Human Dimensions of the Ecosystem Approach to Fisheries: An Overview of Context, Concepts, Tools and Methods

This document aims to provide a better understanding of the role of the economic, institutional and sociocultural components within the ecosystem approach to fisheries (EAF) process and to examine some potential methods and approaches that may facilitate the adoption of EAF management. It explores both the human context for the ecosystem approach to fisheries and the human dimensions involved in implementing the EAF. For the former, the report provides background material essential to understand prior to embarking on EAF initiatives, including an understanding of key concepts and issues, of the valuation of aquatic ecosystems socially, culturally and economically, and of the many policy, legal, institutional, social and economic considerations relevant to the EAF. With respect to facilitating EAF implementation, the report deals with a series of specific aspects: (1) determining the boundaries, scale and scope of the EAF; (2) assessing the various benefits and costs involved, seen from social, economic, ecological and management perspectives; (3) utilizing appropriate decision-making tools in EAF; (4) creating and/or adopting internal incentives and institutional arrangements to promote, facilitate and fund the adoption of EAF management; and (5) finding suitable external (non-fisheries) approaches for financing EAF implementation

What is eHealth?

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From efficacy to equity: Literature review of decision criteria for resource allocation and healthcare decisionmaking

Objectives Resource allocation is a challenging issue faced by health policy decisionmakers requiring careful consideration of many factors. Objectives of this study were to identify decision criteria and their frequency reported in the literature on healthcare decisionmaking. Method An extensive literature search was performed in Medline and EMBASE to identify articles reporting healthcare decision criteria. Studies conducted with decisionmakers (e.g., focus groups, surveys, interviews), conceptual and review articles and articles describing multicriteria tools were included. Criteria were extracted, organized using a classification system derived from the EVIDEM framework and applying multicriteria decision analysis (MCDA) principles, and the frequency of their occurrence was measured. Results Out of 3146 records identified, 2790 were excluded. Out of 356 articles assessed for eligibility, 40 studies included. Criteria were identified from studies performed in several regions of the world involving decisionmakers at micro, meso and macro levels of decision and from studies reporting on multicriteria tools. Large variations in terminology used to define criteria were observed and 360 different terms were identified. These were assigned to 58 criteria which were classified in 9 different categories including: health outcomes; types of benefit; disease impact; therapeutic context; economic impact; quality of evidence; implementation complexity; priority, fairness and ethics; and overall context. The most frequently mentioned criteria were: equity/fairness (32 times), efficacy/effectiveness (29), stakeholder interests and pressures (28), cost-effectiveness (23), strength of evidence (20), safety (19), mission and mandate of health system (19), organizational requirements and capacity (17), patient-reported outcomes (17) and need (16). Conclusion This study highlights the importance of considering both normative and feasibility criteria for fair allocation of resources and optimized decisionmaking for coverage and use of healthcare interventions. This analysis provides a foundation to develop a questionnaire for an international survey of decisionmakers on criteria and their relative importance. The ultimate objective is to develop sound multicriteria approaches to enlighten healthcare decisionmaking and priority-settin

Applications of lean thinking: a briefing document

This report has been put together by the Health and Care Infrastructure Research and Innovation Centre (HaCIRIC) at the University of Salford for the Department of Health. The need for the report grew out of two main simple questions, o Is Lean applicable in sectors other than manufacturing? o Can the service delivery sector learn from the success of lean in manufacturing and realise the benefits of its implementation?The aim of the report is to list together examples of lean thinking as it is evidenced in the public and private service sector. Following a review of various sources a catalogue of evidence is put together in an organised manner which demonstrates that Lean principles and techniques, when applied rigorously and throughout an entire organization/unit, they can have a positive impact on productivity, cost, quality, and timely delivery of services

Lean Thinking: Theory, Application and Dissemination

This book was written and compiled by the University of Huddersfield to share the learnings and experiences of seven years of Knowledge Transfer Partnership (KTP) and Economic and Social Research Council (ESRC) funded projects with the National Health Service (NHS). The focus of these projects was the implementation of Lean thinking and optimising strategic decision making processes. Each of these projects led to major local improvements and this book explains how they were achieved and compiles the lessons learnt. The book is split into three chapters; Lean Thinking Theory, Lean Thinking Applied and Lean Thinking Dissemination

Using a ‘wellbeing’ cost-effectiveness approach to improve resource allocation in social care

The promotion of wellbeing is the newly-stated guiding principle for the long-term care (social care) system in England. It signals a shift away from a focus on care need ‘deficits’ approach. Such a change in perspective has the potential to substantially alter how public care systems operate. The practical challenges are significant, both in the interpretation of wellbeing goals and in determining how the care system might be configured to achieve them. The main aim of this paper is to contrast a needs-led resource allocation system with one using a maximising wellbeing approach; that is, one based on: measuring the wellbeing consequences of using services and applying the principles of cost-effectiveness and opportunity cost. As a precursor, the paper also describes how a maximising wellbeing approach might be applied in the case of long-term care. We argue that in theory a maximising wellbeing approach with full information will produce greater total wellbeing improvement for the same budget than a needs-based system. In practice, the comparison will depend on: (a) whether we can actually measure wellbeing in a way that is consistent with the policy goals; (b) the availability of cost-effectiveness information; and (c) the decision rules used to implement a maximising wellbeing approach

Best practice in undertaking and reporting health technology assessments : Working Group 4 report

[Executive Summary] The aim of Working Group 4 has been to develop and disseminate best practice in undertaking and reporting assessments, and to identify needs for methodologic development. Health technology assessment (HTA) is a multidisciplinary activity that systematically examines the technical performance, safety, clinical efficacy, and effectiveness, cost, costeffectiveness, organizational implications, social consequences, legal, and ethical considerations of the application of a health technology (18). HTA activity has been continuously increasing over the last few years. Numerous HTA agencies and other institutions (termed in this report “HTA doers”) across Europe are producing an important and growing amount of HTA information. The objectives of HTA vary considerably between HTA agencies and other actors, from a strictly political decision making–oriented approach regarding advice on market licensure, coverage in benefits catalogue, or investment planning to information directed to providers or to the public. Although there seems to be broad agreement on the general elements that belong to the HTA process, and although HTA doers in Europe use similar principles (41), this is often difficult to see because of differences in language and terminology. In addition, the reporting of the findings from the assessments differs considerably. This reduces comparability and makes it difficult for those undertaking HTA assessments to integrate previous findings from other HTA doers in a subsequent evaluation of the same technology. Transparent and clear reporting is an important step toward disseminating the findings of a HTA; thus, standards that ensure high quality reporting may contribute to a wider dissemination of results. The EUR-ASSESS methodologic subgroup already proposed a framework for conducting and reporting HTA (18), which served as the basis for the current working group. New developments in the last 5 years necessitate revisiting that framework and providing a solid structure for future updates. Giving due attention to these methodologic developments, this report describes the current “best practice” in both undertaking and reporting HTA and identifies the needs for methodologic development. It concludes with specific recommendations and tools for implementing them, e.g., by providing the structure for English-language scientific summary reports and a checklist to assess the methodologic and reporting quality of HTA reports

Describing the impact of health research: a Research Impact Framework.

BACKGROUND: Researchers are increasingly required to describe the impact of their work, e.g. in grant proposals, project reports, press releases and research assessment exercises. Specialised impact assessment studies can be difficult to replicate and may require resources and skills not available to individual researchers. Researchers are often hard-pressed to identify and describe research impacts and ad hoc accounts do not facilitate comparison across time or projects. METHODS: The Research Impact Framework was developed by identifying potential areas of health research impact from the research impact assessment literature and based on research assessment criteria, for example, as set out by the UK Research Assessment Exercise panels. A prototype of the framework was used to guide an analysis of the impact of selected research projects at the London School of Hygiene and Tropical Medicine. Additional areas of impact were identified in the process and researchers also provided feedback on which descriptive categories they thought were useful and valid vis-à-vis the nature and impact of their work. RESULTS: We identified four broad areas of impact: I. Research-related impacts; II. Policy impacts; III. Service impacts: health and intersectoral and IV. Societal impacts. Within each of these areas, further descriptive categories were identified. For example, the nature of research impact on policy can be described using the following categorisation, put forward by Weiss: Instrumental use where research findings drive policy-making; Mobilisation of support where research provides support for policy proposals; Conceptual use where research influences the concepts and language of policy deliberations and Redefining/wider influence where research leads to rethinking and changing established practices and beliefs. CONCLUSION: Researchers, while initially sceptical, found that the Research Impact Framework provided prompts and descriptive categories that helped them systematically identify a range of specific and verifiable impacts related to their work (compared to ad hoc approaches they had previously used). The framework could also help researchers think through implementation strategies and identify unintended or harmful effects. The standardised structure of the framework facilitates comparison of research impacts across projects and time, which is useful from analytical, management and assessment perspectives

TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma

A Framework for Life Cycle Sustainability Assessment of Road Salt Used in Winter Maintenance Operations

It is important to assess from a holistic perspective the sustainability of road salt widely used in winter road maintenance (WRM) operations. The importance becomes increasingly apparent in light of competing priorities faced by roadway agencies, the need for collaborative decision-making, and growing concerns over the risks that road salt poses for motor vehicles, transportation infrastructure, and the natural environment. This project introduces the concept of Life Cycle Sustainability Assessment (LCSA), which combines Life Cycle Costing, Environmental Life Cycle Assessment, and Social Life Cycle Assessment. The combination captures the features of three pillars in sustainability: economic development, environmental preservation, and social progress. With this framework, it is possible to enable more informed and balanced decisions by considering the entire life cycle of road salt and accounting for the indirect impacts of applying road salt for snow and ice control. This project proposes a LCSA framework of road salt, which examines the three branches of LCSA, their relationships in the integrated framework, and the complexities and caveats in the LCSA. While this framework is a first step in the right direction, we envision that it will be improved and enriched by continued research and may serve as a template for the LCSA of other WRM products, technologies, and practices