1,721,378 research outputs found
Analysing coordination and coherence in non-communicable disease policies: governance challenges in tobacco control and nutrition in South East Asia
Full text linkBACKGROUND:
Alongside longstanding hurdles to promoting whole of government approaches to health policy, the commitment to ensuring policy coherence has emerged as one of the defining challenges of the UN Sustainable Development Goals. Coordination and coherence barriers are often experienced as particularly acute in the context of non-communicable diseases (NCDs), given both divergent approaches to regulation across NCD policy spheres and scope for tensions between health goals and key economic interests. This thesis seeks to address the dearth of substantive research examining such challenges across NCD risk factors and levels of governance. Barriers and facilitators for coordination and coherence in health governance are examined via case studies of the Conference of Parties (COP) of the Framework Convention on Tobacco Control (FCTC), focused on the World Health Organization South East Asia region (WHO SEARO), and of the Scaling Up Nutrition (SUN) initiative in Bangladesh.
METHODS:
Qualitative research involving two multi-level case studies — focusing on tobacco and nutrition governance respectively — was conducted in the context of WHO SEARO. Data collection involved semi-structured interviews — 22 in the tobacco case study and 26 for nutrition — of representatives from governmental, intergovernmental and non-governmental agencies, academia and private sector affiliates. Interview data were thematically analysed using an interpretative approach that involved interpreting policymaking as a social construct. Analysis of interview data was complemented by documentary review.
RESULTS:
In the tobacco case study, which focused on an initiative to enhance transparency of COP delegations, interview findings suggested that SEARO countries sought to use the COP as a platform to promote vertical coherence across national and international levels. However, identified barriers to developing coherence included weak health leadership, lack of financial resources and poor communication on FCTC commitments that impeded in-country coordination and participation in COPs. Tensions between diverse sectoral goals raised challenges for policy making, defining national priorities, and for advancing regional coordination. The competing priority norms of low-and middle-income countries and high-income ones pitting public health safeguards against public accountability measures also obstructed COP-wide coordination.
Some SEARO countries reported overcoming these hurdles by prioritising tobacco control and building safeguards against tobacco industry interference in national policy making alongside active health sector leadership, engagement of non-health sectors and setting up coordination systems for COP preparations. Networks of countries at regional and COP levels were seen to consolidate and facilitate development of a COP decision to enhance transparency of their delegations.
The nutrition case study explored mechanisms and programmes of the SUN initiative in Bangladesh that bring together government agencies, civil society, academia and the private sector to develop a multisectoral and multistakeholder approach to nutrition policies. SUN’s advocacy was reported to have increased awareness, stimulated nutrition-sensitive initiatives, raised the need for funding and promoted nutrition in the national development agenda.
The nutrition response in Bangladesh, however, was considered to be fragmented as exemplified in the case of food fortification initiatives, and strained with regard to the country’s response to a growing obesity burden on NCD prevention. Tensions in reconciling health and economic goals were seen as inhibiting the development of coherent nutrition policy. In this context, the analysis highlighted the significance of polarisation regarding SUN’s promotion of multistakeholderism. While its multistakeholder platform was widely perceived to facilitate coordination and resource mobilisation, some interviewees expressed apprehension about SUN influencing national nutrition and advancing the interests of donors and businesses. The involvement of food companies was similarly contested, with international partners with business links promoting industry engagement, and public officials and civil society from Bangladesh concerned about perceived conflicts of interest. Overall, interviewees considered SUN’s conflict of interest mechanisms inadequate to deal with the country’s vulnerabilities.
CONCLUSION:
Findings illustrate how efforts to promote policy coordination and coherence compare and contrast in two key global health governance platforms relevant to NCD prevention: the FCTC and SUN partnership. There are implications for coordination in terms of conflicts between sectoral goals, resource constraints, information gaps, tensions among stakeholders and commercial sector involvement for collaborative actions at regional and international levels. Findings also highlights the role of international norms and platforms in facilitating vertical coherence in global health governance. Coordination and coherence in health governance in low- and middle-income countries could be supported through enhanced resource allocation, improved sharing of information, frameworks to effectively address conflicts of interest and mechanisms for civil society contributions
Electronic cigarettes for smokers with schizophrenia spectrum disorders
Full text linkTobacco use is the greatest threat to public health worldwide, killing more than seven million people annually. Globally, people with schizophrenia smoke disproportionately more than the general population and those with other mental illnesses. Consequently, they carry the burden of smoking-attributable morbidity and premature mortality. The risk of serious disease diminishes rapidly after stopping smoking and life-long abstinence is known to reduce the risk of lung cancer, heart disease, stroke, chronic lung disease and other cancers.This research involved three novel contributions to the literature. First, a qualitative study was conducted with 30 current smokers with schizophrenia spectrum disorders, some motivated to stop smoking and others with no intention to quit. This study explored their views regarding traditional cigarettes compared with e-cigarettes and licensed cessation aids or e-cigarettes for smoking cessation or smoking reduction. In interviews, about half of participants (16 of 30) reported an interest in using e-cigarettes to quit or reduce smoking. Of these, four were from the less motivated group, suggesting that e-cigarettes may appeal to schizophrenic smokers not currently considering cessation.Secondly, a quantitative, prospective single-arm pilot study was conducted that investigated the role of e-cigarettes in smoking cessation or reduction for smokers with schizophrenia spectrum disorders. Forty smokers were recruited and 37 of these completed the study. Sixteen participants were CO verified as abstinent from smoking at the end of the study (40%) and 21 (52.5%) significantly reduced their cigarette consumption. The e-cigarette and study procedures were deemed feasible and acceptable to participants. Some adverse events were noted but were rare.
Finally, building on these earlier studies, a full protocol for a large multicenter randomised controlled study with long term follow-up was prepared. This protocol could guide the development of a research proposal for a future trial
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
“We need arts as much as we need food. Our responsibility is for that to be possible.” Insights from Scottish cultural leaders on the changing landscape of their work.
Full text linkThe analysis of cultural policy in the last decade suggests that creativity and the arts in general are extensively used in political agendas as means of capitalizing on the forecasted socio-economic potential of creative/artistic activities (e.g. Flew, 2005; Garnham, 2005; Hartley, 2005; Hesmondhalgh, 2007). Although some critical studies have highlighted instrumentalism, short-sidedness and practice/practitioners’ averse policy-making and intervention planning (Belfiore, 2004, 2009; Caust, 2003; Oakley, 2009; Newman, 2013), so far only very few studies have exposed the experiences and voices of particular groups of creative workers in the different national (country-specific) contexts to support this criticism. There has been a significant lack of studies that aim to understand how creative workers experience and cope with the changing policy context in their work. In particular, the voice of non-artists has rarely been considered when seeking a better understanding of the sector’s dynamics.
This thesis explored the Scottish cultural sector through the eyes of cultural leaders. The study was carried out during a time of significant transformation to the funding structure, processes and relationships in the sector, catalysed by the establishment of a new funding agency (the funder). It focuses on cultural leaders’ understandings of an increasingly politicised cultural landscape that constitutes the context of their work. The thesis also looks at the influence of these understandings on the leaders’ role responsibilities, as well as the essence and the sustainability of the cultural sector. The empirical work for the thesis followed a qualitative research approach and focused on 21 semi-structured interviews with cultural leaders and industry experts based in Scotland. These individuals were purposefully chosen as a group of stakeholders who are able to engage in discussions about the cultural sector in the context of recent changes in the governance and financial subsidy of Scottish (publically funded) arts.
The research findings illustrated the importance of leaders’ values and beliefs, which reflect the purpose of their work and shape their enactments in the sector. In particular, the intrinsic motivation, artistic ambitions, social and civic responsibilities of leaders emerged as crucial qualities of their work roles. The findings revealed a discrepancy between these artistic and civic concerns of cultural leaders and the socio-economic expectations of the funder, which contributed to a great deal of unproductive ('inorganic') tensions for which leaders had to find coping mechanisms. Bourdieu’s (1977, 1992) theoretical concepts were used as a starting point in understanding the cultural sector as a cultural field, and cultural leaders as actors enacting their work-related practices in the evolving socio-political and economic system of cultural production. However, upon further analysis of the data, the notions of a ‘worldview’ and ‘stewardship’ emerged and were used to better explain the greater complexity of work in today’s cultural sector. This thesis thus builds upon Bourdieu’s concept of ‘field’ and ‘artistic logic’ and explains the changing cultural sector as a holistic cultural field where cultural leaders enact their stewardship-like work responsibilities from within a strong and dynamic artistic worldview
Smoking cessation: a briefing for midwifery staff.
No full textSmoking in pregnancy poses significant health risks to the mother and to the baby. For the mother, smoking in pregnancy carries with it all the health risks associated with smoking but with some additional pregnancy-related health risks, including ectopic pregnancy, placenta praevia and pre-eclampsia; pregnant women are also at increased risk of deep vein thrombosis
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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