Keeping score, strengthening policy and fighting bad actors over access to research tools.
Ontology highlight
ABSTRACT:
SUBMITTER: Bubela T
PROVIDER: S-EPMC4332873 | biostudies-literature | 2015 Feb
REPOSITORIES: biostudies-literature
Publications
Keeping score, strengthening policy and fighting bad actors over access to research tools.
Bubela Tania T Cook-Deegan Robert R
Nature biotechnology 20150201 2
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Project description:The U.S. federal government is spending billions of dollars to test a multitude of new approaches to pay for healthcare. Unintended consequences are a major consideration in the testing of these value-based payment (VBP) models. Since participation is generally voluntary, any unintended consequences may be magnified as VBP models move beyond the early testing phase. In this paper, we propose a straightforward unsupervised outlier detection approach based on ranked percentage changes to identify participants (e.g., healthcare providers) whose behavior may represent an unintended consequence of a VBP model. The only data requirements are repeated measurements of at least one relevant variable over time. The approach is generalizable to all types of VBP models and participants and can be used to address undesired behavior early in the model and ultimately help avoid undesired behavior in scaled-up programs. We describe our approach, demonstrate how it can be applied with hypothetical data, and simulate how efficiently it detects participants who are truly bad actors. In our hypothetical case study, the approach correctly identifies a bad actor in the first period in 86% of simulations and by the second period in 96% of simulations. The trade-off is that 9% of honest participants are mistakenly identified as bad actors by the second period. We suggest several ways for researchers to mitigate the rate or consequences of these false positives. Researchers and policymakers can customize and use our approach to appropriately guard VBP models against undesired behavior, even if only by one participant.Supplementary informationThe online version contains supplementary material available at 10.1007/s10742-021-00253-9.
| S-EPMC8237252 | biostudies-literature
Project description:There is limited research focused explicitly on understanding how commercial actors use different forms of power to influence policy decision making in Thailand. This study aimed to identify how the food industry has used structural, instrumental and discursive power to influence policy on restricting food marketing in Thailand. Qualitative study using in-depth semistructured interviews SETTINGS: Thailand. The interviews were conducted with 20 participants (of a total of 29 invited actors) from government, civil society, technical experts, international organisation and the food and advertising industry. Interview data were identified in the transcripts and analysed using abductive methods. Non-commercial actors perceived the commercial actors' structural power (its economic influence and structurally privileged position) as central to understanding the government having not implemented policy to restrict food marketing. The commercial actors' instrumental power was observed through sponsorship, campaign and lobbying activities. Discursive power was used by the industry to shift responsibility away from the food companies and onto their customers, by focusing their messaging on freedom of consumer choice and consumer health literacy. This study examined different types of power that commercial actors were perceived to use to influence policy to restrict food marketing in Thailand. The study showed arguments and institutional processes used to enhance commercial actors' ability to shape the policy decision for nutrition, public opinion and the broader regulatory environment. The findings help governments and other stakeholders to anticipate industry efforts to counter policy. The findings also suggest the need for governance structures that counter industry power, including comprehensive monitoring and enforcement in policy implementation.
| S-EPMC9562312 | biostudies-literature
Project description: Not available
| S-EPMC1808281 | biostudies-literature
Project description:Studies on intraspecific contest behavior predominantly focus on contests between individuals of the same sex, however contest behavior is also expected to occur between individuals of the opposite sex including possible mates. Here we investigate potential trade-offs between mating and fighting behavior in the turnip sawfly (Athalia rosae). Adults of this species collect chemical defense compounds (clerodanoids) directly from plants but also indirectly by nibbling on conspecifics that have already obtained clerodanoids, a highly aggressive behavioral interaction. An A. rosae individual without clerodanoids may therefore be the potential mate or attacker of an individual of the opposite sex that has gained clerodanoids. To test the effect of clerodanoids on agonistic and mating behavior we paired females and males with or without clerodanoid access in a two-way factorial design. We show that asymmetrical clerodanoid acquisition between female-male pairs causes an increase in agonistic nibbling behavior, irrespective of sex, and moreover that conflict between individuals delays mating behavior. Our study highlights the importance of investigating agonistic intersex interactions, which can occur when adults are able to acquire valuable non-reproductive resources from a potential partner.
| S-EPMC9015217 | biostudies-literature
Project description: Not available
| S-EPMC2667637 | biostudies-literature
Project description:IntroductionThis study examined the extent to which industry and non-industry actors draw from the same (vs. different) bodies of peer-reviewed evidence in submissions to alcohol advertising policy consultations.MethodsSubmissions (n = 71) to two Australian public consultations about alcohol advertising policy were classified as submitted by industry or non-industry actors. Details of cited journal articles were extracted. Articles were coded according to whether: (i) cited in industry and/or non-industry actor submission/s; (ii) findings were supported or contested by the submitter; and (iii) the article was a systematic review. The most frequently cited first authors were identified.ResultsIn total, 126 articles were cited in 45 industry actor submissions and 159 articles were cited in 26 non-industry actor submissions. Only seven articles were cited by both groups. Authors cited most frequently by one actor group were rarely cited by the other group. The first author most cited by industry actors declared alcohol industry links in two articles. Industry actors cited three systematic reviews (and contested the findings); non-industry actors cited (and supported) seven systematic reviews.Discussion and conclusionThere was a low degree of overlap in peer-reviewed evidence cited by industry and non-industry actors in submissions to Australian alcohol advertising policy consultations. Industry actors often omitted or contested high-quality evidence. Industry actors placed greater emphasis on evidence published by one industry-linked researcher than on evidence from systematic reviews and researchers with no apparent conflicts of interest. The findings raise questions about the suitability of industry actors to participate in evidence-informed policymaking processes.
| S-EPMC9543483 | biostudies-literature
Project description:In April 2008, the National Institutes of Health (NIH) implemented the Public Access Policy (PAP), which mandated that the full text of NIH-supported articles be made freely available on PubMed Central - the NIH's repository of biomedical research. This paper uses 600,000 NIH articles and a matched comparison sample to examine how the PAP impacted researcher access to the biomedical literature and publishing patterns in biomedicine. Though some estimates allow for large citation increases after the PAP, the most credible estimates suggest that the PAP had a relatively modest effect on citations, which is consistent with most researchers having widespread access to the biomedical literature prior to the PAP, leaving little room to increase access. I also find that NIH articles are more likely to be published in traditional subscription-based journals (as opposed to 'open access' journals) after the PAP. This indicates that any discrimination the PAP induced, by subscription-based journals against NIH articles, was offset by other factors - possibly the decisions of editors and submission behaviour of authors.
| S-EPMC7802638 | biostudies-literature
Project description:BackgroundUganda faces a complex policy landscape as it simultaneously addresses infectious diseases and noncommunicable diseases (NCDs). The health system has been overwhelmed by the growing burden of NCDs across all socioeconomic strata. In this study, we sought to understand the policy context around NCDs in Uganda, the roles of actors both within and external to the government, and the factors shaping the development and implementation of NCD policies and programs in Uganda.MethodsWe conducted in-depth interviews with 30 policy actors from the Ugandan Ministry of Health (MOH), nongovernmental organizations, and academia to understand the roles of different actors in the Ugandan NCD space, the programs and policy measures in discussion, and how to bridge any identified gaps. A thematic data analysis was conducted.ResultsAll national actors viewed funding constraints as a critical barrier to developing and executing an NCD strategic plan and as a barrier to leading and coordinating NCD prevention and control efforts in Uganda. The crowding of nongovernment actors was found to fragment NCD efforts, particularly due to the weak implementation of a framework for action among NCD actors. Relatedly, limited recruitment of technical experts on NCDs within the MOH was viewed to further diminish the government's role in leading policy and program formulation and implementation. Though recent MOH efforts have aimed at addressing these concerns, some skepticism remains about the government's commitment to increase budgetary allocations for NCDs and to address the technical and human resources gaps needed to achieve NCD policy aims in Uganda.ConclusionsThis study highlights the immediate need to mobilize more resources, reduce fragmented efforts in the NCD space, and prioritize investment in NCD prevention and management in Uganda.
| S-EPMC8087435 | biostudies-literature
Project description:BackgroundThe institutionalization of evidence-informed health policy-making (EIHP) is complex and complicated. It is complex because it has many players and is complicated because its institutionalization will require many changes that will be challenging to make. Like many other issues, strengthening EIHP needs a road map, which should consider challenges and address them through effective, harmonized and contextualized strategies. This study aims to develop a road map for enhancing EIHP in Iran based on steps of planning.MethodsThis study consisted of three phases: (1) identifying barriers to EIHP, (2) recognizing interventions and (3) measuring the use of evidence in Iran's health policy-making. A set of activities was established for conducting these, including foresight, systematic review and policy dialogue, to identify the current and potential barriers for the first phase. For the second phase, an evidence synthesis was performed through a scoping review, by searching the websites of benchmark institutions which had good examples of EIHP practices in order to extract and identify interventions, and through eight policy dialogues and two broad opinion polls to contextualize the list of interventions. Simultaneously, two qualitative-quantitative studies were conducted to design and use a tool for assessing EIHP in the third phase.ResultsWe identified 97 barriers to EIHP and categorized them into three groups, including 35 barriers on the "generation of evidence" (push side), 41 on the "use of evidence" (pull side) and 21 on the "interaction between these two" (exchange side). The list of 41 interventions identified through evidence synthesis and eight policy dialogues was reduced to 32 interventions after two expert opinion polling rounds. These interventions were classified into four main strategies for strengthening (1) the education and training system (6 interventions), (2) the incentives programmes (7 interventions), (3) the structure of policy support organizations (4 interventions) and (4) the enabling processes to support EIHP (15 interventions).ConclusionThe policy options developed in the study provide a comprehensive framework to chart a path for strengthening the country's EIHP considering both global practices and the context of Iran. It is recommended that operational plans be prepared for road map interventions, and the necessary resources provided for their implementation. The implementation of the road map will require attention to the principles of good governance, with a focus on transparency and accountability. Video abstract.
| S-EPMC8760808 | biostudies-literature
Project description:ObjectiveAs a heavily populated megacity, Shanghai faces major epidemic risks. However, Shanghai's control of COVID-19 has been successful owing to both the strict government policy and wide community participation. Here, we investigated the impact of these stakeholders and examined who played a major role across different epidemic stages.DesignWe extended the classic susceptible-exposed-infectious-recovered (SEIR) model considering the heterogeneous contact structure in four social sceneries, i.e., school, workplace, public entertainment venues, and neighborhood community, which could reflect the impact of lockdown policy and wide participation of residents happened at the community level.ResultThe simulation results showed that without lockdown policy and only with community participation, the daily new confirmed cases would gradually increase to more than 7,000 [292/1,000,000] at the end of Sep. However, without community participation and only with a lockdown policy, the daily new confirmed cases sharply decreased to 30 [1.2/1,000,000] at the end of the 1st month and remained low for several months. However, when a lockdown policy was gradually lifted, the new confirmed cases increased exponentially, eventually reaching more than 17,000 [708/1,000,000]. Therefore, a government lockdown policy was necessary for the rapid control of COVID-19 during the outbreak stage while community participation is more important in keeping the number of new confirmed cases low during the reopening stage.ConclusionGovernment lockdown policy and community participation play different roles in the control of COVID-19 at different stages of the epidemic: although the government played a leading role in setting up policies, the broader participation of community fever clinics (CFCs) and the general public were especially crucial in winning the battle against COVID-19 in the long run.
| S-EPMC9315311 | biostudies-literature