824 resultados para Analysis of health policy


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Typologies have represented an important tool for the development of comparative social policy research and continue to be widely used in spite of growing criticism of their ability to capture the complexity of welfare states and their internal heterogeneity. In particular, debates have focused on the presence of hybrid cases and the existence of distinct cross-national pattern of variation across areas of social policy. There is growing awareness around these issues, but empirical research often still relies on methodologies aimed at classifying countries in a limited number of unambiguous types. This article proposes a two-step approach based on fuzzy-set-ideal-type analysis for the systematic analysis of hybrids at the level of both policies (step 1) and policy configurations or combinations of policies (step 2). This approach is demonstrated by using the case of childcare policies in European economies. In the first step, parental leave policies are analysed using three methods – direct, indirect, and combinatory – to identify and describe specific hybrid forms at the level of policy analysis. In the second step, the analysis focus on the relationship between parental leave and childcare services in order to develop an overall typology of childcare policies, which clearly shows that many countries display characteristics normally associated with different types (hybrids and. Therefore, this two-step approach enhances our ability to account and make sense of hybrid welfare forms produced from tensions and contradictions within and between policies.

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The effectiveness of the Incredible Years Basic parent programme (IYBP) in reducing child conduct problems and improving parent competencies and mental health was examined in a 12-month follow-up. Pre- to post-intervention service use and related costs were also analysed. A total of 103 families and their children (aged 32–88 months), who previously participated in a randomised controlled trial of the IYBP, took part in a 12-month follow-up assessment. Child and parent behaviour and well-being were measured using psychometric and observational measures. An intention-to-treat analysis was carried out using a one-way repeated measures ANOVA. Pairwise comparisons were subsequently conducted to determine whether treatment outcomes were sustained 1 year post-baseline assessment. Results indicate that post-intervention improvements in child conduct problems, parenting behaviour and parental mental health were maintained. Service use and associated costs continued to decline. The results indicate that parent-focused interventions, implemented in the early years, can result in improvements in child and parent behaviour and well-being 12 months later. A reduced reliance on formal services is also indicated.

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Background Early intervention services (EIS) comprise low-stigma, youth-friendly mental health teams for young people undergoing first-episode psychosis (FEP). Engaging with the family of the young person is central to EIS policy and practice. Aims By analysing carers' accounts of their daily lives and affective challenges during a relative's FEP against the background of wider research into EIS, this paper explores relationships between carers' experiences and EIS. Method Semi-structured longitudinal interviews with 80 carers of young people with FEP treated through English EIS. Results Our data suggest that EIS successfully aid carers to support their relatives, particularly through the provision of knowledge about psychosis and medications. However, paradoxical ramifications of these user-focused engagements also emerge; they risk leaving carers' emotions unacknowledged and compounding an existing lack of help-seeking. Conclusions By focusing on EIS's engagements with carers, this paper draws attention to an urgent broader question: as a continuing emphasis on care outside the clinic space places family members at the heart of the care of those with severe mental illness, we ask: who can, and should, support carers, and in what ways?

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Although the benefits of mindfulness meditation practices have been widely documented, research data suggest that there are barriers to regularly engaging in meditation behavior. In order to explore research questions pertaining to meditation initiation and adherence, psychometrically valid scales to assess barriers to meditation practice are necessary. The aim of the present study was to explore the factor structure and construct validity of the Determinants of Meditation Practice Inventory (DMPI) (Williams et al., 2011), a perceived barriers to meditation scale. Exploratory and confirmatory factor analyses along with construct validity tests were performed on data obtained from two large, community samples. Results supported the DMPI as a valid scale assessing perceived barriers with four factors, Lack of Interest, Knowledge Concerns, Pragmatic Concerns and Sociocultural Beliefs. The present study offers a DMPI-revised scale that may be reliably used to assess attitudes and beliefs that might impede meditation behavior.

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Biodiversity and distribution of benthic meiofauna in the sediments of the Southern Caspian Sea (Mazandaran) was studied in order to introducing and determining of their relationship with the environmental factors. From 12 stations (ranging in depths 5, 10, 20 and 50 meters), sediment samples were gathered in 6 months (2012). Environmental factors of water near the bottom including temperature, salinity, dissolved oxygen and pH were measured during sampling with CTD and grain size and total organic matter percentage and calcium carbonate were measured in laboratory. In different months, the average water temperature (9.52-23.93), dissolved oxygen (7.71-10.53 mg/L), salinity (10.57±0/07 and 10.75±0/04 ppt), pH (7.44±0/29 and 7.41±0/22), EC (17.97±0/12 and 18.30±0/04μs/cm2), TDS (8.92±0/04 and 9.14±0/02 mg/L), total organic matter (5.83±1/43 and 6.25±0/97%) and calcium carbonate (2.36±0/36 and 1.68±0/19%) were measured respectively. Structure of the sediment samples mostly consisted of fine sand; very fine sand, silt and clay. From the 4 group animals (Foraminifera, Crustacea, Worms and Mollusca), there were identified 40species belong to 29 genera of 25 families. The cosmopolitan foraminifer, Ammonia beccarii caspica, was common in all sampling stations. Result showed that depth was important factor on distribution of meiofauna. Most density of foraminifera and crustacean was observed in depth of 20m and for mollusca and worms observed in 5m. Shannon diversity index decreased with depth that showed in shallow water diversity was higher than deep water. Mean of maximum and minimum Shannon index was obsorvers in depth of 5m and 50 m that was measured in order 0.93 and 0.43. Account of Shannon index showed that this area is under pressure. Account of peioleo index showed distribution in this area was not steady.

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The number of Open Access (OA) policies that have been adopted by universities, research institutes and research funders has been increasing at a fast pace. The Registry of Open Access Repository Mandates and Policies (ROARMAP) records the existence of 724 OA policies across the world, of which 512 have been adopted by universities and research institutions. The UK is one of the leading countries in terms of OA policy development and implementation with a total of 85 institutional1 and an estimated 35 funder2 OA policies. In order to understand and contextualise how OA policies are developed and how they can be effectively implemented and aligned, this brief looks at two areas. The first section provides an overview on the processes evolving around policy making, policy effectiveness and policy alignment. In particular, it summarises the criteria and elements generally specified in OA policies, it points out some of the relevant steps informing the development, monitoring and revision of OA policies, it outlines what OA policy elements contribute to policy effectiveness, and highlights the benefits in aligning OA policies. The second section revisits the issues previously discussed within the context of the UK institutional (universities) OA policy landscape.

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A multi-residue gas chromatography-mass spectrometry method was developed in order to evaluate the presence of 39 pesticides of different chemical families (organophosphorus, triazines, imidazole, organochlorine), as well as some of their transformation products, in surface water samples from Ria de Aveiro. Ria de Aveiro is an estuarine coastal lagoon, located in the northern west region of Portugal, which receives inputs from agriculture, urban and industrial activities. The analytical method was developed and validated according international guidelines and showed good linearity, with correlation coefficients higher than 0.9949 for all compounds, adequate precision and accuracy, and high sensitivity. Pesticides were chosen from the priority pollutants list of the Directive 2008/105/EC of the European Parliament and of the Council (on environmental quality standards in the field of water policy), or were selected due their common use in agricultural practices. Some of these 39 pesticides are, or are suspected to be, endocrine disruptor compounds (EDCs), being capable of altering the endocrine system of wildlife and humans, causing form malfunction and ultimately health problems. Even those pesticides which are not EDCs, are known to be awfully toxic and have a recognised impact in human health. The aquatic environment is particularly susceptible to pollution due to intentional and accidental release of chemicals to water [3]. Pesticide contamination of surface water is a national issue as it is often used as drinking water. This concern is especially important in rural agricultural areas where population uses small private water supplies, regularly without any laboratory surveillance. The study was performed in seven sampling points and the results showed a considerable concern pesticide contamination of all samples.

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Background: Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population. Methods: An observational, cross-sectional study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors. Results: We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores. Conclusions: The HRQL level of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.

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This dissertation studies refugee resettlement in the United States utilizing the Integration Indicator’s framework developed by Ager and Strang for the U.S. context. The study highlights the U.S. refugee admissions program and the policies in the states of Maryland and Massachusetts while analyzing the service delivery models and its effects on refugee integration in these locations. Though immigration policy and funding for refugee services are primarily the domain of the federal government, funds are allocated through and services are delivered at the state level. The Office of Refugee Resettlement (ORR), which operates under the Department of Health and Human Services, was established after the Refugee Act of 1980 to deliver assistance to displaced persons. The ORR provides funds to individual states primarily through The Refugee Social Service and Targeted Assistance Formula Grant programs. Since the inauguration of the ORR three primary models of refugee integration through service delivery have emerged. Two of the models include the publicly/privately administered programs, where resources are allocated to the state in conjunction with private voluntary agencies; and the Wilson/Fish Alternative programs, where states sub-contract all elements of the resettlement program to voluntary agencies and private organizations —in which they can cease all state level participation and voluntary agencies or private organizations contract directly from the ORR in order for all states to deliver refugee services where the live. The specific goals of this program are early employment and economic self-sufficiency. This project utilizes US Census, state, and ORR data in conjunction with interviews of refugee resettlement practitioners involved in the service delivery and refugees. The findings show that delivery models emphasizing job training, English instruction courses, institutional collaboration, and monetary assistance, increases refugee acclimation and adaptation, providing insight into their potential for integration into the United States.

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Background and Aim: Maternal morbidity and mortality statistics remain unacceptably high in Malawi. Prominent among the risk factors in the country is anaemia in pregnancy, which generally results from nutritional inadequacy (particularly iron deficiency) and malaria, among other factors. This warrants concerted efforts to increase iron intake among reproductive-age women. This study, among women in Malawi, examined factors determining intake of supplemental iron for at least 90 days during pregnancy. Methods: A weighted sample of 10,750 women (46.7%), from the 23,020 respondents of the 2010 Malawi Demographic and Health Survey (MDHS), were utilized for the study. Univariate, bivariate, and regression techniques were employed. While univariate analysis revealed the percent distributions of all variables, bivariate analysis was used to examine the relationships between individual independent variables and adherence to iron supplementation. Chi-square tests of independence were conducted for categorical variables, with the significance level set at P < 0.05. Two binary logistic regression models were used to evaluate the net effect of independent variables on iron supplementation adherence. Results: Thirty-seven percent of the women adhered to the iron supplementation recommendations during pregnancy. Multivariate analysis indicated that younger age, urban residence, higher education, higher wealth status, and attending antenatal care during the first trimester were significantly associated with increased odds of taking iron supplementation for 90 days or more during pregnancy (P < 0.01). Conclusions: The results indicate low adherence to the World Health Organization’s iron supplementation recommendations among pregnant women in Malawi, and this contributes to negative health outcomes for both mothers and children. Focusing on education interventions that target populations with low rates of iron supplement intake, including campaigns to increase the number of women who attend antenatal care clinics in the first trimester, are recommended to increase adherence to iron supplementation recommendations.

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This paper addresses a potential role that tariffs and tariff policy can play in encouraging countries to take part in a multilateral effort to mitigate climate change. It begins by assessing whether increasing tariffs on products from energy intensive or polluting industries amounts to a violation of WTO rules and whether protectionism in this case can be differentiated from genuine environmental concerns. It then argues that while lowering tariffs for environmental goods can serve as a carrot to promote dissemination of cleaner technologies, tariff deconsolidation is a legitimate stick to encourage polluting countries to move towards an international climate agreement. The paper further explores this view by undertaking a partialequilibrium simulation analysis to examine the impact of a unilateral unit increase in tariffs on the imports of the most carbon-intensive products from countries not committed to climate polices. Our results suggest that the committed importing countries would have to raise their tariffs only slightly to effect a significant decline in the imports of these products from the non-committed countries. For instance, a unit increase in the simple average applied tariffs on the imports of these carbon-intensive products in 2005 from our sample of non-committed exporting countries would reduce the imports of these products by an average 32.6% in Australia, 178% in Canada, 195% in the EU, 271% in Japan and 62% in the US, therebysuggesting the effectiveness of such a measure in pushing countries towards a global climate policy.

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This study mainly aims to provide an inter-industry analysis through the subdivision of various industries in flow of funds (FOF) accounts. Combined with the Financial Statement Analysis data from 2004 and 2005, the Korean FOF accounts are reconstructed to form "from-whom-to-whom" basis FOF tables, which are composed of 115 institutional sectors and correspond to tables and techniques of input–output (I–O) analysis. First, power of dispersion indices are obtained by applying the I–O analysis method. Most service and IT industries, construction, and light industries in manufacturing are included in the first quadrant group, whereas heavy and chemical industries are placed in the fourth quadrant since their power indices in the asset-oriented system are comparatively smaller than those of other institutional sectors. Second, investments and savings, which are induced by the central bank, are calculated for monetary policy evaluations. Industries are bifurcated into two groups to compare their features. The first group refers to industries whose power of dispersion in the asset-oriented system is greater than 1, whereas the second group indicates that their index is less than 1. We found that the net induced investments (NII)–total liabilities ratios of the first group show levels half those of the second group since the former's induced savings are obviously greater than the latter.