SEARCH · PubMed Health

Results for “Policy Making”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources

PubMed2000

Public health implications of emerging zoonoses.

Many new, emerging and re-emerging diseases of humans are caused by pathogens which originate from animals or products of animal origin. A wide variety of animal species, both domestic and wild, act as reservoirs for these pathogens, which may be viruses, bacteria or parasites. Given the extensive distribution of the animal species affected, the effective surveillance, prevention and control of zoonotic diseases pose a significant challenge. The authors describe the direct and indirect implications for public health of emerging zoonoses. Direct implications are defined as the consequences for human health in terms of morbidity and mortality. Indirect implications are defined as the effect of the influence of emerging zoonotic disease on two groups of people, namely: health professionals and the general public. Professional assessment of the importance of these diseases influences public health practices and structures, the identification of themes for research and allocation of resources at both national and international levels. The perception of the general public regarding the risks involved considerably influences policy-making in the health field. Extensive outbreaks of zoonotic disease are not uncommon, especially as the disease is often not recognised as zoonotic at the outset and may spread undetected for some time. However, in many instances, the direct impact on health of these new, emerging or re-emerging zoonoses has been small compared to that of other infectious diseases affecting humans. To illustrate the tremendous indirect impact of emerging zoonotic diseases on public health policy and structures and on public perception of health risks, the authors provide a number of examples, including that of the Ebola virus, avian influenza, monkeypox and bovine spongiform encephalopathy. Recent epidemics of these diseases have served as a reminder of the existence of infectious diseases and of the capacity of these diseases to occur unexpectedly in new locations and animal species. The need for greater international co-operation, better local, regional and global networks for communicable disease surveillance and pandemic planning is also illustrated by these examples. These diseases have contributed to the definition of new paradigms, especially relating to food safety policies and more generally to the protection of public health. Finally, the examples described emphasise the importance of intersectorial collaboration for disease containment, and of independence of sectorial interests and transparency when managing certain health risks.

Animals↗

PubMed1994

Health Care Reform: A Caucus of Asian American Health Workers' Perspective.

PURPOSE OF THE PAPER: The purpose of this paper is to offer an American Public Health Association (APHA)/Caucus of Asian American Health Workers' (CAAHW) perspective on health care reform. Dr. William Chen, the CAAHW Chair had asked the author, a Caucus member to present the Caucus' perspective on health care reform as part of a special session that was held during the 1993 APHA annual meeting in San Francisco. This paper is based on the oral presentation made. SUMMARY OF METHODS UTILIZED: The author reviewed the September 7, 1993 draft of the President's Health Care Reform proposal, other related papers, and the literature on Asian and Pacific Islander American health care needs. This was followed by a discussion of major issues and concerns with the CAAHW Chair and key members. This paper has undergone review by the Caucus chair and his reviewers whom he selected and thus is endorsed as the CAAHW's perspective on health care reform. PRINCIPAL FINDINGS: The CAAHW applauds President Clinton for his leadership in introducing muchneeded reform in the U.S. health care system. However, the CAAHW wants to point out that access to medical care is not equivalent to utilizing and benefiting from services. Three issues of special concern to Asian Pacific Islander Americans are: (1) cultural sensitivity and relevancy of health services; (2) adequacy of racial/ethnic specific health data; and (3) due representation and input to key health policymaking and administrative bodies. CONCLUSIONS: The CAHW supports universal health insurance for all Americans and is particularly concerned that cultural sensitivity and appropriateness be assured for all populations. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper calls attention to Asian Pacific Islander Americans as the nation's fastest growing minority that is largely foreignborn and extremely heterogenous and the need for culturally sensitive services. KEY WORDS: Asian Pacific Islander Americans; health care reform; health policy; cultural sensitivity.

Journal Article↗

PubMed2002

Use of a participatory planning process as a way to build community food security.

The purpose of this study was to determine the multiple meanings of community food security among stakeholders with diverse interests and to assess the degree to which these stakeholders could find common ground around community food security during a participatory planning process called a search conference. The conceptual framework of citizen politics guided all aspects of the research design. In-depth, qualitative interviews were conducted with 44 participants purposefully recruited to attend a 2 1/2 h-day search conference. Open-ended questionnaires were distributed to all participants during the search conference, and a document review was performed. Prior to the search conference, 4 community food secruity groups emerged: anti-hunger advocates (n=12), agricultural visionaries (n=12), food traditionalists (n=10), and agricultural entrepreneurs (n=8). Participants were able to find common ground around 6 community food security action agendas: distribution of surplus food, education, family and community values, food processing and marketing, legislative initiatives and action, and new agriculture. Other salient community food security issues emerged, but they were not included on any of the action agendas. Formal training in facilitation, negotiation, conflict resolution, and how to influence the public policy-making process will enable dietetics professionals to effectively collaborate with community-based groups that have a stake in food security issues.

Adult↗

PubMed1997

Nursing ideology and the 'generic career'.

A review of the concept of ideology in a nursing context is presented. The meaning of a nursing ideology is explored and that meaning compared to the proposals for the future of nursing contained in the 1996 report on The Future Healthcare Workforce published by the University of Manchester, England. The paper suggests a number of core beliefs and values that are generally supported in nursing and their implications for the future development of the profession. These include a commitment to the role of science in nursing, the concept of caring in nursing practice and the continued pursuit of the professional project. The paper will demonstrate the extent to which the proposals contained within the report for a 'generic career' compliment or conflict with the suggested ideology of nursing. It concludes with a reference to the policy-making process at local and national levels and the opportunities available to nurses to influence the direction of change. The paper reflects the volatility of the current political climate in health care and the extent to which nurses operating in that climate feel empowered or disenfranchised.

Empathy↗

PubMed1990

Public perceptions of criminal justice policy: does victimization make a difference?

In this paper we examine public perceptions of criminal justice policy and public attitudes toward victims. We are particularly interested in exploring the relationship between the use of social science data and the adoption of public policy affecting victims of crime. To do this we analyze a representative sample of over 450 residents of the Chicago metropolitan area in 1983. The specific issues examined include attitudes toward rape (e.g., whether caused by victim's behavior), prosecution of marital rape, plea bargaining, sentencing of predatory offenders, and the relative importance and efficacy of rehabilitation, incapacitation, and retribution as goals of punishment. Overall, the results suggest that age and education have the most important influence on public attitudes regarding these criminal justice policies. Surprisingly, victimization status does not emerge as a salient predictor of criminal justice perceptions. We conclude with a call for greater use of social science surveys as information input into local and federal decision making on criminal justice policy.

Adolescent↗

PubMed1989

The social costs of tobacco smoking.

This article is concerned with establishing a methodology for the measurement of the social cost of tobacco consumption, and with using that methodology to estimate the relative quantitative importance of each of the identified components of social cost. It begins by defining social cost and explaining its relevance to policy making. The next section derives a matrix of items that need to be calculated if the social cost is to be correctly measured. The third section surveys the existing empirical literature on the social costs of tobacco consumption in the light of the methodology derived in this paper. In general it concludes that most measures of 'social cost' are incorrect. However, some interesting numbers do emerge from the studies and these are highlighted. Finally, the last section discusses the policy relevance of actual and potential measures of social cost and concludes with some general observations on the direction of future research in this field.

Economics↗

PubMed2001

Capacity for research in minority health: the need for infrastructure plus will.

Cardiovascular mortality has continued to decline, but racial disparities in cardiovascular diseases (CVD) continue to grow. To build the capacity to address these racial disparities, two things will be required. First, a research and policy infrastructure must be in place to provide guidance on what to do and how to do it. Second, the will to implement and activate this infrastructure must be present at the community and policy-making levels. The Jackson Heart Study is an example of a research infrastructure with the economic resources, scientific expertise, and technical manpower required to monitor, organize, assess, and follow a cohort of individuals over time to study the burden, natural history, predictive factors, and level of care for CVD in an African American community. The creation of will within the community for CVD research may require additional strategies than in the majority community, such as community organization and local policy development. These additional efforts at the community level should create a fertile environment to develop research and, ultimately, test strategies for reducing national disparities in cardiovascular health.

Attitude to Health↗

PubMed2001

Capacity for research in minority health: the need for infrastructure plus will.

Black People↗

PubMed2000

Managing medical technology: lessons for the United States from Quebec and France.

Important modifications to technology assessment, diffusion, adoption, and utilization must take place if the United States is to better employ medical technology and save resources so as to assure access for the uninsured and underinsured. The United States can learn from other health systems that are more successful in achieving these goals. The author selects for comparison the health systems of France and Quebec. The discussion focuses on the differences between the three systems in the management of medical technology on a range of policy-relevant dimensions, including health system structure, attitudes about planning versus market competition, government regulation, the balance between decentralization and centralization, the needs of the individual and those of the society, linkages between technology assessment and policy-making, and the importance of medical technology assessment for medical practice. Seven specific recommendations are made for better managing medical technology in the United States, drawing on what can be observed from the experiences of Quebec and France.

Diffusion of Innovation↗

PubMedDate not supplied

Non-medical selection criteria for artificial insemination and adoption.

A survey of Canadian providers of AID was conducted, along with a parallel survey of adoption workers. The questionnaire focused upon non-medical criteria for patient acceptance (for AID and adoption), including acceptance/rejection of single, lesbian, and common-law women, those economically or mentally unable to support children, and those who themselves have or whose partners have criminal records. Further questions concerned decision-making in patient selection, referral of unacceptable patients elsewhere, and the influence if any of legal advice. Most characteristics reflect great disagreement and lack of consensus within the profession. Attitudes towards characteristics may be influenced by the size and form (university vs private) of the practice, as well as by experience with patients with those characteristics. Systematic differences between AID and adoption providers are detailed and explored, as are implications of the study for the development of bioethical thinking and policy making.

Adoption↗

PubMed2005

"To enrol or not to enrol?": A qualitative investigation of demand for health insurance in rural West Africa.

In spite of the fact that feeble levels of participation have long been identified as a major constraint to the successful long-term implementation of community-based health insurance (CBI) in low-income countries, evidence on determinants of enrolment in CBI is still lacking. The application of econometric modelling has provided a partial answer to the question, but on its own it has proved to be insufficient to guide policy making. This paper aims to fill this gap in knowledge using qualitative research methods. In-depth interviews with 32 household heads were conducted in the Nouna Health District, Burkina Faso, West Africa to assess determinants of enrolment in a newly established CBI scheme. The findings highlight that factors previously neglected in the literature, such as institutional rigidities and socio-cultural practices, play an important role in shaping the decision to enrol. The discussion of the findings focuses on the policy implications, offering concrete recommendations to maximise enrolment, within and beyond Burkina Faso.

Adult↗

PubMed1997

Beyond the black letter of the law: an empirical study of an individual judge's decision process for civil commitment hearings.

To study the role of parens patriae and "police powers" considerations in an individual judge's civil commitment decisions, the judge's reports of the impact of various characteristics of the patient were analyzed. The validity of this methodology was tested by comparing it to an alternative technique based on objective statistical analysis of the dependence of the judge's decisions upon patient characteristics. A probate court judge filled out a questionnaire after each civil commitment hearing over which he presided during a seven-month study. For each of 26 decisions, the judge rated the patient on 26 features and indicated the impact of each feature on the decision. The judge's responses were analyzed to measure the role of various statutory and nonstatutory considerations (expressed as patient characteristics) in the judge's decisions. Results using self-reported impacts are compared with an objective, statistical characterization of the judge's decision-making policy. As in previous studies, the parens patriae model more closely described the individual judge's decision process than the "police powers" model. Contextual variables (e.g., the patient's family favoring commitment) also were influential. Results with the two methods were similar. The methodology developed here can be used not only in further research on judicial commitment decisions but also to educate judges and other decision-makers individually faced with potentially tragic choices as to their personal implicit decision-making strategies.

Civil Rights↗

PubMed2003

The influence of educational preparation on evaluations of applicants for radiation therapy positions: a policy-capturing experiment.

PURPOSE: To determine whether radiation therapy department administrators prefer to hire graduates with certain types of educational preparation. The study was undertaken by the American Registry of Radiologic Technologists as part of a larger project to determine educational requirements for radiation therapists. METHODS AND MATERIALS: Forty-one department administrators evaluated applications from a pool of 984 hypothetical applicants for the position of radiation therapist. Applications were created by systematically varying eight characteristics such as years of experience, quality of educational program, and ratings from prior references. Type of educational program (baccalaureate degree, associate's degree, or hospital certificate) was of particular interest in this study. Each administrator evaluated 24 applications and assigned a rating ranging from 1 to 5 to indicate the extent to which he or she desired to interview each applicant. All ratings and applicant characteristics were coded and subjected to regression-type analyses to determine the relative importance of each applicant characteristic to administrators' decision-making policies. RESULTS: Information obtained from applicant references had the greatest impact on administrators' evaluations of applicant quality. Specifically, reference ratings of cooperation and technical skills were the two most important characteristics, followed closely by reference ratings of interpersonal skills and dependability. Quality of educational program had some influence, as did years of experience. Type of educational program had virtually no impact on interview decisions for a vast majority of the administrators. CONCLUSIONS: When making hiring decisions about hypothetical applicants, department administrators place most emphasis on evidence relating to past performance and give almost no weight to type of educational preparation. The extent to which these results generalize to actual applicants is addressed in the article.

Certification↗

PubMed2003

Nursing informatics: the key to unlocking contemporary nursing practice.

Nursing informatics is a relatively new nursing specialty. Recognized by the American Nurses' Association in 1992, this field within nursing has grown exponentially. Once the purview of highly specialized individuals, nursing informatics has now crept into all dimensions of nursing, from domain of advanced nurse practitioners to prominence in critical care nursing. Nowhere is the management and processing of health-related information more important than in the care of the critically ill patient. Fast-paced environments, split-second decision making, wireless communications, monitoring systems run with computerized backbones, and computerized ordering and documentation, all things unimaginable just a decade ago, are now fundamental to nursing practice. Each requires a baseline understanding of informatics for true mastery. The domain of nursing informatics continues to grow as nursing incorporates expanded roles and new technology into practice. Education for nurse informaticians includes preparation from the baccalaureate level through the doctorate level and national board certification. Areas of practice are expansive, including hospitals, industry, education, policy-making, research, administration, and international settings. Although informaticians work with computers, computing technology is not the heart of the domain. Computers are simply tools that are used. Examples of informatics tools include handheld devices, point-of-care documentation, computerized provider order entry, and bar code medication administration. Nursing informatics plays an essential role in the future directions of healthcare by defining the relationship between nurses and information technology as well as the knowledge that can be gained when these domains work together.

Biomedical Technology↗

PubMed1996

State initiatives to promote telemedicine.

OBJECTIVE: To identify states that have played a key role in promoting, developing, and supporting telemedicine initiatives aimed at improving access to basic health care and to characterize the range of actions and policy-making roles taken by the states. METHODS: State agencies involved in telemedicine initiatives and state-funded telemedicine programs were interviewed by telephone. An informal case study approach was used with a standard, open-ended questionnaire. Twenty-seven states were contacted in early 1995. RESULTS: Sixteen states have been active in telemedicine development since 1989, with the level of activity expanding considerably in the last 2 years. Some states, particularly Georgia, Kansas, Texas, South Dakota, and Louisiana, have well-developed programs. Policy actions taken by the states in support of telemedicine differ considerably. They include planning and coordination, development of networks, more limited program development, funding, building a telecommunications infrastructure for telemedicine, and regulatory support and clarification. A wide array of funding sources has been used, including state tax dollars and state-earmarked federal monies and regulatory judgments. The level of funding by the states has also varied, ranging from less than $100,000 to tends of millions of dollars. CONCLUSION: There are varied roles and policy actions that states have assumed in promoting and supporting telemedicine development. States are investing considerable dollars and effort in telemedicine and appear likely to continue this activity in order to promote its development and improve access to health care.

Financing, Government↗

PubMed2000

Regulated competition and citizen participation: lessons from Israel.

OBJECTIVE: To investigate the relationship between health system structure and citizen participation, in particular whether increased reliance on competition encourages or depresses citizen involvement. SETTING: The case of Israel's ongoing health reform, based on regulated competition among sick funds, is examined. DESIGN: Interviews with government officials and representatives of consumer groups; analysis of policy documents, judicial rulings, public surveys and journalistic accounts. RESULTS: The Israeli reform is based in large measure on a regulated competition model, in which citizens have free choice among highly regulated competing sick funds. At the same time, the reform process has been accompanied by legal, institutional and political frameworks, as well as significant interest group activity, all aimed at increasing public input into processes of health policy making and implementation. The Israeli case, it is argued, lends support to the proposition that citizen participation (voice) and individual choice (exit) are complementary, rather than alternative, modes of ensuring citizen influence over health services. The question is whether the development of multiple avenues for citizen involvement represents disarray or a healthy social learning process regarding the running of the health system. CONCLUSION: This paper expresses cautious optimism that citizen participation is a projection of a healthy social learning process, and suggests directions for public policy to encourage this outcome.

Journal Article↗

PubMed1991

Shared governance for nursing. Part II: Putting the organization into action.

Shared governance is a major departure from traditional management-drive systems. It requires commitment and investment from all of nursing. It builds on the trust developed in the nursing service between all participants who deliver nursing care. It requires management and clinical teams to work closely and redefine their roles. The need for mutual understanding and support is undeniable. Unfortunately, there has not been much reason for that trust to develop at a rate and a level it should in most health care facilities. As institutions move to higher levels of interaction to compete and survive and as the nursing shortage requires hospitals to address the role of the nurse, hospitals are laying the groundwork for nurses to play a larger role in governance and control. These circumstances, among others, stimulate interest and provide a basis on which nurses can work together, whether in management or clinical positions, to strengthen the accountability and role of nurses in managing their services and their practices. Moving to shared governance affects the way in which nurses work and relate to the organization. The use of collective bargaining strategies, movement of the nurse into areas of control over issues that institutions once considered beyond his or her role or right, and conflict management strategies will have to change to facilitate the move of nurses into the main-stream of decision making. As the institution moves from a hierarchical structure to a multiservice setting and a more responsive market-based organization is created, nurses will have to play a stronger role in marketing and managing their practices. This flexibility extends to moving health care services out of the institution and into the community and the home and requiring nurses to become more invested in processes and mechanisms that affect what they do and how they do it. If nurses are to have a place in creating policies and define their part in unfolding the future of health care, they must be able to reorganize their services, create stronger peer-based governance approaches, and exhibit stronger control in the exercise of their practices. That will not happen by accident, nor will there be many people from other disciplines who will be heralding this cause for nurses. Before others in policy-making positions move over to provide the necessary space for nurses, the practicing nurse will have to operate and manage his or her practice at the same level and in a similar manner as other professional workers who are outside of the typical dependent, vocational employee role.(ABSTRACT TRUNCATED AT 400 WORDS)

Decision Making, Organizational↗

PubMed2005

The intimate mediator: a carer's experience of Alzheimer's.

This research arose out of a collaboration between a service user (M) and two researchers. Following M's invitation to us to explore issues surrounding a carer's experience of Alzheimer's, we jointly agreed a research strategy in which we would engage in a series of interviews with M, with the aim of developing insight into how the intimate carer's complex journey can support and benefit other family caregivers faced with similar challenges. Using a broadly hermeneutic-phenomenological method, three essential themes emerged to describe the carer's journey: (i) something is wrong; (ii) the challenging shared journey: being the carer; (iii) coping through meaning-making: advocacy. We arrive at a position which considers the unique role of an intimate carer as a 'liminal' figure between the private world of an Alzheimer's sufferer and the public world of health and social care systems. The paper concludes with a consideration of how the unique role of the intimate carer as mediator could be more respectfully involved as an ongoing knowledge source for care planning and treatment decisions. Specific areas of consideration in this regard include mechanisms for such user involvement in policy making, day-to-day care delivery, and developments in the support of other carers. We hope to highlight the 'intimacy' of this position and the distinctive benefits and challenges of such intimacy in providing a crucial level of user knowledge and 'evidence' for ongoing treatment decisions. We also hope to highlight the value and power of single-case study in generating useful insights for practice.

Alzheimer Disease↗