Interest In Health Policy Research Articles

Wind turbines: Vacated/abandoned homes study – Exploring research participants’ descriptions of observed effects on their pets, animals, and well water

Abstract Background: Neighbors living within 10 km of industrial wind turbines have reported occurrences of adverse health effects and contemplated vacating their homes. Some participants described concerns for wildlife and effects on their pets, animals, and well water. While sources such as the scientific literature, social media, and Internet websites have reported these effects, research is limited. Methods: This ethics-reviewed study used the qualitative grounded theory methodology and interviewed 67 consenting participants, 18 years or older who had previously lived, or were currently living within 10 km of wind turbines. Audio files were transcribed to text, and the data were coded and analyzed using NVivo Pro (version 12.6) software. Objectives: The objectives of this study were to explore participants’ descriptions of effects related to their pets, animals, and well water and to generate a theory. Results: Data analysis revealed primary themes of environmental interference and altered living conditions and associated sub-themes of effects on animals and well water. Discussion: Internationally and in Ontario neighbors have reported effects on their pets and domestic animals, concerns for wildlife, and a loss of potable well water. It is recommended that members of the public, government authorities, policy-makers, researchers, health practitioners and social scientists with an interest in health policy acknowledge the potential for these effects and seek resolution for those negatively affected.

Wind turbines: Vacated/abandoned homes – Exploring participants’ descriptions of their personal views, effects on safety, security, trust, and social justice

Introduction: Some neighbors living in proximity to industrial wind turbines (IWTs) have described adverse health effects and contemplated vacating their homes. While the decision to vacate a home is reported by sources such as judicial proceedings, the scientific literature, media outlets, social media, and Internet websites, research on its extent and outcomes is limited. Methodology: This ethics-reviewed study used the qualitative Grounded Theory methodology. Sixty-seven consenting participants, 18 years or older, who had previously lived or were currently living within 10 km of IWTs were interviewed. Audio files were transcribed to text and the data were coded and analyzed using NVivo Pro (v. 12.6) software. Objectives: The objective is to explore participants’ descriptions of their personal views on wind turbines and their effects on safety, security, trust, and social justice, and generate a theory of influences contributing to these decisions. Results: Data analysis revealed primary and subthemes associated with environmental interference and altered living conditions. Descriptions of participants’ personal views associated with the use of wind energy and effects on safety, security, trust, and social justice are provided. Discussion: It is recommended that members of the public, government authorities, policymakers, researchers, health practitioners, and social scientists with an interest in health policy acknowledge these effects and seek resolution for those who are negatively affected when living or working near IWTs. Conclusion: We conclude that using a systematic methodology, data analysis lends support that the Grounded Theory was applicable to this study as it assisted with the development of a coherent theory which explained participants’ housing decisions.

Wind turbines: Vacated/abandoned homes – Exploring research participants’ descriptions of adverse health effects and medical diagnoses provided by their physicians and physician specialists

Introduction: The risk of harm associated with living within 10 km of industrial wind turbines (IWTs) is unresolved and continues to be debated internationally. While sources such as judicial proceedings, scientific literature, social media, and Internet websites report that some neighbors contemplate leaving their homes, research on this topic is limited. This study continues to explore why they contemplated such a housing decision. Methodology: The ethics-reviewed study used the qualitative Grounded Theory (GT) methodology and interviewed 67 consenting participants, 18 years or older, who had previously lived, or were currently living, within 10 km of IWTs. Audio files were transcribed to text and the data were coded and analyzed using NVivo Pro (v. 12.6) software. Objectives: The objective of this manuscript is to explore participants’ descriptions of their medical diagnoses provided by their physicians and physician specialists. Results: Data analysis revealed primary and subthemes associated with environmental interference and altered living conditions. Of the 67 participants, eight described their diagnoses of medical conditions as given by their physicians and physician specialists. Descriptions of conversations with participants’ health-care providers were also surveyed. Discussion: Medical diagnoses, descriptions of comments by health practitioners and the commonality of globally reported adverse health effects (AHEs), support the potential risk of locating IWTs near residential areas. It is recommended that members of the public, government authorities, policy makers, researchers, health practitioners, and social scientists with an interest in health policy and disease prevention acknowledge this risk and advocate for the immediate, effective, and timely resolution for affected neighbors. Conclusions: The GT methodology was used to develop a substantive theory regarding the housing decisions of participants living within 10 km of a Wind Power Plant. Results from the interviews indicate that these decisions were motivated by the potential for, or the experience of, AHEs which they attributed to living in proximity to these installations.

The Tension between National and Local Concerns in Preparing for Large-Scale Generic Systems in Healthcare

Large-scale generic systems are typically adapted to local practice through configuration. This is especially important in healthcare, which involves a plurality of institutions and users. However, the decision to acquire a generic system in public healthcare is typically founded on regional and national health policy goals, which often are translated into various forms of standardization. As a result, national and regional health policy interests may stand in contrast to interests on the local level. Therefore, we analyze how national and local concerns are weighed against each other in the preparations for implementing large-scale generic systems in healthcare. We explore what role configuration plays and what the prospects are for long-term development. We contribute with insight into how the organizational consequences of generic systems are formed already in the preparation phase and point to how configuration easily results in standardization, thereby basically privileging national and regional health goals at the expense of local needs. Empirically, we focus on the preparations for implementing the Epic electronic health record in Central Norway.

Policy parameters for optimising hospital ePrescribing: An exploratory literature review of selected countries of the Organisation for Economic Co-operation and Development

ObjectiveElectronic prescribing systems offer considerable opportunities to enhance the safety, effectiveness and efficiency of prescribing and medicines management decisions but, despite considerable investments in health IT infrastructure and healthcare professional training, realising these benefits continues to prove challenging. How systems are customised and configured to achieve optimal functionality is an increasing focus for policymakers. We sought to develop an overview of the policy landscape currently supporting optimisation of hospital ePrescribing systems in economically developed countries with a view to deriving lessons for the United Kingdom (UK).MethodsWe conducted a review of research literature and policy documents pertaining to optimisation of ePrescribing within hospitals across Organisation for Economic Co-operation and Development (OECD) countries on Embase, Medline, National Institute for Health (NIH), Google Scholar databases from 2010 to 2020 and the websites of organisations with international and national health policy interests in digital health and ePrescribing. We designed a typology of policies targeting optimisation of ePrescribing systems that provides an overview of evidence relating to the level at which policy is set, the aims and the barriers encountered in enacting these policies.ResultsOur database searches retrieved 11 relevant articles and other web resources mainly from North America and Western Europe. We identified very few countries with a national level strategy for optimisation of ePrescribing in hospitals. There were hotspots of digital maturity in relation to ePrescribing at institutional, specialisation, regional and national levels in the US and Europe. We noted that such countries with digital maturity fostered innovations such as patient involvement.ConclusionsWe found that, whilst helpful to achieve certain aims, coordinated strategies within and across countries for optimisation of ePrescribing systems are rare, even in countries with well-established ePrescribing and digital health infrastructures. There is at present little policy focus on maximising the utility of ePrescribing systems.

Involvement of Jordanian Head Nurses' in Health Policy Development: A Cross-Sectional Study.

Despite the importance of involving nurses in health policy, nurse's involvement faces many challenges. Literature showed that there is a low level of nurses' and nurse leaders' involvement in health policy development. The aims of this study were to examine (a) the level of Jordanian head nurses' involvement in health policy development and their perceived benefits and barriers; (b) the relationships between level of knowledge, competence, and interest in health policy and the level of involvement in health policy development; and (c) the relationship between the level of self-efficacy (efficacy expectation and outcome expectation) and the level of involvement in health policy development. A cross-sectional descriptive correlational study design was adopted in this study. A convenience sampling of 250 participants from hospitals affiliated to three health sectors in Jordan (private, governmental, and university) were recruited to complete a self-administered questionnaire. Descriptive statistics and Pearson correlation coefficient were used to answer the study questions. The results revealed a moderate level of involvement of head nurses in the policy development. The most frequent cited political activity was "providing written reports, consultations, research." "Lack of time" was the most perceived barrier, while "improving the health of the public" was the most perceived benefit. Workshops or sessions at conferences is the most indicated source of knowledge. Participants had an excellent level of skills with positive relationships between the competence and both of the levels of professional and personal involvement in health policy. Participants reported a low level of confidence in performing political activities as well as the impact of such activities on health outcomes. Positive relationship was indicated between self-efficacy and the levels of professional and personal involvement in political activities.Implications: Health policies affect nurses and their practice. Overcoming the barriers and enhancing the levels of head nurses' knowledge and competence regarding health policies can help activating their roles in health policy development process. This will help in activating nurses' role in health policy development, which in turn will have a positive impact on health outcomes.

Global value chains, import orientation, and the state: South Africa\u2019s pharmaceutical industry

As opposed to the predominant focus of global value chain (GVC) research on export-oriented contexts, this article examines the prospects for development in places where the dominant form of engagement with GVCs is import-oriented. Through the case of South Africa’s pharmaceutical industry, this analysis demonstrates the challenge for local manufacturing to compete, and the associated state policy responses, in a place which is largely plugged into GVCs as an end market rather than as a production location. As multinationals have concentrated production elsewhere, South Africa’s manufacturing capacity in the pharmaceutical industry has relatively declined in recent decades. Having struggled in its facilitator role, the South African state’s efforts to promote local manufacturing have turned to the producer role through a state-owned company and especially the buyer role through public procurement. Motivations for state policy in this context, however, must navigate the tension which sometimes exists between the industrial interest in local manufacturing and the consumer and health policy interest in access to medicines. The experience of South Africa’s pharmaceutical industry points to the wider challenge and consequences of import-oriented engagement with GVCs for local industrial development.

Health Policy Immersion Experience of Doctoral Nursing Students: A Phenomenological Study

Background: In today’s political environment, there is a significant need for healthcare professionals to be aware of health policy and its impact on practice and the population. Nursing, a respected and trusted profession, has a responsibility to increase its awareness and advocacy efforts to ensure practice and execution of responsible and ethical health policy. Objectives: The purpose of this study was to describe the lived experience of doctoral nursing students' (PhD and DNP) engagement in a week-long immersion trip to Washington, D.C. as a requirement of their mandatory health policy course. This immersion trip encompassed participation in numerous activities that focused on health policy, nursing's role in research, and its presence in the political arena. In addition to describing doctoral nursing students' lived experience, the researchers sought to discover how this experience impacts doctorally-prepared nurses’ political awareness and future interest in health policy. Methods: Data were gathered using Google Forms to obtain doctoral nursing students’ experiences after participating in a week-long Washington, D.C. immersion as part of their mandatory doctoral coursework at a Mid-Atlantic college in the United States. The survey was emailed to 43 PhD and DNP students, of which 30 met the inclusion criteria. Demographic data analysis, in addition to thematic analysis of survey responses with the aid of NVivo, were performed. Results: Four themes emerged from the analysis to describe the experience and impact that the week-long Washington, D.C. immersion had on doctoral nursing students: Knowledge and Understanding of the Political Process, Recognition of the Role Professional Nursing Organizations Play in the Political Arena, Empowerment Through Increased Awareness, and Nursing’s Role as an Advocate for the People Conclusion: Through increased knowledge and awareness of health policy, doctorally-prepared nurses may be more inclined to seek and engage in the political arena and actively participate in advocacy efforts to improve health policy and the healthcare system. Keywords: advocacy, doctoral nursing students, health policy, healthcare system, political process

Grounded Theory as an Analytical Tool to Explore Housing Decisions Related to Living in the Vicinity of Industrial Wind Turbines

Background: Some people living near wind turbines have reported adverse health effects and taken the step to vacate/abandon their homes, while others contemplate doing so or have decided to remain in their homes. Research on the extent and outcomes of these events is lacking. To date, our preliminary findings and an overview of results have been published in the scientific literature. Methods: This study utilized a qualitative methodology, specifically Grounded Theory, to interview 67 residents of Ontario living within 10 km of an industrial wind turbine project. Objectives: Quantitative, qualitative and mixed methods research each has strengths and weaknesses in addressing particular research questions. The purpose of this article is to compare the qualitative and quantitative methodologies and to describe the benefits of having used a qualitative methodology, specifically Grounded Theory, to explore the events that influenced families living within 10 km of wind energy facilities to contemplate vacating their homes and to formulate a substantive theory regarding these housing decisions. Results: It was found that research into the impacts of siting industrial wind turbines in a rural residential population can be challenging for a quantitative methodological approach due to factors such as low population density, obtaining a sufficient sample, and achieving statistical power and statistical significance. We conclude that the Grounded Theory methodology was applicable to this study as it assisted with the development of a coherent theory which explained participants’ housing decisions. Discussion: This paper assesses the appropriateness of a qualitative methodology for conducting the vacated/abandoned home study. Through the utilization of the qualitative Grounded Theory methodology, government authorities, researchers, medical and health practitioners, social scientists and policy makers with an interest in health policy and disease prevention have the opportunity to gain an awareness of the potential risk of placing wind energy projects near family homes.

Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study

Mental health and well-being are of great interest in health policy and research. Longitudinal surveys are needed to provide solid population-based data. We describe the design and methods of an 11-year follow-up of the German BELLA study in children, adolescents and young adults, and we report on age- and gender-specific courses of general health and well-being, long-term health-related outcomes of mental health problems, and mental health care use. The BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Standardised measures were used at each of the five measurement points of the BELLA study. In the 11-year follow-up, young people aged 7–31 years participated (n = 3492). Individual growth modelling, linear regression and descriptive analyses were conducted. Self-reported general health and well-being were both better in younger (vs. older) and in male (vs. female) participants according to the data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) predicted impaired health outcomes at 6-year and 11-year follow-ups. Approximately one out of four children with a diagnosed mental disorder was not undergoing mental health treatment. With its 11-year follow-up, the prospective longitudinal BELLA study provides new and solid data on mental health and well-being from childhood to adulthood in Germany, and these data are important for health promotion and prevention practices. These results are consistent with previous findings. Promising future analyses are planned.

A Magyar Orvosi Kamara, mint első polgári mozgalom újraalakításának szubjektív története. Az újkori orvostörténelem egyik nagy eseménye

“General of Hungarian Medical Chamber (MOK), recalled my memory, about the history, purpose and goals of the MOK.” Re-founded in 1988, the MOK has previously been prohibited for decades since it ceased to exist after the World War 2, because 1945 it was deemed a fascist corporation. In its newly founded structure between 1988 and 1989, the MOK became soon the body for representing ethical, professional, social and health policy interests of medical doctors. Efforts of the MOK re-foundation turned out as a historical victory of the medical doctors’ community during the political changes of the socio-economic system in Hungary.

The Key to Safety: Inspire, Innovate, and Influence

The Key to Safety: Inspire, Innovate, and Influence

Deliberative Dialogues Between Policy Makers and Researchers in Canada and Australia

Knowledge translation (KT) and implementation science are growing fields in Canada, Australia, and worldwide. Many audiences are targeted as KT knowledge users—policy makers represent one key knowledge user in the health care field. The need for policy makers to understand research and for researchers to understand policy processes is commonly recognized. There is also increasing interest in health policy that focuses on KT as a framework for understanding the use of evidence and, in particular, describing the influence of research on policy along with concepts of coproduction and user involvement. With relationship building central to successful evidence-informed policy, this article explores deliberative dialogue as a potential approach to enhancing KT. It describes two examples of researcher efforts to cultivate relationships and contacts with policy and decision makers via such dialogues and illustrates the inherent opportunities and challenges of doing so.

Distribution of High-Volume Shoulder Arthroplasty Surgeons in the United States: Data from the 2014 Medicare Provider Utilization and Payment Data Release.

Access to total shoulder arthroplasty (TSA) may become a concern in the United States because of an aging and active population resulting in increased demand. As high-volume TSA surgeons have demonstrated superior outcomes, access to these surgeons is a matter of patient and public health policy interest. The release of the 2012 Medicare Provider Utilization and Payment Data Public Use File (MPUPD-PUF) in 2014 provided volume and reimbursement data for procedures performed by individual physicians participating in Medicare. This study analyzed surgeon prevalence, surgeon distribution, and factors associated with higher or lower surgeon prevalence in metropolitan areas. The MPUPD-PUF was reviewed for the 2012 calendar year, and data were extracted for all physicians who performed a minimum of 11 TSA procedures for Medicare beneficiaries. Physicians in each major metropolitan area (population of >1 million) were grouped together. Average reimbursement, number of high-volume TSA surgeons, and number of total procedures were calculated per major metropolitan area. The presence of an American Shoulder and Elbow Surgeons (ASES) fellowship program and mean geographic reimbursement were analyzed for association with the number of high-volume TSA surgeons. The MPUPD-PUF included 774 surgeons across the United States who performed an annual minimum of 11 TSA procedures covered by Medicare, with a combined total of 19,505 TSA procedures. Of these surgeons, 45% practiced within major metropolitan areas with a population of >1 million. Surgeons who had completed an ASES fellowship had a higher volume of procedural claims (median, 26; range, 11 to 120) compared with other surgeons (median, 17; range, 11 to 163; p < 0.001). The distribution among major metropolitan areas was highly unequal, and more surgeons were present in cities with an ASES fellowship program. Access to high-volume shoulder arthroplasty surgeons by the Medicare population is lacking in multiple major metropolitan areas in the United States because of the uneven distribution of these surgeons. The method of analysis in this study allows for opportunities to target training programs as well as placement of physicians to ensure access to high-volume shoulder arthroplasty surgeons.

Right Here Right Now: Developing an understanding of responses to smoking policy developments using online data collection in near to real time

Right Here Right Now: Developing an understanding of responses to smoking policy developments using online data collection in near to real time

Gambling with interests.

Gambling with interests.

Burwell v. Hobby Lobby Stores, Inc

STUDY OBJECTIVE: To survey obstetrics and gynecology residents' knowledge of and interest in the Supreme Court of the United States' decision regarding Burwell v. Hobby Lobby Stores, Inc., along with their general interest in health policy. METHODS: Identical, anonymous surveys were administered to 15 obstetrics and gynecology residents following the Burwell v. Hobby Lobby Stores, Inc. decision. RESULTS: A total of 15 obstetrics and gynecology residents were surveyed. Although 100% heard of Burwell v. Hobby Lobby Stores, Inc., less than half felt comfortable discussing the case in lay terms. Among those surveyed, 73% had actively sought to learn more about the case and answered correctly regarding the forum and basic premise of the case. All residents surveyed believe that physicians should be involved in politics and that health policy should be a part of resident education. All residents also expressed some desire for personal future involvement in healthy policy. Approximately half currently follow policy related media, and 93% were interested in a resident-generated women's reproductive health policy email. CONCLUSION: Residents demonstrated strong awareness regarding Burwell v. Hobby Lobby Stores, Inc., however had gaps in knowledge and were less confident in their ability to discuss the case, even in lay terms. They showed strong agreement that physicians have a role in health policy and that residency training should include health policy education. Residency is an opportune time to foster policy interests in trainees and thereby bolster the presence of obstetrics and gynecology physicians in women's health policy decisions.

John Yudkin: a global health fanatic

John Yudkin: a global health fanatic

Task-Shifting From Physicians to Nurses in Primary Care and its Impact on Resource Utilization

Task-shifting from physicians to nurses has gained increasing interest in health policy but little is known about its efficiency. This systematic review was conducted to compare resource utilization with task-shifting from physicians to nurses in primary care. Literature searches yielded 4,589 citations. Twenty studies comprising 13,171 participants met the inclusion criteria. Meta-analyses showed nurses had more return consultations and longer consultations than physicians but were similar in their use of referrals, prescriptions, or investigations. The evidence has limitations, but suggests that the effects may be influenced by the utilization of resources, context of care, available guidance, and supervision. Cost data suggest physician-nurse salary and physician's time spent on supervision and delegation are important components of nurse-led care costs. More rigorous research involving a wider range of nurses from many countries is needed reporting detailed accounts of nurses' roles and competencies, qualifications, training, resources, time available for consultations, and all-cause costs.

Bringing Specialties Together: The Power of Intra-Professional Teams.

Bringing Specialties Together: The Power of Intra-Professional Teams.