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  1 / 14011 MEDLINE  
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PMID:28231066
Autor:Máca V; Melichar J; Scasný M; Kohlová MB
Título:Valuing environmental health for informed policy-making.
Fonte:Rev Environ Health; 32(1-2):171-175, 2017 Mar 01.
ISSN:2191-0308
País de publicação:Germany
Idioma:eng
Resumo:BACKGROUND: Monetized environmental health impact assessments help to better evaluate the environmental burden of a wide range of economic activities. Apart from the limitations and uncertainties in physical and biological science used in such assessments, assumptions taken from economic valuation may also substantially influence subsequent policy-making considerations. AIM: This study attempts to demonstrate the impact of normative policy assumptions on quantified external costs using a case study of recently discussed variants of future coal mining and use of extracted coal in electricity and heat generation in the Czech Republic. METHODS: A bottom-up impact-pathway approach is used for quantification of external costs. Several policy perspectives are elaborated for aggregating impacts that differ in geographic coverage and in how valuation of quantified impacts is adjusted in a particular perspective. RESULTS: We find that the fraction of monetized external impacts taken into policy-making considerations may vary according to choice of decision perspective up to a factor of 10. CONCLUSION: At present there are virtually no hard rules for defining geographical boundaries or adjusting values for a summation of monetized environmental impacts. We, however, stress that any rigorous external cost assessment should, for instance in a separate calculation, take account of impacts occurring beyond country borders.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Coal)


  2 / 14011 MEDLINE  
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PMID:28212625
Autor:Alemayehu M; Wubshet M; Mesfin N; Gebayehu A
Endereço:Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. mekuriaw14@gmail.com.
Título:Prevalence of Human Immunodeficiency Virus and associated factors among Visceral Leishmaniasis infected patients in Northwest Ethiopia: a facility based cross-sectional study.
Fonte:BMC Infect Dis; 17(1):152, 2017 Feb 17.
ISSN:1471-2334
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Visceral Leishmaniasis coinfection with HIV/AIDS has emerged as a series of disease pattern. It most often results in unfavorable responses to treatment, frequent relapses, and deaths. Scarce data is available regarding the prevalence of HIV and associated factors among Visceral Leishmaniasis coinfected patients. This study sought to determine the prevalence of HIV and associated factors among Visceral Leishmaniasis infected patients. METHODS: Facility based cross-sectional study was conducted from October, 2015 to August, 2016 in Northwest Ethiopia. Cluster sampling technique was used to select 462 Visceral Leishmaniasis infected patients. Serologic and parasitological test results have been used to diagnose Visceral Leishmaniasis. The HIV diagnosis was based on the national algorithm with two serial positive rapid test results. In case of discrepancy between the two tests, Uni-Gold was used as a tie breaker. Structured questionnaire was used to collect independent variables. Data was entered by using Excel and analyzed by using SPSS version 20. Descriptive statistics and logistic regression model was used to analyze the data. RESULTS: A total of 462 study participants were included in the study with a response rate of 92.4%. HIV and Visceral Leishmaniasis coinfection was found to be 17.75% with 95% CI; 14.30-21.40. Age ≥ 30 years (AOR = 22.58, 95% CI 11.34, 45.01), urban residents (AOR = 2.02, 95% CI 1.16, 4.17) and daily laborer workers (AOR = 4.99, 95% CI 2.33, 10.68) were significantly associated with HIV and Visceral Leishmaniasis coinfection. CONCLUSION: HIV and Visceral Leishmaniasis coinfection in the Northwest Ethiopia was found to be low. Age, residence and employment were independently associated with HIV-VL coinfection in the Northwest Ethiopia. It is better to design interventions to prevent and control HIV-VL coinfection for productive age groups (age ≥ 30) and daily laborers.
Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY


  3 / 14011 MEDLINE  
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PMID:28426291
Autor:Harris JK; Jonson-Reid M; Carothers BJ; Fowler P
Endereço:1 Brown School, Washington University in St Louis, St Louis, MO, USA.
Título:The Structure of Policy Networks for Injury and Violence Prevention in 15 US Cities.
Fonte:Public Health Rep; 132(3):381-388, 2017 May/Jun.
ISSN:1468-2877
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVES: Changes in policy can reduce violence and injury; however, little is known about how partnerships among organizations influence policy development, adoption, and implementation. To understand partnerships among organizations working on injury and violence prevention (IVP) policy, we examined IVP policy networks in 15 large US cities. METHODS: In summer 2014, we recruited 15 local health departments (LHDs) to participate in the study. They identified an average of 28.9 local partners (SD = 10.2) working on IVP policy. In late 2014, we sent survey questionnaires to 434 organizations, including the 15 LHDs and their local partners, about their partnerships and the importance of each organization to local IVP policy efforts; 319 participated. We used network methods to examine the composition and structure of the policy networks. RESULTS: Each IVP policy network included the LHD and an average of 21.3 (SD = 6.9) local partners. On average, nonprofit organizations constituted 50.7% of networks, followed by government agencies (26.3%), schools and universities (11.8%), coalitions (11.2%), voluntary organizations (9.6%), hospitals (8.5%), foundations (2.2%), and for-profit organizations (0.7%). Government agencies were perceived as important by the highest proportion of partners. Perceived importance was significantly associated with forming partnerships in most networks; odds ratios ranged from 1.07 (95% CI, 1.02-1.13) to 2.35 (95% CI, 1.68-3.28). Organization type was significantly associated with partnership formation in most networks after controlling for an organization's importance to the network. CONCLUSIONS: Several strategies could strengthen local IVP policy networks, including (1) developing connections with partners from sectors that are not well integrated into the networks and (2) encouraging indirect or less formal connections with important but missing partners and partner types.
Tipo de publicação: JOURNAL ARTICLE


  4 / 14011 MEDLINE  
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PMID:28165380
Autor:Pottie K; Hui C; Rahman P; Ingleby D; Akl EA; Russell G; Ling L; Wickramage K; Mosca D; Brindis CD
Endereço:Departments of Family Medicine & Epidemiology and Community Medicine, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada. kpottie@uottawa.ca.
Título:Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus.
Fonte:Int J Environ Res Public Health; 14(2), 2017 Feb 03.
ISSN:1660-4601
País de publicação:Switzerland
Idioma:eng
Resumo:Persons affected by migration require health systems that are responsive and adaptable to the needs of both disadvantaged migrants and non-migrant populations. The objective of this study is to support health systems for populations affected by migration. MATERIALS AND METHODS: An international Delphi consensus process was used to identify policy approaches to improve health systems for populations affected by migration. Participants were leading migrant health experts from Americas, Europe, Middle East, Asia, and Australasia. We calculated average ranking scores and qualitatively analyzed open-ended questions. RESULTS: Participants identified the following key areas as priorities for policy development: health inequities, system discrimination, migrant related health data, disadvantaged migrant sub-groups, and considerations for disadvantaged non-migrant populations. Highly ranked items to improve health systems were: Health Equity Impact Assessment, evidence based guidelines, and the International Organization for Migration annual reports. DISCUSSION: Policy makers need tools, data and resources to address health systems challenges. Policies need to avoid preventable deaths of migrants and barriers to basic health services.
Tipo de publicação: JOURNAL ARTICLE


  5 / 14011 MEDLINE  
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PMID:28460861
Autor:Postma J; Zuiderent-Jerak T
Endereço:Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands. Electronic address: postma@bmg.eur.nl.
Título:Beyond Volume Indicators and Centralization: Toward a Broad Perspective on Policy for Improving Quality of Emergency Care.
Fonte:Ann Emerg Med; 69(6):689-697.e1, 2017 Jun.
ISSN:1097-6760
País de publicação:United States
Idioma:eng
Resumo:STUDY OBJECTIVE: Policymakers increasingly regard centralization of emergency care as a useful measure to improve quality. However, the clinical studies that are used to justify centralization, arguing that volume indicators are a good proxy for quality of care ("practice makes perfect"), have significant shortcomings. In light of the introduction of a new centralization policy in the Netherlands, we show that the use of volume indicators in emergency care is problematic and does not do justice to the daily care provided in emergency departments (EDs). METHODS: We conducted an ethnographic study in 3 EDs, a primary care facility, and an ambulance call center in the Netherlands, including 109 hours of observation, more than 30 ethnographic interviews with professionals and managers, and 5 semistructured follow-up interviews. RESULTS: We argue that emergency care is a complex, multilayered practice and distinguish 4 different repertoires: acute and complex care, uncertain diagnostics, basic care, and physical, social, and mental care. A "repertoire" entails a definition of what good care is, what professional skills are needed, and how emergency care should be organized. CONCLUSION: The first repertoire of acute and complex care might benefit from centralization. The other 3 repertoires, however, equally deserve attention but are made invisible in policies that focus on the first repertoire and extrapolate the idea of centralization to emergency care as a whole. Emergency care research and policies should take all repertoires into account and pay more attention to alternative measures and indicators beyond volume, eg, patient satisfaction, professional expertise, and collaboration between EDs and other facilities.
Tipo de publicação: JOURNAL ARTICLE


  6 / 14011 MEDLINE  
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PMID:28114624
Autor:Rose SL; Highland J; Karafa MT; Joffe S
Endereço:Office of Patient Experience, Department of Bioethics, Cleveland Clinic, Cleveland, Ohio2Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.
Título:Patient Advocacy Organizations, Industry Funding, and Conflicts of Interest.
Fonte:JAMA Intern Med; 177(3):344-350, 2017 Mar 01.
ISSN:2168-6114
País de publicação:United States
Idioma:eng
Resumo:Importance: Patient advocacy organizations (PAOs) are influential health care stakeholders that provide direct counseling and education for patients, engage in policy advocacy, and shape research agendas. Many PAOs report having financial relationships with for-profit industry, yet little is known about the nature of these relationships. Objective: To describe the nature of industry funding and partnerships between PAOs and for-profit companies in the United States. Design, Setting, and Participants: A survey was conducted from September 1, 2013, to June 30, 2014, of a nationally representative random sample of 439 PAO leaders, representing 5.6% of 7865 PAOs identified in the United States. Survey questions addressed the nature of their activities, their financial relationships with industry, and the perceived effectiveness of their conflict of interest policies. Main Outcomes and Measures: Amount and sources of revenue as well as organizational experiences with and policies regarding financial conflict of interest. Results: Of the 439 surveys mailed to PAO leaders, 289 (65.8%) were returned with at least 80% of the questions answered. The PAOs varied widely in terms of size, funding, activities, and disease focus. The median total revenue among responding organizations was $299 140 (interquartile range, $70 000-$1 200 000). A total of 165 of 245 PAOs (67.3%) reported receiving industry funding, with 19 of 160 PAOs (11.9%) receiving more than half of their funding from industry. Among the subset of PAOs that received industry funding, the median amount was $50 000 (interquartile range, $15 000-$200 000); the median proportion of industry support derived from the pharmaceutical, device, and/or biotechnology sectors was 45% (interquartile range, 0%-100%). A total of 220 of 269 respondents (81.8%) indicated that conflicts of interest are very or moderately relevant to PAOs, and 94 of 171 (55.0%) believed that their organizations' conflict of interest policies were very good. A total of 22 of 285 PAO leaders (7.7%) perceived pressure to conform their positions to the interests of corporate donors. Conclusions and Relevance: Patient advocacy organizations engage in wide-ranging health activities. Although most PAOs receive modest funding from industry, a minority receive substantial industry support, raising added concerns about independence. Many respondents report a need to improve their conflict of interest policies to help maintain public trust.
Tipo de publicação: JOURNAL ARTICLE


  7 / 14011 MEDLINE  
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PMID:28114439
Autor:Jefferson AA; Pearson SD
Endereço:Clinical Center, Department of Bioethics, National Institutes of Health, Bethesda, Maryland.
Título:Conflict of Interest in Seminal Hepatitis C Virus and Cholesterol Management Guidelines.
Fonte:JAMA Intern Med; 177(3):352-357, 2017 Mar 01.
ISSN:2168-6114
País de publicação:United States
Idioma:eng
Resumo:Importance: Little is known regarding whether Institute of Medicine (IOM) standards for managing conflicts of interest (COI) have been met in the development of recent important clinical guidelines. Objective: To evaluate adherence to the IOM standards for limits on commercial COI, guideline development, and evaluation of evidence by the 2013 American College of Cardiology and American Heart Association cholesterol management guideline and the 2014 American Association for the Study of Liver Diseases and Infectious Diseases Society of America hepatitis C virus management guideline. Design, Setting, and Participants: This study was a retrospective document review of the June 2014 print version of the cholesterol guideline and the final September 2015 print version of the hepatitis C virus guideline. Each guideline was assessed for adherence to the IOM standards for commercial COI published in the 2011 special report Clinical Practice Guidelines We Can Trust. Main Outcomes and Measures: The IOM standards call for no commercial COI among guideline committee chairs and cochairs and for less than 50% of committee members to have commercial COI. Guideline and contemporaneous article disclosure statements were used to evaluate adherence to these standards. Each guideline was also reviewed for adherence to other IOM standards for guideline development and evidence review. Results: Among the 16 cholesterol guideline committee members, 7 (44%) disclosed commercial COI, all 7 reported industry-sponsored research, and 6 (38%) also reported consultancy. Of 3 guideline chairs and cochairs, 1 (33%) disclosed commercial COI. Review of contemporaneous articles identified additional commercial COI. Among the 29 hepatitis C virus guideline committee members, 21 (72%) reported commercial COI. Eighteen (62%) disclosed industry-sponsored research, 10 (34%) served on advisory boards, 5 (17%) served on data safety monitoring boards, 3 (10%) were consultants, and 3 (10%) reported other honoraria. Of 6 guideline cochairs, 4 (67%) disclosed commercial COI. All 4 disclosed additional COI in other publications that were not listed in their guideline disclosures. Contemporaneous literature review revealed an additional cochair with commercial COI. Of the 9 IOM guideline development and evidence standards, the cholesterol guideline met 5 (56%), and the hepatitis C virus guideline met them all. Conclusions and Relevance: Neither the cholesterol guideline nor the hepatitis C virus guideline fully met the IOM standards for commercial COI management, and discordance between committee leader guideline disclosures and those in contemporaneous articles was common. Adherence to additional IOM standards for guideline development and evidence review was mixed. Adoption of consistent COI frameworks across specialty societies may help ensure that clinical guidelines are developed in a transparent and trustworthy manner.
Tipo de publicação: JOURNAL ARTICLE


  8 / 14011 MEDLINE  
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PMID:28564562
Autor:Newhouse JP; Normand ST
Endereço:From the Departments of Health Care Policy (J.P.N., S-L.T.N.) and Biostatistics (S.-L.T.N.), Harvard Medical School, Boston.
Título:Health Policy Trials.
Fonte:N Engl J Med; 376(22):2160-2167, 2017 Jun 01.
ISSN:1533-4406
País de publicação:United States
Idioma:eng
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  9 / 14011 MEDLINE  
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PMID:28489011
Autor:Palsson R
Título:[The Icelandic organ donation law: has the time arrived for presumed consent?[Editorial]].
Fonte:Laeknabladid; 103(2):65, 2017 Februar.
ISSN:0023-7213
País de publicação:Iceland
Idioma:ice
Tipo de publicação: EDITORIAL


  10 / 14011 MEDLINE  
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PMID:28489010
Autor:Jonsson T
Título:[New government, new health policy?[Editorial]].
Fonte:Laeknabladid; 103(2):63, 2017 Februar.
ISSN:0023-7213
País de publicação:Iceland
Idioma:ice
Tipo de publicação: EDITORIAL



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