settlements consumed a more varied diet. Significantly more respondents living in informal settlements consumed a diet of low diversity (68.1%) versus those in formal settlements (15.4%). When grouped in quintiles, two-thirds of respondents from informal settlements fell in the lowest two, versus 15.4% living in formal settlements. Households who experienced periods of food shortages during the previous 12 months had a lower mean DDS than those from food secure households (4.00 ± 1.6 versus 4.36 ± 1.7; p = 0.026). Conclusions Respondents in the informal settlements were more nutritionally vulnerable. Achieving nutrition security requires policies, strategies and plans to include specific nutrition considerations. PMID:24088249

  15. Wireless technologies and accessibility for people with disabilities: findings from a policy research instrument.

    PubMed

    Baker, Paul M A; Moon, Nathan W

    2008-01-01

    The near universal deployment in the United States of a wide variety of information and communications technologies, both wired and wireless, creates potential barriers to use for several key populations, including the poor, people with disabilities, and the aging. Equal access to wireless technologies and services can be achieved through a variety of mechanisms, including legislation and regulations, market-based solutions, and awareness and outreach-based approaches. This article discusses the results of policy research conducted by the Rehabilitation Engineering Research Center on Wireless Technologies (Wireless RERC) using policy Delphi polling methodology to probe stakeholders' opinions on key access barrier issues and to explore potential policy responses. Participants included disability advocates, disability/wireless technology policy makers, and product developers/manufacturers. Respondent input informed subsequent development of potential policy initiatives to increase access to these technologies. The findings from the Delphi suggest that awareness issues remain most important, especially manufacturer awareness of user needs and availability of consumer information for selecting the most appropriate wireless devices and services. Other key issues included the ability of people with disabilities to afford technologies and inadequacies in legislation and policy making for ensuring their general accessibility, as well as usefulness in emergencies. Technical issues, including interoperability, speech-to-text conversion, and hearing aid compatibility, were also identified by participating stakeholders as important. To address all these issues, Delphi respondents favored goals and options congruent with voluntary market-driven solutions where possible but also supported federal involvement, where necessary, to aid this process.

  16. Family Policy in the US, Japan, Germany, Italy and France: Parental Leave, Child Benefits/Family Allowances, Child Care, Marriage/Cohabitation, and Divorce. A Briefing Paper Prepared by the Council on Contemporary Families.

    ERIC Educational Resources Information Center

    Henneck, Rachel

    Within the last 50 years, the work-family-household arrangements upon which social policy systems in industrial nations were formulated have disappeared. This briefing paper examines how social policies of the United States, Japan, Germany, Italy, and France have responded. The paper is presented in two major sections. The first section describes…

  17. Public support for tobacco control policy extensions in Western Australia: a cross-sectional study

    PubMed Central

    Rosenberg, Michael; Wood, Lisa; Ferguson, Renee; Houghton, Stephen

    2012-01-01

    Objectives Policy makers seeking to introduce new tobacco control measures need to anticipate community support to assist them in planning appropriate implementation strategies. This study assessed community support for plain packaging and smoking bans in outdoor locations in Australia. Design Analytical cross-sectional survey. Setting and participants 2005 Western Australian adults participated in a computer-assisted telephone interview. Random household telephone numbers were used to obtain a representative sample. Outcome measures Support for plain packaging of cigarettes and smoking bans at outdoor venues by demographic characteristics. Results Around half of the survey respondents supported plain packaging and almost a further quarter reported being neutral on the issue. Only one in three smokers disagreed with the introduction of a plain packaging policy. A majority of respondents supported smoking bans at five of the six nominated venues, with support being strongest among those with children under the age of 15 years. The venues with the highest levels of support were those where smoke-free policies had already been voluntarily introduced by the venue managers, where children were most likely to be in attendance, and that were more limited in size. Conclusions The study results demonstrate community support for new tobacco control policies. This evidence can be used by public policy makers in their deliberations relating to the introduction of more extensive tobacco control regulations. PMID:22382124

  18. Support for Smoke-Free Policies: A Nationwide Analysis of Immigrants, US-Born, and Other Demographic Groups, 1995–2002

    PubMed Central

    Acevedo-Garcia, Dolores

    2010-01-01

    Objectives. We examined whether support for tobacco control policies varies by demographic group, including nativity status (i.e., immigrant versus US born). Methods. We analyzed 1995 to 2002 data from the Current Population Survey Tobacco Use Supplement (n = 543 951). The outcome was a summary attitudinal measure assessing support of smoking bans in 4 of 6 venues. Results. US-born respondents, smokers, male respondents, Native Americans, Whites, and those who were unmarried, of lower socioeconomic status, and whose workplaces and homes were not smoke free were less likely to support smoking bans. Immigrants exhibited stronger support for banning smoking in every venue, with a generation-specific gradient in which support eroded with increasing assimilation to the United States. Levels of support were more than twice as high among immigrants as among US-born respondents (odds ratio [OR] = 2.16; 95% confidence interval [CI] = 2.08, 2.23). Naturalized citizens displayed higher support than US-born citizens, which may be relevant for mobilization of the electorate. Differences in population composition and contexts (e.g., smoke-free workplaces) only partially accounted for immigrants' stronger level of support. Conclusions. Immigrants and their children may be valuable tobacco control allies given their supportive attitudes toward smoke-free policies. PMID:19910345

  19. Support for smoke-free policies: a nationwide analysis of immigrants, US-born, and other demographic groups, 1995-2002.

    PubMed

    Osypuk, Theresa L; Acevedo-Garcia, Dolores

    2010-01-01

    We examined whether support for tobacco control policies varies by demographic group, including nativity status (i.e., immigrant versus US born). We analyzed 1995 to 2002 data from the Current Population Survey Tobacco Use Supplement (n=543,951). The outcome was a summary attitudinal measure assessing support of smoking bans in 4 of 6 venues. US-born respondents, smokers, male respondents, Native Americans, Whites, and those who were unmarried, of lower socioeconomic status, and whose workplaces and homes were not smoke free were less likely to support smoking bans. Immigrants exhibited stronger support for banning smoking in every venue, with a generation-specific gradient in which support eroded with increasing assimilation to the United States. Levels of support were more than twice as high among immigrants as among US-born respondents (odds ratio [OR]=2.16; 95% confidence interval [CI]=2.08, 2.23). Naturalized citizens displayed higher support than US-born citizens, which may be relevant for mobilization of the electorate. Differences in population composition and contexts (e.g., smoke-free workplaces) only partially accounted for immigrants' stronger level of support. Immigrants and their children may be valuable tobacco control allies given their supportive attitudes toward smoke-free policies.

  20. Surviving the storms: Emergency preparedness in Texas nursing facilities and assisted living facilities.

    PubMed

    Castro, Carmen; Persson, Diane; Bergstrom, Nancy; Cron, Stanley

    2008-08-01

    This study assesses the preparedness of long-term care facilities in Texas responding to Hurricanes Katrina and Rita. A 41-item questionnaire was mailed to facilities; the response rate was 42%. Among responding facilities, 4513 residents were evacuated, and 6% of respondents reported resident death. Financial losses were reported by 8% of nursing facilities and 45% of assisted living facilities due to transportation and staff overtime. Respondents indicated the need for improved disaster preparednesstraining, better coordination, and transportation. Changes in policy and practice will lead to better trained staff who will provide the care residents need for improved health outcomes during future public health disasters.

  1. Navigating the Contested Terrain of Teacher Education Policy and Practice: Authors Respond to SCALE

    ERIC Educational Resources Information Center

    Henning, Nick; Dover, Alison G.; Dotson, Erica; Agarwal-Rangath, Ruchi; Clayton, Christine D.; Donovan, Martha K.; Cannon, Susan O.; Cross, Stephanie Behm; Dunn, Alyssa Hadley

    2018-01-01

    Stanford Center for Assessment, Learning, and Equity (SCALE) provided a commentary on the manuscripts in the first part of this special issue, which highlighted the benefits of edTPA and the necessity for such assessment programs to improve teacher education and strengthen teaching practices. In turn, the authors responded to the SCALE commentary.…

  2. LEAVE OF ABSENCE PRACTICES IN SOUTH DAKOTA SCHOOLS--SCHOOL YEAR 1964-65.

    ERIC Educational Resources Information Center

    South Dakota Education Association, Pierre.

    IN ADDITION TO SCHOOL POLICIES RELATING TO TEACHER LEAVES OF ABSENCE IN SOUTH DAKOTA, STATE BY STATE SUMMARIES OF EDUCATIONAL LEGISLATION REGARDING SICK LEAVE, MATERNITY LEAVE, AND SABBATICAL LEAVE ARE PRESENTED IN THIS DOCUMENT. OF THE 228 RESPONDING SCHOOLS IN SOUTH DAKOTA, 215 REPORTED EXISTING SICK LEAVE POLICIES. THE MAJORITY OF RESPONDING…

  3. Reimagining the Education of Teachers: The Role of Comparative and International Research

    ERIC Educational Resources Information Center

    Tatto, Maria Teresa

    2011-01-01

    For years social science researchers have bemoaned their lack of impact on educational policy. The general view is that policy makers respond to urgent problems with ad hoc solutions and without evidence of what works. It has also become fashionable among comparativists to argue that little learning occurs at the local level but that innovations…

  4. Policy Interventions Designed to Combat Sexual Violence: Community Notification and Civil Commitment

    ERIC Educational Resources Information Center

    Levenson, Jill S.

    2003-01-01

    Much attention has been given to the problem of sexual predators and the struggles of the legal-justice system to contain them. In response to public outcry over high-profile sex crimes, federal and state legislators have responded in the past decade with innovative but controversial public policy initiatives, called "sexually violent predator…

  5. A Report on the Status of Sabbatical Leaves for Administrators in California Junior Colleges.

    ERIC Educational Resources Information Center

    Bandley, Marion K.

    This recent study investigates sabbatical leave policy for administrators in 80 California Junior Colleges. Except for a few newly-formed colleges or those having boards generally unfavorable to the idea, most of the colleges responding to the survey indicated some type of policy for granting such leaves. Justification for these leaves ranges from…

  6. Bringing Democratic Governance into Practice: Policy Enactments Responding to Neoliberal Governance in Spanish Public Schools

    ERIC Educational Resources Information Center

    Prieto-Flores, Òscar; Feu, Jordi; Serra, Carles; Lázaro, Laura

    2018-01-01

    This article explores different ways in which public primary schools sustain democratic governance structures created beyond those mandated by law in Spain. These new institutional designs, while not opposed to policy text requirements of having a governing body with representatives of parents, teachers and public administration, are being carried…

  7. Employer Child Care Resources: A Guide to Developing Effective Child Care Programs and Policies.

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    Increasing numbers of employers are responding to employee child care needs by revising their benefit packages, work schedules, and recruitment plans to include child care options. This guide details ways to develop effective child care programs and policies. Section 1 of the guide describes employees' growing child care needs and employers'…

  8. Do Schools Respond to Pressure? Evidence from NCLB Implementation Details

    ERIC Educational Resources Information Center

    Wong, Vivian C.; Wing, Coady; Martin, David

    2016-01-01

    Over the last decade, accountability reform has been at the forefront of the domestic policy agenda. Although the Obama Administration was critical of some elements of No Child Left Behind (NCLB), its policies endorsed high-stakes testing and expanded the scope of the stakes. With the Race to the Top and an NCLB waiver process, the administration…

  9. Understanding perception of wood household furniture: application of a policy capturing approach

    Treesearch

    David Brinberg; Matthew Bumgardner; Kim Daniloski

    2007-01-01

    Consumer and retailer perceptions of wood household furniture were modeled using a policy capturing approach. A sample of consumers and retailers evaluated four pictures of wood furniture on eight visual cues deemed representative of the furniture purchasing environment. These cues were then regressed on respondents' judgment of willingness to pay for each...

  10. Responding to Changes in HIV Policy: Updating and Enhancing the "Families Matter!" Curriculum

    ERIC Educational Resources Information Center

    Miller, Kim S; Winskell, Kate; Berrier, Faith L

    2016-01-01

    Objectives: The past decade has seen changes in US HIV policy in sub-Saharan Africa in response to a new Administration and far-reaching technical, scientific and programmatic developments. These include dramatically increased access to life-saving anti-retroviral therapy (ART) and related services, the roll-out of voluntary medical male…

  11. Learning from Others to Make Sense of the Law: Legal Response Policy Making in Higher Education

    ERIC Educational Resources Information Center

    Glick, David Matthew

    2010-01-01

    This research explores how organizations decide how to respond to the laws that affect them. It investigates how they convert abstract legal changes into concrete policy responses. Much of the legal impact literature focuses exclusively on either on legal institutions and social outcomes, or on the dynamics within organizations. This work…

  12. STEM Policy and Science Education: Scientistic Curriculum and Sociopolitical Silences

    ERIC Educational Resources Information Center

    Gough, Annette

    2015-01-01

    This essay responds to the contribution of Volny Fages and Virginia Albe, in this volume, to the field of research in science education, and places it in the context of the plethora of government and industry policy documents calling for more Science, Technology, Engineering and Mathematics (STEM) education in schools and universities and the…

  13. Legitimating and Contesting the Commodification of Schooling: The Case of Teachers' Learning in Queensland

    ERIC Educational Resources Information Center

    Hardy, Ian

    2016-01-01

    This paper draws upon research into the nature of teachers' learning practices in the context of current policy conditions in the state of Queensland, Australia. The research explores how teachers in one school in the north of the state responded to policy pressure to adopt a specific standardised approach to "explicit teaching",…

  14. Curriculum Policy Reform in an Era of Technical Accountability: "Fixing" Curriculum, Teachers and Students in English Schools

    ERIC Educational Resources Information Center

    Winter, Christine

    2017-01-01

    Drawing on a Levinasian ethical perspective, the argument driving this paper is that the technical accountability movement currently dominating the educational system in England is less than adequate because it overlooks educators' responsibility for ethical relations in responding to difference in respect of the other. Curriculum policy makes a…

  15. Education for Toleration in an Era of Zero Tolerance School Policies: A Deweyan Analysis

    ERIC Educational Resources Information Center

    Rice, Suzanne

    2009-01-01

    Americans in U.S. Society find themselves at a historical juncture where schools are implementing zero tolerance policies and--at the same time--also trying to promote tolerance, typically across differences such as race, class, culture, ability, and religion. Both these efforts respond to deeply held and serious concerns. But depending on the…

  16. Developing a Communication Strategy for Protecting Children. Report on Problem Definition Analysis Presented to: The Stuart Foundations.

    ERIC Educational Resources Information Center

    Brandon, Richard N.; Gordon, Andrew; Gordon, Margaret T.; Messerschmidt, David; Mitchell, Lorelei

    The Human Services Policy Center of Washington undertook a study of communication strategies for protecting children because of the perception among many leading child protection professionals that a distorted pattern of media coverage is driving child protection policies toward responding to the small proportion of atypical cases which the media…

  17. Incorporating operational flexibility into electric generation planning Impacts and methods for system design and policy analysis

    NASA Astrophysics Data System (ADS)

    Palmintier, Bryan S.

    This dissertation demonstrates how flexibility in hourly electricity operations can impact long-term planning and analysis for future power systems, particularly those with substantial variable renewables (e.g., wind) or strict carbon policies. Operational flexibility describes a power system's ability to respond to predictable and unexpected changes in generation or demand. Planning and policy models have traditionally not directly captured the technical operating constraints that determine operational flexibility. However, as demonstrated in this dissertation, this capability becomes increasingly important with the greater flexibility required by significant renewables (>= 20%) and the decreased flexibility inherent in some low-carbon generation technologies. Incorporating flexibility can significantly change optimal generation and energy mixes, lower system costs, improve policy impact estimates, and enable system designs capable of meeting strict regulatory targets. Methodologically, this work presents a new clustered formulation that tractably combines a range of normally distinct power system models, from hourly unit-commitment operations to long-term generation planning. This formulation groups similar generators into clusters to reduce problem size, while still retaining the individual unit constraints required to accurately capture operating reserves and other flexibility drivers. In comparisons against traditional unit commitment formulations, errors were generally less than 1% while run times decreased by several orders of magnitude (e.g., 5000x). Extensive numerical simulations, using a realistic Texas-based power system show that ignoring flexibility can underestimate carbon emissions by 50% or result in significant load and wind shedding to meet environmental regulations. Contributions of this dissertation include: 1. Demonstrating that operational flexibility can have an important impact on power system planning, and describing when and how these impacts occur; 2. Demonstrating that a failure to account for operational flexibility can result in undesirable outcomes for both utility planners and policy analysts; and 3. Extending the state of the art for electric power system models by introducing a tractable method for incorporating unit commitment based operational flexibility at full 876o hourly resolution directly into planning optimization. Together these results encourage and offer a new flexibility-aware approach for capacity planning and accompanying policy design that can enable cleaner, less expensive electric power systems for the future. (Copies available exclusively from MIT Libraries, libraries.mit.edu/docs - docs mit.edu)

  18. Assessing policy dialogues and the role of context: Liberian case study before and during the Ebola outbreak.

    PubMed

    Nabyonga-Orem, Juliet; Gebrikidane, Mesfin; Mwisongo, Aziza

    2016-07-18

    In the last decade participatory approaches have gained prominence in policy-making, becoming the focus of good policy-making processes. Policy dialogue is recognised as an important aspect of policy-making among several interactive and innovative policy-making models applied in different contexts and sectors. Recently there has been emphasis on the quality of policy dialogue in terms of how it should be conducted to attain participation and inclusiveness. However, there is paucity of evidence on how the context influences policy dialogue, particularly participation of stakeholders. Liberia's context, which is characterised as post-war, highly donor dependent and in recovery from the recent catastrophic Ebola outbreak, provides an opportunity to understand the influence of context on policy dialogue. This was an exploratory study using qualitative methods. Key informant interviews were conducted using an interview guide. A total of 16 interviews were conducted, 12 at the national level and 4 at the sub national level. Data were analysed using inductive thematic content analysis. The respondents felt that the dialogues were a success and involved important stakeholders; however, there were concerns about the improper methodology and facilitation used to conduct them. Opinions among the respondents about the process of generating and selecting the themes for the dialogues were extremely divergent. Both before and during the Ebola outbreak, the context was instrumental in shaping the dialogues according to the issue of focus, requirements for participation and the decisions to be made. Policy dialogues have become a platform for policy discussions and decisions in Liberia. It is a process that is well recognised and appreciated and is highly attributed to the success of the negotiations during the Ebola outbreak. To sustain and strengthen policy dialogues in future, there needs to be proper information sharing through diverse forums and avenues, stakeholders' empowerment and competent facilitation. These will ensure that the process is credible and legitimate.

  19. Medication management in North Carolina elementary schools: Are pharmacists involved?

    PubMed

    Stegall-Zanation, Jennifer; Scolaro, Kelly L

    2010-01-01

    To determine the extent of pharmacist use in medication management, roles of school nurses, and use of other health care providers at elementary schools in North Carolina. Prospective survey of 153 (130 public and 23 private) elementary schools in four counties of North Carolina. A 21-question survey was e-mailed to the head administrator of each school (e.g., principal, headmaster) containing a Qualtrics survey link. Questions were designed to elicit information on school policies and procedures for medication management and use of health care providers, including pharmacists, in the schools. Responses were collected during a 2-month period. Representatives from 29 schools participated in the survey (19% response rate). All 29 schools reported having a school policy regarding medication administration during school hours. Of those, 27 schools reported consulting with nurses on their policies. Only 1 of 27 respondents reported consulting with pharmacists on medication management policies. The majority of the respondents (93.1%) stated that administrative staff was responsible for medication administration at the schools. Use of pharmacists in creating and reviewing policies for schools and actual medication management at schools was extremely low. The findings in this study reinforce the findings in previous studies that pharmacists are not being used and are not a major presence in elementary school health.

  20. Falling through the Coverage Cracks: How Documentation Status Minimizes Immigrants' Access to Health Care.

    PubMed

    Joseph, Tiffany D

    2017-10-01

    Recent policy debates have centered on health reform and who should benefit from such policy. Most immigrants are excluded from the 2010 Affordable Care Act (ACA) due to federal restrictions on public benefits for certain immigrants. But, some subnational jurisdictions have extended coverage options to federally ineligible immigrants. Yet, less is known about the effectiveness of such inclusive reforms for providing coverage and care to immigrants in those jurisdictions. This article examines the relationship between coverage and health care access for immigrants under comprehensive health reform in the Boston metropolitan area. The article uses data from interviews conducted with a total of 153 immigrants, health care professionals, and immigrant and health advocacy organization employees under the Massachusetts and ACA health reforms. Findings indicate that respondents across the various stakeholder groups perceive that immigrants' documentation status minimizes their ability to access health care even when they have health coverage. Specifically, respondents expressed that intersecting public policies, concerns that using health services would jeopardize future legalization proceedings, and immigrants' increased likelihood of deportation en route to medical appointments negatively influenced immigrants' health care access. Thus, restrictive federal policies and national-level anti-immigrant sentiment can undermine inclusive subnational policies in socially progressive places. Copyright © 2017 by Duke University Press.

  1. Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

    PubMed Central

    Tung, Fabian Ling Ngai; Yan, Vincent Chun Man; Tai, Winnie Ling Yin; Chen, Jing Han; Chung, Joanne Wai-yee; Wong, Thomas Kwok Shing

    2016-01-01

    Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services. PMID:26959330

  2. The Influence of Long-Term Care Insurance on the Likelihood of Nursing Home Admission

    PubMed Central

    Gure, Tanya R.; Kabeto, Mohammed U.; Langa, Kenneth M.

    2009-01-01

    OBJECTIVES To determine the effect of long-term care (LTC) insurance on nursing home use. DESIGN Longitudinal analysis, 1998 to 2006 waves of the Health Retirement Study. SETTING Community-dwelling nationally representative sample. PARTICIPANTS Nineteen thousand one hundred seventy adults aged 50 and older, 1998 wave. METHODS Two groups of respondents were created at baseline: those with and without an LTC insurance policy. Respondents admitted to the nursing home from 1998 to 2006 were identified. Propensity scores were used to control for known predictors of LTC insurance possession. A Cox proportional hazards model was used to compare the probability of nursing home admission over 8 years of follow-up for respondents possessing LTC insurance and those without a policy. RESULTS Of the 19,170 respondents aged 50 and older in 1998, 1,767 (9.2%) possessed LTC insurance. A total of 1,778 (8.5%) were admitted to a nursing home during the 8-year period: 149 (8.7%) of those with LTC insurance and 1,629 (8.4%) of those without LTC insurance. The hazard ratio, adjusted for propensity score, for those with LTC insurance entering a nursing home compared with those without was 1.07 (95% confidence interval = 0.83–1.38). Likelihood of nursing home admission was relatively low because the low-risk population included in the study, limiting the power to detect small differences in risk of nursing home utilization between groups. CONCLUSION There was no difference in nursing home utilization between low-risk older adults who did and did not possess an LTC insurance policy. PMID:19694868

  3. Accrual and Recruitment Practices at Clinical and Translational Science Award (CTSA) Institutions: A Call for Expectations, Expertise, and Evaluation

    PubMed Central

    Kost, Rhonda G.; Mervin-Blake, Sabrena; Hallarn, Rose; Rathmann, Charles; Kolb, H. Robert; Himmelfarb, Cheryl Dennison; D’Agostino, Toni; Rubinstein, Eric P.; Dozier, Ann M.; Schuff, Kathryn G.

    2014-01-01

    Purpose To respond to increased public and programmatic demand to address underenrollment of clinical translational research studies, the authors examine participant recruitment practices at Clinical and Translational Science Award sites (CTSAs) and make recommendations for performance metrics and accountability. Method The CTSA Recruitment and Retention taskforce developed and, in 2010, invited representatives at 46 CTSAs to complete an online 48-question survey querying CTSA accrual and recruitment outcomes, practices, evaluation methods, policies, and perceived gaps in related knowledge/practice. Descriptive statistical and thematic analyses were conducted. Results Forty-six respondents representing 44 CTSAs completed the survey. Recruitment conducted by study teams was the most common practice reported (78–91%, by study type); 39% reported their institution offered recruitment services to investigators. Respondents valued study feasibility assessment as a successful practice (39%); their desired additional resources included feasibility assessments (49%) and participant registries (44%). None reported their institution systematically required justification of feasibility; some indicated relevant information was considered prior to IRB review (30%) or contract approval (22%). All respondents’ IRBs tracked study progress, but only 10% of respondents could report outcome data for timely accrual. Few reported written policies addressing poor accrual or provided data to support recruitment practice effectiveness. Conclusions Many CTSAs lack the necessary framework to support study accrual. Recommendations to enhance accrual include articulating institutional expectations and policy for routine recruitment planning; providing recruitment expertise to inform feasibility assessment and recruitment planning; and developing interdepartmental coordination and integrated informatics infrastructure to drive the conduct, evaluation, and improvement of recruitment practices. PMID:24826854

  4. Excessive use of force by police: a survey of academic emergency physicians.

    PubMed

    Hutson, H R; Anglin, D; Rice, P; Kyriacou, D N; Guirguis, M; Strote, J

    2009-01-01

    To determine the clinical experience, management and training of emergency physicians in the suspected use of excessive force by law enforcement officers. Surveys were mailed to a random sample of academic emergency physicians in the USA. Of 393 emergency physicians surveyed, 315 (80.2%) responded. Of the respondents, 99.8% (95% CI 98.2% to 100.0%) believed excessive use of force actually occurs and 97.8% (95% CI 95.5% to 99.1%) replied that they had managed patients with suspected excessive use of force. These incidents were not reported by 71.2% (95% CI 65.6% to 76.4%) of respondents, 96.5% (95% CI 93.8% to 98.2%) had no departmental policies and 93.7% (95% CI 90.4% to 96.1%) had not received training in the management of these cases. Suspected excessive use of force is encountered by academic emergency physicians in the USA. There is only limited training or policies for the management of these cases.

  5. A Review of the Literature on Policies Directed at the Youth Consumption of Sugar Sweetened Beverages123

    PubMed Central

    Levy, David T.; Friend, Karen B.; Wang, Y. Claire

    2011-01-01

    Sugar sweetened beverages (SSB) constitute a large percentage of energy consumed by youth. This paper reviews the literature on school nutrition policies and price interventions directed at youth SSB consumption. In addition to considering the direct effect of policies on SSB consumption, we provide an overview of the literature on how SSB consumption affects total energy intake (TEI) and BMI, as well as on how TEI affects BMI. By considering each of these links, we attempted to gauge the effect of policies directed at SSB consumption, as well as highlight areas that merit future research. We found that school nutrition and price policies reduce SSB consumption and that reduced SSB consumption is associated with a reduction in energy intake that can influence BMI. Policies directed at SSB consumption can play an important role in reducing youth overweight and obesity. PMID:22332051

  6. The Role of Veterinary Education in Safety Policies for Animal-Assisted Therapy and Activities in Hospitals and Nursing Homes.

    PubMed

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

    Animal-assisted activities (AAA) and animal-assisted therapy (AAT) programs are increasing in popularity, but current programs vary in their safety and health policies. Veterinarians can have an important role in ensuring the safety of both the animals and humans involved, but it is unclear how best to educate veterinary students to serve effectively in this role. Therefore, the goal of this study was to assess the knowledge gaps and perceptions of first-year veterinary students on health and safety aspects of AAA/AAT programs by administering a survey. This information could then guide future educational training in veterinary schools to address the knowledge gaps in this area. Formal education during the veterinary curriculum had not yet been provided to these students on AAA/AAT before the survey. Of 98 first-year veterinary students, 91 completed the survey. When asked about policies on visiting animals, 58% of students responded that nursing homes are required to have a policy and 67% responded that hospitals are required to have one. Three quarters of students reported that veterinarians, animal handlers, and facilities should share the responsibility for ensuring safe human-animal interaction in AAA/AAT programs. Most (82%) of the students responded that all or most national and local therapy animal groups prohibit animals that consume raw meat diets from participating in AAA/AAT programs. The results of this survey will help veterinary schools better identify knowledge gaps that can be addressed in veterinary curricula so future veterinarians will be equipped to provide appropriate public health information regarding AAA/AAT programs.

  7. Academic medical libraries' policies and procedures for notifying library users of retracted scientific publications.

    PubMed

    Hughes, C

    1998-01-01

    Academic medical libraries have a responsibility to inform library users regarding retracted publications. Many have created policies and procedures that identify flawed journal articles. A questionnaire was sent to the 129 academic medical libraries in the United States and Canada to find out how many had policies and procedures for identifying retracted publications. Of the returned questionnaires, 59% had no policy and no practice for calling the attention of the library user to retracted publications. Forty-one percent of the libraries called attention to retractions with or without a formal policy for doing so. Several responding libraries included their policy statement with the survey. The increasing number of academic medical libraries that realize the importance of having policies and practices in place highlights the necessity for this procedure.

  8. Cognitive laboratory approach to designing questionnaires for surveys of the elderly.

    PubMed Central

    Jobe, J B; Mingay, D J

    1990-01-01

    Data from surveys of the elderly are used by policy analysts to design health services programs. Consequently, the quality of survey data on elderly respondents has important implications for this growing segment of society: improving the quality of data should result in more cost effective programs for the elderly. However, studies suggest that the quality of responses from the elderly may be less than that for other respondents. Moreover, the increasing needs of policy analysts and health researchers for data have resulted in more complex survey questions that place a high cognitive burden on respondents. New methods for improving the design of these questionnaires are needed. This project investigated whether new techniques of questionnaire design, adapted from the theories and methods of cognitive psychology, could be effectively used in interviewing older respondents. The techniques used in this study, concurrent think-aloud interviews with followup probe questions, have been shown recently to be effective with younger respondents. Problems that elderly respondents have in comprehending survey questions, retrieving relevant information from memory, and using decision processes to estimate and provide answers were investigated. Questions on functional ability and social support were taken from the 1984 Supplement on Aging to the National Health Interview Survey. Analysis of respondents' think-aloud protocols and responses to probes suggest that the cognitive interview procedures were effective in identifying problems with the survey questions that would result in data of poorer quality and in suggesting the wording of questions that would be likely to result in answers of greater validity and reliability. Implications of these results for survey design and validation studies are discussed. PMID:2120731

  9. Perspectives on the Market Globalization of Korean Herbal Manufacturers: A Company-Based Survey

    PubMed Central

    Kim, Dongsu; Ahn, Miyoung; Jung, Jeeyoun; Kwon, Soohyun; Park, Eun-Ji; Koo, Ki Hoon; Woo, Jong-Min

    2015-01-01

    The growth of herbal markets has increased substantially in South Korea, but the worldwide market share remains small despite significant governmental efforts. This study aimed to characterize manufacturing employment and identify employees' general perceptions of market expansion. A survey study covering 567 companies was conducted using face-to-face interviews in 2012. Data were analyzed using comparisons among three manufacturing groups (i.e., the herbal dietary supplement manufacturing group, the herbal medicine manufacturing group, and the personal care product manufacturing group) or among the manufacturers themselves. We found that the majority of the manufacturing employee respondents were regular permanent and production workers. The domestic distributors were primarily chain stores/direct outlets or retailers/wholesalers, and the dominant product was red ginseng (hongsam). Although the responding companies exhibited a variety of perspectives, “advertisement/public relations” was cited as the most important factor in the development of the herbal industry. In contrast, “low manpower/seeking business partners” were the most crucial limiting and challenging factors for market globalization. Our results can be used to design a proper national plan by reducing the gaps in perspective between herbal product producers and policy makers. PMID:26199635

  10. Perspectives on the Market Globalization of Korean Herbal Manufacturers: A Company-Based Survey.

    PubMed

    Kim, Dongsu; Ahn, Miyoung; Jung, Jeeyoun; Kwon, Soohyun; Park, Eun-Ji; Koo, Ki Hoon; Woo, Jong-Min

    2015-01-01

    The growth of herbal markets has increased substantially in South Korea, but the worldwide market share remains small despite significant governmental efforts. This study aimed to characterize manufacturing employment and identify employees' general perceptions of market expansion. A survey study covering 567 companies was conducted using face-to-face interviews in 2012. Data were analyzed using comparisons among three manufacturing groups (i.e., the herbal dietary supplement manufacturing group, the herbal medicine manufacturing group, and the personal care product manufacturing group) or among the manufacturers themselves. We found that the majority of the manufacturing employee respondents were regular permanent and production workers. The domestic distributors were primarily chain stores/direct outlets or retailers/wholesalers, and the dominant product was red ginseng (hongsam). Although the responding companies exhibited a variety of perspectives, "advertisement/public relations" was cited as the most important factor in the development of the herbal industry. In contrast, "low manpower/seeking business partners" were the most crucial limiting and challenging factors for market globalization. Our results can be used to design a proper national plan by reducing the gaps in perspective between herbal product producers and policy makers.

  11. Relations among Teachers’ Emotion Socialization Beliefs and Practices, and Preschoolers’ Emotional Competence

    PubMed Central

    Morris, Carol A.S.; Denham, Susanne A.; Bassett, Hideko H.; Curby, Timothy W.

    2013-01-01

    Research Findings Utilizing a three-part model of emotion socialization that includes Modeling, Contingent Responding, and Teaching, this study examined the associations between 44 teachers’ self-reported and observed emotion socialization practices and 326 preschoolers’ emotion knowledge and observed emotional behavior. Multi-level analyses revealed that the majority of the variance in the children’s emotion knowledge scores and observed emotional behavior was predicted by factors within, rather than between, classrooms. Teachers’ use of all three emotion socialization techniques did contribute to the prediction of the children’s scores; however, the nature of these associations differed by children’s age and gender. Practice or Policy The development of children’s emotional competence is a complex, multi-faceted process in which many interaction partners play a role; early childhood teachers act as emotion socialization agents for the children in their care by modeling emotions, responding either supportively or punitively to children’s expressions of emotions, and engaging in direct instruction regarding emotional experience. This research may provide a basis for potential future interventions designed to assist teachers in developing their own emotion socialization skills so that they can be more effective emotion socialization agents for the children in their care. PMID:24159256

  12. Management of patients with implanted cardiac devices during radiotherapy: results of a Spanish survey in radiation oncology departments.

    PubMed

    Sabater, S; Montero, A; López Fernández, T; González Ferrer, J J; Arenas, M

    2018-05-23

    There is an increasing number of patients with cardiac implantable electronic devices (CIED), either pacemakers or defibrillators, who are receiving a course of radiotherapy. Several guidelines have been published by national societies, but no Spanish national guidelines for management of these patients have been published. More importantly, national clinical practice regarding these patients is not standardised. Members of the Spanish Breast Cancer Radiation Oncology Group (GEORM in Spanish) were surveyed through an online questionnaire on behalf of the Spanish radiation oncology departments. Only 39.3% of the Spanish radiation oncology departments have policies aimed at CIED carrier patients. Regardless of that, 96.4% of those who responded to the survey refer these patients to their Cardiology department before the start of the course of radiotherapy, and 17.8% of respondents said to manipulate the CIED without any cardiology department direction. A wide range of responses was obtained related to concepts such as "distance from the irradiation field to the CIED" or "safe accumulated doses". Our results demonstrate the need for national guidelines for CIED patients and the need to promote educational activities addressed to standardise clinical management of these patients in the radiation oncology departments.

  13. [The nature, extent and judicial response to aggression and violence directed against care workers in psychiatry].

    PubMed

    Harte, J M; van Leeuwen, M E; Theuws, R

    2013-01-01

    The Dutch government and the Council for public prosecutions consider aggression against and violence directed against public officers and care workers as unacceptable. But what is the attitude of these official bodies to violence directed against mental health care workers? To examine the nature and the prevalence of violence against mental health care professionals and the possible judicial consequences of this violence. Dutch mental health professionals who work in the psychiatric hospitals and clinics were asked to fill in an online questionnaire about their experiences, over the past five years, of violence perpetrated by patients. The 1534 respondents had encountered violence regularly in the course of their work. Some of the violence was of a very serious nature and sometimes had severe consequences. Only a small number of the violent incidents were reported to the police and ultimately brought to court. The victims were poorly informed about the possible judicial consequences of the violence they had encountered. Not only should the mental health institutes counsel and inform the employees who have been victims of violence, they should also promote the development and implementation of an effective prosecution policy.

  14. Air Quality Co-benefits of Energy Policy in China: Evidence from Iron & Steel and Cement Industries

    NASA Astrophysics Data System (ADS)

    Qiu, M.; Weng, Y.; Selin, N. E.; Karplus, V. J.; Cao, J.

    2017-12-01

    Previous literature has calculated large air quality co-benefits from policies that reduce CO2 emissions and increase energy efficiency. These (often prospective) studies rely on assumptions about how air pollutant emissions respond to energy use changes. Using a unique firm-level data set from China, we examine how a real-world energy efficiency policy affected SO2 emissions, estimate its actual effects on atmospheric PM2.5, and compare to ex ante theoretical estimates. During the 11th Five-year plan (2006-2010), the Chinese government implemented policies directing large energy-consuming firms to reduce their energy consumption per unit of economic output. The Top 1000 Enterprises Program (T1000P) set binding energy intensity targets for China's 1000 highest energy-consuming firms. This program is widely considered a policy success, as 92% of firms met their energy intensity target. Focusing on the cement and iron and steel industry, we examine how T1000P (and related provincial policies) affected firms' SO2 emissions and coal consumption from 2005 to 2008. By comparing T1000P firms with similar firms not subject to the policy, we find that T1000P had a very limited incremental effect on energy use or on air quality co-benefits. Compared to firms not subject to the policy, T1000P firms had 14.7% (cement) and 24.0% (iron & steel) lower reductions in SO2 emission per unit energy use. We also observe large, heterogeneous changes in emission factors (defined as SO2 emissions per unit of coal consumption) among all firms during this period. In comparison to co-benefits estimates that assume constant emission factors, SO2 emissions from T1000P firms in the post-policy period are 23.2% (iron and steel) and 40.2% (cement) lower, but spatially heterogeneous, with some regions experiencing increases. Using the GEOS-Chem model, we estimate the air quality co-benefits of the T1000P policy with realized SO2 emissions changes and compare them with two theoretical estimations of co-benefits: one assuming that emission factors stay the same, and one in which emissions factors decline exponentially with time. We conclude that heterogeneous technology and behavioral responses of covered firms can significantly affect the real-world air quality co-benefits of energy intensity policies delivered by a fixed policy design.

  15. The Impact Of State Policies On ACA Applications And Enrollment Among Low-Income Adults In Arkansas, Kentucky, And Texas.

    PubMed

    Sommers, Benjamin D; Maylone, Bethany; Nguyen, Kevin H; Blendon, Robert J; Epstein, Arnold M

    2015-06-01

    States are taking variable approaches to the Affordable Care Act (ACA) Medicaid expansion, Marketplace design, enrollment outreach, and application assistance. We surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, which expanded Medicaid, created a successful state Marketplace, and supported outreach efforts; Arkansas, which enacted the private option and a federal-state partnership Marketplace, but with legislative limitations on outreach; and Texas, which did not expand Medicaid and passed restrictions on navigators. We found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions. Application assistance from navigators and others was the strongest predictor of enrollment, while Latino applicants were less likely than others to successfully enroll. Twice as many respondents felt that the ACA had helped them as hurt them (although the majority reported no direct impact), and advertising was strongly associated with perceptions of the law. State policy choices appeared to have had major impacts on enrollment experiences among low-income adults and their perceptions of the ACA. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Summary of regional response to the fourth inquiry.

    PubMed

    1979-01-01

    Most of the governments that have responded to the 4th United Nations Population Growth Inquiry consider that the current rates of population growth are constraining the achievement of objectives of social economic development, and thus are unsatisfactory. The view of the governments of Iran, Pakistan, the Republic of Korea and Sri Lanka is that their current rates of growth constrain all aspects of development. The governments of Japan, Malaysia, and Singapore regard their current rates of growth as satisfactory and contributing to different aspects of economic and social development. As for mortality, most governments in the ESCAP region consider the current level of average life expectancy at birth acceptable, but present levels are unacceptable to the governments of Bangladesh, India, Iran, Nepal, Samoa and Thailand. Most governments consider their current levels of fertility to be too high and that they constrain the family well being, but the governments of Japan and Singapore believe that their fertility has contributed to the family well being. Additional attention in the inquiry was directed to obtaining information on the promotion of knowledge and policies (data collection and analysis; research; management, training, education and information; and development and evaluation of population policies). 10 governments have established a high level unit to deal with population policies, and 10 governments have indicated that they have integrated population measures and programs into comprehensive social and economic plans and programs.

  17. Relationships between environmental governance and water quality in a growing metropolitan area of the Pacific Northwest, USA

    NASA Astrophysics Data System (ADS)

    Chang, H.; Thiers, P.; Netusil, N. R.; Yeakley, J. A.; Rollwagen-Bollens, G.; Bollens, S. M.; Singh, S.

    2014-04-01

    We investigate relationships between environmental governance and water quality in two adjacent growing metropolitan areas in the western US. While the Portland, Oregon and Vancouver, Washington metro areas share many common biophysical characteristics, they have different land development histories and water governance structures, providing a unique opportunity for examining how differences in governance might affect environmental quality. We conceptualize possible linkages in which water quality influences governance directly, using monitoring efforts as a metric, and indirectly by using the change in the sale price of single-family residential properties. Governance may then influence water quality directly through riparian restoration resulting from monitoring results and indirectly through land use policy. We investigate evidence to substantiate these linkages. Our results showed that changes in monitoring regimes and land development patterns differed in response to differences in growth management policy and environmental governance systems. Our results also showed similarities in environmental quality responses to varying governance systems. For example, we found that sales prices responded positively to improved water quality (e.g., increases in DO and reductions in bacteria counts) in both cities. Furthermore, riparian restoration efforts improved over time for both cities, indicating the positive effect of governance on this land-based resource that may result in improved water quality. However, as of yet, there were no substantial differences across study areas in water temperature over time, despite an expansion of these urban areas of more than 20 % over 24 years. The mechanisms by which water quality was maintained was similar in the sense that both cities benefited from riparian restoration, but different in the sense that Portland benefited indirectly from land use policy. A combination of long-term legacy effects of land development, and a relatively short history of riparian restoration in both the Portland and Vancouver regions, may have masked any subtle differences between study areas. An alternative explanation is that both cities exhibited combinations of positive indirect and direct water quality governance that resulted in maintenance of water quality in the face of increased urban growth. These findings suggest that a much longer-term water quality monitoring effort is needed to identify the effectiveness of alternative land development and water governance policies.

  18. Resident use of the Internet, e-mail, and personal electronics in the care of surgical patients.

    PubMed

    Plant, Mathew A; Fish, Joel S

    2015-01-01

    The use of smartphones, e-mail, and the Internet has affected virtually all areas of patient care. Current university and hospital policies concerning the use of devices may be incongruent with day-to-day patient care. The goal was to assess the current usage patterns of the Internet, e-mail, and personal electronics for clinical purposes by surgical residents as well as their communication habits and preferences. Also assessed was residents' knowledge regarding the institutional policies surrounding these issues. Surgical residents (n = 294) at a large teaching institution were surveyed regarding their knowledge of university policies as well as daily use of various communication technologies. Communication preferences were determined using theoretical clinical scenarios. Our survey with a response rate of 54.7% (n = 161) revealed that 93.8% of participants indicated daily Internet use for clinical duties. Most respondents (72%) were either completely unaware of the existence of guidelines for its use or aware but had no familiarity with their content. Use of e-mail for clinical duties was common (85%), and 74% of the respondents rated e-mail as "very important" or "extremely important" for patient care. Everyone who responded had a mobile phone with 98.7% being "smartphones," which the majority (82.9%) stated was "very important" or "extremely important" for patient care. Text messaging was the primary communication method for 57.8% of respondents. The traditional paging system was the primary communication method for only 1.3% of respondents and the preferred method for none. Daily use of technology is the norm among residents; however, knowledge of university guidelines was exceedingly low. Residents need better education regarding current guidelines. Current guidelines do not reflect current clinical practice. Hospitals should consider abandoning the traditional paging system and consider facilitating better use of residents' mobile phones.

  19. Child and Family Policies in a Time of Economic Crisis

    ERIC Educational Resources Information Center

    Richardson, Dominic

    2010-01-01

    At the beginning of 2008, a number of the world's major economies began to experience the effects of the biggest economic financial crisis in history. By the end of that year, the financial crisis was a global recession, and governments responded with changes to a suite of social and economic policies. Two broad stages of government response are…

  20. Katrina's Children: Social Policy Considerations for Children in Disasters. Social Policy Report. Volume 21, Number 1

    ERIC Educational Resources Information Center

    Osofsky, Joy D.; Osofsky, Howard J.; Harris, William W.

    2007-01-01

    Hurricane Katrina resulted in a disaster of proportions not previously known in the United States. The traumatic experiences of children and families during Hurricane Katrina, the flooding that resulted from the breach of the levees, the evacuation, and the aftermath are unprecedented. In responding to the enormous mental health needs of children…

  1. Globalisation, the Singapore Developmental State and Education Policy: A Thesis Revisited

    ERIC Educational Resources Information Center

    Gopinathan, S.

    2007-01-01

    In this article I revisit and extend arguments made in 1996 and 1997 about the relationship between globalisation, the state and education policy. I was particularly concerned then to see how a small but strong state, Singapore, was responding in the education arena to globalisation. I also wished to draw attention to the literature on the high…

  2. 24 CFR 15.108 - What are HUD's policies concerning designating confidential commercial or financial information...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false What are HUD's policies concerning designating confidential commercial or financial information under Exemption 4 of the FOIA and responding to requests for business information? 15.108 Section 15.108 Housing and Urban Development Office of the Secretary, Department of Housing and...

  3. The Home Smoking Environment: Influence on Behaviors and Attitudes in a Racially Diverse Adolescent Population

    ERIC Educational Resources Information Center

    Muilenburg, Jessica Legge; Latham, Teaniese; Annang, Lucy; Johnson, William D.; Burdell, Alexandra C.; West, Sabra J.; Clayton, Dixie L.

    2009-01-01

    Although studies indicate that public policy can influence the decrease in smoking behaviors, these policies have not necessarily transferred to home environments at the same rate. The authors surveyed 4,296 students in a southern urban area. African American students were 76.3% of the respondents and Caucasians accounted for 23.7%. African…

  4. The Relationship between Sun Protection Policy and Associated Practices in a National Sample of Early Childhood Services in Australia

    ERIC Educational Resources Information Center

    Ettridge, Kerry A.; Bowden, Jacqueline A.; Rayner, Joanne M.; Wilson, Carlene J.

    2011-01-01

    Limiting exposure to sunlight during childhood can significantly reduce the risk of skin cancer. This was the first national study to assess the sun protection policies and practices of early childhood services across Australia. It also examined the key predictors of services' sun protection practices. In 2007, 1017 respondents completed a…

  5. Women in Combat: Is the Current Policy Obsolete

    DTIC Science & Technology

    2007-02-23

    gender issues were cited by fewer than 1 percent of their respondents when asked about issues that affect morale in recently gender -integrated units...37 GENDER ISSUES /POLICIES THAT EFFECT MILITARY CAPABILITY..................42 Pregnancy... Gender Issues ,” Report No. GAO/NSAID-99-7, 19 October 1998, p. 4. 2 personal experiences as a combat pilot and military commander frame my

  6. String of turquoise: The future of Sacred Mountain Peaks in the southwest U.S.

    Treesearch

    Linda Moon Stumpff

    2011-01-01

    The Southwest is the birthplace of wilderness policy in the United States, yet the unique ecological environments of its peaks, cordilleras, and ranges that dot the high desert remain only partially protected. Some areas are relatively secure, yet midcentury Federal policy responded to multiple development pressures, from ski basins to roads, that sliced these peaks...

  7. Consumer Support for Policies to Reduce the Sodium Content in School Cafeterias

    ERIC Educational Resources Information Center

    Patel, Sheena M.; Gunn, Janelle P.; Merlo, Caitlin L.; Tong, Xin; Cogswell, Mary E.

    2014-01-01

    Purpose/Objectives: The objective of this study was to assess consumer support for policies lowering the sodium content of cafeteria foods in schools. Methods: Data were used from 9,634 adults aged >18 years who responded to questions about sodium in general and in school foods in a 2010 national mail panel survey. Prevalence of consumer…

  8. Agents of Change and Continuity: The Pivotal Role of Teachers in Albanian Educational Reform and Democratization

    ERIC Educational Resources Information Center

    Gardinier, Meg P.

    2012-01-01

    This article explores how teachers navigate and respond to the competing pressures of school change in a global policy context. In postcommunist Albania, national policies reflecting global norms for the teacher's role overshadowed complex and cultural aspects of teaching and learning and, as a result, led to gaps in implementation. On the basis…

  9. Mexicans in the Pacific Northwest: Lesson from Progressive School Leaders for Progressive Educational Policy

    ERIC Educational Resources Information Center

    Shannon, Sheila M.

    2008-01-01

    Latinos now live and work in areas of the United States where they have not been before. These changes impact schools in a variety ways. This article reviews recent research on how communities have responded in the South, New England and the West with a primarily assimilationist approach including English-only policies. The article then provides a…

  10. Concepts, Policies and Practices of Teacher Education: An Analysis of Studies on Teacher Education in Portugal

    ERIC Educational Resources Information Center

    Pereira, Fátima

    2013-01-01

    Education policies, and in particular those related to teacher education, are central to the construction of Europe as a knowledge society and for facing the social and economic challenges that European countries must respond to in this millennium. This article presents an analysis of studies on the evaluation of in-service teacher education…

  11. Policy options for responding to the growing challenge from obesity (PorGrow) in Poland.

    PubMed

    Szponar, L; Ciok, J; Dolna, A; Oltarzewski, M

    2007-05-01

    To explore the perspectives of stakeholders towards a range of policy options to respond to obesity in Poland, a multi-criteria mapping method was used. During structured interviews, stakeholders were invited to appraise policy options by reference to criteria of their own choosing. They also provided relative weightings to their criteria, generating overall rankings of the policy options in relation to each other. Efficacy, feasibility and societal benefits were the groups of criteria deemed most important. There was most consensus in favour of options related to health education, particularly in schools, compared with options that aimed at modifying the environment to prevent obesity, i.e. options around physical activity, modifying the supply and demand for food products, and information-related options. There was little support for technological solutions or institutional reforms. There was broad consensus that to reverse the rising trend in the incidence of obesity, it will be necessary to implement a portfolio of measures, but options related to behaviour change through education are most highly regarded. It will also be necessary to invest in improved surveillance and monitoring of Polish dietary practices, levels of physical activity and obesity in terms of data on height, weight and body mass indexes.

  12. What's fair is fair--or is it? Value differences underlying public views about social justice.

    PubMed

    Rasinski, K A

    1987-07-01

    Individual differences in judgments of the fairness of various sociopolitical phenomena were examined in three surveys. Scales measuring two value dimensions thought to underlie the meaning of fairness were constructed, and survey respondents endorsing these different values were compared on their evaluation of the procedural and distributive fairness of political objects. Those endorsing the value of proportionality, hypothesized by equity theorists to underlie fairness judgments, judged equity-based public policies to be fairer than equality-based policies and judged that Ronald Reagan would be a fairer president than Walter Mondale. These people also emphasized the procedural aspects of government when judging government fairness. Respondents endorsing the value of egalitarianism, hypothesized by developmental theorists and some political philosophers to underlie fairness judgments, judged equality-based public policies to be fairer than equity-based policies and judged that Mondale would be a fairer president than Reagan. These people emphasized the distributive aspects of government when judging government fairness. Results support the naive moral philosopher image of the individual as judge of political objects (Tyler, 1984a). Political fairness judgments are ideological responses and are subject to the influence of the value structure of the judge (Tetlock, 1986).

  13. Public support for policy initiatives regulating high-fat food use in Minnesota: a multicommunity survey.

    PubMed

    Schmid, T L; Jeffery, R W; Forster, J L; Rooney, B; McBride, C

    1989-11-01

    Public support of eight policies to regulate the sale and consumption of high-fat food was evaluated in a survey of 438 women and 383 men in seven Minnesota communities. The survey was part of the ongoing activities of the Minnesota Heart Health Program (MHHP). Respondents, when asked to indicate their level of support or opposition to each of eight policies, expressed general support for all but two. Women were consistently more supportive than men. Other sociodemographic characteristics and reported use of food and other substances were generally not predictive of support. Policies that would control conditions of sale or information about the product were the most strongly supported. Taxation as an incentive to food producers to provide alternatives to high-fat food or as a disincentive to consumers to purchase these foods was moderately supported. A proposal to limit sale of high-fat food to children was the most strongly opposed. The majority of respondents indicated that they felt the individual consumer, as opposed to the producer or retailer, is most responsible for problems associated with high-fat food use. The three communities which had received MHHP health promotion activities were significantly more supportive than the comparison communities on two of the eight proposals. There is a moderate level of support in the general public for additional policies to regulate the sale and consumption of high-fat foods. These policy level interventions, similar to policies common in the regulation of alcohol and tobacco use, may be a feasible strategy to help moderate use of potentially health-compromising food products.

  14. The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand

    PubMed Central

    Teerawattananon, Yot; Russell, Steve

    2008-01-01

    Background This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Methods Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Results Twenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence. Conclusion This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions. PMID:18817579

  15. Healthcare staff attitudes towards the use of electronic cigarettes ('e-cigarettes') compared with a local trust policy.

    PubMed

    Pippard, Benjamin J; Shipley, Mark D

    2017-07-01

    E-cigarette use has risen dramatically in recent years, despite uncertainty over long-term health effects and concerns regarding efficacy as a smoking cessation device. Currently, there is no legislation prohibiting use in public, though many trusts have extended the NHS Smokefree policy to include e-cigarettes. The successful implementation of such policy is, however, unclear. This study examined staff attitudes towards the use of e-cigarettes in a hospital environment with respect to enforcement of a local trust smoking policy. A total of 79 healthcare professionals working at South Tyneside District Hospital, South Shields, completed a written questionnaire regarding use of e-cigarettes, particularly views on use in public and on hospital premises. Factors influencing the likelihood of individuals to challenge the use of e-cigarettes were assessed. In all, 45% of respondents thought that e-cigarettes should be allowed in public places, though a majority (62%) favoured use on hospital grounds compared to within hospital buildings (18%). Over 50% of respondents were unaware of trust policy relating to e-cigarettes and only 25% had ever challenged someone using a device. Roughly, one-third reported that they would still not challenge someone in future, despite being informed of trust policy. Fear of abuse was the most cited reason for not challenging. Expressed concerns of e-cigarette use related to fire risk, 'normalising' smoking behaviour and uncertainty of long-term effects. Most staff do not enforce trust policy regarding e-cigarette use. This reflects variation in opinion over use, poor awareness of the policy itself and perceived barriers to implementation, including fear of abuse. Addressing these issues through staff education sessions may help successful future implementation.

  16. Worldwide policies on epilepsy and blood donation: a survey among blood services.

    PubMed

    Kellens, A; De Buck, E; Emonds, M-P; Vandekerckhove, P; Lagae, L

    2018-02-01

    Epilepsy is a common neurological disorder characterized by the appearance of seizures. Often, epilepsy patients are temporarily or permanently excluded from blood donation. To gain a better understanding of the policies that are currently applied, we performed a survey among blood services. A cross-sectional, Web-based questionnaire using the online Questback tool was developed and distributed to 46 representatives of blood services worldwide. The questionnaire was composed of nine questions. A total of 27 respondents, representing blood services in 26 countries on five continents, participated in the survey. Current policies range from permanent acceptance over temporary exclusion to permanent exclusion. Rationales for these different policies are diverse. The majority of blood services (59·3%) apply temporary exclusion as their policy, though no consensus exists on the length of time that epilepsy patients have to be medication-free or seizure-free. None of the respondents could provide data about adverse events in epilepsy patients during the blood donation process. The results of this survey indicate a large discrepancy in policies applied worldwide. A lack of scientific evidence could be one of the underlying reasons. Therefore, it is of paramount importance to further research the potential risks for donors and recipients regarding blood donation by people with epilepsy. This can then serve as a base for evidence-based policymaking and lead to safer and more effective blood transfusion programmes. © 2018 International Society of Blood Transfusion.

  17. 32 CFR 22.315 - Merit-based, competitive procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... This OMB policy directive is available at the Internet site http://www.whitehouse.gov/omb/grants/grants... accordance with that OMB policy directive, DoD Components also must post on the Internet any notice under...), the notice need not be posted on the Internet. (3) To comply with an OMB policy directive entitled...

  18. 32 CFR 22.315 - Merit-based, competitive procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... This OMB policy directive is available at the Internet site http://www.whitehouse.gov/omb/grants/grants... accordance with that OMB policy directive, DoD Components also must post on the Internet any notice under...), the notice need not be posted on the Internet. (3) To comply with an OMB policy directive entitled...

  19. 76 FR 1616 - Federal Open Market Committee; Domestic Policy Directive of December 14, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of December 14... 271), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on December 14, 2010.\\1\\ \\1\\ Copies of the Minutes of the Federal Open Market...

  20. Effect of Tourist Characteristic, Marine Tourism Demand, and Number of Visits to the Value Perceptions and Willingness to Pay to Environmental Marine Tourism in Ambon City

    NASA Astrophysics Data System (ADS)

    Papilaya, Renoldy L.

    2018-02-01

    Development of tourism in this era must balance between supply and demand aspects. The tendency of policy makers pay more attention to aspects of supply than demand aspect will lead to the development of tourist products and services do not get good results. This research examined the relationship between marine tourism demand, characteristics and number of visits to the level of perception and willingness to pay (WTP) for a tourists on a marine tourism destination in Ambon city. Respondents come from overseas tourists, domestic and local, amounting to 140 people. The analysis was performed descriptively and further using SEM analysis Amos 19.00 with path analysis. The analysis shows the close relationship between marine tourism demand variables, characteristics, and the number of tourist visits to the perception of value and WTP for tourists. Variable marine tourism demand when connected directly to the tourists perception and WTP tends to correlate negatively than when using a variable as a variable number of tourist visits as a intervening variables. Instead tourists characteristic variables are positively correlated directly or indirectly with the perception of value and WTP for tourists. It is hoped that with this study will motivate tourism policy makers and local communities to be concerned and studied aspects of perception, WTP, marine tourism demand, the number of tourist visits and the characteristics that turned out to be related to each other.

  1. Knowledge Brokers in the Making: Opportunities to Connect Researchers and Stakeholders

    NASA Astrophysics Data System (ADS)

    Pennell, K. G.; Pennell, M. C.

    2014-12-01

    Environmental science and engineering graduate students often lack training on how to communicate with policy decision makers who are grappling with questions to which research is responding. They communicate directly with mutual experts, but are many times unable to engage with non-experts about their research, thereby limiting the reach and impact of their findings. This presentation highlights opportunities within environmental science and engineering research to create opportunities for researchers to hone skills as knowledge brokers, so they learn ways to meaningfully engage with a range of stakeholders. A knowledge broker is an individual who connects scientific experts and relevant stakeholders with meaningful and useable information. Recognizing that information must flow in multiple directions, the knowledge broker must quickly and effectively translate needs and questions using established relationships. It is these relationships, as well as the synthesis of scientific knowledge into useable information, on which the success of the knowledge broker lies. Using lessons learned, as well as communication science theory related to knowledge brokering, this presentation highlights training opportunities for knowledge brokers who are primarily educated in science and engineering fields, yet seek to engage with societally relevant stakeholders. We present case study examples of knowledge brokering within two large multi-disciplinary research centers. These centers provide unique experiences for researchers to build relationships with stakeholders, so that the scientific experts not only create novel research within their specific discipline, but also inform policy decision makers, community members and regulatory officials.

  2. Multi-country willingness to pay study on road-traffic environmental health effects: are people willing and able to provide a number?

    PubMed

    Istamto, Tifanny; Houthuijs, Danny; Lebret, Erik

    2014-05-09

    The health impacts from traffic-related pollutants bring costs to society, which are often not reflected in market prices for transportation. We set out to simultaneously assess the willingness-to-pay (WTP) for traffic-related air pollution and noise effect on health, using a single measurement instrument and approach. We investigated the proportion and determinants of "protest vote/PV responses (people who were against valuing their health in terms of money)" and "don't know"/DK answers, and explored the effect of DK on the WTP distributions. Within the framework of the EU-funded project INTARESE, we asked over 5,200 respondents in five European countries to state their WTP to avoid health effects from road traffic-related air pollution and noise in an open-ended web-based questionnaire. Determinants of PV and DK were studied by logistic regression using variables concerning socio-demographics, income, health and environmental concern, and risk perception. About 10% of the respondents indicated a PV response and between 47-56% of respondents gave DK responses. About one-third of PV respondents thought that costs should be included in transportation prices, i.e. the polluter should pay. Logistic regression analyses showed associations of PV and DK with several factors. In addition to social-demographic, economic and health factors known to affect WTP, environmental concern, awareness of health effects, respondent's ability to relax in polluted places, and their view on the government's role to reduce pollution and on policy to improve wellbeing, also affected the PV and DK response. An exploratory weighting and imputation exercise did not show substantial effects of DK on the WTP distribution. With a proportion of about 50%, DK answers may be a more relevant issue affecting WTP than PV's. The likelihood to give PV and DK response were influenced by socio-demographic, economic and health factors, as well as environmental concerns and appreciation of environmental conditions and policies. In contested policy issues where actual policy may be based on WTP studies, PV and DK answers may indeed affect the outcome of the WTP study. PV and DK answers and their determinants therefore deserve further study in CV studies on environmental health effects.

  3. Responding to information about children in adversity: ten years of a differential response model in Western Australia.

    PubMed

    Harries, Maria; Cant, Rosemary L; Bilson, Andy; Thorpe, David

    2015-01-01

    This article uses a comprehensive database about children in adversity collected over the 16-year period from 1990 to 2005 in the state of Western Australia. The focus of this interrogation is the effect of major changes in responses to information about children brought to the attention of the Western Australian statutory authority in a 10-year period during this 16 years. The initiative for these changes was termed New Directions, and its associated policy and practice changes were aimed at differentiating information expressing concerns about children and families from allegations of child maltreatment. They emphasized the provision of supportive and empowering services to families experiencing difficulties - a form of differential response to children in adversity. The article covers the period leading up to the policy and practice change and the 10 years during which these changes were implemented. It examines some effects of the new policy and comments on whether the changes resulted in missed opportunities to protect children from harm, which in turn, might have led to higher rates of re-reporting. The authors present an overall picture of the nature of the information accepted by the statutory authority and how the interpretation of that information might have affected subsequent outcomes for children. In doing so, it shows that the policy and consequential practice changes associated with a differential response mechanism had long lasting positive effects that, despite dire warnings, did not compromise the protection of the small group of children identified as requiring protective interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Welfare Reform and Labor Force Exit by Young, Low-Skilled Single Males.

    PubMed

    Groves, Lincoln H

    2016-04-01

    While the labor market woes of low-skilled male workers in the United States over the past several decades have been well documented, the academic literature identifying causal factors leading to declines in labor force participation (LFP) by young, low-skilled males remains scant. To address this gap, I use the timing and characteristics of welfare-reform policies implemented during the 1990s and fixed-effects, instrumental variable regression modeling to show that policies seeking to increase LFP rates for low-skilled single mothers inadvertently led to labor force exit by young, low-skilled single males. Using data from the Current Population Survey and a bundle of work inducements enacted by states throughout the 1990s as exogenous variation in a quasi-experimental design, I find that the roughly 10 percentage point increase in LFP for low-skilled single mothers facilitated by welfare reform resulted in a statistically significant 2.8 percentage point decline in LFP for young, low-skilled single males. After conducting a series of robustness checks, I conclude that this result is driven entirely by white males, who responded to welfare-reform policies with a 3.7 percentage point decline in labor supply. Young black males, as well as other groups of potentially affected workers, appear to be uninfluenced by the labor supply response of less-educated single mothers to welfare reform. Impacts on young, single white males are large and economically significant, suggesting that nearly 150,000 males departed the formal labor market in response to directed welfare-reform policies.

  5. A survey of African American physicians on the health effects of climate change.

    PubMed

    Sarfaty, Mona; Mitchell, Mark; Bloodhart, Brittany; Maibach, Edward W

    2014-11-28

    The U.S. National Climate Assessment concluded that climate change is harming the health of many Americans and identified people in some communities of color as particularly vulnerable to these effects. In Spring 2014, we surveyed members of the National Medical Association, a society of African American physicians who care for a disproportionate number of African American patients, to determine whether they were seeing the health effects of climate change in their practices; the response rate was 30% (n = 284). Over 86% of respondents indicated that climate change was relevant to direct patient care, and 61% that their own patients were already being harmed by climate change moderately or a great deal. The most commonly reported health effects were injuries from severe storms, floods, and wildfires (88%), increases in severity of chronic disease due to air pollution (88%), and allergic symptoms from prolonged exposure to plants or mold (80%). The majority of survey respondents support medical training, patient and public education regarding the impact of climate change on health, and advocacy by their professional society; nearly all respondents indicated that the US should invest in significant efforts to protect people from the health effects of climate change (88%), and to reduce the potential impacts of climate change (93%). These findings suggest that African American physicians are currently seeing the health impacts of climate change among their patients, and that they support a range of responses by the medical profession, and public policy makers, to prevent further harm.

  6. Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: perspectives of refugees and health care providers.

    PubMed

    Al-Rousan, Tala; Schwabkey, Zaker; Jirmanus, Lara; Nelson, Brett D

    2018-06-10

    The United Nations has declared the Syrian refugee crisis to be the biggest humanitarian emergency of our era. Neighbouring countries, such as Jordan, strain to meet the health needs of Syrian refugees in addition to their own citizens given limited resources. This study aimed to determine the perspectives of Syrian refugees in Jordan, Jordanian health care providers and other stakeholders in addressing the public health issues of the refugee crisis. Qualitative and quantitative methodologies were used to explore Syrian refugee health needs and services in camp and urban settings in Jordan. Focus group discussions and key informant interviews were used to identify needs, challenges and potential solutions to providing quality health care to refugees. By-person factor analysis divided refugee participants into 4 unique respondent types and compared priorities for interventions. Focus group discussions and key informant interviews revealed a many different problems. Cost, limited resources, changing policies, livelihoods and poor health literacy impeded delivery of public and clinical health services. Respondent Type 1 emphasized the importance of policy changes to improve Syrian refugee health. Type 2 highlighted access to fresh foods and recreational activities for children. For Type 3, poor quality drinking-water was the primary concern, and Type 4 believed the lack of good, free education for Syrian children exacerbated their mental health problems. Syrian refugees identified cost as the main barrier to health care access. Both refugees and health care providers emphasized the importance of directing more resources to chronic diseases and mental health. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

  7. Corporate social responsibility in countries with mature and emerging pharmaceutical sectors

    PubMed Central

    Volodina, Anna; Sax, Sylvia; Anderson, Stuart

    2009-01-01

    In recent decades the concept of Corporate Social Responsibility (CSR) has been adopted by many business sectors, including the pharmaceutical industry. However, in this and other sectors its application remains variable, particularly between mature and developing economies. Its stakeholders include pharmacy and medical students, their attitude to the involvement of companies in socially responsible activities will be important determinants of public response to the industry. Objective: To investigate the knowledge, attitudes and practices of senior medical and pharmacy students towards the CSR concept in the pharmaceutical sector in mature (Germany) and developing (Russia) markets. Methods: A questionnaire survey was carried out among senior pharmacy and medical students during the summer semester 2008 in two Russian and one German university. In each country 120 questionnaires were distributed. The response rate was 95% in Russia and 93% in Germany. Results: Although the relevance of CSR was widely acknowledged by the students, very few were aware of CSR practices currently performed by companies. The reputation of the pharmaceutical industry was generally poor: less than 15% of respondents gave credence to the information provided in advertisements and fully supported pricing strategies as well as policies towards the developing countries. When choosing an employer more than 90% of respondents consider the policies affecting an employee directly as pivotal. However, for a high proportion of students (59% in Russia and 64% in Germany) socially irresponsible behavior by companies has a significant negative impact. Conclusions: This paper identifies practices which students believe should be a part of the CSR programmes for the pharmaceutical industry, and also some that should be abandoned. It recommends that corporate communication on CSR should be expanded. Key differences are seen in perceptions of students in Germany and Russia towards the extent of irresponsible actions and the variation between them. PMID:25136398

  8. Placebo Trends across the Border: US versus Canada

    PubMed Central

    Harris, Cory S.; Campbell, Natasha K. J.; Raz, Amir

    2015-01-01

    Background Physicians around the world report to using placebos in a variety of situations and with varying degrees of frequency. Inconsistent methodologies, however, complicate interpretation and prevent direct comparisons across studies. While US- and Canada-based physicians share similar professional standards, Canada harbours a less-litigious universal healthcare model with no formal placebo-related policy—factors that may impact how physicians view and use placebos. Methods To compare American and Canadian data, we circulated an online survey to academic physicians practicing in Canada, collected anonymous responses, and extracted those of internists and rheumatologists for comparison to US data obtained through parallel methodologies. Results Whereas our data show overall concordance across the border—from definitions to ethical limitations and therapeutic potential—differences between American- and Canadian-based placebo practices merit acknowledgement. For example, compared to 45%-80% among US-based respondents, only 23±7% of Canada-based respondents reported using placebos in clinical practice. However, 79±7% of Canada-respondents—a figure comparable to US data—professed to prescribing at least one form of treatment without proven or expected efficacy. Placebo interventions including unwarranted vitamins and herbal supplements (impure placebos) as well as sugar pills and saline injections (pure placebos) appear more common in Canada, where more doctors described placebos as “placebos” (rather than “medications”) and used them as a “diagnostic” tool (rather than a means of placating patient demands for treatment). Interpretation Cross-border variation in the use of clinical placebos appears minor despite substantial differences in health care delivery system, malpractice climate, and placebo-related policy. The prevalence of impure placebos in both Canadian and US clinics raises ethical and practical questions currently unaddressed by policy and warranting investigation. PMID:26606749

  9. Corporate social responsibility in countries with mature and emerging pharmaceutical sectors.

    PubMed

    Volodina, Anna; Sax, Sylvia; Anderson, Stuart

    2009-10-01

    In recent decades the concept of Corporate Social Responsibility (CSR) has been adopted by many business sectors, including the pharmaceutical industry. However, in this and other sectors its application remains variable, particularly between mature and developing economies. Its stakeholders include pharmacy and medical students, their attitude to the involvement of companies in socially responsible activities will be important determinants of public response to the industry. To investigate the knowledge, attitudes and practices of senior medical and pharmacy students towards the CSR concept in the pharmaceutical sector in mature (Germany) and developing (Russia) markets. A questionnaire survey was carried out among senior pharmacy and medical students during the summer semester 2008 in two Russian and one German university. In each country 120 questionnaires were distributed. The response rate was 95% in Russia and 93% in Germany. Although the relevance of CSR was widely acknowledged by the students, very few were aware of CSR practices currently performed by companies. THE REPUTATION OF THE PHARMACEUTICAL INDUSTRY WAS GENERALLY POOR: less than 15% of respondents gave credence to the information provided in advertisements and fully supported pricing strategies as well as policies towards the developing countries. When choosing an employer more than 90% of respondents consider the policies affecting an employee directly as pivotal. However, for a high proportion of students (59% in Russia and 64% in Germany) socially irresponsible behavior by companies has a significant negative impact. This paper identifies practices which students believe should be a part of the CSR programmes for the pharmaceutical industry, and also some that should be abandoned. It recommends that corporate communication on CSR should be expanded. Key differences are seen in perceptions of students in Germany and Russia towards the extent of irresponsible actions and the variation between them.

  10. Resisting market-inspired reform in healthcare: the role of professional subcultures in medicine.

    PubMed

    Martinussen, Pål Erling; Magnussen, Jon

    2011-07-01

    The reorganisation efforts of the hospital sector in many Western countries in recent decades have challenged the role, identity and autonomy of medical professionals. This has led to increased focus on the role and impact of physicians who are also managers and on the unique discourse being formed through the integration of medical and managerial knowledge. Following the line of studies addressing the professional subcultures in medicine, we investigated whether assessments of health reform differ between medical doctors with managerial responsibilities and their colleagues at the clinical level as well as between those involved in direct patient care and those who are not. The analysis was performed within the context of the Norwegian hospital sector, where a major reform was implemented in 2002, and it was based on a survey of a representative sample of hospital physicians in 2006. The analysis focused on how the respondents viewed the overall effect of the reform and on the reform's effect on three central health policy goals: equity, quality and productivity. Combining data from the survey with organisational and financial data from the hospitals, we employed multilevel techniques to control for a number of individual and hospital-specific factors that could explain the physicians' views. As expected, respondents with managerial responsibilities were more positive in their evaluations of the reform, whereas respondents who spent time on direct patient-related work showed the opposite pattern. Of the hospital-specific factors of interest, the share of department managers with medical backgrounds and the economic situation positively affected the evaluations. Our findings support the view that, rather than managerialist values colonising the medical profession through a process of hybridisation, there is heterogeneity within the profession: some physician managers are adopting management values and tools, whereas others remain alienated from them. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. The facilitators and barriers associated with implementation of a patient-centered medical home in VHA.

    PubMed

    Helfrich, Christian D; Sylling, Philip W; Gale, Randall C; Mohr, David C; Stockdale, Susan E; Joos, Sandra; Brown, Elizabeth J; Grembowski, David; Asch, Steven M; Fihn, Stephan D; Nelson, Karin M; Meredith, Lisa S

    2016-02-24

    The patient-centered medical home (PCMH) is a team-based, comprehensive model of primary care. When effectively implemented, PCMH is associated with higher patient satisfaction, lower staff burnout, and lower hospitalization for ambulatory care-sensitive conditions. However, less is known about what factors contribute to (or hinder) PCMH implementation. We explored the associations of specific facilitators and barriers reported by primary care employees with a previously validated, clinic-level measure of PCMH implementation, the Patient Aligned Care Team Implementation Progress Index (Pi(2)). We used a 2012 survey of primary care employees in the Veterans Health Administration to perform cross-sectional, respondent-level multinomial regressions. The dependent variable was the Pi(2) categorized as high implementation (top decile, 54 clinics, 235 respondents), medium implementation (middle eight deciles, 547 clinics, 4537 respondents), and low implementation (lowest decile, 42 clinics, 297 respondents) among primary care clinics. The independent variables were ordinal survey items rating 19 barriers to patient-centered care and 10 facilitators of PCMH implementation. For facilitators, we explored clinic Pi(2) score decile both as a function of respondent-reported availability of facilitators and of rating of facilitator helpfulness. The availability of five facilitators was associated with higher odds of a respondent's clinic's Pi(2) scores being in the highest versus lowest decile: teamlet huddles (OR = 3.91), measurement tools (OR = 3.47), regular team meetings (OR = 2.88), information systems (OR = 2.42), and disease registries (OR = 2.01). The helpfulness of four facilitators was associated with higher odds of a respondent's clinic's Pi(2) scores being in the highest versus lowest decile. Six barriers were associated with significantly higher odds of a respondent's clinic's Pi(2) scores being in the lowest versus highest decile, with the strongest associations for the difficulty recruiting and retaining providers (OR = 2.37) and non-provider clinicians (OR = 2.17). Results for medium versus low Pi(2) score clinics were similar, with fewer, smaller significant associations, all in the expected direction. A number of specific barriers and facilitators were associated with PCMH implementation, notably recruitment and retention of clinicians, team huddles, and local education. These findings can guide future research, and may help healthcare policy makers and leaders decide where to focus attention and limited resources.

  12. Integrity of the National Resident Matching Program for Radiation Oncology: National Survey of Applicant Experiences

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

    Holliday, Emma B.; Thomas, Charles R., E-mail: thomasch@ohsu.edu; Kusano, Aaron S.

    Purpose: The aim of this study was to examine the experiences of radiation oncology applicants and to evaluate the prevalence of behaviors that may be in conflict with established ethical standards. Methods and Materials: An anonymous survey was sent to all 2013 applicants to a single domestic radiation oncology residency program through the National Resident Matching Program (NRMP). Questions included demographics, survey of observed behaviors, and opinions regarding the interview and matching process. Descriptive statistics were presented. Characteristics and experiences of respondents who matched were compared with those who did not match. Results: Questionnaires were returned by 87 of 171more » applicants for a 51% response rate. Eighty-two questionnaires were complete and included for analysis. Seventy-eight respondents (95.1%) reported being asked at least 1 question in conflict with the NRMP code of conduct. When asked where else they were interviewing, 64% stated that this query made them uncomfortable. Forty-five respondents (54.9%) reported unsolicited post-interview contact by programs, and 31 (37.8%) felt pressured to give assurances. Fifteen respondents (18.3%) reported being told their rank position or that they were “ranked to match” prior to Match day, with 27% of those individuals indicating this information influenced how they ranked programs. Half of respondents felt applicants often made dishonest or misleading assurances, one-third reported that they believed their desired match outcome could be improved by deliberately misleading programs, and more than two-thirds felt their rank position could be improved by having faculty from their home institutions directly contact programs on their behalf. Conclusions: Radiation oncology applicants report a high prevalence of behaviors in conflict with written NRMP policies. Post-interview communication should be discouraged in order to enhance fairness and support the professional development of future radiation oncologists.« less

  13. A summary analysis of the 3rd inquiry.

    PubMed

    1977-01-01

    20 ESCAP member countries responded to the "Third Population Inquiry among Governments: Population policies in the context of development in 1976." The questionnaire sent to the member countries covered economic and social development and population growth, mortality, fertility and family formation, population distribution and internal migration, international migration, population data collection and research, training, and institutional arrangements for the formulation of population policies within development. Most of the governments in the ESCAP region that responded indicate that the present rate of population growth constrains their social and economic development. Among the governments that consider the present rate of population growth to constrain economic and social development, 13 countries regarded the most appropriate response to the constraint would include an adjustment of both socioeconomic and demographic factors. 11 of the governments regarded their present levels of average life expectancy at birth "acceptable" and 7 identified their levels as "unacceptable." Most of the governments who responded consider that, in general, their present level of fertility is too high and constrains family well-being. Internal migration and population distribution are coming to be seen as concerns for government population policy. The most popular approaches to distributing economic and social activities are rural development, urban and regional development and industrial dispersion. There was much less concern among the governments returning the questionnaire about the effect of international migration than internal migration on social and economic development.

  14. Perceptions of inpatient rehabilitation changes after the Centers for Medicare and Medicaid Service 2010 regulatory updates contrasted with actual performance.

    PubMed

    Riggs, Richard V; Roberts, Pamela S; DiVita, Margaret A; Niewczyk, Paulette; Granger, Carl V

    2014-01-01

    To compare and contrast subjective perceptions with objective compliance of the impact of the 2010 Centers for Medicare and Medicaid Service updates of the Medicare Benefit Policy Manual. Cross-sectional survey. An electronic survey was sent by the Uniform Data System for Medical Rehabilitation to all enrolled inpatient rehabilitation facility subscribers (n = 817). The survey was sent April 15, 2011, and responses were tabulated if they were received by May 15, 2011. Comparing and contrasting of the subjective perception to objective evaluation and/or compliance with the Medicare Benefit Policy Manual on case mix index, length of stay, admissions by diagnostic category as well as perception of preadmission screening, postadmission evaluation, plan of care, and interdisciplinary conferencing. Twenty-five percent of the 817 facilities responded, for a total of 209 responses. Complete data were present in 148 of the respondents. For most diagnostic categories, perception of change did not mirror reality of change; neither did the perception between change in case mix index and length of stay. Perception did match reality in stroke and multiple trauma cases; respondents perceived an increase in admissions for the 2 impairments, and there was an overall increase in reality. Comparison with actual data identified that gaps exist between diagnostic category perceptions and actual diagnostic category admission performance. Regulations such as the 75%-60% rule and audit focus on non-neurologic conditions as well as actual inpatient rehabilitation facility program payment reports may have influenced respondents perceptions to change associated with the Medicare Benefit Policy Manual modifications. This disparity between perception and actual data may have implications for programmatic planning, forecasting, and resource allocation. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  15. Public attitudes towards smoking and tobacco control policy in Russia

    PubMed Central

    Danishevski, Kirill; Gilmore, Anna; McKee, Martin

    2014-01-01

    Background Since the political transition in 1991, Russia has been targeted intensively by the transnational tobacco industry. Already high smoking rates among men have increased further; traditionally low rates among women have more than doubled. The tobacco companies have so far faced little opposition as they shape the discourse on smoking in Russia. This paper asks what ordinary Russians really think about possible actions to reduce smoking. Methods A representative sample of the Russian population (1600 respondents) was interviewed face-to-face in November 2007. Results Only 14% of respondents considered tobacco control in Russia adequate, while 37% felt that nothing was being done at all. There was support for prices keeping pace with or even exceeding inflation. Over 70% of all respondents favoured a ban on sales from street kiosks, while 56% believed that existing health warnings (currently 4% of front and back of packs) were inadequate. The current policy of designating a few tables in bars and restaurants as non-smoking was supported by less than 10% of respondents, while almost a third supported a total ban, with 44% supporting provision of equal space for smokers and non-smokers. Older age, non-smoking status and living a smaller town all emerged as significantly associated with the propensity to support of antismoking measures. The tobacco companies were generally viewed as behaving like most other companies in Russia, with three-quarters believing that they definitely or maybe bribe politicians. Knowledge of impact of smoking on health was limited with significant underestimation of dangers and addictive qualities of tobacco. A third believed that light cigarettes are safer than normal. Conclusion The majority of the Russian population would support considerable strengthening of tobacco control policies but there is also a need for effective public education campaigns. PMID:18653793

  16. Demographic and socioeconomic disparity in knowledge about tuberculosis in Inner Mongolia, China.

    PubMed

    Ma, Enbo; Ren, Liping; Wang, Wensheng; Takahashi, Hideto; Wagatsuma, Yukiko; Ren, Yulin; Gao, Fei; Gao, Fangfang; Wang, Wenrui; Bi, Lifu

    2015-01-01

    The aim of this study is to evaluate the awareness status, attitudes, and care-seeking behaviors concerning tuberculosis (TB) and associated factors among the public in Inner Mongolia, China. A five-stage sampling was conducted, in which counties as the primary survey units and towns, villages, and households as sub-survey units were selected progressively. A standardized questionnaire was used to collect TB information. Complex survey analysis methods, including the procedures of survey frequency and survey logistic regression, were applied for analysis of TB knowledge and associated factors. The sample was weighted by survey design, non-respondent, and post-stratification adjustment. Among 10 581 respondents, awareness that TB is an infectious disease was 86.7%. Knowing that a cough lasting ≥3 weeks is suggestive of TB was 26.9%. Knowledge about TB dispensaries in county administrative areas was reported by 68.3% of respondents, and knowledge about the free TB detection/treatment policy was reported by 57.5% of respondents. About 52.5% of participants would stigmatize TB patients. Compared with the majority Han ethnic group, Mongolians and other minorities were 1.52-2.18 times more likely to know about TB curability, TB symptoms, the free detection/treatment policy, and TB dispensaries' locations, but were less likely to know about the TB transmission mode (odds ratio, 0.74; 95% confidence interval, 0.65-0.84). The main sources of TB information were TV (65.6%) and other persons (47.2%). In the past year, 19.7% of TB knowledge was from acquaintances, and 16.1% was from TB institutes. Improvement in knowledge about TB risk (symptoms and transmission), the free treatment policy, and facilities is necessary and should be provided through effective multimedia for different target populations.

  17. Demographic and Socioeconomic Disparity in Knowledge About Tuberculosis in Inner Mongolia, China

    PubMed Central

    Ma, Enbo; Ren, Liping; Wang, Wensheng; Takahashi, Hideto; Wagatsuma, Yukiko; Ren, Yulin; Gao, Fei; Gao, Fangfang; Wang, Wenrui; Bi, Lifu

    2015-01-01

    Background The aim of this study is to evaluate the awareness status, attitudes, and care-seeking behaviors concerning tuberculosis (TB) and associated factors among the public in Inner Mongolia, China. Methods A five-stage sampling was conducted, in which counties as the primary survey units and towns, villages, and households as sub-survey units were selected progressively. A standardized questionnaire was used to collect TB information. Complex survey analysis methods, including the procedures of survey frequency and survey logistic regression, were applied for analysis of TB knowledge and associated factors. The sample was weighted by survey design, non-respondent, and post-stratification adjustment. Results Among 10 581 respondents, awareness that TB is an infectious disease was 86.7%. Knowing that a cough lasting ≥3 weeks is suggestive of TB was 26.9%. Knowledge about TB dispensaries in county administrative areas was reported by 68.3% of respondents, and knowledge about the free TB detection/treatment policy was reported by 57.5% of respondents. About 52.5% of participants would stigmatize TB patients. Compared with the majority Han ethnic group, Mongolians and other minorities were 1.52–2.18 times more likely to know about TB curability, TB symptoms, the free detection/treatment policy, and TB dispensaries’ locations, but were less likely to know about the TB transmission mode (odds ratio, 0.74; 95% confidence interval, 0.65–0.84). The main sources of TB information were TV (65.6%) and other persons (47.2%). In the past year, 19.7% of TB knowledge was from acquaintances, and 16.1% was from TB institutes. Conclusions Improvement in knowledge about TB risk (symptoms and transmission), the free treatment policy, and facilities is necessary and should be provided through effective multimedia for different target populations. PMID:25797599

  18. State Repression and its Effects on Civil Conflict, Socio-Economic Outcomes, and Leadership Tenure

    DTIC Science & Technology

    feedback loop: how citizens respond peacefully or violently influences the type of repression rulers employ. How rulers use repression influences how and...whether citizens protest. Moreover, how rulers respond to their citizens may influence leadership duration. Obviously, the relationship among repression...US (and allied) officials may want policy options to influence rulers who are becoming increasingly repressive (as in Turkey and Egypt) or leaders who

  19. Networking and knowledge exchange to promote the formation of transdisciplinary coalitions and levels of agreement among transdisciplinary peer reviewers.

    PubMed

    Lobb, Rebecca; Petermann, Lisa; Manafo, Elizabeth; Keen, Deb; Kerner, Jon

    2013-01-01

    Funding for transdisciplinary chronic disease prevention research has increased over the past decade. However, few studies have evaluated whether networking and knowledge exchange activities promote the creation of transdisciplinary teams to successfully respond to requests for proposals (RFPs). Such evaluations are critical to understanding how to accelerate the integration of research with practice and policy to improve population health. To examine (1) the extent of participation in pre-RFP activities among funded and nonfunded transdisciplinary coalitions that responded to a RFP for cancer and chronic disease prevention initiatives and (2) levels of agreement in proposal ratings among research, practice, and policy peer reviewers. Descriptive report of a Canadian funding initiative to increase the integration of evidence with action. Four hundred forty-nine representatives in 41 research, practice, and policy coalitions who responded to a RFP and whose proposals were peer reviewed by a transdisciplinary adjudication panel. The funder hosted 6 national meetings and issued a letter of intent (LOI) to foster research, practice, and policy collaborations before issuing a RFP. All provinces and territories in Canada were represented by the coalitions. Funded coalitions were 2.5 times more likely than nonfunded coalitions to submit a LOI. A greater proportion of funded coalitions were exposed to the pre-RFP activities (100%) compared with coalitions that were not funded (68%). Overall research, practice, and policy peer reviewer agreement was low (intraclass correlation 0.12). There is widespread interest in transdisciplinary collaborations to improve cancer and chronic disease prevention. Engagement in networking and knowledge exchange activities, and feedback from LOIs prior to submission of a final application, may contribute to stronger proposals and subsequent funding success. Future evaluations should examine best practices for transdisciplinary peer review to facilitate funding of proposals that on balance have both scientific rigor and are relevant to the real world.

  20. Factors that affect the willingness of residents to pay for solid waste management in Hong Kong.

    PubMed

    Yeung, Iris M H; Chung, William

    2018-03-01

    In Hong Kong, problems involving solid waste management have become an urgent matter in recent years. To solve these problems, the Hong Kong government proposed three policies, namely, waste charging, landfill extension, and development of new incinerators. In this study, a large sample questionnaire survey was conducted to examine the knowledge and attitude of residents on the three policies, the amount of their daily waste disposal, and their willingness to pay (WTP). Results reveal that only 22.7% of respondents are aware of the earliest time that one of the landfills will be sated, and more than half of respondents support the three policies. However, more than one third of residents (36.1%) are unwilling to pay the minimum waste charge amount of HK$30 estimated by the Council for Sustainable Development in Hong Kong. Logit model results indicate that five key factors affect WTP, namely, knowledge of residents on the timing of landfill fullness, degree of support in waste charge policy, amount of daily waste disposal, age, and income. These results suggest that strong and rigorous promotional and educational programs are needed to improve the knowledge and positive attitude of residents towards recycling methods and the three policies. However, subsidy should be provided to low-income groups who cannot afford to pay the waste charge.

  1. 76 FR 10364 - Federal Open Market Committee; Domestic Policy Directive of January 25-26, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-24

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of January 25-26... 271), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on January 25-26, 2011.\\1\\ \\1\\ Copies of the Minutes of the Federal Open...

  2. 76 FR 21894 - Federal Open Market Committee; Domestic Policy Directive of March 15, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-19

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of March 15, 2011...), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on March 15, 2011.\\1\\ \\1\\ Copies of the Minutes of the Federal Open Market Committee...

  3. 75 FR 19647 - Federal Open Market Committee; Domestic Policy Directive of March 16, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of March 16, 2010...), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on March 16, 2010.\\1\\ \\1\\[thinsp]Copies of the Minutes of the Federal Open Market...

  4. 76 FR 43687 - Federal Open Market Committee; Domestic Policy Directive of June 21-22, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-21

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of June 21-22... 271), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on June 21-22, 2011.\\1\\ \\1\\ Copies of the Minutes of the Federal Open Market...

  5. 75 FR 56110 - Federal Open Market Committee; Domestic Policy Directive of August 10, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-15

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of August 10, 2010...), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on August 10, 2010.\\1\\ \\1\\[thinsp]Copies of the Minutes of the Federal Open Market...

  6. 76 FR 55677 - Federal Open Market Committee; Domestic Policy Directive of August 9, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    .... English, Secretary, Federal Open Market Committee. [FR Doc. 2011-22896 Filed 9-7-11; 8:45 am] BILLING CODE... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of August 9, 2011...), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at...

  7. 75 FR 30029 - Federal Open Market Committee; Domestic Policy Directive of April 27 and 28, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... F. Madigan, Secretary, Federal Open Market Committee. [FR Doc. 2010-12955 Filed 5-27-10; 8:45 am... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of April 27 and 28...), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at...

  8. 78 FR 2996 - Federal Open Market Committee; Domestic Policy Directive of December 11-12, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-15

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of December 11-12... 271), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on December 11-12, 2012.\\1\\ \\1\\ Copies of the Minutes of the Federal Open...

  9. 76 FR 37114 - Federal Open Market Committee; Domestic Policy Directive of April 26-27, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of April 26-27... 271), there is set forth below the domestic policy directive issued by the Federal Open Market Committee at its meeting held on April 26-27, 2011.\\1\\ \\1\\ Copies of the Minutes of the Federal Open Market...

  10. 78 FR 13673 - Federal Open Market Committee; Domestic Policy Directive of January 29-30, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ..., Federal Open Market Committee. [FR Doc. 2013-04693 Filed 2-27-13; 8:45 am] BILLING CODE 6210-01-P ... FEDERAL RESERVE SYSTEM Federal Open Market Committee; Domestic Policy Directive of January 29-30... 271), there is set forth below the domestic policy directive issued by the Federal Open Market...

  11. Policies of inclusion: immigrants, disease, dependency, and American immigration policy at the dawn and dusk of the 20th century.

    PubMed

    Fairchild, Amy L

    2004-04-01

    The racial politics of immigration have punctuated national discussions about immigration at different periods in US history, particularly when concerns about losing an American way of life or American population have coincided with concerns about infectious diseases. Nevertheless, the main theme running through American immigration policy is one of inclusion. The United States has historically been a nation reliant on immigrant labor and, accordingly, the most consequential public policies regarding immigration have responded to disease and its economic burdens by seeking to control the behavior of immigrants within our borders rather than excluding immigrants at our borders.

  12. Coordination of palliative cancer care in the community: "unfinished business".

    PubMed

    Brazil, Kevin; Bainbridge, Daryl; Sussman, Jonathan; Whelan, Tim; O'Brien, Mary Ann; Pyette, Nancy

    2009-07-01

    This study assessed the degree to which services in south-central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families. Programs within the region that were identified as providing supportive care to palliative cancer patients and their families were eligible to participate in the study. Program administrators participated in a semi-structured interview and direct-care providers completed a survey instrument. Administrators from 37 (97%) of 38 eligible programs and 109 direct-care providers representing 26 (70%) programs participated in the study. Most administrator and direct-care respondents felt that existing services in the community were responsive to palliative care patients' individual needs. However, at a system level, most respondents in both groups felt that required services were not available and that resources were inadequate. The most frequently reported unmet supportive care need identified by both respondent groups was psychological/social support. Most administrator (69%) and direct-care (64%) respondents felt that palliative care services were not available when needed. The majority of administrator and direct-care respondents were satisfied with the exchange of patient information within and between programs, although direct-care staff identified a deficit in information transferred on palliative care patients' social/psychological status. The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care.

  13. Connecting the sustainable development goals by their energy inter-linkages

    NASA Astrophysics Data System (ADS)

    McCollum, David L.; Gomez Echeverri, Luis; Busch, Sebastian; Pachauri, Shonali; Parkinson, Simon; Rogelj, Joeri; Krey, Volker; Minx, Jan C.; Nilsson, Måns; Stevance, Anne-Sophie; Riahi, Keywan

    2018-03-01

    The United Nations’ Sustainable Development Goals (SDGs) provide guide-posts to society as it attempts to respond to an array of pressing challenges. One of these challenges is energy; thus, the SDGs have become paramount for energy policy-making. Yet, while governments throughout the world have already declared the SDGs to be ‘integrated and indivisible’, there are still knowledge gaps surrounding how the interactions between the energy SDG targets and those of the non-energy-focused SDGs might play out in different contexts. In this review, we report on a large-scale assessment of the relevant energy literature, which we conducted to better our understanding of key energy-related interactions between SDGs, as well as their context-dependencies (relating to time, geography, governance, technology, and directionality). By (i) evaluating the nature and strength of the interactions identified, (ii) indicating the robustness of the evidence base, the agreement of that evidence, and our confidence in it, and (iii) highlighting critical areas where better understanding is needed or context dependencies should be considered, our review points to potential ways forward for both the policy making and scientific communities. First, we find that positive interactions between the SDGs outweigh the negative ones, both in number and magnitude. Second, of relevance for the scientific community, in order to fill knowledge gaps in critical areas, there is an urgent need for interdisciplinary research geared toward developing new data, scientific tools, and fresh perspectives. Third, of relevance for policy-making, wider efforts to promote policy coherence and integrated assessments are required to address potential policy spillovers across sectors, sustainability domains, and geographic and temporal boundaries. The task of conducting comprehensive science-to-policy assessments covering all SDGs, such as for the UN’s Global Sustainable Development Report, remains manageable pending the availability of systematic reviews focusing on a limited number of SDG dimensions in each case.

  14. Evaluating the federal role in financing health-related research

    PubMed Central

    Garber, Alan M.; Romer, Paul M.

    1996-01-01

    This paper considers the appropriate role for government in the support of scientific and technological progress in health care; the information the federal government needs to make well-informed decisions about its role; and the ways that federal policy toward research and development should respond to scientific advances, technology trends, and changes in the political and social environment. The principal justification for government support of research rests upon economic characteristics that lead private markets to provide inappropriate levels of research support or to supply inappropriate quantities of the products that result from research. The federal government has two basic tools for dealing with these problems: direct subsidies for research and strengthened property rights that can increase the revenues that companies receive for the products that result from research. In the coming years, the delivery system for health care will continue to undergo dramatic changes, new research opportunities will emerge at a rapid pace, and the pressure to limit discretionary federal spending will intensify. These forces make it increasingly important to improve the measurement of the costs and benefits of research and to recognize the tradeoffs among alternative policies for promoting innovation in health care. PMID:8917484

  15. The Politics of PISA: The Media, Policy and Public Responses in Norway and England

    ERIC Educational Resources Information Center

    Hopfenbeck, Therese N.; Görgen, Kristine

    2017-01-01

    Using the PISA 2015 releases in Norway and England, this article explores how PISA has been presented in the media and how the policy level has responded to the results. England will be used as an example for comparison. The article presents early media responses from the 20 most circulated daily newspapers in the two countries and discusses them…

  16. Unanswered Questions in Colombia's Foreign Language Education Policy (Preguntas por responder en la política educativa de lenguas extranjeras en Colombia)

    ERIC Educational Resources Information Center

    Bonilla Carvajal, Camilo Andrés; Tejada-Sánchez, Isabel

    2016-01-01

    Following the trend of much of the Western, non-English speaking world, Colombia has tirelessly strived for spreading English education in an effort to augment economic benefits. This paper aims at providing a critical account of foreign language education policy in Colombia, with special attention to English. It outlines the impact of its…

  17. Student Perceptions of Alcohol Policy Issues. Office for Student Affairs Research Bulletin; v15 n5 Jul74.

    ERIC Educational Resources Information Center

    Brown, Joel; And Others

    A mailed survey was conducted of students' opinions on issues relevant to the university's policy toward the consumption of alcoholic beverages on campus. Responses were received from 402 members of a random sample of 496 students from the Twin Cities Campus of the University of Minnesota. Key findings include: A majority of respondents believed…

  18. Beauty and the beast: results of the Rhode Island smokefree shop initiative.

    PubMed

    Linnan, Laura A; Emmons, Karen M; Abrams, David B

    2002-01-01

    Licensed hairdressing facilities are prevalent in communities nationwide and represent a unique and promising channel for delivering public health interventions. The Rhode Island Smokefree Shop Initiative tested the feasibility of using these facilities to deliver smoking policy interventions statewide. A statewide survey of hairdressing facilities was followed by interventions targeted to the readiness level (high/low) of respondents to adopt smoke-free policies.

  19. The Relations of School Staff Smokers' Attitudes about Modeling Smoking Behavior in Students and Their Receptivity to No-Smoking Policy.

    ERIC Educational Resources Information Center

    Galaif, Elisha R.; And Others

    1996-01-01

    Examines school personnel smokers' reports on how they would feel if a no-smoking ban was instituted on school premises. Results show that the 59 respondents from 14 schools were interested in quitting smoking, but did not favor a policy prohibiting smoking on campus. Discusses smoking influences on students and other issues. (RJM)

  20. Finance issue brief: long-term care insurance: year end report-2002.

    PubMed

    Tanner, Rachel

    2002-12-31

    A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policy makers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

  1. How State and Federal Accountability Policies Have Influenced Curriculum and Instruction in Three States: Common Findings from Rhode Island, Illinois, and Washington

    ERIC Educational Resources Information Center

    Srikantaiah, Deepa

    2009-01-01

    This report takes an in-depth look at how classroom practices in Rhode Island, Illinois, and Washington State have been influenced by state accountability policies and the No Child Left Behind Act (NCLB). It examines how teachers and administrators have responded to increased accountability and pressure to meet state standards. Drawing from case…

  2. A Study of the Role of a Technology-Enhanced Learning Implementation Group in Mediating an Institutional VLE Minimum Standards Policy

    ERIC Educational Resources Information Center

    Varga-Atkins, Tünde

    2016-01-01

    Recent years have seen a focus on responding to student expectations in higher education. As a result, a number of technology-enhanced learning (TEL) policies have stipulated a requirement for a minimum virtual learning environment (VLE) standard to provide a consistent student experience. This paper offers insight into an under-researched area of…

  3. Influence of Special Needs Education Policy on Access to Secondary School Education by Learners with Hearing Impairments in Nandi County, Kenya

    ERIC Educational Resources Information Center

    Muhombe, Joseph Andrew; Rop, Naftali K.; Ogola, Fredrick O.; Wesonga, Justus Nyongesa

    2015-01-01

    This study sought to examine influence of Special Needs Education Policy on access to secondary school education by learners with hearing impairments in Nandi County, Kenya. The study was informed by the Multiple Intelligences theory and the Dewey theory of Progressivism. The findings showed that majority of the respondents were aware of the…

  4. Meeting Total Fat Requirements for School Lunches: Influence of School Policies and Characteristics. Economic Research Report Number 87

    ERIC Educational Resources Information Center

    Newman, Constance; Guthrie, Joanne; Mancino, Lisa; Ralston, Katherine; Musiker, Melissa

    2009-01-01

    Concerns about child obesity have raised questions about the quality of meals served in the National School Lunch Program. Local, State, and Federal policymakers responded to these concerns beginning in the mid-1990s by instituting a range of policies and standards to improve the quality of U.S. Department of Agriculture-subsidized meals. Schools…

  5. Responding to Poverty and Its Complex Challenges: The Importance of Policy Fluency for Educational Leaders

    ERIC Educational Resources Information Center

    Miller, Peter; Pavlakis, Alexandra; Lac, Van; Hoffman, Deborah

    2014-01-01

    We present a case example of a school leader whose understanding of both in- and out-of-school policies and issues supported 2 students who experienced severe trauma. We describe some of the principal's key beliefs and practices that led to the development of a justice-oriented school, and then contextualize her work in a "social…

  6. Meeting Total Fat Requirements for School Lunches: Influence of School Policies and Characteristics. ERS Report Summary

    ERIC Educational Resources Information Center

    Newman, Constance; Guthrie, Joanne; Mancino, Lisa; Ralston, Katherine; Musiker, Melissa

    2009-01-01

    Concerns about child obesity have raised questions about the quality of meals served in the National School Lunch Program (NSLP). Local, State, and Federal policymakers responded to these concerns beginning in the mid-1990s by instituting a range of policies and standards to improve the quality of USDA-subsidized meals. While most of USDA's…

  7. An Exploration of Virginia Law on Recognition, University Officials, and Perceptions of the International Baccalaureate Diploma Programme

    ERIC Educational Resources Information Center

    Daly, Kimberley

    2012-01-01

    This study investigated how university officials at five public universities in the Commonwealth of Virginia responded in the aftermath of a law concerning credit policies for International Baccalaureate (IB) and Advanced Placement (AP) examinations. Mandated by the Code of Virginia § 23-9.2:3.8, this policy is unique in the area of AP and IB…

  8. Responses of medical schools to institutional conflicts of interest.

    PubMed

    Ehringhaus, Susan H; Weissman, Joel S; Sears, Jacqueline L; Goold, Susan Dorr; Feibelmann, Sandra; Campbell, Eric G

    2008-02-13

    Institutional financial conflicts of interest may affect research results. No national data exist on the extent to which US medical schools have formally responded to challenges associated with institutional conflicts of interest (ICOI). To assess the current state of ICOI policies and practices in US medical schools using the recommendations issued by 2 national higher education and research organizations as the standard. National survey of deans of all 125 accredited allopathic medical schools in the United States, administered between February 2006 and December 2006. The extent to which medical schools have adopted ICOI policies applicable to their institution and to their institutional officials; the scope of these policies in terms of those covered entities, offices, and financial relationships; the existence of recommended organizational structures as means to address ICOI; and the institutions' linkages between ICOI and their institutional review boards (IRBs). Responses were received from a total of 86 (69%) of 125 US medical schools. Although only 30 (38%) respondents (not all overall respondents answered all questions) have adopted an ICOI policy applicable to financial interests held by the institutions, a much higher number have adopted ICOI policies applicable to the financial interests of the officials: 55 (71%) for senior officials, 55 (69%) for midlevel officials, 62 (81%) for IRB members, and 51 (66%) for governing board members. Most institutions treat as potential ICOI the financial interests held by an institutional research official for a research sponsor (43 [78%]) or for a product that is the subject of research (43 [78%]). The majority of institutions have adopted organizational structures that separate research responsibility from investment management and from technology transfer responsibility. Gaps exist in institutions informing their IRBs of potential ICOI in research projects under review. This study provides the first national data on the existence and nature of policies and practices of US medical schools for addressing potential ICOI. The gaps identified suggest the need for continuing attention by the academic medical community to address the challenges presented by ICOI more consistently and comprehensively.

  9. Essays in Applied Microeconomics

    NASA Astrophysics Data System (ADS)

    Ge, Qi

    This dissertation consists of three self-contained applied microeconomics essays on topics related to behavioral economics and industrial organization. Chapter 1 studies how sentiment as a result of sports event outcomes affects consumers' tipping behavior in the presence of social norms. I formulate a model of tipping behavior that captures consumer sentiment following a reference-dependent preference framework and empirically test its relevance using the game outcomes of the NBA and the trip and tipping data on New York City taxicabs. While I find that consumers' tipping behavior responds to unexpected wins and losses of their home team, particularly in close game outcomes, I do not find evidence for loss aversion. Coupled with the findings on default tipping, my empirical results on the asymmetric tipping responses suggest that while social norms may dominate loss aversion, affect and surprises can result in freedom on the upside of tipping. Chapter 2 utilizes a novel data source of airline entry and exit announcements and examines how the incumbent airlines adjust quality provisions as a response to their competitors' announcements and the role of timing in such responses. I find no evidence that the incumbents engage in preemptive actions when facing probable entry and exit threats as signaled by the competitors' announcements in either short term or long term. There is, however, evidence supporting their responses to the competitors' realized entry or exit. My empirical findings underscore the role of timing in determining preemptive actions and suggest that previous studies may have overestimated how the incumbent airlines respond to entry threats. Chapter 3, which is collaborated with Benjamin Ho, investigates the habit formation of consumers' thermostat setting behavior, an often implicitly made decision and yet a key determinant of home energy consumption and expenditures. We utilize a high frequency dataset on household thermostat usage and find that while thermostat usage exhibits strong persistence in habits, consumers do respond to salient outdoor temperature shocks and the underlying heterogeneity in preferences can help explain much of the variation in responses. Our findings have direct policy implications on how conservation policies impact energy use.

  10. Internists' attitudes toward prevention of firearm injury.

    PubMed

    Butkus, Renee; Weissman, Arlene

    2014-06-17

    Professional organizations have called for the medical community's attention to the prevention of firearm injury. However, little is known about physicians' attitudes and practices in preventing firearm injury. To determine internists' attitudes and practices about firearms and to assess whether opinions differ according to whether there are gun owners in a physician's home. Cross-sectional survey. Internal medicine practices. 573 internists representative of American College of Physicians' members. Respondents' experiences and reported practice behaviors related to firearms and their opinions about contributors and public policies related to firearm violence, as well as physician education and training in firearm safety. The survey response rate was 56.5%. Eighty-five percent of respondents believed that firearm injury is a public health issue, and 71% believed that it is a bigger problem today than a decade ago. Seventy-six percent of respondents believed that stricter gun control legislation would help reduce the risks for gun-related injuries or deaths. Although 66% of respondents believed that physicians should have the right to counsel patients on preventing deaths and injuries from firearms, 58% reported never asking whether patients have guns in their homes. The generalizability of these findings to non-American College of Physicians' member internists and other physicians is unknown. Responses may not reflect actual behavior. Most respondents believed that firearm-related violence is a public health issue and favored policy initiatives aimed at reducing it. Although most internists supported a physician's right to counsel patients about gun safety, few reported currently doing it. None.

  11. Post‐war development of emergency medicine in Kosovo

    PubMed Central

    O'Hanlon, K P

    2007-01-01

    Objectives To (1) investigate emergency medical care priorities in Kosovo, (2) assess Kosovo's post‐war development of emergency medical services and (3) identify expectations. Methods An instrument with seven open‐ended questions, approved by the institutional review board, was designed for in‐person interviews (preferred) or written survey. The survey was administered in October 2003 at the Kosovo University Clinical Center, Pristina, Kosovo, and one regional hospital. Targeted participants were emergency care providers, clinical consultants and health policy consultants. Surveys were conducted by interview with simultaneous interpretation by a native Albanian speaker, an orthopaedic surgeon or in written Albanian form. The responses were evaluated quantitatively and qualitatively. Results 13 respondents participated in the study: 10 gave interviews and 3 provided written response; 7 were emergency care providers, 4 were emergency care consultants and 2 were health policy consultants. Emergency care priorities were defined as trauma, cardiac disease and suicide. Most respondents believed that emergency medicine as a specialised field was a post‐war development. The international community was credited with the provision of infrastructure, supplies and training. Most respondents denied any harm from international assistance. However, some respondents described instances of inappropriate international investment. Ongoing needs are training of providers and equipping of facilities and vehicles. Improved hospital management, political administration and international involvement are thought to be necessary for continued development. Conclusions Survey respondents agreed on priorities in emergency care, credited the international community with development to date, and identified administrative structures and international training support as the keys to ongoing development. PMID:17183036

  12. Prioritization of zoonotic diseases of public health significance in Vietnam.

    PubMed

    Trang, Do Thuy; Siembieda, Jennifer; Huong, Nguyen Thi; Hung, Pham; Ky, Van Dang; Bandyopahyay, Santanu; Olowokure, Babatunde

    2015-12-30

    Prioritization of zoonotic diseases is critical as it facilitates optimization of resources, greater understanding of zoonotic diseases and implementation of policies promoting multisectoral collaboration. This study aimed to establish strategic priorities for zoonotic diseases in Vietnam taking a key stakeholder approach. Two weeks prior to a workshop on zoonotic diseases a questionnaire was developed and posted to key professionals involved in different areas of zoonotic disease management in Vietnam. Respondents were asked to assess the relative priority of 12 zoonotic diseases using a number of evidence-based criteria, and to provide suggestions to strengthen multisectoral collaboration. A response rate of 69% (51/74) was obtained, and 75% (38/51) respondents worked in non-international Vietnamese organizations. Respondents identified the top five diseases for prioritization in Vietnam as: avian influenza, rabies, Streptococcus suis infection, pandemic influenza and foodborne bacterial diseases. The three criteria most used to rank diseases were severity of disease, outbreak potential and public attention. Avian influenza was ranked as the number one priority zoonotic disease in Vietnam by 57% of the respondents, followed by rabies (18%). Respondents identified coordination mechanisms, information sharing and capacity building as the most important areas for strengthening to enhance multisectoral collaboration. This study is the first systematic and broad-based attempt to prioritize zoonotic diseases of public health significance in Vietnam using key stakeholders, and a comparative and transparent method. There is limited literature for policy makers and planners on this topic and the results of this study can be used to guide decision-making.

  13. Policies of Inclusion

    PubMed Central

    Fairchild, Amy L.

    2004-01-01

    The racial politics of immigration have punctuated national discussions about immigration at different periods in US history, particularly when concerns about losing an American way of life or American population have coincided with concerns about infectious diseases. Nevertheless, the main theme running through American immigration policy is one of inclusion. The United States has historically been a nation reliant on immigrant labor and, accordingly, the most consequential public policies regarding immigration have responded to disease and its economic burdens by seeking to control the behavior of immigrants within our borders rather than excluding immigrants at our borders. PMID:15053996

  14. Restrictions on the use of e-cigarettes in public and private places—current practice and support among adults in Great Britain

    PubMed Central

    McNeill, Ann; Arnott, Deborah; Cheeseman, Hazel

    2017-01-01

    Abstract Background Debates around policies regulating e-cigarette use make it important to obtain an overview of current practice, people’s attitudes and correlates of policy support. Aims were to assess (i) current practices for e-cigarette use in homes and workplaces; (ii) characteristics associated with allowing e-cigarette use in the home; and (iii) level of, and characteristics associated with, support for extending smoke-free legislation to include e-cigarettes. Methods Online survey in 2016, n = 11 389 adults in Great Britain. Descriptives for all measures; multivariable logistic regressions assessed correlates of allowing e-cigarette use and support for extension of legislation. Results Most (79%) reporting on workplace policies reported some level of restrictions on e-cigarette use. Small majorities would not allow e-cigarette use in their home (58%) and supported an extension of smoke-free legislation (52%; 21% opposed). Allowing use was less likely and supporting an extension more likely among men, respondents from a higher socio-economic status, ex-smokers, never-smokers, non-users of e-cigarettes and respondents with increased perceived harm of e-cigarettes or nicotine (all P < 0.001). Older respondents were less likely to allow use and to support an extension and Labour voters more likely to allow use. Conclusions In Great Britain, the majority of workplaces has policies restricting e-cigarette use. Over half of adults would not allow use of e-cigarettes in their home and support prohibiting the use of e-cigarettes in smoke-free places. Adjusting for socio-demographics, more restrictive attitudes are more common among never-smokers, never-users and those with increased perception of relative harms of e-cigarettes or nicotine as cause of smoking-related illness. PMID:28339940

  15. Use of the World Health Organization's Medical Eligibility Criteria for Contraceptive Use Guidance in sub-Saharan African Countries: A Cross-Sectional Study.

    PubMed

    Chen, Melissa J; Gaffield, Mary E; Kiarie, James

    2016-09-28

    Given recent updates to the postpartum contraception recommendations in the fifth edition of the Medical Eligibility Criteria for Contraceptive Use (MEC), published by the World Health Organization (WHO), the purpose of this qualitative study was to assess the extent to which national family planning policies in sub-Saharan African countries are in agreement with the WHO MEC, particularly with regard to postpartum contraceptive use. WHO headquarters sent questionnaires to country-level focal points to complete with their Ministry of Health counterparts. Between February and May 2016, 23 of 32 (72%) surveys were completed. All respondents reported that their countries had used the MEC document in the past, with most reporting that they had used the guidance as a reference (n = 20, 87%), for training purposes (n = 19, 83%), to change clinical practices (n = 17, 74%), and to develop national policies (n = 16, 70%). While many respondents (16, 70%) indicated their countries already include immediate postpartum intrauterine device insertion among breastfeeding women in their family planning policies, few reported currently allowing use of progestogen-only pills (n = 8, 35%) or implants (n = 8, 35%) during the immediate postpartum period (i.e., less than 48 hours after delivery) for breastfeeding women. A higher percentage of respondents indicated their countries allowed breastfeeding women the option of progestogen-only pills (n = 16, 70%) and implants (n = 13, 57%) between 48 hours and 6 weeks postpartum. Findings from this baseline assessment suggest that many countries may benefit from training and policy formulation support to adapt both new WHO MEC updates as well as existing recommendations from previous MEC revisions into national family planning guidelines. © Chen et al.

  16. Climate negotiators' and scientists' assessments of the climate negotiations

    NASA Astrophysics Data System (ADS)

    Dannenberg, Astrid; Zitzelsberger, Sonja; Tavoni, Alessandro

    2017-06-01

    Climate negotiation outcomes are difficult to evaluate objectively because there are no clear reference scenarios. Subjective assessments from those directly involved in the negotiations are particularly important, as this may influence strategy and future negotiation participation. Here we analyse the perceived success of the climate negotiations in a sample of 656 experts involved in international climate policy. Respondents were pessimistic when asked for specific assessments of the current approach centred on voluntary pledges, but were more optimistic when asked for general assessments of the outcomes and usefulness of the climate negotiations. Individuals who were more involved in the negotiation process tended to be more optimistic, especially in terms of general assessments. Our results indicate that two reinforcing effects are at work: a high degree of involvement changes individuals' perceptions and more optimistic individuals are more inclined to remain involved in the negotiations.

  17. Wide-Open: Accelerating public data release by automating detection of overdue datasets

    PubMed Central

    Poon, Hoifung; Howe, Bill

    2017-01-01

    Open data is a vital pillar of open science and a key enabler for reproducibility, data reuse, and novel discoveries. Enforcement of open-data policies, however, largely relies on manual efforts, which invariably lag behind the increasingly automated generation of biological data. To address this problem, we developed a general approach to automatically identify datasets overdue for public release by applying text mining to identify dataset references in published articles and parse query results from repositories to determine if the datasets remain private. We demonstrate the effectiveness of this approach on 2 popular National Center for Biotechnology Information (NCBI) repositories: Gene Expression Omnibus (GEO) and Sequence Read Archive (SRA). Our Wide-Open system identified a large number of overdue datasets, which spurred administrators to respond directly by releasing 400 datasets in one week. PMID:28594819

  18. Wide-Open: Accelerating public data release by automating detection of overdue datasets.

    PubMed

    Grechkin, Maxim; Poon, Hoifung; Howe, Bill

    2017-06-01

    Open data is a vital pillar of open science and a key enabler for reproducibility, data reuse, and novel discoveries. Enforcement of open-data policies, however, largely relies on manual efforts, which invariably lag behind the increasingly automated generation of biological data. To address this problem, we developed a general approach to automatically identify datasets overdue for public release by applying text mining to identify dataset references in published articles and parse query results from repositories to determine if the datasets remain private. We demonstrate the effectiveness of this approach on 2 popular National Center for Biotechnology Information (NCBI) repositories: Gene Expression Omnibus (GEO) and Sequence Read Archive (SRA). Our Wide-Open system identified a large number of overdue datasets, which spurred administrators to respond directly by releasing 400 datasets in one week.

  19. A retrospective and prospective look at strategies to increase adolescent HPV vaccine uptake in the United States.

    PubMed

    Head, Katharine J; Biederman, Erika; Sturm, Lynne A; Zimet, Gregory D

    2018-01-23

    The HPV vaccine debuted more than ten years ago in the United States and many strategies have been evaluated to increase HPV vaccination rates, which include not only improving current vaccination behaviors but also sustaining these behaviors. Researchers and practitioners from a variety of backgrounds have engaged in this work, which has included efforts directed at public health and government policies, health education and health promotion programs, and clinical and patient-provider approaches, as well as work aimed to respond to and combat anti-HPV vaccination movements in society. Using a previously developed conceptual model to organize and summarize each of these areas, this paper also highlights the need for future HPV vaccine promotion work to adopt a multi-level and, when possible, integrated approach in order to maximize impact on vaccination rates.

  20. The EU sustainable energy policy indicators framework.

    PubMed

    Streimikiene, Dalia; Sivickas, Gintautas

    2008-11-01

    The article deals with indicators framework to monitor implementation of the main EU (European Union) directives and other policy documents targeting sustainable energy development. The main EU directives which have impact on sustainable energy development are directives promoting energy efficiency and use of renewable energy sources, directives implementing greenhouse gas mitigation and atmospheric pollution reduction policies and other policy documents and strategies targeting energy sector. Promotion of use of renewable energy sources and energy efficiency improvements are among priorities of EU energy policy because the use of renewable energy sources and energy efficiency improvements has positive impact on energy security and climate change mitigation. The framework of indicators can be developed to establish the main targets set by EU energy and environmental policies allowing to connect indicators via chain of mutual impacts and to define policies and measures necessary to achieve established targets based on assessment of their impact on the targeted indicators representing sustainable energy development aims. The article discusses the application of indicators framework for EU sustainable energy policy analysis and presents the case study of this policy tool application for Baltic States. The article also discusses the use of biomass in Baltic States and future considerations in this field.

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