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Pesquisa : SP1.001.002 [Categoria DeCS]
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  1 / 14182 MEDLINE  
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PMID:29018085
Autor:Morgan SG; Gagnon MA; Charbonneau M; Vadeboncoeur A
Endereço:School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; School of Public Policy and Administration (Gagnon), Carleton University, Ottawa, Ont.; Karl Polanyi Institute of Political Economy (Charbonneau), Concordia University; Family and Emergency Medicine Depar
Título:Evaluating the effects of Quebec's private-public drug insurance system.
Fonte:CMAJ; 189(40):E1259-E1263, 2017 10 10.
ISSN:1488-2329
País de publicação:Canada
Idioma:eng
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  2 / 14182 MEDLINE  
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PMID:28847779
Autor:Gagnon M
Endereço:School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ont. marilou.gagnon@uottawa.ca.
Título:It's time to allow assisted injection in supervised injection sites.
Fonte:CMAJ; 189(34):E1083-E1084, 2017 08 28.
ISSN:1488-2329
País de publicação:Canada
Idioma:eng
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  3 / 14182 MEDLINE  
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PMID:28420401
Autor:Bou-Karroum L; El-Jardali F; Hemadi N; Faraj Y; Ojha U; Shahrour M; Darzi A; Ali M; Doumit C; Langlois EV; Melki J; AbouHaidar GH; Akl EA
Endereço:Center for Systematic Review for Health Policy and Systems Research, American University of Beirut, Beirut, Lebanon.
Título:Using media to impact health policy-making: an integrative systematic review.
Fonte:Implement Sci; 12(1):52, 2017 Apr 18.
ISSN:1748-5908
País de publicação:England
Idioma:eng
Resumo:INTRODUCTION: Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions-including social media-on the health policy-making process. METHODS: Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment. RESULTS: Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers' awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence. CONCLUSION: There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and the circumstances under which media interventions are successful. TRIAL REGISTRATION: PROSPERO 2015: CRD42015020243.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  4 / 14182 MEDLINE  
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PMID:28185593
Autor:Panda B; Thakur HP
Endereço:Public Health Foundation of India, IIPH-Bhubaneswar, Bhubaneswar, India. bhuputra.panda@iiphb.org.
Título:Decentralization and health system performance - a focused review of dimensions, difficulties, and derivatives in India.
Fonte:BMC Health Serv Res; 16(Suppl 6):561, 2016 Oct 31.
ISSN:1472-6963
País de publicação:England
Idioma:eng
Resumo:INTRODUCTION: One of the principal goals of any health care system is to improve health through the provision of clinical and public health services. Decentralization as a reform measure aims to improve inputs, management processes and health outcomes, and has political, administrative and financial connotations. It is argued that the robustness of a health system in achieving desirable outcomes is contingent upon the width and depth of 'decision space' at the local level. Studies have used different approaches to examine one or more facets of decentralization and its effect on health system functioning; however, lack of consensus on an acceptable framework is a critical gap in determining its quantum and quality. Theorists have resorted to concepts of 'trust', 'convenience' and 'mutual benefits' to explain, define and measure components of governance in health. In the emerging 'continuum of health services' model, the challenge lies in identifying variables of performance (fiscal allocation, autonomy at local level, perception of key stakeholders, service delivery outputs, etc.) through the prism of decentralization in the first place, and in establishing directed relationships among them. METHODS: This focused review paper conducted extensive web-based literature search, using PubMed and Google Scholar search engines. After screening of key words and study objectives, we retrieved 180 articles for next round of screening. One hundred and four full articles (three working papers and 101 published papers) were reviewed in totality. We attempted to summarize existing literature on decentralization and health systems performance, explain key concepts and essential variables, and develop a framework for further scientific scrutiny. Themes are presented in three separate segments of dimensions, difficulties and derivatives. RESULTS: Evaluation of local decision making and its effect on health system performance has been studied in a compartmentalized manner. There is sparse evidence about innovations attributable to decentralization. We observed that in India, there is very scant evaluative study on the subject. We didn't come across a single study examining the perception and experiences of local decision makers about the opportunities and challenges they faced. The existing body of evidences may be inadequate to feed into sound policy making. The principles of management hinge on measurement of inputs, processes and outputs. In the conceptual framework we propose three levels of functions (health systems functions, management functions and measurement functions) being intricately related to inputs, processes and outputs. Each level of function encompasses essential elements derived from the synthesis of information gathered through literature review and non-participant observation. We observed that it is difficult to quantify characteristics of governance at institutional, system and individual levels except through proxy means. CONCLUSION: There is an urgent need to sensitize governments and academia about how best more objective evaluation of 'shared governance' can be undertaken to benefit policy making. The future direction of enquiry should focus on context-specific evidence of its effect on the entire spectrum of health system, with special emphasis on efficiency, community participation, human resource management and quality of services.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  5 / 14182 MEDLINE  
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PMID:28427353
Autor:Hu Y; van Lenthe FJ; Hoffmann R; van Hedel K; Mackenbach JP
Endereço:Erasmus MC, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands.
Título:Assessing the impact of natural policy experiments on socioeconomic inequalities in health: how to apply commonly used quantitative analytical methods?
Fonte:BMC Med Res Methodol; 17(1):68, 2017 Apr 20.
ISSN:1471-2288
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: The scientific evidence-base for policies to tackle health inequalities is limited. Natural policy experiments (NPE) have drawn increasing attention as a means to evaluating the effects of policies on health. Several analytical methods can be used to evaluate the outcomes of NPEs in terms of average population health, but it is unclear whether they can also be used to assess the outcomes of NPEs in terms of health inequalities. The aim of this study therefore was to assess whether, and to demonstrate how, a number of commonly used analytical methods for the evaluation of NPEs can be applied to quantify the effect of policies on health inequalities. METHODS: We identified seven quantitative analytical methods for the evaluation of NPEs: regression adjustment, propensity score matching, difference-in-differences analysis, fixed effects analysis, instrumental variable analysis, regression discontinuity and interrupted time-series. We assessed whether these methods can be used to quantify the effect of policies on the magnitude of health inequalities either by conducting a stratified analysis or by including an interaction term, and illustrated both approaches in a fictitious numerical example. RESULTS: All seven methods can be used to quantify the equity impact of policies on absolute and relative inequalities in health by conducting an analysis stratified by socioeconomic position, and all but one (propensity score matching) can be used to quantify equity impacts by inclusion of an interaction term between socioeconomic position and policy exposure. CONCLUSION: Methods commonly used in economics and econometrics for the evaluation of NPEs can also be applied to assess the equity impact of policies, and our illustrations provide guidance on how to do this appropriately. The low external validity of results from instrumental variable analysis and regression discontinuity makes these methods less desirable for assessing policy effects on population-level health inequalities. Increased use of the methods in social epidemiology will help to build an evidence base to support policy making in the area of health inequalities.
Tipo de publicação: JOURNAL ARTICLE


  6 / 14182 MEDLINE  
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PMID:28297129
Autor:Alvargonzález D
Endereço:Department of Philosophy, University of Oviedo, Asturias, Spain.
Título:Towards a non-ethics-based consensual public policy on abortion.
Fonte:Int J Health Plann Manage; 32(1):e39-e46, 2017 Jan.
ISSN:1099-1751
País de publicação:England
Idioma:eng
Resumo:The absence of agreement on the ethical legitimacy of abortion does not entail the impossibility of finding a consensus on the best policy on abortion. This consensus is affordable because nobody doubts that, regarding the methods of birth control, contraception is better than abortion, abortion is better than infanticide and abortion is worse the later and the less safe it is performed. Because the complete elimination of abortion is not possible, the most relevant realistic political objectives that can be proposed are reducing the abortion rate, reducing the gestational age of abortions and making the remaining abortions safer. Restrictive policies do not contribute to lowering the abortion rate while are associated with unsafe abortions and higher women's morbidity and mortality. Copyright © 2015 John Wiley & Sons, Ltd.
Tipo de publicação: JOURNAL ARTICLE


  7 / 14182 MEDLINE  
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PMID:28162814
Autor:De Raeve P; Rafferty AM; Bariball L; Young R; Boiko O
Endereço:Clos du Parnasse 11A, 1050 Brussels, Belgium. Electronic address: efn@efn.be.
Título:EU accession: A policy window opportunity for nursing?
Fonte:Health Policy; 121(3):292-299, 2017 Mar.
ISSN:1872-6054
País de publicação:Ireland
Idioma:eng
Resumo:European enlargement has been studied in a wide range of policy areas within and beyond health. Yet the impact of EU enlargement upon one of the largest health professions, nursing, has been largely neglected. This paper aims to explore nurse leadership using a comparative case study method in two former Communist countries, Romania and Croatia. Specifically, it considers the extent to which engagement in the EU accession policy-making process provided a policy window for the leaders to formulate and implement a professional agenda while negotiating EU accession. Findings of qualitative interviews and documentary analysis indicate that the mechanisms used to facilitate the accession process were not successful in achieving compliance with the education standards in the Community Acquis, as highlighted in the criteria on the mutual recognition of professional qualifications set out in Directive 2005/36/EC. EU accession capacity building and accession funds were not deployed efficiently to upgrade Romanian and Croatian nursing education towards meeting EU standards. Conflicting views on accession held by the various nursing stakeholders (nursing regulator, nursing union, governmental chief nurse and the professional association) inhibited the setting of a common policy agenda to achieve compliance with EU standards. The study findings suggest a need to critically review EU accession mechanisms and better align leadership at all governance levels.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  8 / 14182 MEDLINE  
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PMID:28139253
Autor:van de Goor I; Hämäläinen RM; Syed A; Juel Lau C; Sandu P; Spitters H; Eklund Karlsson L; Dulf D; Valente A; Castellani T; Aro AR; REPOPA consortium
Endereço:Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands. Electronic address: L.vandegoor@uvt.nl.
Título:Determinants of evidence use in public health policy making: Results from a study across six EU countries.
Fonte:Health Policy; 121(3):273-281, 2017 Mar.
ISSN:1872-6054
País de publicação:Ireland
Idioma:eng
Resumo:The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities, lacking the most effective approaches, thus limiting the impact of health promotion strategies. This article focuses on facilitators and barriers in the use of evidence in developing health enhancing physical activity policies. Data was collected in 2012 by interviewing 86 key stakeholders from six EU countries (FI, DK, UK, NL, IT, RO) using a common topic guide. Content analysis and concept mapping was used to construct a map of facilitators and barriers. Barriers and facilitators experienced by most stakeholders and policy context in each country are analysed. A lack of locally useful and concrete evidence, evidence on costs, and a lack of joint understanding were specific hindrances. Also users' characteristics and the role media play were identified as factors of influence. Attention for individual and social factors within the policy context might provide the key to enhance more sustainable evidence use. Developing and evaluating tailored approaches impacting on networking, personal relationships, collaboration and evidence coproduction is recommended.
Tipo de publicação: JOURNAL ARTICLE


  9 / 14182 MEDLINE  
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PMID:28108136
Autor:Ellen ME; Panisset U; Araujo de Carvalho I; Goodwin J; Beard J
Endereço:McMaster Health Forum, McMaster University, 1280 Main St. West, CRL 209, Hamilton, Ontario L8S 4K1, Canada; Jerusalem College of Technology, Ha-Va'ad ha-Le'umi St. 21, Jerusalem 93721, Israel; Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor, 155 College St., T
Título:A Knowledge Translation framework on ageing and health.
Fonte:Health Policy; 121(3):282-291, 2017 Mar.
ISSN:1872-6054
País de publicação:Ireland
Idioma:eng
Resumo:BACKGROUND: The world's population aged 60 and over will more than triple from 600 million to 2 billion between the years 2000 to 2050. This demographic change has significant impact on health, social, and economic sectors. The need to ensure that research into older peoples' health is effectively translated to policy is immediate. OBJECTIVE: The purpose of this paper is to present a proposed framework to support evidence informed policymaking in ageing and health. METHODS: We undertook a two stage process to develop the framework. We (a) conducted a review of the literature, and (b) convened an expert panel to provide feedback. RESULTS: Numerous frameworks have been proposed yet the majority do not address all the barriers. The Lavis et al., framework addresses a majority of the obstacles associated with evidence-informed policymaking and this framework was modified to include sub-elements important to ageing and health and to reflect the order of importance of the elements. The main elements are: a climate and/or context for research use, linkage and exchange efforts, creation of new knowledge, push efforts, facilitating pull efforts, pull efforts, and evaluation. A four-step implementation process is proposed. DISCUSSION: This paper offers an approach to Knowledge Translation within the field of ageing and health. The framework and proposed implementation could be used to conceptualize and implement evidence-informed policymaking.
Tipo de publicação: JOURNAL ARTICLE


  10 / 14182 MEDLINE  
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PMID:29073662
Autor:Thomson G; Wilson N
Endereço:Public Health, University of Otago, Wellington.
Título:Smokefree signage at New Zealand racecourses and sports facilities with outdoor stands.
Fonte:N Z Med J; 130(1464):80-86, 2017 Oct 27.
ISSN:1175-8716
País de publicação:New Zealand
Idioma:eng
Resumo:Smokefree signage is crucial to the implementation of smokefree policies for outdoor venues and for facilitating smoking denormalisation. Such signage helps to communicate the expected norms for not smoking at venues. Therefore, we aimed to identify such signage at racecourses and sports facilities that had outdoor stands. We surveyed the entrances of 25 racecourse and 25 sport facilities with outdoor stands, across New Zealand. There were smokefree signs at the main entrances of 40% of the sports facilities with outdoor stands, and at 16% of the 25 other entrances. None of the horse/greyhound racecourses had smokefree signage at any of their entrances.
Tipo de publicação: LETTER
Nome de substância:0 (Tobacco Smoke Pollution)



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