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PubMed1985

Policy development in The Netherlands concerning enhanced exposure to natural radiation.

Exposure to enhanced natural radiation is treated in terms of the so called "environmental policy life cycle model". The integral policy development is described taking into account environmental, economic and social factors. In the present phase, the policy development is focussed on enhanced levels of radioactivity in building materials. In the following phases, attention will be given to the infiltration of radon from the underground, and to possible enhanced natural radiation due to industrial chemical processes. In each phase the decision process concerning regulations is preceded by a corresponding research programme which forms the necessary scientific basis for the specific regulatory choices. A status report closes the contribution.

Construction Materials↗

PubMed2000

Mental health policy developments in Latin America.

New assessment guidelines for measuring the overall impact of mental health problems in Latin America have served as a catalyst for countries to review their mental health policies. Latin American countries have taken various steps to address long-standing problems such as structural difficulties, scarce financial and human resources, and social, political, and cultural obstacles in the implementation of mental health policies and legislation. These policy developments, however, have had uneven results. Policies must reflect the desire, determination, and commitment of policy-makers to take mental health seriously and look after people's mental health needs. This paper describes the development of mental health policies in Latin American countries, focusing on published data in peer-reviewed journals, and legislative change and its implementation. It presents a brief history of mental health policy developments, and analyzes the basis and practicalities of current practice.

Health Policy↗

PubMed1996

Consumers and health policy development: confessions of a guarded optimist.

Using the example of a large coalition of senior citizens in Ontario, Canada, the potential of consumer input to contribute to policy development and some key barriers to fulfilling that potential are explored. The political appeal of consumer involvement in policy development is highlighted, as is the potential for opposition from providers. The critical issue of finding sustainable funding to support consumer activities is also identified, along with the worrying trend of diminishing government support for such involvement in Canada.

Aged↗

PubMed2002

Nurses and English primary care groups: their experiences and perceived influence on policy development.

AIMS OF THE STUDY: To investigate the experiences and perceived influence of nurses serving on English primary care group boards. BACKGROUND: The development of the nursing workforce and nursing services in primary care have been piecemeal and nurses have not always contributed to policy development. The recent establishment of primary care groups (PCGs) in the United Kingdom (UK) potentially offers nurses the opportunity to take a concerted and strategic role in developing professional roles and planning service developments. RESEARCH METHODS: As part of a longitudinal study of a 15% random sample of English primary care groups, nurse board members were surveyed in the winter of 1999. One hundred and forty-four nurses were invited to return self-completion questionnaires. RESULTS: Completed questionnaires were returned by 106 of those invited to participate (73%). Respondents reported that combining their usual work with their role in the PCG was frequently difficult. Only 26% perceived that they had been well prepared for their new role. Compared with other board members [for example, general practitioners (GPs)], nurses perceived that their own influence was limited, with only a quarter rating the influence of nurses on decision-making as great. Most of the sample were feeding back information to other primary care and community nurses working in the locality and 52% rated communication with this wider constituency as good or better. Nurse board members were enthusiastic about their role and optimistic about the positive future impact of PCGs on health. CONCLUSIONS: PCGs are still at a relatively early stage in their development. It is still too early to assess their impact on nurses working in primary care and community settings. Board membership offers nurses a voice in local health policy development.

Attitude of Health Personnel↗

PubMedDate not supplied

National policy development for the clinical application of genetic diagnostic technologies. Lessons from cystic fibrosis.

In recognition of the earlier experiences with genetic diagnostic services and in anticipation of a greater potential for genetic testing for presymptomatic disease and disease susceptibility, this article provides an analysis of policy development for cystic fibrosis carrier screening. The deficiencies of relying on an extemporaneous model for health policy development are described. Preferably, an evidentiary model, based on the evaluation of clinical research and incorporating professional and public attention to underlying normative issues, should define the standard of care. Appropriate procedural mechanisms should be established at both state and federal levels to prevent the unnecessary confusion, expense, and personal or social harms likely to result from a completely unrestrained application of developing genetic technologies or continuing ad hoc responses to rapid increases in genetic diagnostic capabilities. A broadly constituted national advisory commission on the ethical, legal, and social implications of the Human Genome Project would provide an important locus for national decision making and may offer an efficient mechanism for implementing the evidentiary model, promoting public involvement at a time when social policy decisions must be made to restructure the health care system to be more sensitive to issues of access, allocation, and costs.

Advisory Committees↗

PubMed1993

Policy development lessons from two federal initiatives: protecting human research subjects and handling misconduct in science.

The authors compare and contrast two policy development exercises--one that resulted in the publication of a common federal policy for the protection of human research subjects, and the other that is under way to develop a government-wide common policy for addressing misconduct in science. The article offers some basic lessons derived from these interagency activities and may shed some light on the issues that institutions face in developing their own policies and procedures for handling allegations of misconduct in science. These lessons include, among others: lead from a position of authority; use smaller working groups to draft text or work out differences; never underestimate the time needed to elucidate where all the participants are coming from; garner support of key players; timing is everything; and when presented with lemons, make lemonade. Although the process is not yet finished, interagency work is developing concerning misconduct in science. The different participants agree in theory that coordination is desirable, but they can be understandably concerned that they might have to relinquish some of their autonomy in setting policies for activities supported by their agencies. Although it may seem that the federal government moves slowly, often there is much going on behind the scenes, and often that work can be as important as, if not more important than, the task at hand.

Federal Government↗

PubMed1997

Multifaceted approach to medication use policy development: the restriction of meperidine.

As institutions continue to expand their drug policy development efforts in order to improve care and reduce cost, the use of multifaceted approaches offer several benefits. Population data on drug use support the need for policy action. The use of institutional outcomes data in conjunction with published evidence augments the process, and the consensus approach to guideline development engenders medical staff support. Such efforts, however, require significant dedication of human resources. Institutions with limited personnel to allocate to drug policy activities may consider increasing the depth of their efforts (using a multifaceted approach) while limiting the breadth of their efforts (only attempting one or two major targets per year, and doing them well).

Adverse Drug Reaction Reporting Systems↗

PubMed1998

Simplify and energize policy development.

Nurse managers revamp nursing policy and procedure development to increase efficiency, engage their staff, and ensure current easy-to-use policies. The system has worked successfully in a community hospital and a regional health care network.

Humans↗

PubMed1991

You can get there from here: guide to problem definition in policy development.

1. Nurses can enhance their abilities to formulate and implement health policy through the use of the assessment part of the nursing process. 2. Problem definition, the first step in policy development, includes identifying the issues, discussing and framing the issues, analyzing data and resources, and deciding on a problem definition. 3. Problem definition develops as an interaction between an instrumental, or cognitive, component and an expressive component, which represents the contextual setting of the problem. 4. Problem definitions change over a course of events. Current solutions may lead to new concerns and issues that then require new problem definitions.

Data Interpretation, Statistical↗

PubMed1979

Some practical observations on the writing, implementation, and revision of collection development policy.

This paper was conceived in the context of the "RTSD Guidelines for the Formulation of Collection Development Policies." It describes fundamental qualities of policy applicable to all kinds of libraries and recommends a step-by-step process leading to the successful realization of policy planning. Placing an emphasis on the values of the process itself, the paper also suggests implications for collection development personnel and for the library as an organization, when a working policy is adopted.

Book Selection↗

PubMed1990

Effects of agricultural development policies on migration in peninsular Malaysia.

State planning plays a central role in Malaysia's social and economic development. The government's rural development policies are designed to promote agricultural incomes and help counterbalance ethnic inequalities. The Federal Land Development Authority (FELDA) implements one of the internationally most successful land development and resettlement programs. In this article, we quantify the impact of FELDA settlements on local out-migration rates, linking macro and micro approaches and using data from the Malaysian Family Life Survey, national censuses, and other sources. A model of instantaneous migration rates specifies an individual's migration rate as a function of individual-level sociodemographic characteristics, the level of urbanization of the origin and destination, and the extent of rural development at the district of current residence. Our results show that in the late 1960s and early 1970s, the existence of rural development centers in a district reduced the levels of out-migration to pre-1965 levels.

Agriculture↗

PubMed2000

Grounding policy development within an educational setting: an exploration.

OBJECTIVE: To explore an approach for informing the development of regional policy by eliciting the considered views of GP participants at an educational event. In particular we discuss the reaction of GP participants to this approach. (In this instance our GP participants were trainers and the evolving policy under discussion was that of 'clinical governance'.) METHOD: An educational event was planned to facilitate discussion and the recording of the considered views of GP trainer participants. The acceptability of this approach to the participants was evaluated via observation and through feedback forms. RESULTS: While observation suggested that the participants were involved in many lively and constructive discussions, the feedback generated showed that many participants felt uncomfortable about the use of an educational event to inform development. DISCUSSION: We recognize the need to inform and facilitate change through the involvement of those who will be participants in the change process. The rapid timescales imposed by change and the 'burden' of additional research involvement on practitioners are issues. Approaches based on action research and participatory research principles may have potential and can throw light on the difficulties we experienced. CONCLUSION: We need to identify approaches which will allow us to ground development within the views of those to be affected by change. Our own attempt demonstrated difficulties. We would welcome further debate over methods and approaches applicable in this border territory between research, development and education.

Clinical Competence↗

PubMed1997

Regulating biotechnology: a rational-political model of policy development.

While technology assessment is seen as a mechanism for achieving effective and efficient use of health care resources, it has not as yet made the impact on policy decisions that its potential would suggest. Considerable barriers have been encountered in translating assessment results into policy concerning the adoption and use of technologies, with 'political' factors often being decisive. This paper places technology assessment in the content of the policy process to clarify both (a) how conflicting interests and organizational features can often hinder the selection of optimal policies, and (b) the potential roles technology assessment could nonetheless play. The resulting framework is termed the 'rational-political' model of policy development. The paper uses the example of policy making about the regulation of biotechnology, drawing on information from a survey of decision-makers (n = 561) involved in issues concerning the development, approval, and payment for pharmaceutical products.

Biotechnology↗

PubMed1999

Road trauma, PTSD and occupational functioning: implications for policy development, intervention and rehabilitation.

OBJECTIVE: With survivors of road trauma at risk of experiencing posttraumatic stress disorder (PTSD) and more routinely seeking psychosocial and vocational rehabilitation services, published research findings on the impact of PTSD on occupational functioning following road trauma are of increasing interest. This report investigates the literature in this area to highlight findings that may guide the development of public policy and interventions to improve occupational functioning post-accident. METHOD: A comprehensive search of the psychiatric and psychological literature in the subject area was undertaken for the period 1980-1998. RESULTS: In the absence of a conceptual framework empirical findings have focused on one aspect of occupational functioning, individual ability, at the expense of other contributing factors from both the individual and work environment. CONCLUSIONS: Very little research has been focused on developing a model that would explain the impact of PTSD on occupational functioning following road trauma. IMPLICATIONS: The absence of an empirically supported theoretical framework hinders the development of appropriate preventative interventions and tailored vocational rehabilitation for individuals with PTSD.

Accidents, Traffic↗

PubMed2002

What targets for international development policies are appropriate for improving health in Russia?

BACKGROUND: The OECD countries and the United Nations have agreed to co-ordinate their work around a series of International Development Targets. The targets for health are based on improvements in infant, child and maternal mortality. Progress towards these goals will be used to assess the effectiveness of development policies. OBJECTIVES: To assess the potential impact of achievement of the International Development Targets on health in Russia, and to identify possible alternatives that may be more relevant to transition countries. DESIGN: The study covered the population of the Russian Federation from 1995-99. The effects of reducing infant, child and maternal mortality on Russian life expectancy at birth were modelled using construction of life tables. Three scenarios were modelled, reducing rates to those of the best performing regions in Russia, those required to achieve the International Development Targets and current UK rates. The results were compared with the effect on life expectancy at birth of policies to reduce adult mortality in different ways. RESULTS: Achieving the International Development Targets for infant, child and maternal mortality (66.7 and 75% reductions) will contribute very little to improving life expectancy in Russia (0.96 years). In contrast, even a 20% reduction in adult mortality would give rise to an increase in male life expectancy at birth of 1.86 years. CONCLUSION: Targets for health improvement in transition countries such as Russia should take account of adult mortality as well as the indicators contained in the International Development Targets.

Adult↗

PubMed1997

Newborn screening for cystic fibrosis: a paradigm for public health genetics policy development. Proceedings of a 1997 workshop.

Cystic fibrosis (CF) is a genetic disease that can be detected in newborn infants (i.e., those aged < or = 1 month) by immunotrypsinogen testing. The sensitivity and specificity of such testing can now be improved as a result of the recent discovery of the Cystic Fibrosis Transmembrane Conductance Regulatory (CFTR) gene. Although limited CF screening for newborns has been used since the 1980s, the clinical, social, and economic outcomes of population-based screening are controversial. During January 1997, a workshop was convened at CDC in Atlanta, Georgia to discuss the benefits and risks associated with screening newborns for CF and to develop public health policy concerning such screening. The workshop planning committee comprised representatives from CDC, the Cystic Fibrosis Foundation, the National Institutes of Health, and the University of Wisconsin. Experts in the fields of CF, public health, the screening of newborns, and economics also contributed to discussions. Workshop participants addressed a) benefits and risks, b) laboratory testing, and c) economics concerning the implementation of routine CF screening for newborns. Summaries of these discussions and the resulting workshop recommendations are presented in this report. These recommendations, developed by workshop participants, will be useful to medical and public health professionals and state policymakers who are evaluating the merits of population-based screening of newborns for CF.

Clinical Laboratory Techniques↗

PubMed1979

Reference aids for developing policies and procedures for intravenous admixture services.

A table of literature citations designed to help hospital pharmacists develop a policy and procedure manual for i.v. admixture services is presented. The table is categorized according to literature that will aid in developing policies and procedures for specific aspects of admixutre services (e.g., distribution procedures, quality assurance). The citations were selected from two periodicals (American Journal of Hospital Pharmacy and Drug Intelligence & Clinical Pharmacy) and three other publications.

Bibliographies as Topic↗

PubMed1995

Whose policy is it anyway? International and national influences on health policy development in Uganda.

As national resources for health decline, so dependence on international resources to finance the capital and recurrent costs is increasing. This dependence, combined with an increasing emphasis on policy-based, as opposed to project-based, lending and grant-making has been accompanied by greater involvement of international actors in the formation of national health policy. This paper explores the process of health policy development in Uganda and examines how major donors are influencing and conflicting with national policy-making bodies. Focusing on two examples of user fees and drugs policies, it argues that while the content of international prescriptions to strengthen the health system may not be bad in itself, the process by which they are applied potentially threatens national sovereignty and weakens mechanisms for ensuring accountability. It concludes by proposing that in order to increase the sustainability of policy reforms, much greater emphasis should be placed on strengthening national capacity for policy analysis and research, building up policy networks and enhancing the quality of information available to the public concerning key policy changes.

Developing Countries↗