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 955 records · Page 53Linked to original sources

PubMedDate not supplied

Informed consent--wishful thinking?

This article is concerned with the concept of "informed consent" as applied both in biomedical research involving human subjects and in clinical medicine in general. The current crisis over the elaboration and interpretation of the concept will be examined, along with the broader question of whether "informed consent" is any longer meaningful or viable as a criterion for complex bioethical policy-making. Finally, I will attempt to sketch a prognosis for the concept in doctor-patient relations, even if it is only wishful thinking.

Communication↗

PubMed1993

Quality of life. 1. Perspectives.

Assessing the value of health care interventions is more and more a concern of governments, clinicians, health insurance companies, policy makers, and the general public. One dimension of the outcomes of such interventions that has received relatively little attention until recently is quality of life. However, during the last decade, measuring quality of life has become more frequent. Methodologies have also developed rapidly. At the same time, methodological problems continue to be troubling. In part, this explains the relative lack of use of validated measures of quality of life in clinical trials. In the future, measuring quality of life will certainly become more frequent. It may even be demanded by policy making bodies. Increasingly, too, economic costs will be part of such studies. This requires considering both clinical and economic data.

Cost-Benefit Analysis↗

PubMed1991

The utility of level of functioning to characterize community residential settings.

An assessment of client functioning was utilized to characterize differences among community residential placement facilities, with the aim of understanding the relationships among settings. Clients recommended for placement in one of nine settings differed significantly on seven scales measuring community living skills, self-care skills, sociability, nuisance behaviors, violence, irritability and nursing needs. Results indicate that community residential settings, although characterized as forming a continuum, may be better conceptualized as an array of settings, where clients may differ in some but not all functional abilities. Facilities may also serve different functions for clients of different ages, either because of expectations concerning older clients or due to different patterns of functioning. Illustrations of the implications that can be drawn for purposes of policy-making and service planning are provided.

Activities of Daily Living↗

PubMed2002

Operationalizing biodiversity for conservation planning.

Biodiversity has acquired such a general meaning that people now find it difficult to pin down a precise sense for planning and policy-making aimed at biodiversity conservation. Because biodiversity is rooted in place, the task of conserving biodiversity should target places for conservation action; and because all places contain biodiversity, but not all places can be targeted for action, places have to be prioritized. What is needed for this is a measure of the extent to which biodiversity varies from place to place. We do not need a precise measure of biodiversity to prioritize places. Relative estimates of similarity or difference can be derived using partial measures, or what have come to be called biodiversity surrogates. Biodiversity surrogates are supposed to stand in for general biodiversity in planning applications. We distinguish between true surrogates, those that might truly stand in for general biodiversity, and estimator surrogates, which have true surrogates as their target variable. For example, species richness has traditionally been the estimator surrogate for the true surrogate, species diversity. But species richness does not capture the differences in composition between places; the essence of biodiversity. Another measure, called complementarity, explicitly captures the differences between places as we iterate the process of place prioritization, starting with an initial place. The relative concept of biodiversity built into the definition of complementarity has the level of precision needed to undertake conservation planning.

Australia↗

PubMed2006

Calculating utility: preclinical evidence for cost-benefit analysis by mesolimbic dopamine.

RATIONALE: Throughout our lives we constantly assess the costs and benefits of the possible future outcomes of our actions and use this information to guide behavior. There is accumulating evidence that dopamine contributes to a fundamental component of this computation-how rewards are compared with the costs incurred when obtaining them. OBJECTIVE: We review the evidence for dopamine's role in cost-benefit decision making and outline a simple mathematical framework in which to represent the interactions between rewards, costs, behavioral state and dopamine. CONCLUSIONS: Dopamine's effects on cost-benefit decision making can be modeled using simple utility-function curves. This approach provides a useful framework for modeling existing data and generating experimental hypotheses that can be objectively and quantitatively tested by observing choice behavior without the necessity to account for subjective psychological states such as pleasure or desire. We suggest that dopamine plays a key role in overcoming response costs and enabling high-effort behaviors. A particularly important anatomical site of this action is the core of the nucleus accumbens. Here, dopamine is able to modulate activity originating from the frontal cortical systems that also assess costs and rewards. Internal deprivation states (e.g., hunger and thirst) also help to energize goal-seeking behaviors, probably in part by their rich influence on dopamine, which can in turn modify decision making policies.

Animals↗

PubMed2004

Certified reference materials to support a European thematic strategy for soil protection: the EUROSOILS (IRMM-443) experience.

The recent proposal of thematic strategy for soil protection by the European Commission outlines that knowledge of problems associated with soil has increased considerably based on surveys, monitoring systems and data networks. Although this information is very useful, its value for the policy-making process is limited due to a lack of comparability. From this unsatisfying situation the need arises to develop an EU-wide monitoring system accompanied by suitable matrix reference materials. Experiences gained from the development and certification of IRMM-443 (The EUROSOILS) show how to approach the complex problem of providing suitable (i.e. representative) soil CRMs for the arising analytical needs to support existing and upcoming EU legislation. This paper presents briefly the quantitative findings of a certification exercise (adsorption coefficients for atrazine, lindane and 2,4-D, as well as pH in suspension). A comparison of these results with those of an intercomparison exercise organised in 1989 by the German UBA on very similar soils shows the significant improvement in the determination of soil adsorption coefficients that was induced by the EUROSOIL project. Indicative values of total and organic carbon content and nitrogen according to ISO Standards are also presented.Furthermore, the idea of reference soils and derived reference materials (for analytical purposes) as well as reference matrices (substrates for ecotoxicological testing) is highlighted and set into the context of horizontal standardisation of methods.

Journal Article↗

PubMed2006

Groundwater vulnerability assessment for organic compounds: fuzzy multi-criteria approach for Mexico city.

This study was based on a groundwater vulnerability assessment approach implemented for the Mexico City Metropolitan Area (MCMA). The approach is based on a fuzzy multi-criteria procedure integrated in a geographic information system. The approach combined the potential contaminant sources with the permeability of geological materials. Initially, contaminant sources were ranked by experts through the Analytic Hierarchy Process. An aggregated contaminant sources map layer was obtained through the simple additive weighting method, using a scalar multiplication of criteria weights and binary maps showing the location of each source. A permeability map layer was obtained through the reclassification of a geology map using the respective hydraulic conductivity values, followed by a linear normalization of these values against a compatible scale. A fuzzy logic procedure was then applied to transform and combine the two map layers, resulting in a groundwater vulnerability map layer of five classes: very low, low, moderate, high, and very high. Results provided a more coherent assessment of the policy-making priorities considered when discussing the vulnerability of groundwater to organic compounds. The very high and high vulnerability areas covered a relatively small area (71 km(2) or 1.5% of the total study area), allowing the identification of the more critical locations. The advantage of a fuzzy logic procedure is that it enables the best possible use to be made of the information available regarding groundwater vulnerability in the MCMA.

Cities↗

PubMed1998

Using Dynamic Modeling to Scope Environmental Problems and Build Consensus

/ This paper assesses the changing role of dynamic modeling for understanding and managing complex ecological economic systems. It discusses new modeling tools for problem scoping and consensus building among a broad range of stakeholders and describes four case studies in which dynamic modeling has been used to collect and organize data, synthesize knowledge, and build consensus about the management of complex systems. The case studies range from industrial systems (mining, smelting, and refining of iron and steel in the United States) to ecosystems (Louisiana coastal wetlands, and Fynbos ecosystems in South Africa) to linked ecological economic systems (Maryland's Patuxent River basin in the United States). They illustrate uses of dynamic modeling to include stakeholders in all stages of consensus building, ranging from initial problem scoping to model development. The resultant models are the first stage in a three-stage modeling process that includes research and management models as the later stages.KEY WORDS: Dynamic modeling; Scoping; Consensus building; Environmental management; Ecosystem management; Policy making; Graphical programming languages

Journal Article↗

PubMed2005

Toward a comprehensive strategy for effective practitioner-scientist partnerships and larger-scale community health and well-being.

This article articulates joint priorities for the fields of prevention science and community psychology. These priorities are intended to address issues raised by the frequent observation of natural tensions between community practitioners and scientists. The first priority is to expand the knowledge base on practitioner-scientist partnerships, particularly on factors associated with positive outcomes within communities. To further articulate this priority, the paper first discusses the rapid growth in community-based partnerships and the emergent research on them. Next described is an illustrative research project on a partnership model that links state university extension and public school delivery systems. The article then turns to the second, related priority of future capacity-building for diffusion of effective partnership-based interventions to achieve larger-scale health and well-being across communities. It outlines two salient tasks: clarification of a conceptual framework and the formulation of a comprehensive capacity-building strategy for diffusion. The comprehensive strategy would require careful attention to the expansion of networks of effective partnerships, partnership-based research agendas, and requisite policy-making.

Community Mental Health Services↗

PubMed2005

Identifying the public's knowledge and intention to use human cloning in Greek urban areas.

PURPOSE: The understanding of the public's knowledge on human cloning (HC) and its acceptability are considered important for the development of evidence-based policy making. The aim of this research study was to investigate the demographic and socioeconomic variables that affect the public's knowledge and intention to use HC in urban areas of Greece. Additionally, the possible association of religiousness with the knowledge and the intention to use HC were also investigated. METHODS: Individual interviews were conducted with 1020 men and women of urban areas in Greece. Stratified random sampling was performed to select the respondents. Several scientists, experts in HC, evaluated the content of the instrument initially developed. The final questionnaire was consequently the result of a pilot study. RESULTS: Almost half of the respondents (51.5%) believed that "HC is a sort of in vitro fertilization" and 42.9% that "it has already been applied to human being." They were not aware that "the cloned fetus grows in the woman's uterus" (41.5%) and that "HC could regenerate human organs" (41.7%). The acceptability of human cloning for the cure of terminal diseases and transplantation need is very high (70.7% and 58.6%, respectively). The public's intention to have recourse to cloning on the grounds of "bringing" back to life a loved person or because of reproductive disorders was reported as desire by 35% and 32.5%, respectively. The occupational category (scientists, self-employed, and artists), the Intention to use HC, and the number of children are highly significant predictors of valid knowledge about HC. Low rates of church attendance appeared to relate with high reported Intention to use HC, and increasing scores of valid knowledge about HC increased the public's Intention to use HC. CONCLUSIONS: A number of specific demographic and socioeconomic characteristics and high scores of knowledge provide a persuasive justification in demonstrating intention toward HC. The current study suggests that these findings should receive further attention by policymakers and scientists within the Greek context.

Adult↗

PubMed2026

Risk governance of transgenic plants: bridging science, policy, and public trust.

Transgenic plants and genome editing technologies are revolutionizing agriculture through sustainable approaches to food security, pest management, and adaptation to climate change; but their widespread use is hampered by regulatory systems that are fragmented, ethics considerations, and an ongoing lack of trust from the general public. In contrast to other literature that evaluates regulation processes and public acceptance separately, our review paper introduces a new, holistic approach that includes both technical risk assessment from a scientific perspective, and Codex Alimentarius and OECD standards, and the socio-legal and judicial environment of how the national policy decisions are actually made. The paper provides a comparative, historical analysis of the key difference between product- and process-based risk governance in the USA, the EU, and India. Through the use of case studies with global significance like MON810 maize, Bt Brinjal, and the April 2024 Philippine Court of Appeals' order for cease-and-desist of Golden Rice, we discuss the increasing tension between administrative scientific approvals and precautionary judicial orders. We further explore the emerging exemptions to regulation of Site-Directed Nuclease (SDN-1 and SDN-2) genome edited crops which led to India's revolutionary 2025 commercialization of climate-resilient rice crops. Our review ends with a forward-looking approach to biotechnology regulation policy, making an appeal to shift from static historical dichotomies towards flexible risk-proportionate and internationally coordinated regulatory systems. Finally, we show that global success of agricultural biotechnology is not just about safety verification, but rather about establishment of transparent and communicable institutions that can transform scientific risk assessments into legitimate risk management decisions.

Plants, Genetically Modified↗

PubMed2004

Gene-environment interactions and correlations in psychiatric disorders.

Genetic and environmental risk factors are known to influence many aspects of human behavior, including the susceptibility to various psychiatric conditions in adult and childhood. Recent evidence suggests that these risk factors interact and correlate with each other to influence phenotypic outcomes. Gene-environment interactions are expressed through genetic variation in the susceptibility toward particular environmental risks, whereas gene-environment correlations are genetically mediated propensities in the exposure toward certain environments. Recent findings from quantitative and molecular methodologic approaches have highlighted their prevalence and importance across several samples and phenotypic outcomes. These have important implications in guiding future psychiatric research, mental health practice, and policy-making bodies.

Adult↗

PubMed1988

Epidemiology and tropical public health: current and future contributions with particular emphasis on the role of the London School of Hygiene and Tropical Medicine.

This paper presents a forward look at the contribution of epidemiology to public health in developing countries and pays particular attention to the present and future role of the London School of Hygiene and Tropical Medicine. Three types of epidemiology are distinguished for the purposes of the paper: micro-epidemiology, desk epidemiology and macro-epidemiology. Micro-epidemiology, the application of epidemiology to particular health problems in particular settings, is illustrated through examples in both child and adult health. More emphasis on acute respiratory infections in children, maternal and neonatal health, and adult health in general is advocated. The contributions of desk epidemiology are illustrated through examples of the exploration of the effects of confounding and mis-classification. Continued attention to theoretical and methodological issues is essential if the quality and cost-effectiveness of field studies are to continue to improve. Macro-epidemiology is concerned with the absolute and relative contributions of particular causes or diseases to the overall burden of ill-health in a population. It is a young field in which important advances may be made in the 1990s. Its results are highly relevant to policy making and resource allocation in the health sector. In conclusion, the relationship between epidemiologists in developed and developing countries is briefly discussed and some recommendations are made.

Adolescent↗

PubMed1985

Drinking water and health hazards in environmental perspective.

Among the present environmental issues drinking water quality and more specifically organic micropollutants receive not the highest priority. The long tradition of potable water quality assurance and the sophisticated evaluation methodologies provide a very useful approach which has great potential for wider application in environmental research and policy making. Water consumption patterns and the relative importance of the drinking water exposure route show that inorganic water contaminants generally contribute much more to the total daily intake than organic micropollutants. An exception is chloroform and probably the group of typical chlorination by-products. Among the carcinogenic organic pollutants in drinking water only chlorination by-products may potentially increase the health risk. Treatment should therefore be designed to reduce chemical oxidant application as much as possible. It is expected that in the beginning of next century organic micropollutants will receive much less attention and that the present focus on treatment by-products will shift to distribution problems. Within the total context of water quality monitoring microbiological tests will grow in relative importance and might once again dominate chemical analysis the next century. As disinfection is the central issue of the present water treatment practice the search for the ideal disinfection procedure will continue and might result in a further reduction in the use of chemical oxidants.

Carcinogens↗

PubMed1984

The prevalence of child sexual abuse victimization in an adult sample of Texas residents.

Attempts to identify characteristics of children who have been sexually abused have generally been based on cases reported to clinics, hospitals, law enforcement and social service agencies. In this study a questionnaire was mailed to a representative sample of the adult population in Texas. Child sexual abuse was defined as sexual interaction between a child and an adult or between two minors when the perpetrator is significantly older than the victim or is in a position of power over the victim. A return rate of 53% was obtained. The surveys returned varied from previous studies of the same population in that the respondents were slightly older, more often married and from a slightly higher socioeconomic level. They were, however, closely matched on the variables of sex, race and educational level. Childhood sexual victimization was reported by 7.4% of the respondents. Female victims comprised 82% of this group. The racial/ethnic distribution of victims paralleled that of the Texas census with 77% white, 5% black, and 16% Hispanic. Victimization rates were highest for Hispanic females followed by black and white females in that order. Hispanic and black males reported the lowest victimization rates. Based on these findings, it was estimated that 821,359 adult Texas residents were sexually abused as children. These results were compared with those of other studies along with their implications for policy-making.

Adolescent↗

PubMed1986

Health care financing in the Netherlands: recent changes and future options.

Following a short outline of the structure of the Dutch health care system and the regulatory activities of the government, budgeting in health care is being considered at three levels: the national level, the level of the health care institution and the intermediate level of the region. The authors foresee that regional budgeting and regional policy-making will become more important. Instead of a nation-wide introduction of the Health Services Act, which means more government interference at regional and local levels in health care, the authors believe that a re-orientation on market-principles as the dominating mechanism in resource allocation in health care will take place in the coming years. This will coincide with strengthening the position of sickness funds and private insurers at the cost of that of provincial and local government.

Data Collection↗

PubMed1993

Institutional responses to Medicare's prospective payment system.

The introduction of Medicare's prospective payment system (PPS) meant an important change in the environment of US hospitals. The new payment system was expected to improve clinical and non-clinical efficiency in hospitals. A case study in a non-profit Pennsylvania hospital was performed to analyse the impact of PPS on hospital services. The hospital responded to PPS by a twofold strategy. First, attempts were made to achieve effective cost containment by improving the efficiency of intermediate and final outputs. Here special attention is paid to the activities of the DRG coordinator and the Utilization Review Committee and to the activities of nurses in their role as case manager. The second strategy was directed at revenue enhancement, initially mainly by shifting more costs to non-Medicare patients and later by trying to strengthen the position of the hospital in the local health care market. This second strategy was considered more important than the strategy of cost containment. With respect to organizational structure and policy-making, the following changes can be observed: a growing importance of strategic management; more integrated hospital-physician relationships; and the development of an adequate medical information system and a medical records department.

Cost Control↗

PubMed1994

A cross-national analysis of midwifery politics: six lessons for midwives.

Research based on interviews and analysis of documentary sources on the politics of midwifery in Canada, Denmark, the Netherlands, the UK and the US, suggests six political lessons for midwives and the organisations that represent them. The lessons are: general health reforms represent both an opportunity and a threat to midwives' status, and midwives must learn to communicate in ways policy makers understand; research matters; coalition building is essential; the media cares (a little); it is much easier to defend the status quo than create new policy; it is essential to clarify who is to be considered a midwife. A constant grass roots awareness of and involvement in a country's political and policy making process is seen as a necessity if midwives are to prosper as a profession.

Cross-Cultural Comparison↗