PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Policy--changes”

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 19 recordsLinked to original sources
PubMed2026

Assessing the potential of wastewater-based epidemiology to evaluate the impact of COVID-19 policy changes on stimulant use across 17 countries.

BACKGROUND AND AIMS: A limited number of studies have employed wastewater-based epidemiology (WBE) to assess the impact of specific COVID-19 public health directives on stimulant consumption. This study investigates the potential of WBE as a complementary information source to support decision-making, by examining drug use changes during the pandemic. METHODS: WBE data on stimulant use from 2019 through 2022 was obtained from 17 countries covering a total of 47 wastewater treatment plants worldwide. The Oxford Coronavirus Government Response Tracker stringency index was used to standardize the severity of the COVID-19 interventions across different countries. A multiple linear regression model was fitted for the population-normalized mass loads of amphetamine, cocaine (through its metabolite benzoylecgonine), MDMA, and methamphetamine to investigate whether changes in COVID-19 restrictions influenced stimulant use, controlling for possible week-weekend and spatial effects. RESULTS: In most locations, WBE suggests that stimulant use was not significantly affected by the COVID-19 interventions, or even increased under the stricter measures. Methamphetamine use showed the largest decrease with increasing policy stringency, with a negative linear relationship found in 19% of cities, followed by MDMA (18%), cocaine (15%) and amphetamine (6%). Social gathering restrictions mainly impacted cocaine and MDMA use, while methamphetamine consumption declined most under stringent travel restrictions. CONCLUSIONS: This study highlights the heterogeneous effects of the COVID-19 policy changes on stimulant use, even within countries. The ability of WBE to compile consecutive daily estimates proves to be particularly useful to assess the direct effect of specific policy changes on the consumption of different stimulants.

COVID-19 interventions↗
PubMed1977

An analysis of selected blood service policy changes.

Prinicipal national goals for a blood service system are concerned with shortage, quality, acessibility, and efficiency. Since regional blood service operating objectives based on these goals are in partial conflict, a single policy does not exist. Using a computer-based planning system, four policies are examined and tested for their effects on these objectives. [corrected] The policies are: use of frozen red cells ( a technological alternative); extension of the useful life of fresh blood (a legal alternative); improved collection planning (a planning alternative), and improved inventory management (a management alternative). Model projections of the effects of each policy and comparative performance of each policy with respect to the principal objectives are discussed.

Blood Banks↗
PubMed1975

An instrument to assess staff time utilization in a community mental health center.

The Daily Staff Log is an empirically refined instrument to assess staff hours spent in direct patient and collateral contact, clinical backup time, consultation, education, and administration. Its primary uses as a management tool include description of staff activities, comparisons by discipline or clinic, pre- and postcomparisons following administrative policy change, and cost-effectiveness studies. Conditions for successful use include a firmly committed administrative interest, in-service education on the value of log data for decisionmaking to improve delivery of care, and positive feedback when logs indicate service goals are being met. Following the introduction of logging it was possible to document improvements in clinical and financial efficiency.

Administrative Personnel↗
PubMed1992

Geographic distribution of physicians in Japan.

In the 1970s, Japan's physician manpower policy was to increase the number of medical students and medical schools to ease the difficulties caused by shortage of doctors and their maldistribution. 34 medical schools were established during this time, which eventually doubled the number of newly certificated physicians from about 4000 to about 8000 per year by the mid 1980s. To examine the success of this policy, we analysed the numbers of physicians in relation to the population in all municipal bodies (n = 3268) in Japan. Between 1980 and 1990, the number of practising physicians increased by about 37%, and the ratio of physicians per 100,000 population increased from 127 to 165 throughout the country. However, analyses by the Lorenz curve and the Gini coefficient indicated that the inequality in physician distribution did not improve. While municipal bodies with a population over 30,000 gained proportionally more physicians, most communities with fewer than 10,000 residents showed little gain. Our findings have important implications for policy changes now being considered by the government to plan the future supply of physician manpower in Japan. A policy that will alleviate physician maldistribution also needs to be devised.

Education, Medical↗
PubMed2025

Bacterial metabolite patterns of infants receiving multi-strain probiotics and risk of late-onset sepsis.

The effect of multi-strain probiotics containing Bifidobacterium longum (B. longum) on late-onset sepsis (LOS) risk in very-low-birth-weight infants (VLBWIs; birth weight < 1,500 g) remains uncertain. In a single-center study, we analyzed intestinal metagenome and metabolome data in VLBWIs during the period of highest vulnerability of LOS. Using a unit's policy change to routinely administer B. longum subspecies infantis plus Lactobacillus acidophilus as natural experiment, we compared 97 infants (including 38 LOS cases) after change with 78 infants (including 32 LOS cases) before. Probiotic supplementation was associated with more beneficial bacteria and reduced abundance of nosocomial pathobionts, such as Klebsiella spp. Infants in the probiotic group had significantly lower concentrations of B. longum fermentation products prior to sepsis diagnosis than matched non-LOS cases (acetate: padj = 0.0049; lactate: padj = 0.048). Modulation of the gut metabolic milieu is an interesting target for LOS prevention.

Humans↗
PubMed2026

A 20-Y Analysis of Motorcycle Trauma After Helmet Law Repeal.

INTRODUCTION: After Arkansas repealed its universal motorcycle helmet law in 1997, helmet use decreased and motorcycle-related injuries and fatalities increased. Long-term clinical and population-level impacts of this policy change remain incompletely characterized. This study integrates statewide crash and fatality data with trauma center data to evaluate trends in helmet use, injury severity, and mortality at scene and hospitalization. METHODS: We retrospectively reviewed motorcycle-related admissions and emergency department deaths at the state's only adult level I trauma center from 2004 to 2023 across three periods: 2004-2006, 2013-2015, and 2021-2023. Demographics, helmet use, injury severity, and outcomes were assessed. Logistic regression evaluated associations between helmet use, severe head injury (Abbreviated Injury Scale &#x2265;3), and inhospital mortality. Fatality data were obtained from the National Highway Traffic Safety Administration, and crash-level data (2015-2023) were obtained from the State Department of Transportation. RESULTS: Among 1104 trauma admissions, annual admissions nearly tripled over time, with nonhelmeted riders representing 64%-72%. Helmet use was independently associated with lower odds of severe head injury (odds ratio 0.48, P < 0.001). Nonhelmeted riders had higher on-scene fatality risk (relative risk 1.21). Severe head injuries increased and were strong predictors of inhospital mortality. Population-adjusted motorcycle fatality rates rose from 2.34 to 3.18 per 100,000 residents by 2021-2023. CONCLUSIONS: Motorcycle fatalities and severe head injuries increased during the postrepeal period and were associated with helmet nonuse and severe head trauma. Clinical and statewide data show consistent associations among helmet nonuse, severe head injury, and prehospital and in-hospital mortality, highlighting helmet use as a target for injury prevention policy.

Acute brain injury↗
PubMed1992

The consequences of a change in formulation of methadone prescribed in a drug clinic.

Methadone mixture DTF (1mg in 1ml) is a safe non-injectable alternative to methadone tablets (5mg). It also allows for a more gradual detoxification from opiate dependence. For these reasons it was decided to 'rationalise' our prescribing so that methadone in mixture form only would be dispensed. At the beginning of 1989, 66 opiate-dependent patients were receiving methadone tablets, 61 the methadone mixture. We report the consequences of instituting a policy change which was clearly very unpopular with patients. Of the 66 patients receiving methadone tablets prior to the change to mixture, 53 were represcribed tablets by the end of the 3-month follow-up period. In many cases this was because of an intense resistance to the change over, physical complications of methadone mixture occurred in very few. We were able to observe a decline in social stability and an increased use of non-prescribed drugs in some patients who changed to methadone mixture. More far-reaching consequences of the change included an increase in chemist break-ins, an increase in the street value of methadone tablets and greater hostility and threatening behaviour towards staff. These changes reflect psychological rather than pharmacological or pharmacokinetic effects.

Adult↗
PubMed1978

The distributional effects of national health insurance in Quebec.

In November of 1970 a major change in public health policy occurred in Quebec: the movement from a mixed private-public system to a completely public system of financing health care (known as Medicare). This policy change had important economic effects on the distribution of income, taxation, and health care costs. This paper analyzes these economic effects by focusing on the changes in financial burden of medical care costs between 1969-70 and 1971-72 for eight income classes. The key results that emerge are: the total cost of medical care increases sharply for all of the income groups, and the burden of the cost of medical care becomes more equitable across the income groups. Based on these results, policy considerations for the present debate on national health insurance in the United States are offered.

Financing, Government↗
PubMed1976

Psychosocial factors in low-incidence genetic disease: the case of osteogenesis imperfecta.

Osteogenesis imperfecta (OI), a dominant genetic disorder, was examined in an exploratory case study of psychosocial implications. The cross-sectional survey sample consisted of 13 OI-affected adults and 21 families with an OI-affected child who were interviewed. Findings revealed numerous psychosocial concerns and problems in addition to their complex and lifelong medical problems. Specific problem areas differed according to the severity of the disease, type, and mode of genetic inheritance. The results indicate the need for local as well as national policy changes through legislation and extensions of existing services for low-incidence disease groups such as OI-affected persons. Implications for social work practice interventions call for greater involvement with genetic diseases, more aggressive approaches in case identification and service coordination, and performing longer-range monitoring functions than is usually the case.

Adult↗
PubMed1976

Fear of trying.

Unless the nutrition community intervenes in national and international policymaking, the world could well be headed for serious trouble with deaths from starvation on a consequential scale. There has been near-total dissociation between agricultural planning policies and food distribution and nutritional needs of populations. Unfortunately, the nutrition community is out of the mainstream of forces which affect nutritional status and which produce the macro-decisions. Why? Perhaps the professionals have too narrow a view of their role; although malnutrition is a health problem, the solution is not necessarily one of health delivery. Perhaps they don't seriously wish to be involved with policy change and the work it entails. Perhaps, by being unable to achieve consensus within their own ranks, they have generated a lack of credibility. The nutrition community needs to recognize a broader scope for nutrition and to take new approaches in advocacy directed to education policy-makers. No one else can play this role with authority.

Agriculture↗
PubMed1992

Back to direct payment: German dentists lobby to leave the national sickness fund scheme.

Oral health care in Germany is delivered by private dentists working predominantly in solo practice. Services are financed indirectly by sickness funds for 89 percent of the population. With caries rates declining, dentists' numbers increasing, and federal policies changing the remuneration regulations to enhance preventive behavior in consumers, dentists are concerned about their shrinking incomes. In an attempt to secure their professional interests, a faction among dentists advocates to return to direct payment and to opt out of the sick fund scheme. Their strategy and professional goals are described and the chances of succeeding discussed.

Dentists↗
PubMedDate not supplied

Attitudes of program directors toward women in pediatric dentistry training programs.

The number of women entering pediatric dentistry graduate programs is increasing. A formal survey was conducted in the fall of 1990 to determine what impact, if any, this increase is having on the programs. The survey sample consisted of the 57 pediatric dentistry graduate program directors from the United States and Canada. The survey form included program data about gender distribution in the current and previous classes, and female faculty distribution within the programs. The survey requested information about the attitudes of various groups of individuals who interacted with the residents relative to the gender of the resident and again, relative to whether the resident was pregnant. Inquiry was made concerning maternity leave policies and selected treatment scenarios involving pregnant residents. Finally, questions were asked about motivational factors, personal priorities, and policy change for female vs. male residents. Fifty forms were returned for a return rate of 88%. The 48 forms analyzed revealed that 52% of current classes are female and 51% of applicants for 1991 were female. Women comprise 23% of full-time and 26% of part-time faculty. There was no single issue perceived by program directors as a group to be a significant concern or problem relating to gender. Program directors would consider removing pregnant females from contact with combative patients (83%) and environmental hazards (85%), but fewer would consider removing them from contact with for HIV+ or Hb+ patients.

Administrative Personnel↗
PubMed1992

Assessing the impact of patient care policies using simulation analysis.

Simulation models are ideal for assessing the performance of strategic, tactical, and operational policies for hospitals. Simulation can validate a proposed policy, uncover fallacies of a proposal, or determine the sensitivity of the response to a policy change. A simulation model was developed to analyze the complex interactions comprising patient placement processes, beginning with patient arrivals and continuing through discharge. The model reflects current and potential patient assignment policies at a major southeastern general hospital. The system developed was utilized to assess proposed policies for the hospital. The simulated results of the hospital policy proposals, as well as other proposals, demonstrate the usefulness of simulation analysis in hospital policy decision-making.

Bed Occupancy↗
PubMed1978

Health care in early infancy.

The pattern of illness and of health care during the first 16 weeks of life in a cohort of 1210 infants was examined. Children from families in the lower social strata had a significantly increased risk of respiratory illness and gastrointestinal disturbance and received less routine well baby care than children from more socially advantaged backgrounds. A number of policy changes which might improve the distribution of health care resources are examined.

Child Health Services↗