Policy-practice gaps

  • 文章类型: Journal Article
    目的:结直肠癌(CRC)是全球最常见的三种癌症,在乳腺癌和肺癌之后,估计每年有200万新病例,占全球所有癌症的百分之十。CRC具有与多种营养相关危险因素相关的复杂病因。癌症幸存者经常报告他们的饮食习惯和营养摄入量发生了变化,对健康相关生活质量(QOL)有相关不利影响。虽然营养相关因素被认为是幸存者的优先事项,并嵌入在幸存者护理政策中,饮食支持通常不是实践中的护理标准。
    结果:在本评论中,我们详细介绍了CRC幸存者在营养护理领域的关键政策-实践差距,我们在文献中看到,在医院里,社区和私人执业。
    结论:由于这些营养问题会对生活质量、发病率和死亡率产生不利影响,我们希望提高对这些问题的认识,为今后在这一领域的工作奠定基础,以便政策制定者和临床医生可以改善对CRC幸存者及其家人的支持和结果。
    OBJECTIVE: Colorectal cancer (CRC) is among the three most commonly diagnosed cancers globally, after breast and lung cancer, with an estimated 2 million new cases each year, comprising ten per cent of all cancers worldwide. CRC has a complex aetiology associated with several nutrition-related risk factors. Cancer survivors frequently report alterations to their dietary habits and nutritional intake, with related adverse impacts on health-related quality of life (QOL). Whilst nutrition-related factors are recognised as survivor priorities and embedded in survivor care policies, dietary support is frequently not the standard of care in practice.
    RESULTS: In this Commentary, we present details of a critical policy-practice gap for CRC survivors across the spectrum of nutrition care that we have seen growing in the literature, in hospitals, community and private practice.
    CONCLUSIONS: As these nutrition concerns can adversely impact QOL and morbidity and mortality risks, we hope to raise awareness of these issues to provide a basis of future work in this area, so that policymakers and clinicians can improve support and outcomes for CRC survivors and their families.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:世界范围内,全民健康覆盖(UHC)热情与日俱增。南非政府于2012年开始试行旨在实现UHC的政策。这些全民健康覆盖政策已经并正在十个选定的试点地区推出。我们的研究探索了参与UHC政策实施的71个参与者的政策实施经验,在一个使用上下文交互理论(CIT)镜头的南非试点地区。
    方法:我们的研究应用了双演员演绎实现理论,上下文互动理论(CIT)分析了来自南非一个国家健康保险(NHI)试点区的71个关键线人访谈。该理论使用动机,信息,电源,资源和这些资源之间的相互作用来解释实施经验和成果。研究问题集中在CIT原则在解释参与者观察到的实施经验和结果方面的效用,特别是政策-实践差距。
    结果:AllCIT中心原则(信息,动机,电源,资源和互动)是行为者在其政策实施经验中提到的,这些原则的缺乏或存在被解释为政策执行的促进者或障碍。人们发现该理论对于解释决策者和促进者的政策实施经验非常有用。
    结论:在这种情况下存在但未被CIT完全捕获的核心原则是领导力。领导互动被揭示为政策实施的关键,因此,我们建议将领导力互动纳入当前的CIT中心原则,成为动力,信息,电源,资源,所有这些的领导和互动。
    BACKGROUND: World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens.
    METHODS: Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps.
    RESULTS: All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators.
    CONCLUSIONS: A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    Childhood tuberculosis (TB) has been underreported and underrepresented in TB statistics across the globe. Contributing factors include health system barriers, diagnostic barriers, and community barriers leading to an underdetected epidemic of childhood tuberculosis. Despite considerable progress in childhood TB management, there is a concerning gap in policy and practice in high-burden countries leading to missed opportunities for active case detection, early diagnosis and treatment of TB exposure, and infection and disease in children regardless of human immunodeficiency virus status. Bridging this gap requires multisectoral coordination and political commitment along with an eye to research and innovation with potential to scale.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号