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 1,063 records · Page 59Linked to original sources

PubMed1998

Perceptions of care access: the experience of rural and urban women following brain injury.

To examine care access among women with brain injuries, a qualitative, phenomenological study was conducted. Twenty-one women with acquired brain injuries were recruited for the inquiry, representing rural and urban regions of Colorado. The phenomenological approach allowed the investigators to examine the shared experiences of women with brain injuries as they sought rehabilitative supports and services, and attempted to re-enter their lives and communities. Each woman was interviewed one or two times, the interviews were transcribed and then coded and analysed by both authors separately. Thematic analysis of the data revealed two major emergent themes: issues surrounding diagnosis and barriers to accessing care. A total of 10 women interviewed experienced difficulty obtaining a diagnosis of brain injury and experienced serious personal and professional consequences as a result. All the women experienced barriers to accessing care, including problems with service providers and service systems, financial challenges, travelling for services, lack of information or services in their area, lack of care coordination and funneling. Some of the barriers cannot be changed secondary to cost, efficiency and logistics. Other barriers, could be changed through education, training and policy making.

Brain Damage, Chronic↗

PubMed2001

Assessment of needs of adult symptomatic HIV patients in Hong Kong.

A cross-sectional survey was designed to assess the physical, psychosocial, health behaviour and informational needs of symptomatic HIV patients in Hong Kong, using both quantitative and qualitative data collection methods. Forty-six consenting adults from an outpatient clinic of a hospital in Hong Kong participated in the study. Results showed that up to 67.3% of the sample had partially or completely unmet needs in one or more areas of functioning. Major needs were related to income, social networking, family processes, money management and financial assistance. Only half the sample was satisfied with the information received related to their HIV infection and its management. Unsafe sexual practices were common, as well as smoking. Meeting these needs through policy making or practice could contribute to the enhancement of the quality of care and support provided to people living with HIV/AIDS in Hong Kong.

Adult↗

PubMed1996

What does mathematical modeling tell us about harm reduction?

This paper argues, primarily by example, that mathematical modeling can contribute to harm reduction-orientated drug policy making in three ways: by contributing to quantitative evaluations of effectiveness, by improving data and understanding of the underlying drug-related phenomena, and by encouraging precise thinking about the goals and objectives of harm reduction.

Journal Article↗

PubMed2002

The risk of enteric diseases in young children and environmental indicators in sentinel areas of Mexico City.

The overall objective of this study is to promote the development of environmental health indicators in Mexico City. Specific examples focused on water quality, household characteristics e.g., sanitation and risk of enteric diseases. A geographic information system (GIS) was used in order to identify eligible wells and their surrounding homesteads (0.5 km around each well). A pilot study was conducted during the rainy season (1999), and a total of 1, 250 eligible households were visited on a random sample basis; only those having children under 5 years of age were interviewed. Data on diarrheal disease (i.e. occurrence in the previous two weeks) were obtained from 950 children, and their guardians provided information on their water supply, sanitation and socioeconomic variables. A total of 320 water samples were obtained from 40 wells, and tested for Total coliforms (TC/100 ml), Fecal coliforms (FC/100 ml). Escherichia coli (EC) and Fecal streptococci (FS). Bacterial indicators were detected in 40% of the wells in the western zone and in 32% of the southern zone (p = 0.01). The rate of diarrheal diseases was higher for children from the southern areas than in the west (OR = 1.7 and 95% CI: 0.99, 2.86). The final analysis showed a higher risk of diarrhea in children from rented homes than those living in owned dwellings (OR = 1.7 and 95% Cl: 1.04, 2.77): the risk was also highest for children living in houses with poor sanitation facilities (e.g., latrine) than those connected to a sewerage (OR = 1.7 and 95% Cl: 1.00, 2.93). Children from households perceiving unpleasant taste of water showed a higher risk than those without complaints (OR = 2.2 and 95% Cl: 1.28, 3.75). Linkages between environmental factors and health risk were created from spatially distributed information, and the proposed environmental health indicator (EHI) summarized the most significant predictors of diarrheal diseases. This baseline information may contribute to further environmental health investigation and policy making analysis.

Child Welfare↗

PubMed2001

A community of citizens: disability rehabilitation in the Palestinian transition to statehood.

PURPOSE: It has been widely argued that community based programmes offer considerable advantages to the classical institutional forms of health and rehabilitation services delivery. With about 10 years of experience in operating community based rehabilitation projects (CBR) for the disabled, the Palestinian experience points to potentially serious problems relating to the conception and operationalization of such programmes in real life situations. ISSUES: Of importance is the issue of the impact of communal care on the already burdened lives of women, especially when such care is expected to be voluntary in nature. Caretaking in the Palestinian context, especially of the disabled, elderly and the sick, is a pre-defined sex linked role dictated by a patriarchal society and system of policy making that excludes women from economic and social life. The voluntary care aspect entailed in the CBR conception and practice, can and does contribute further to the exclusion of women not only from the labour force, but from most other aspects of life as well. This represents an apparent contradiction between the needs of two excluded groups, the disabled and women. The other problematic entailed in the communal model of caring for the disabled is the strategic and operational bias focusing on community, to the exclusion of the notion of social rights of all citizens, and the role and duty of state structures in the fulfilment of the disabled basic needs. Such an approach can only relegate the disabled rights back to their original place as charity. On the other hand, when CBR projects are operated holistically, in the context of social movements existing within power relation and with a broader democratic agenda engaging different groups-including a disability movement-as is currently taking place in Palestine, CBR projects can also turn into a mobilizing force for the social rights of all excluded groups. CONCLUSION: Thus the question is not merely one of governmental involvement as opposed to the involvement of non-governmental organizations and charitable societies in community based projects. Rather, it is a question of the right to a decent life for all, in dignity and security, that citizenship and statehood promise, but have yet to deliver in many developing countries, especially in Palestine.

Arabs↗

PubMed2005

Use of subsampled traffic data to estimate roadway emissions, including conversion to MOBILE6 vehicle classifications.

Air quality is degraded by many factors, among which the emissions from on-road vehicles play a significant role. Timely and accurate estimate of such emissions becomes very important for policy-making and effective control measures. However, lack of traffic data and outdated emission software make this task difficult. This research has demonstrated a new method that facilitates the vehicular emission inventories at the local level by using shorter-time Highway Performance Monitoring System (HPMS) traffic data along with the latest U.S. Environment Protection Agency (EPA) emission modeling software, MOBILE6. The conversion methodology was developed for converting readily available HPMS traffic volume data into EPA MOBILE-based traffic classifications, and a corresponding software program was written for automating the process. EPA MOBILE6 model was used to obtain emissions of nitrogen oxides (NOx), volatile organic compound (VOC), and cabon monoxide (CO) emitted by the parent traffic and subsampled traffic data, and these emissions were additionally compared. The case study has shown that the difference of the magnitude between the emission estimates produced by certain subsampled and parent traffic data are minor, indicating that subsampled HPMS data can be used for reporting parent traffic emissions. It was also observed that traffic emissions follow a Weibull distribution, and NOx emissions were more sensitive to the traffic data composition than VOC and CO. Lastly, use of average emission values of 20 or 30 consecutive minutes appears to be valid for representing hourly emissions.

Air Pollutants↗

PubMed2005

Methods and results from a new survey of values for eastern regional haze improvements.

A contingent valuation survey was designed and implemented in 2003 to elicit the willingness to pay for haze reduction in scenic areas of the Eastern United States. This survey updated and enhanced a portion of a 1988 survey, Chestnut and Rowe's Preservation Values Study, which is commonly used to estimate benefits of haze reduction policies. The 2003 survey incorporated features to address criticisms of the 1988 survey regarding its lack of budget constraints and its simplistic descriptions of changes in visibility. In preparing the new survey, we identified a fundamental error in the 1988 survey regarding the amount of visibility change that respondents were asked to value. When corrected, it reduces the estimates in that study of willingness to pay per unit of visibility change by approximately 40%. More importantly, we estimate that haze reduction benefits based on that study are overstated by approximately 70%. Results from our 2003 survey demonstrate that the distribution of willingness to pay is highly skewed, which implies that a haze reduction policy of which the costs per person are equal to the average willingness to pay would be rejected by between 70% and 80% of the public if subjected to a majority vote. Moreover, estimates of willingness to pay are sensitive to how respondents are reminded of their budget constraints. We find a statistically significant decline in willingness to pay when budgetary reminders are included. Finally, we find evidence that a large portion of the willingness to pay appears to be associated with improvement on the worst condition days. Little additional value appears to be associated with improvements to the majority of days that have haze conditions nearer the average. These survey results have important implications for policy making on haze reduction.

Air↗

PubMedDate not supplied

Values and justifications in health communication interventions: an analytic framework.

A conceptual framework for analyzing health communication interventions is presented as a systematic approach to identify values and justifications embedded in major facets of the communication intervention: the definition of the problem, the strategies adopted, the intervention stakeholders or its targeted populations, and the evaluation of the program. Although values and ethical concerns are embedded in all facets of health communication interventions, they are often left unexamined, or are taken for granted by practitioners and intervention populations (policy makers and the researchers who analyze, evaluate, or help design and implement them). The development, adaptation, and application of this framework can serve three inter-related purposes: (1) to provide constructs and a systematic approach to examine the design and implementation of interventions from a normative perspective, (2) to contribute to a theoretical perspective on health interventions as a social change phenomenon, and (3) to provide additional criteria for program evaluation and policy-making.

Communication↗

PubMedDate not supplied

Role of gender, insurance status and culture in attitudes and health behavior in a US Chinese student population.

INTRODUCTION: Asians are an understudied population in health research. Often their lower utilization of health care services and low participation in clinical trials has been attributed to socioeconomic factors and cultural beliefs. However, the role of gender and perceptions of health beliefs across generations in determining access have not been studied in this population. OBJECTIVE: This study seeks to examine the relationship of gender to the health beliefs and health utilization patterns of a group of undergraduate Chinese students in regard to their own use and what they perceived as their parents' use. DESIGN: Seventy-eight Chinese students responded to a health belief and utilization survey. They were asked to provide information on their perceptions and attitudes of health as well as what they perceived to be their parents' health attitudes and behavior. RESULTS: Findings indicated that female students were more proactive in their health beliefs towards preventive care and getting regular check-ups than male students. This difference between genders remained true in the students' perceptions of their mothers being more likely to seek preventive care and to get regular check-ups than their fathers. Cultural factors including privacy and modesty were important factors in determining use of health care by Chinese women. Insurance status played an important role in determining health behavior among Chinese men. Uninsured fathers were perceived as more likely to use complementary and alternative therapies (CAM) than mothers. Male students and fathers who had private insurance were perceived to access and utilize health services equally as the women. Gender differences are seemingly less apparent among parents who are using CAM. Language difficulty was identified most frequently as the major barrier to accessing care among this population. CONCLUSIONS: Considerations of socioeconomic factors, cultural and language barriers need to be made with particular focus on gender differences in attitudes and health behavior when making policy decisions for the Asian American population. Further studies are also needed on intergenerational attitudes and health behavior of older Asian Americans.

Adolescent↗

PubMedDate not supplied

Science, politics and ethics in the low dose debate.

The roles of science, ethics and politics are identified in respect of the risks of exposure to low-dose radiation. Two case studies, the epidemiology of the United Kingdom nuclear test veterans and the risks to civilians associated with the military use of depleted uranium, are considered in the context of their ethical framing, scientific evaluation and political resolution. Two important issues for the present and future, the safe management of U.K. radioactive waste and the future of nuclear power, in which the science of low dose effects will be crucial and where the ethical issues are much more complex, are introduced. Specific consideration is given to the potential hereditary effects of ionising radiation in relation to the current state of radiobiological knowledge. It is concluded that for science to be useful in public health policy making there needs to be some reform from within the profession and the political imperative for freely independent scientific institutions.

Disaster Planning↗

PubMed2004

Informed consent and biobanks: a population-based study of attitudes towards tissue donation for genetic research.

AIMS: The procurement and usage of tissue samples has begun receiving increasing legal and ethical attention. The authors' aim was to develop an empirically based understanding of public attitudes to the use of tissue for research. METHOD: A questionnaire was distributed to a randomized sample (n=1,000) of the population in the age group 18-85 in Västerbotten County, Sweden. RESULTS: The response rate was approximately 60%. There was a general acceptance of genetic research based on biobank material (71%) but, though it is often a prerequisite for tissue-based research, a majority (62%) would not allow researchers to examine their healthcare records without specific consent. A majority (66.8%) accepted surrogate decisions by research ethical committees; 48% of the respondents estimated that they would feel respected if they were notified each time a sample was used. When compared and ranked with other issues, informed consent was a principal concern to a minority (4%) only. Should research efforts generate information on future health risks, a majority (55%) would want to be told only if treatment was available. CONCLUSION: Though genetic research in bioethical debate is often viewed as a potential threat to the integrity of the donor, the confidentiality of medical records still seems to concern donors more. Research ethical committees have support in the majority of the population for some surrogate decisions. The current emphasis on the question of informed consent in policy making for biobank-based research does not seem to be reflected unambiguously in the concerns of the general public.

Adolescent↗

PubMed2000

The origins and consequences of public trust in government: a time series analysis.

The study of citizens' trust in the national government has been primarily individual-level, cross-sectional analysis. In the current research, we develop a quarterly time series measure of trust in the U.S. national government from 1980 to 1997 and conduct the first multivariate time series examination of public trust in government. We find that negative perceptions of the economy, scandals associated with Congress, and increasing public concern about crime each lead to declining public trust in government. Declining trust in government in turn leads to less positive evaluations of Congress and reduced support for government action to address a range of domestic policy concerns. These results provide new evidence of the influence of public concern about crime and the centrality of Congress in understanding public evaluations of the national government and new evidence of how declining levels of trust in government may influence elections and domestic policy making.

Journal Article↗

PubMed1990

Changing surgical antimicrobial prophylaxis practices through education targeted at senior department leaders.

Prescribing antibiotics for perioperative prophylaxis in common surgical procedures presents an ideal target for educational intervention. In this situation, antibiotics are often used inappropriately, with consequent excess expense and risk of morbidity. We developed an educational intervention aimed at the choice and appropriate dosing of antibiotics for the prophylaxis of cesarean sections. Person-to-person educational messages targeted at authoritative senior department members were supplemented by brief reminders on a structured antibiotic order form. Time-series analyses were conducted on 34 months of antibiotic use data for 2,783 cesarean sections to estimate the trend of magnitude and significance of discontinuities associated with the start of the program. Prior to the intervention, 95% of sections receiving prophylaxis were given cefoxitin and 3% were given cefazolin. After the intervention, these proportions were reversed, with the shift in use occurring immediately after the intervention (p less than .001). Two years after the intervention, virtually all patients undergoing cesarean sections who receive antibiotic prophylaxis are given cefazolin. Savings from this change alone accounted for over $26,000 each year, or $47.36 per patient-day of prophylaxis. Substantial changes in prescribing practices for routine procedures can be accomplished through the implementation of a coordinated educational program that enlists influential senior staff members in a department in which policy-making is highly centralized, coupled with a structured educational ordering system. Lasting improvements in clinical practices may be brought about by means that are noncoercive, inexpensive and well-accepted by medical staff.

Anti-Bacterial Agents↗

PubMed2002

Communication challenges for science and religion.

How can the very different worlds of science and religion communicate effectively? Religion requires faith, belief without question. Science demands we take nothing on faith, reject any anecdotal evidence. How might these seemingly opposed disciplines collaborate to improve public understanding of science and impact pending policy making without undermining spiritual well being? Are scholars from both disciplines engineering the needed bridges?

Communication↗

PubMed2001

Report by David M. Eisenberg, M.D., on complementary and alternative medicine in the United States: overview and patterns of use.

In the first of his two presentations, David Eisenberg, M.D., discussed four topics. First he reviewed current complementary and alternative medicine (CAM) terminology and definitions. Then, based on two studies he conducted in 1990 and 1997, he summarized patterns of complementary medicine use in the United States. Next, he raised the implications of his findings on research and policy-making. And, finally, he highlighted opportunities to develop a collaborative international agenda.

Complementary Therapies↗

PubMed1994

Assessing diets to improve world health: nutritional research on disease causation in populations.

Dietary assessment plays a crucial role in our ability to detect relationships between dietary exposure and disease causation. Nutritional problems are at the root of major mass diseases that are impediments to progress toward national and international health goals. This is true for chronic undernutrition and famine as well as many of the chronic diseases afflicting middle-aged and elderly people in industrialized and developing countries. High-quality dietary assessment provides a sound scientific foundation for the primary prevention of mass diseases, whereas inadequate assessment can produce false-negative results and result in apparent inconsistencies between cross-population and within-population findings for a particular disease. The critical role of dietary assessment in the elucidation of disease causation is discussed with regard to high blood pressure, heart disease, breast cancer, and several other major chronic diseases. Improved approaches to dietary assessment need to be made more widely known, not only among research scientists and health practitioners, but also among policymakers who require high-quality dietary data for establishing nutrition goals and making policy decisions.

Adult↗

PubMed2006

Individual-level modifiers of the effects of particulate matter on daily mortality.

Consistent evidence has shown a positive association between particulate matter with an aerodiameter of less than or equal to 10 mum (PM(10)) and daily mortality. Less is known about the modification of this association by factors measured at the individual level. The authors examined this question in a case-crossover study of 20 US cities. Mortality events (1.9 million) were obtained for nonaccidental, respiratory, heart disease, and stroke mortality between 1989 and 2000. PM(10) concentrations were obtained from the US Environmental Protection Agency. The authors examined the modification of the PM(10)-mortality association by sociodemographics, location of death, season, and secondary diagnoses. They found different patterns of PM(10)-mortality associations by gender and age but no differences by race. The level of education was inversely related to the risk of mortality associated with PM(10). PM(10)-related, out-of-hospital deaths were more likely than were in-hospital deaths, as were those occurring during spring/fall versus summer/winter. A secondary diagnosis of diabetes modified the effect of PM(10) for respiratory and stroke mortality. Pneumonia was a positive effect modifier for deaths from all causes and stroke, while secondary stroke modified the effects for all-cause and respiratory deaths. The findings suggest that more attention must be paid to population characteristics to identify greater likelihood of exposures and susceptibility and, as a result, to improve policy making for air pollution standards.

Aged↗

PubMed1989

The HSE National Exposure Database--(NEDB).

The U.K. Health and Safety Executive's (HSE) National Exposure Database (NEDB) enables the storage and selective retrieval of occupational hygiene data. These data are used to inform policy-making and standard-setting bodies, such as the Advisory Committee on Toxic Substances (ACTS), of national trends in exposure to particular substances categorized into the various industries, processes and jobs at which exposures occur. The exposure data currently held are limited to those obtained from inspections and investigations carried out by HSE specialist inspectors. Discussion is under way with industry on how the database can be extended to include validated data provided by industry so as to provide a focal point for exposure data in the U.K. The database will thereby become a valuable source of information for industry. Standardization of the way in which exposure data and qualifying information are presented will assist in fulfilling these aims. The paper describes the structure of the database, the types of information input to it and the information which can be obtained from it. Organizations wishing to establish their own exposure databases, those who may wish to contribute data, and the many who are concerned with the collection and recording of occupational hygiene data, irrespective of the methods of storage and retrieval, are encouraged to use a similar format.

Air Pollutants, Occupational↗