Successful Strategies for Implementation of a High School Standards-Based Integrated Mathematics Curriculum

ERIC Educational Resources Information Center

Brown, Linda

2012-01-01

Math achievement for students in the United States is not as high as in other countries. In response, one state implemented a new standards-based, integrated math curriculum that combines traditional high school math courses and emphasizes student centered instruction. The purpose of this study was to examine the implementation of a standards…

The factors affecting Nigeria's success toward implementation of global public health priorities.

PubMed

Echebiri, Vitalis C

2015-06-01

This paper examines the challenges facing the Nigerian government toward the implementation of global public health priories. The Nigerian government recognizes the need to implement these priorities by putting in place the necessary policy framework, but political instability, poor infrastructural development and inadequate funding have remained barriers toward the achievement of success in implementing these priorities. The rest of the paper elucidates the fact that despite leadership and influence from the World Health Organization and other United Nations agencies, and some responses from the Nigerian government, tackling these public health problems requires much more fundamental reform to primary health services and a reduction in poverty. Although the government has shown enough political will to tackle these problems, it is expected that a better result will be achieved through injecting more funds into the Nigerian health sector, and deploying astute health administrators to manage the sector rather than pure health professionals without managerial acumen. © The Author(s) 2014.

Coordinated Transformation among Community Colleges Lacking a State System

ERIC Educational Resources Information Center

Russell, James Thad

2016-01-01

Community colleges face many challenges in the face of demands for increased student success. Institutions continually seek scalable interventions and initiatives focused on improving student achievement. Effectively implementing sustainable change that moves the needle of student success remains elusive. Facilitating systemic, scalable change…

Four malaria success stories: how malaria burden was successfully reduced in Brazil, Eritrea, India, and Vietnam.

PubMed

Barat, Lawrence M

2006-01-01

While many countries struggle to control malaria, four countries, Brazil, Eritrea, India, and Vietnam, have successfully reduced malaria burden. To determine what led these countries to achieve impact, published and unpublished reports were reviewed and selected program and partner staff were interviewed to identify common factors that contributed to these successes. Common success factors included conducive country conditions, a targeted technical approach using a package of effective tools, data-driven decision-making, active leadership at all levels of government, involvement of communities, decentralized implementation and control of finances, skilled technical and managerial capacity at national and sub-national levels, hands-on technical and programmatic support from partner agencies, and sufficient and flexible financing. All these factors were essential in achieving success. If the goals of Roll Back Malaria are to be achieved, governments and their partners must take the lessons learned from these program successes and apply them in other affected countries.

Generation Z, Meet Cooperative Learning

ERIC Educational Resources Information Center

Igel, Charles; Urquhart, Vicki

2012-01-01

Today's Generation Z teens need to develop teamwork and social learning skills to be successful in the 21st century workplace. Teachers can help students develop these skills and enhance academic achievement by implementing cooperative learning strategies. Three key principles for successful cooperative learning are discussed. (Contains 1 figure.)

Total Quality Management (TQM). Implementers Workshop

DTIC Science & Technology

1990-05-15

SHEE’T :s t’ii ,rrl DEPARTMENT OF DEFENSE May 15, 1990 Lfl CN I TOTAL QUALITY MANAGEMENT (TQM) Implementers Workshop © Copyright 1990 Booz.Allen...must be continually performed in order to achieve successful TQM implementation. 1-5 = TOTAL QUALITY MANAGEMENT Implementers Workshop Course Content...information, please refer to the student manual, Total Quality Management (TOM) Awareness Seminar, that was provided for the Awareness Course. You may

The Balanced Reading Program: Helping All Students Achieve Success.

ERIC Educational Resources Information Center

Blair-Larsen, Susan M., Ed.; Williams, Kathryn A., Ed.

This book explains the methodologies, techniques, strategies, and knowledge base necessary to achieve a balanced reading program. The book's contributors define the key elements in a balanced reading program and provide guidelines for implementing a balanced instructional program in the classroom. Following an introduction which addresses…

A Knowledge Management Approach to Support Software Process Improvement Implementation Initiatives

NASA Astrophysics Data System (ADS)

Montoni, Mariano Angel; Cerdeiral, Cristina; Zanetti, David; Cavalcanti da Rocha, Ana Regina

The success of software process improvement (SPI) implementation initiatives depends fundamentally of the strategies adopted to support the execution of such initiatives. Therefore, it is essential to define adequate SPI implementation strategies aiming to facilitate the achievement of organizational business goals and to increase the benefits of process improvements. The objective of this work is to present an approach to support the execution of SPI implementation initiatives. We also describe a methodology applied to capture knowledge related to critical success factors that influence SPI initiatives. This knowledge was used to define effective SPI strategies aiming to increase the success of SPI initiatives coordinated by a specific SPI consultancy organization. This work also presents the functionalities of a set of tools integrated in a process-centered knowledge management environment, named CORE-KM, customized to support the presented approach.

National Aeronautics and Space Administration Marshall Space Flight Center Space Transportation Directorate Risk Management Implementation Program

NASA Technical Reports Server (NTRS)

Duarte, Luis Alberto; Kross, Denny (Technical Monitor)

2001-01-01

The US civil aerospace program has been a great contributor to the creation and implementation of techniques and methods to identify, analyze, and confront risk. NASA has accomplished mission success in many instances, but also has had many failures. Anomalies have kept the Agency from achieving success on other occasions, as well. While NASA has mastered ways to prevent risks, and to quickly and effectively react and recover from anomalies or failures, it was not until few years ago that a comprehensive Risk Management process started being implemented in some of its programs and projects. A Continuous Risk Management (CRM) cycle process was developed and has been promoted and used successfully in programs and projects across the Agency.

Achieving College Success: The Impact of the College Success/STEM Program on Students' Matriculation to and Persistence in College. Research Brief

ERIC Educational Resources Information Center

Lane, Brett; Souvanna, Phomdaen

2014-01-01

This College Success Research Brief is one of a series of briefs documenting the implementation and impact of Mass Insight's College Success/STEM program. The research briefs are intended to share key findings, highlight ongoing questions and lines of inquiry, and inform the thinking of practitioners and policymakers on how to scale up efforts to…

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

Implementation of School-Based Management in Indonesia. Monograph

ERIC Educational Resources Information Center

Vernez, Georges; Karam, Rita; Marshall, Jeffery H.

2012-01-01

This study provides a quantitative and qualitative status report on the implementation of school-based management (SBM) in Indonesia, identifies factors associated with the successful practices of SBM, and assesses SBM effects on student achievement eight years after its inception. The authors' findings are based on face-to-face surveys of…

Guiding principles for successful innovation in regional medical education development.

PubMed

Hays, Richard B

2006-01-01

This is an era of extraordinary expansion in medical education in both the developed and developing world. This article reflects on the author's experience in implementing new regional medical education programs, and distils ten principles to guide successful innovation once funding for such development has been achieved.

Perceptions about Implementation of Differentiated Instruction

ERIC Educational Resources Information Center

Robinson, Lora; Maldonado, Nancy; Whaley, Jerita

2014-01-01

The absence of differentiated instruction in many classrooms stifles success for students who do not learn the same way as their peers. Providing teachers with the knowledge and tools to differentiate in their classrooms may increase test scores and help low achieving students find success, while expanding the learning growth of gifted and…

Importance of relationship quality in the success of data warehouse systems

NASA Astrophysics Data System (ADS)

Almabhouh, Alaaeddin; Saleh, Abdul; Ahmad, Azizah

2011-10-01

Increased organizational dependence on data warehouse (DW) systems drives management attention towards improving DW systems success. However, the successful implementation rate of DW systems is low and many firms did not achieve intended goals. A recent studies show that improves and evaluates DW success is one of the top concerns facing IT/DW executives. Existing information system (IS) research has studied DW success more from information quality and system quality. Researchers argue in this study that we should also take the relationship quality, which has significant research and practical implications in that it connects to IS success directly. As our first attempt, this study, referring to both IS and marketing literature, examines how communication, coordination, cooperation, commitment, and trust can be achieved to some degrees by high quality relationships between DW parties.

The future of radiology augmented with Artificial Intelligence: A strategy for success.

PubMed

Liew, Charlene

2018-05-01

The rapid development of Artificial Intelligence/deep learning technology and its implementation into routine clinical imaging will cause a major transformation to the practice of radiology. Strategic positioning will ensure the successful transition of radiologists into their new roles as augmented clinicians. This paper describes an overall vision on how to achieve a smooth transition through the practice of augmented radiology where radiologists-in-the-loop ensure the safe implementation of Artificial Intelligence systems. Copyright © 2018 Elsevier B.V. All rights reserved.

Ethical budgets: a critical success factor in implementing new public management accountability in health care.

PubMed

Bosa, Iris M

2010-05-01

New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the critical role played by the novel concept of an 'ethical budget' in engaging the willing cooperation of the medical profession in implementing change. Utilizing a qualitative research design, with in-depth interviews with GPs, hospital doctors and managers, along with archival analysis, the present study finds that management accounting can be successfully implemented among medical professionals provided there is alignment between the management imperative and the ethical framework in which doctors practise their profession. The concept of an 'ethical budget' has been shown to be an innovative and effective tool in achieving this alignment.

Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

PubMed

Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

2015-07-01

Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

Increase Productivity with Volunteers.

ERIC Educational Resources Information Center

Gray, Sandra T.

1984-01-01

The advantages of volunteer programs including school business partnerships are described, among which are cutting costs, improving productivity, increasing student achievement, and expanding community support. Hints for successful implementation are offered. (MJL)

What determines successful implementation of inpatient information technology systems?

PubMed

Spetz, Joanne; Burgess, James F; Phibbs, Ciaran S

2012-03-01

To identify the factors and strategies that were associated with successful implementation of hospital-based information technology (IT) systems in US Department of Veterans Affairs (VA) hospitals, and how these might apply to other hospitals. Qualitative analysis of 118 interviews conducted at 7 VA hospitals. The study focused on the inpatient setting, where nurses are the main patient-care providers; thus, the research emphasized the impact of Computerized Patient Record System and Bar Code Medication Administration on nurses. Hospitals were selected to represent a range of IT implementation dates, facility sizes, and geography. The subjects included nurses, pharmacists, physicians, IT staff, and managers. Interviews were guided by a semi-structured interview protocol, and a thematic analysis was conducted, with initial codes drawn from the content of the interview guides. Additional themes were proposed as the coding was conducted. Five broad themes arose as factors which affected the process and success of implementation: (1) organizational stability and implementation team leadership, (2) implementation timelines, (3) equipment availability and reliability, (4) staff training, and (5) changes in work flow Overall IT implementation success in the VA depended on: (1) whether there was support for change from both leaders and staff, (2) development of a gradual and flexible implementation approach, (3) allocation of adequate resources for equipment and infrastructure, hands-on support, and deployment of additional staff, and (4) how the implementation team planned for setbacks, and continued the process to achieve success. Problems that developed in the early stages of implementation tended to become persistent, and poor implementation can lead to patient harm.

A model for successful use of student response systems.

PubMed

Klein, Kathleen; Kientz, Mary

2013-01-01

This article presents a model developed to assist teachers in selecting, implementing, and assessing student response system (SRS) use in the classroom. Research indicates that SRS technology is effective in achieving desired outcomes in higher education settings. Studies indicate that effective SRS use promotes greater achievement of learning outcomes, increased student attention, improved class participation, and active engagement. The model offered in this article is based on best practices described in the literature and several years of SRS use in a traditional higher education classroom setting. Student feedback indicates increased class participation and engagement with SRS technology. Teacher feedback indicates opportunities for contingent teaching. The model described in this article provides a process to assist teachers in the successful selection, implementation, and assessment of SRS technology in the classroom.

Implementing Evidence-Based Programs: Lessons Learned from the Field

ERIC Educational Resources Information Center

Powers, Jane; Maley, Mary; Purington, Amanda; Schantz, Karen; Dotterweich, Jutta

2015-01-01

Evidence-based programs (EBPs) are used in many health promotion efforts to ensure that the intended positive behavioral and health outcomes will be achieved. However, because EBPs are developed and tested in research settings, the contextual elements of real world implementation play an important role in their successful delivery in communities.…

Implementation of a Proficiency-Based Diploma System: Phase I--Early Experiences in Maine

ERIC Educational Resources Information Center

Stump, Erika K.; Silvernail, David L.

2014-01-01

Following the passage of No Child Left Behind, there has been increased attention among researchers, policymakers, and practitioners on the emergence and implementation of standards-based education. Existing literature documents both the promise of standards-based education and the various potential obstacles to achieving success that teachers,…

Implementing RTI in a High School: A Case Study

ERIC Educational Resources Information Center

Fisher, Douglas; Frey, Nancy

2013-01-01

This case study chronicles the efforts of a small high school over a 2-year period as it designed and implemented a response to intervention (RTI) program for students at the school. Their efforts were largely successful, with improved achievement, attendance, and grade point averages and a decrease in special education referrals. Major themes…

E-Learning Readiness in Public Secondary Schools in Kenya

ERIC Educational Resources Information Center

Ouma, Gordon O.; Awuor, Fredrick M.; Kyambo, Benjamin

2013-01-01

As e-learning becomes useful to learning institutions worldwide, an assessment of e-learning readiness is essential for the successful implementation of e-learning as a platform for learning. Success in e-learning can be achieved by understanding the level of readiness of e-learning environments. To facilitate schools in Kenya to implement…

Reconciling research and community priorities in participatory trials: application to Padres Informados/Jovenes Preparados.

PubMed

Allen, Michele L; Garcia-Huidobro, Diego; Bastian, Tiana; Hurtado, G Ali; Linares, Roxana; Svetaz, María Veronica

2017-06-01

Participatory research (PR) trials aim to achieve the dual, and at times competing, demands of producing an intervention and research process that address community perspectives and priorities, while establishing intervention effectiveness. To identify research and community priorities that must be reconciled in the areas of collaborative processes, study design and aim and study implementation quality in order to successfully conduct a participatory trial. We describe how this reconciliation was approached in the smoking prevention participatory trial Padres Informados/Jovenes Preparados (Informed Parents/Prepared Youth) and evaluate the success of our reconciled priorities. Data sources to evaluate success of the reconciliations included a survey of all partners regarding collaborative group processes, intervention participant recruitment and attendance and surveys of enrolled study participants assessing intervention outcomes. While we successfully achieved our reconciled collaborative processes and implementation quality goals, we did not achieve our reconciled goals in study aim and design. Due in part to the randomized wait-list control group design chosen in the reconciliation process, we were not able to demonstrate overall efficacy of the intervention or offer timely services to families in need of support. Achieving the goals of participatory trials is challenging but may yield community and research benefits. Innovative research designs are needed to better support the complex goals of participatory trials. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Causal-comparative study analyzing student success in hybrid anatomy and physiology courses

NASA Astrophysics Data System (ADS)

Levy, Jacqueline Anita

In the biological sciences, higher student success levels are achieved in traditionally formatted, face-to-face coursework than in hybrid courses. The methodologies used to combine hybrid and in-person elements to the course need to be applied to the biological sciences to emulate the success seen in the traditional courses since the number of hybrid course offerings at community colleges are rapidly increasing. Research has delineated that creating online collaborative communities and increasing student engagement all function to increase student successful outcomes. This causal-comparative study was conducted using student data from four sections of hybrid, introductory anatomy and physiology courses over the 2011 and 2012 calendar years. The study included two sources of data: unit exam scores and student surveys. Analysis of the unit exam scores determined that there were statistically significant differences in student success and achievement by the implementation of the following web-enhanced technologies: a) discussion boards, b) Breeze, and c) Wiki tools. In the scope of this study, student success and achievement was defined as a student earning a C (70%) or higher at the completion of the course. There were a total of 29 surveys conducted per each unit during the 2012 semesters that related to the web-enhanced technologies implemented into the course: Discussion boards, BreezeRTM, and Wiki tools. Demographic data was also compiled on all of the students enrolled in the classes during this study to demonstrate that there is no specified niche or trend seen in the students enrolling for this particular course. Unit 1 was used as a baseline to compare the students from the two years. It was determined that the students were not significantly different in aptitude levels at the beginning of the courses based on their Unit 1 exam scores. Inferential statistical analysis was done to examine student success and achievement using the following tools: t-test of independent means of the variables, mean, standard deviation, and magnitude of effect. The findings of this study indicate that the web-enhanced technology Wiki tools provided the largest increase in student success and achievement in the hybrid, introductory anatomy and physiology course. Descriptive analysis of the surveys revealed that more than a third of each class felt that the implemented web-enhanced technology functioned to increase collaboration amongst the students and helped to emulate a traditional, face-to-face formatted course. The study included four recommendations for practice and nine recommendations for further research. A couple of recommendations for practice included using a single web-enhanced technology for the duration of the semester and having instructors and students complete tutorial sessions for the chosen technology being implemented. Examples of recommendations for research include replicating this study at other institutions and comparing face-to-face, traditional classes to hybrid courses within the same STEM discipline.

The Value of Successful MBSE Adoption

NASA Technical Reports Server (NTRS)

Parrott, Edith

2016-01-01

The value of successful adoption of Model Based System Engineering (MBSE) practices is hard to quantify. Most engineers and project managers look at the success in terms of cost. But there are other ways to quantify the value of MBSE and the steps necessary to achieve adoption. The Glenn Research Center (GRC) has been doing Model-Based Engineering (design, structural, etc.) for years, but the system engineering side has not. Since 2010, GRC has been moving from documents centric to MBSE/SysML. Project adoption of MBSE has been slow, but is steadily increasing in both MBSE usage and complexity of generated products. Sharing of knowledge of lessons learned in the implementation of MBSE/SysML is key for others who want to be successful. Along with GRC's implementation, NASA is working hard to increase the successful implementation of MBSE across all the other centers by developing guidelines, templates and libraries for projects to utilize. This presentation will provide insight into recent GRC and NASA adoption efforts, lessons learned and best practices.

Accountability in Education: An Imperative for Service Delivery in Nigerian School Systems

ERIC Educational Resources Information Center

Usman, Yunusa Dangara

2016-01-01

Schools and other educational institutions are established, maintained and sustained essentially to achieve certain assured objectives. The goals of such establishment cannot be easily achieved without putting in place certain mechanisms towards ensuring the success of implementation of its policies and programmes. In the education system, one of…

Academic Preparedness as a Predictor of Achievement in an Engineering Design Challenge

ERIC Educational Resources Information Center

Mentzer, Nathan; Becker, Kurt

2010-01-01

The purpose of this study was to determine if a student's academic success, measured by grade point average (GPA) in mathematics, science, and communication courses, is correlated with student change in achievement during an engineering design challenge. Engineering design challenges have been implemented and researched in K-16 environments where…

Closing the Obesity Achievement Gap: Evidence-Based Practices that School Counselors Can Help Implement

ERIC Educational Resources Information Center

Perusse, Rachelle; Kailimang, Lukas; Krell, Megan

2009-01-01

School counselors are charged with helping students in the personal/social, academic, and career development domains. Obesity creates adverse educational outcomes for students along these three domains, suggesting an obesity achievement gap. Thus, school counselors can benefit from knowing which interventions have been shown to be successful in…

Redesigning a Large-Enrollment Introductory Biology Course

PubMed Central

Ueckert, Catherine; Adams, Alison; Lock, Judith

2011-01-01

Using an action research model, biology faculty examined, implemented, and evaluated learner-centered instructional strategies to reach the goal of increasing the level of student achievement in the introductory biology course BIO 181: Unity of Life I, which was characterized by both high enrollments and a high DFW rate. Outcomes included the creation and implementation of an assessment tool for biology content knowledge and attitudes, development and implementation of a common syllabus, modification of the course to include learner-centered instructional strategies, and the collection and analysis of data to evaluate the success of the modifications. The redesigned course resulted in greater student success, as measured by grades (reduced %DFW and increased %AB) as well as by achievement in the course assessment tool. In addition, the redesigned course led to increased student satisfaction and greater consistency among different sections. These findings have important implications for both students and institutions, as the significantly lower DFW rate means that fewer students have to retake the course. PMID:21633065

Some Aspects of the Implementation of the Principle of Transparency in Russian Universities: Research, Experience, Perspectives

ERIC Educational Resources Information Center

Egorov, Evgeny Evgenievich; Lebedev?, Tatiana Evgenievna; Bulganina, Svetlana Viktorovna; Vasilyeva, Lyudmila Ivanovna

2015-01-01

The aim of this study is to identify achieved successes, existing gaps and possible prospects of implementing the principle of transparency by Russian universities. It was focused upon the information transparency of educational activities from the perspective of legal requirements and interests of applicants and university students. The analysis…

Meeting Multicultural Needs in School Libraries: An Examination of Mexican Migrant Families and Factors that Influence Academic Success

ERIC Educational Resources Information Center

Plocharczyk, Leah

2005-01-01

The children of Mexican migrants face a number of hardships and difficulties that greatly hamper their ability to succeed in American schools. This paper examines some of the major difficulties and suggests multicultural programs that school librarians can implement in order to help migrant children achieve academic success.

A Comparison of Two Reading Programs on Third Grade Reading Achievement

ERIC Educational Resources Information Center

Miller, Tawana D.

2008-01-01

Background: The No Child Left Behind Act legislation requires both higher standards and higher success rates at the same time. Failure of students to learn to read adequately as shown by national and state test results and the need for continued school success had prompted education officials to implement two reading programs--Voyager Universal…

The Board of Governors Fee Waiver, Financial Aid, and Community College Student Success

ERIC Educational Resources Information Center

Coria, Elizabeth F.

2013-01-01

California established the Board of Governors (BOG) fee waiver in 1984 to maintain educational access after the implementation of the state's first ever unit-based fees for community college attendance. Although it was not designed as an incentive to stimulate higher levels of academic achievement or student success, recent accountability policy…

Understanding Variation in Implementation of SFA in the i3 Scale-Up Project

ERIC Educational Resources Information Center

Quint, Janet; Zhu, Pei; Doolittle, Fred

2012-01-01

The main confirmatory research question guiding the design of the impact evaluation is: "What is the impact of Success for All (SFA) on elementary school students' reading achievement, compared to students in non-SFA schools?" An answer to this question will determine the assessment of whether SFA is successful at turning around low-performing…

Write on Target: Preparing Young Writers To Succeed on State Writing Achievement Tests.

ERIC Educational Resources Information Center

Thomason, Tommy; York, Carol

This handbook guides teachers through nine workshops designed to share strategies for success on writing tests. The workshops in the handbook give practical ideas that can be implemented in the elementary classroom to set the stage for test success without compromising children's growth as writers. Following a foreword by Michael R. Sampson and…

Is There a Relationship between the Play Attention Program and Improved Student Achievement?

ERIC Educational Resources Information Center

Webber, Jenny Ann

2011-01-01

Attention Deficit/Hyperactivity Disorder (ADHD) and its effects on student academic achievement have been researched for many years. There have been many interventions that have been used in treating ADHD that have been found successful when implemented consistently. Some of the interventions that have been researched in the past are behavior…

Is the Four-Day School Week Detrimental to Student Success?

ERIC Educational Resources Information Center

Tharp, Timothy W.; Matt, John; O'Reilly, Frances L.

2016-01-01

School districts across the United States are implementing four-day school weeks. This study looks at the relationship between student achievement in the four-day school week compared to student achievement in the five-day school week. This analysis focused on a common criteria referenced test given to all students over a period of seven years in…

A Mixed-Methods Study: Motivational Aspects of a Summer Reading Program for Young Adolescents with Low Reading Achievement

ERIC Educational Resources Information Center

Strahler, Brianna R.

2013-01-01

Throughout the United States, school districts are integrating programs into their reading curricula in response to an increased focus on reading achievement. While many school districts are implementing successful remedial and after-school programs, their approach does not include providing literacy instruction for students during summer…

School Discipline, Classroom Management, and Student Self-Management: A PBS Implementation Guide

ERIC Educational Resources Information Center

Knoff, Howard M.

2012-01-01

How do you help students who "act out" or "shut down" due to academic frustration or whose social and emotional issues keep them from achieving success in school? Based on Project ACHIEVE, a nationally recognized model of school effectiveness and continuous improvement program, this book shows you how. Educators will find a pragmatic,…

Lean practices for quality results: a case illustration.

PubMed

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific organisations and inter-organisational networks. Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.

Technological Innovation and Developmental Strategies for Sustainable Management of Aquatic Resources in Developing Countries

NASA Astrophysics Data System (ADS)

Agboola, Julius Ibukun

2014-12-01

Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

Technological innovation and developmental strategies for sustainable management of aquatic resources in developing countries.

PubMed

Agboola, Julius Ibukun

2014-12-01

Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

PubMed

Lan, Jesse Yu-Chen

2017-12-01

The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

Building Sustainable Professional Development Programs: Applying Strategies From Implementation Science to Translate Evidence Into Practice.

PubMed

Baldwin, Constance D; Chandran, Latha; Gusic, Maryellen E

2017-01-01

Multisite and national professional development (PD) programs for educators are challenging to establish. Use of implementation science (IS) frameworks designed to convert evidence-based intervention methods into effective health care practice may help PD developers translate proven educational methods and models into successful, well-run programs. Implementation of the national Educational Scholars Program (ESP) is used to illustrate the value of the IS model. Four adaptable elements of IS are described: (1) replication of an evidence-based model, (2) systematic stages of implementation, (3) management of implementation using three implementation drivers, and (4) demonstration of program success through measures of fidelity to proven models and sustainability. Implementation of the ESP was grounded on five established principles and methods for successful PD. The process was conducted in four IS stages over 10 years: Exploration, Installation, Initial Implementation, and Full Implementation. To ensure effective and efficient processes, attention to IS implementation drivers helped to manage organizational relationships, build competence in faculty and scholars, and address leadership challenges. We describe the ESP's fidelity to evidence-based structures and methods, and offer three examples of sustainability efforts that enabled achievement of targeted program outcomes, including academic productivity, strong networking, and career advancement of scholars. Application of IS frameworks to program implementation may help other PD programs to translate evidence-based methods into interventions with enhanced impact. A PD program can follow systematic developmental stages and be operationalized by practical implementation drivers, thereby creating successful and sustainable interventions that promote the academic vitality of health professions educators.

Energy and Environment Guide to Action - Chapter 4.5: Lead by Example

EPA Pesticide Factsheets

Provides recommendations on designing, implementing, and evaluating lead by example programs, which offer states opportunities to achieve substantial energy cost savings within their operations. State success stories are included for reference.

Pathways to Program Success: A Qualitative Comparative Analysis (QCA) of Communities Putting Prevention to Work Case Study Programs

PubMed Central

Kane, Heather; Hinnant, Laurie; Day, Kristine; Council, Mary; Tzeng, Janice; Soler, Robin; Chambard, Megan; Roussel, Amy; Heirendt, Wendy

2016-01-01

Objective To examine the elements of capacity, a measure of organizational resources supporting program implementation that result in successful completion of public health program objectives in a public health initiative serving 50 communities. Design We used crisp set Qualitative Comparative Analysis (QCA) to analyze case study and quantitative data collected during the evaluation of the Communities Putting Prevention to Work (CPPW) program. Setting CPPW awardee program staff and partners implemented evidence-based public health improvements in counties, cities, and organizations (eg, worksites, schools). Participants Data came from case studies of 22 CPPW awardee programs that implemented evidence-based, community-and organizational-level public health improvements. Intervention Program staff implemented a range of evidence-based public health improvements related to tobacco control and obesity prevention. Main Outcome Measure The outcome measure was completion of approximately 60% of work plan objectives. Results Analysis of the capacity conditions revealed 2 combinations for completing most work plan objectives: (1) having experience implementing public health improvements in combination with having a history of collaboration with partners; and (2) not having experience implementing public health improvements in combination with having leadership support. Conclusion Awardees have varying levels of capacity. The combinations identified in this analysis provide important insights into how awardees with different combinations of elements of capacity achieved most of their work plan objectives. Even when awardees lack some elements of capacity, they can build it through strategies such as hiring staff and engaging new partners with expertise. In some instances, lacking 1 or more elements of capacity did not prevent an awardee from successfully completing objectives. Implications for Policy & Practice These findings can help funders and practitioners recognize and assemble different aspects of capacity to achieve more successful programs; awardees can draw on extant organizational strengths to compensate when other aspects of capacity are absent. PMID:27598714

Australian Curriculum Implementation in a Remote Aboriginal School: A Curriculum Leader's Search for a Transformational Compromise

ERIC Educational Resources Information Center

Parkinson, Chloe

2015-01-01

This paper examines the trial implementation of the Australian Curriculum in a remote Aboriginal school. It was a school that at the time was beginning to achieve successes with the development of dual-knowledge, transformational outcomes based curriculum that had its justification in the Northern Territory Curriculum Framework. Drawing on the…

Co-Construction of Agency and Environmental Management. The Case of Agri-Environmental Policy Implementation at Finnish Farms

ERIC Educational Resources Information Center

Kaljonen, Minna

2006-01-01

One of the main challenges of European environmental policies is to recruit local-level actors to fulfill set targets. This article explores how targets of European agri-environmental policy have been achieved in Finland. It also analyses how implementation practices produce conditions for agri-environmental management and how policy success-or…

Job Corps Annual Report: Program Year July 1, 2005 - June 30, 2006

ERIC Educational Resources Information Center

Job Corps, 2006

2006-01-01

For more than 40 years, Job Corps has led America as one of the most successful job training programs nationwide, meeting the needs of high school graduates and those without a diploma who have the desire to embark on a successful career path. In Program Year 2005, Job Corps implemented a new initiative called STARS (Speakers, Tutors, Achievement,…

Building the Capacity of Principals and Teacher-Leaders to Implement Effective School and Classroom Practices.

ERIC Educational Resources Information Center

Southern Regional Education Board (SREB), 2012

2012-01-01

Great leaders make great schools. The most successful school leaders create a school climate of high achievement and continuous improvement, give teachers a voice in decision-making, use data to drive curriculum and instruction, and assure students and parents that everyone at the school is focusing on student success. They know what is going on…

Emotional Intelligence: An Analysis between Implementing The Leader In Me and Fifth-Grade Achievement

ERIC Educational Resources Information Center

Wilkens, Coral L.

2013-01-01

Goleman, Boyatzis, and McKee (2002) stated, "Leaders are made, not born" (p. 100). The quote is indicative of the shift in skills necessary to be a successful 21st-century learner. Instead of mere academic competencies, the 21st Century learner will need a different type of intelligence to be successful. Emotional intelligence may be…

Using qualitative psychology to investigate HACCP implementation barriers.

PubMed

Taylor, Eunice; Taylor, Joanne Zaida

2004-02-01

Hazard Analysis Critical Control Point (HACCP) is a system of food safety management that in the last few decades has become an increasing part of national government and international strategy to reduce the prevalence of food borne disease. Yet despite wide dissemination and scientific support of its principles, successful HACCP implementation has been limited. There has been very little in-depth consideration of the reasons behind this, and qualitative psychological research examining the interplay of factors involved is almost non-existent. For this study therefore, four in-depth narrative interviews were carried out with small business owners attempting to implement HACCP. Non-prescriptive analysis of their interviews was carried out, and this revealed five key themes acting as 'barriers' to successful implementation. These were of HACCP as difficult, burdensome and unnecessary, and hindered by staff and external problems. The analysis showed furthermore the complexity of issues underpinning problems with HACCP implementation and the way in which they operate at knowledge, attitude and behavioural levels. From this, essential issues to be addressed in order for successful HACCP to be achieved are put forward.

An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model.

PubMed

Grant, Bettyanne; Colello, Sandra; Riehle, Martha; Dende, Denise

2010-04-01

To discuss the new Magnet Model as it relates to the successful implementation of a practice change. There is growing international interest in the Magnet Recognition Programme. The latest generation of the Magnet Model has been designed not only as a road map for organizations seeking to achieve Magnet recognition but also as a framework for nursing practice and research in the future. The Magnet Model was used to identify success factors related to a practice change and to evaluate the nursing practice environment. Even when proposed changes to practice are evidence based and thoughtfully considered, the nurses' work environment must be supportive and empowering in order to yield successful and sustainable implementation of new practice. Success factors for implementation of a practice change can be illuminated by aligning environmental characteristics to the components of the new Magnet Model. The Magnet Model provides an exceptional framework for building an agile and dynamic work force. Thoughtful consideration of the components and inter-relationships represented in the new model can help to both predict and ensure organizational vitality.

The Mayor's Plan for Achieving Success in the DCPS: Is the Implementation Likely to Match the Vision?

ERIC Educational Resources Information Center

Council of the Great City Schools, 2007

2007-01-01

The Mayor Adrian Fenty's achievement plan for the District of Columbia Public Schools (DCPS) is divided into four major parts. The first section outlines the philosophical foundation undergirding the plan. The second section outlines the plan's goals and strategies. In preparing this commentary, the Council of the Great City Schools assessed how…

Hospital IT adoption strategies associated with implementation success: implications for achieving meaningful use.

PubMed

Ford, Eric W; Menachemi, Nir; Huerta, Timothy R; Yu, Feliciano

2010-01-01

Health systems are facing significant pressure to either implement health information technology (HIT) systems that have "certified" electronic health record applications and that fulfill the federal government's definition of "meaningful use" or risk substantial financial penalties in the near future. To this end, hospitals have adopted one of three strategies, described as "best of breed," "best of suite," and "single vendor," to meet organizational and regulatory demands. The single-vendor strategy is used by the simple majority of U.S. hospitals, but is it the most effective mode for achieving full implementation? Moreover, what are the implications of adopting this strategy for achieving meaningful use? The simple answer to the first question is that the hospitals using the hybrid best of suite strategy had fully implemented HIT systems in significantly greater proportions than did hospitals employing either of the other strategies. Nonprofit and system-affiliated hospitals were more likely to have fully implemented their HIT systems. In addition, increased health maintenance organization market penetration rates were positively correlated with complete implementation rates. These results have ongoing implications for achieving meaningful use in the near term. The federal government's rewards and incentives program related to the meaningful use of HIT in hospitals has created an organizational imperative to implement such systems. For hospitals that have not begun systemwide implementation, pursuing a best of suite strategy may provide the greatest chance for achieving all or some of the meaningful use targets in the near term or at least avoiding future penalties scheduled to begin in 2015.

Optical implementation of neocognitron and its applications to radar signature discrimination

NASA Technical Reports Server (NTRS)

Chao, Tien-Hsin; Stoner, William W.

1991-01-01

A feature-extraction-based optoelectronic neural network is introduced. The system implementation approach applies the principle of the neocognitron paradigm first introduced by Fukushima et al. (1983). A multichannel correlator is used as a building block of a generic single layer of the neocognitron for shift-invariant feature correlation. Multilayer processing is achieved by iteratively feeding back the output of the feature correlator to the input spatial light modulator. Successful pattern recognition with intraclass fault tolerance and interclass discrimination is achieved using this optoelectronic neocognitron. Detailed system analysis is described. Experimental demonstration of radar signature processing is also provided.

Adaptation and Implementation of a Science-Based Prevention System in Colombia: Challenges and Achievements

PubMed Central

Pérez-Gómez, Augusto; Mejía-Trujillo, Juliana; Brown, Eric C.; Eisenberg, Nicole

2016-01-01

During the last 2 years, the Colombian government and the Nuevos Rumbos Corporation have been implementing an adapted version of the Communities That Care (CTC) prevention system, called Comunidades Que se Cuidan (CQC) in Spanish, for use in Colombia. This brief report presents the process of implementing CQC and identifies some of the main challenges and achievements of implementing the system in eight communities in Colombia. Preliminary results of a pilot study of CQC implementation in Colombia show that prevention system development, including a focus on measuring community risk and protection, can be established successfully in Latin American communities despite a lack of rigorously tested prevention programs and strategies. Moreover, mobilizing community coalitions toward science-based prevention, with a focus on examining local risk and protective factor data, can spur development and evaluation of prevention efforts in Latin America. PMID:28154437

School IPM Recognition and Certification

EPA Pesticide Factsheets

Schools and school districts can get support and recognition for implementation of school IPM. EPA is developing a program to provide recognition for school districts that are working towards or have achieved a level of success with school IPM programs.

Factors Affecting Successful Implementation of Hospital Information Systems.

PubMed

Farzandipur, Mehrdad; Jeddi, Fatemeh Rangraz; Azimi, Esmaeil

2016-02-01

Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers' satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system. The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software. About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3. Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered.

Monte-Carlo Tree Search in Settlers of Catan

NASA Astrophysics Data System (ADS)

Szita, István; Chaslot, Guillaume; Spronck, Pieter

Games are considered important benchmark opportunities for artificial intelligence research. Modern strategic board games can typically be played by three or more people, which makes them suitable test beds for investigating multi-player strategic decision making. Monte-Carlo Tree Search (MCTS) is a recently published family of algorithms that achieved successful results with classical, two-player, perfect-information games such as Go. In this paper we apply MCTS to the multi-player, non-deterministic board game Settlers of Catan. We implemented an agent that is able to play against computer-controlled and human players. We show that MCTS can be adapted successfully to multi-agent environments, and present two approaches of providing the agent with a limited amount of domain knowledge. Our results show that the agent has a considerable playing strength when compared to game implementation with existing heuristics. So, we may conclude that MCTS is a suitable tool for achieving a strong Settlers of Catan player.

Successful Implementation of Clinical Information Technology: Seven Key Lessons from CPOE.

PubMed

Gellert, G A; Hill, V; Bruner, K; Maciaz, G; Saucedo, L; Catzoela, L; Ramirez, R; Jacobs, W J; Nguyen, P; Patel, L; Webster, S L

2015-01-01

To identify and describe the most critical strategic and operational contributors to the successful implementation of clinical information technologies, as deployed within a moderate sized system of U.S. community hospitals. CHRISTUS Health is a multi-state system comprised of more than 350 services and 60 hospitals with over 9 000 physicians. The Santa Rosa region of CHRISTUS Health, located in greater San Antonio, Texas is comprised of three adult community hospital facilities and one Children's hospital each with bed capacities of 142-180. Computerized Patient Order Entry (CPOE) was first implemented in 2012 within a complex market environment. The Santa Rosa region has 2 417 credentialed physicians and 263 mid-level allied health professionals. This report focuses on the seven most valuable strategies deployed by the Health Informatics team in a large four hospital CHRISTUS region to achieve strong CPOE adoption and critical success lessons learned. The findings are placed within the context of the literature describing best practices in health information technology implementation. While the elements described involved discrete de novo process generation to support implementation and operations, collectively they represent the creation of a new customer-centric service culture in our Health Informatics team, which has served as a foundation for ensuring strong clinical information technology adoption beyond CPOE. The seven success factors described are not limited in their value to and impact on CPOE adoption, but generalize to - and can advance success in - varied other clinical information technology implementations across diverse hospitals. A number of these factors are supported by reports in the literature of other institutions' successful implementations of CPOE and other clinical information technologies, and while not prescriptive to other settings, may be adapted to yield value elsewhere.

Why TQM does not work in Iranian healthcare organisations.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran. This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation. TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers' about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers' and employees' commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively. Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence. Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.

Natural implementation of neutralino dark matter

NASA Astrophysics Data System (ADS)

King, Steve F.; Roberts, Jonathan P.

2006-09-01

The prediction of neutralino dark matter is generally regarded as one of the successes of the Minimal Supersymmetric Standard Model (MSSM). However the successful regions of parameter space allowed by WMAP and collider constraints are quite restricted. We discuss fine-tuning with respect to both dark matter and Electroweak Symmetry Breaking (EWSB) and explore regions of MSSM parameter space with non-universal gaugino and third family scalar masses in which neutralino dark matter may be implemented naturally. In particular allowing non-universal gauginos opens up the bulk region that allows Bino annihilation via t-channel slepton exchange, leading to ``supernatural dark matter'' corresponding to no fine-tuning at all with respect to dark matter. By contrast we find that the recently proposed ``well tempered neutralino'' regions involve substantial fine-tuning of MSSM parameters in order to satisfy the dark matter constraints, although the fine tuning may be ameliorated if several annihilation channels act simultaneously. Although we have identified regions of ``supernatural dark matter'' in which there is no fine tuning to achieve successful dark matter, the usual MSSM fine tuning to achieve EWSB always remains.

pyGFC - A Python Extension to the C++ Geodesy Foundation Classes

DTIC Science & Technology

2008-09-01

imperative for a successful emulation of a dynamic MANET as intended. To achieve this objective, the same algorithm and its implementation for...solution has two options: (1) selecting, implementing, and integrating an appropriate algorithm into the tool and in the MANE system, or (2) using an...GFCCoord *estimate_southeast_coords(double, double); double lat; double lon; double alt; private: CEarth *earth; char * cstr

Is Sustainability Achievable? Exploring the Limits of Sustainability with Model Systems

EPA Science Inventory

Successful implementation of sustainability ideas in ecosystem management requires a basic understanding of the often nonlinear and non-intuitive relationships amongst different dimensions of sustainability, particularly the systemwide implications of human actions. This basic un...

Design and Development of the Terrain Information Extraction System

DTIC Science & Technology

1990-09-04

system successfully demonstrated relief measurement and orthophoto production, automated feature extraction has remained "the major problem of today’s...the hierarchical relaxation correlation method developed by Helava Associates, Inc. and digital orthophoto production. To achieve this high accuracy...image memory transfer rates will be achieved by using data blocks or "image tiles ." Further, an image fringe loading module will be implemented which

Implementation of the Secondary 3 Program of Project P.A.T.H.S.: observations based on the co-walker scheme.

PubMed

Shek, Daniel T L; Ma, Cecilia M S

2012-01-17

The present study was conducted to explore the implementation quality of the Secondary 3 Program of the Tier 1 Program of Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in the third year of the Full Implementation Phase. Classroom observations of 182 units in 129 schools were conducted. Results showed that the overall level of program adherence was 73.9%. Thirteen aspects concerning program delivery were significantly correlated. Multiple regression analyses revealed that overall implementation quality was significantly predicted by student participation and involvement, strategies to enhance student motivation, use of positive and supportive feedback, degree of achievement of the objectives, and lesson preparation. Success of implementation was significantly predicted by student participation and involvement, classroom control, use of positive and supportive feedback, opportunity for reflection, degree of achievement of the objectives and time management. The present findings generally suggest that the implementation quality of Project P.A.T.H.S. was high.

Achieving profound anesthesia using the intraosseous technique.

PubMed

Coury, K A

1997-10-01

The intraosseous technique has been described as a useful adjunct to primary anesthetic administration. It has several advantages (Table 3) over other supplemental techniques in that it is relatively simple to implement into routine practice, it affords fast, predictable results, and it is relatively painless. The technique has been shown to be very successful in achieving profound pulpal anesthesia when administered as a supplement to the inferior alveolar nerve block and is effective in achieving profound anesthesia in irreversibly inflamed teeth, especially mandibular molars.

[Implementation of clinical practice guidelines: how can we close the evidence-practice gap?].

PubMed

Muche-Borowski, Cathleen; Nothacker, M; Kopp, I

2015-01-01

Guidelines are intended as instruments of knowledge transfer to support decision-making by physicians, other health professionals and patients in clinical practice and thereby contribute to quality improvements in healthcare. To date they are an indispensable tool for healthcare. Their benefit for patients can only be seen in application, i.e. the implementation of guideline recommendations. For successful implementation, implementability and practicability play a crucial role and these characteristics can be influenced and should be promoted by the guideline development group. In addition, a force field analysis to identify barriers against and facilitators for the implementation of specific guideline recommendations from the perspective of physicians and patients is recommended to guide the development of an individual implementation strategy and the selection of appropriate interventions. However, implementation cannot be achieved by the guideline development group alone and a universal implementation strategy does not exist. Therefore, a process using theory, analysis, experience and shared responsibility of stakeholders in healthcare is recommended, with the aim to achieve sustainable behavioral change and improve the quality of care by guideline-oriented behavior.

Evaluation of design and construction issues of thin HMA overlays.

DOT National Transportation Integrated Search

2015-04-01

While the overall implementation of thin HMA overlays in Texas has been successful, some issues need to be addressed: : appropriate blending of SAC A and SAC B aggregate to ensure adequate skid resistance; best practices to achieve adequate bonding :...

The Spanish human papillomavirus vaccine consensus group: a working model.

PubMed

Cortés-Bordoy, Javier; Martinón-Torres, Federico

2010-08-01

Successful implementation of Human Papillomavirus (HPV) vaccine in each country can only be achieved from a complementary and synergistic perspective, integrating all the different points of view of the diverse related professionals. It is this context where the Spanish HPV Vaccine Consensus Group (Grupo Español de Consenso sobre la Vacuna VPH, GEC-VPH) was created. GEC-VPH philosophy, objectives and experience are reported in this article, with particular attention to the management of negative publicity and anti-vaccine groups. Initiatives as GEC-VPH--adapted to each country's particular idiosyncrasies--might help to overcome the existing barriers and to achieve wide and early implementation of HPV vaccination.

Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.

PubMed

Dattalo, M; Wise, M; Ford Ii, J H; Abramson, B; Mahoney, J

2017-04-01

As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.

Teacher Beliefs, Teacher Concerns, and School Leadership Support as Influences on School Readiness for Implementing a Research-Based Reform Model

ERIC Educational Resources Information Center

Carhart, Elizabeth Hoag

2013-01-01

Federal policy makers and school leaders increasingly recognize middle school math as a turning point in students' academic success. An i3 scale-up grant allowed grant partners to conduct a large-scale implementation of PowerTeaching (PT), a research-based reform to increase student math achievement. In a mixed-methods study during the pilot phase…

Hubble Space Telescope Reduced-Gyro Control Law Design, Implementation, and On-Orbit Performance

NASA Technical Reports Server (NTRS)

Clapp, Brian R.; Ramsey, Patrick R.; Wirzburger, John H.; Smith, Daniel C.; VanArsadall, John C.

2008-01-01

Following gyro failures in April 2001 and April 2003, HST Pointing Control System engineers designed reduced-gyro control laws to extend the spacecraft science mission. The Two-Gyro Science (TGS) and One-Gyro Science (OGS) control laws were designed and implemented using magnetometers, star trackers, and Fine Guidance Sensors in succession to control vehicle rate about the missing gyro axes. Both TGS and OGS have demonstrated on-orbit pointing stability of 7 milli-arcseconds or less, which depends upon the guide star magnitude used by the Fine Guidance Sensor. This paper describes the design, implementation, and on-orbit performance of the TGS and OGS control law fine-pointing modes using Fixed Head Star Trackers and Fine Guidance Sensors, after successfully achieving coarse-pointing control using magnetometers.

Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

PubMed

Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

2017-12-01

Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological levels of the health care system and demands continuous effort in the postimplementation phase. © 2017 John Wiley & Sons, Ltd.

A mentoring program to help junior faculty members achieve scholarship success.

PubMed

Kohn, Harold

2014-03-12

The University of North Carolina Eshelman School of Pharmacy launched the Bill and Karen Campbell Faculty Mentoring Program (CMP) in 2006 to support scholarship-intensive junior faculty members. This report describes the origin, expectations, principles, and best practices that led to the introduction of the program, reviews the operational methods chosen for its implementation, provides information about its successes, and analyzes its strengths and limitations.

Factors Influencing the Improved Academic Success in Literacy at the Knowledge Is Power Program (KIPP) Schools in the Delta Region According to Adult Perceptions

ERIC Educational Resources Information Center

Brown, Kimberly J.; Holt, Carleton R.

2014-01-01

This qualitative case study explored factors that have influenced literacy success of Knowledge is Power Program (KIPP) students in the low-income, poverty stricken Delta Region of Arkansas. The study examined progress made since implementation of the KIPP Program and the influence the program had made upon student achievement in literacy at the…

A Mentoring Program to Help Junior Faculty Members Achieve Scholarship Success

PubMed Central

2014-01-01

The University of North Carolina Eshelman School of Pharmacy launched the Bill and Karen Campbell Faculty Mentoring Program (CMP) in 2006 to support scholarship-intensive junior faculty members. This report describes the origin, expectations, principles, and best practices that led to the introduction of the program, reviews the operational methods chosen for its implementation, provides information about its successes, and analyzes its strengths and limitations. PMID:24672062

Success factors for strategic change initiatives: a qualitative study of healthcare administrators' perspectives.

PubMed

Kash, Bita Arbab; Spaulding, Aaron; Johnson, Christopher E; Gamm, Larry

2014-01-01

Success factors related to the implementation of change initiatives are well documented and discussed in the management literature, but they are seldom studied in healthcare organizations engaged in multiple strategic change initiatives. The purpose of this study was to identify key success factors related to implementation of change initiatives based on rich qualitative data gathered from health leader interviews at two large health systems implementing multiple change initiatives. In-depth personal interviews with 61 healthcare leaders in the two large systems were conducted and inductive qualitative analysis was employed to identify success factors associated with 13 change initiatives. Results from this analysis were compared to success factors identified in the literature, and generalizations were drawn that add significantly to the management literature, especially to that in the healthcare sector. Ten specific success factors were identified for the implementation of change initiatives. The top three success factors were (1) culture and values, (2) business processes, and (3) people and engagement. Two of the identified success factors are unique to the healthcare sector and not found in the literature on change models: service quality and client satisfaction (ranked fourth of 10) and access to information (ranked ninth). Results demonstrate the importance of human resource functions, alignment of culture and values with change, and business processes that facilitate effective communication and access to information to achieve many change initiatives. The responses also suggest opportunities for leaders of healthcare organizations to more formally recognize the degree to which various change initiatives are dependent on one another.

The Navy’s Superior Supplier Incentive Program: Analysis of Supplier Proposed Benefits

DTIC Science & Technology

2015-12-01

rather than “short-term, easy, expendable and replaceable sources of goods and services” (Carter & Choi, 2008, p. 2). Japanese automakers Toyota ...was the key element behind Toyota and Honda’s strategic successes. Under the supplier keiretsu, the automakers worked closely with the selected...suppliers to achieve mutually beneficial objectives. Toyota and Honda implemented the keiretsu model in their North American plants and achieved

Implementation of clinical governance in hospitals: challenges and the keys for success.

PubMed

Mousavi, Seyed Mohammad Hadi; Agharahimi, Zahra; Daryabeigi, Maede; Rezaei, Nima

2014-01-01

There is a number of models and strategies for improving the quality of care such as total quality management, continuous quality improvement and clinical governance. The policy of clinical governance is part of the governments overall strategy for monitoring, assuring and improving in the national health services organization. Clinical governance has been introduced as a bridge between managerial and clinical approaches to quality. For successful implementing of clinical governance, it is necessary to pay attention to firm foundations of the structure, including equipment, staffing arrangement, supporting specialties, and staff training. Therefore, as clinical governance improves safety and quality in health care services, the current situation in hospitals should be evaluated before any intervention while barriers and blocks on structure and process should be determined to select a method for changing them. Considering these points could guarantee success in implementation of clinical governance; otherwise there would be a little chance to achieve the desired results despite consumption of plenty of time and huge paper works.

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.

PubMed

Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

2014-11-25

Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada. In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation. Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period. Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p < 0.001). The median number of KT strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership, staff engagement, and dedicated time and resources were identified as facilitating effective implementation of the strategies. Further research is required to better understand implementation outcomes, such as feasibility and fidelity, how context influences the effectiveness of multifaceted KT strategies, and the sustainability of improved pain practices and outcomes over time.

Predicting Mission Success in Small Satellite Missions

NASA Technical Reports Server (NTRS)

Saunders, Mark; Richie, Wayne; Rogers, John; Moore, Arlene

1992-01-01

In our global society with its increasing international competition and tighter financial resources, governments, commercial entities and other organizations are becoming critically aware of the need to ensure that space missions can be achieved on time and within budget. This has become particularly true for the National Aeronautics and Space Administration's (NASA) Office of Space Science (OSS) which has developed their Discovery and Explorer programs to meet this need. As technologies advance, space missions are becoming smaller and more capable than their predecessors. The ability to predict the mission success of these small satellite missions is critical to the continued achievement of NASA science mission objectives. The NASA Office of Space Science, in cooperation with the NASA Langley Research Center, has implemented a process to predict the likely success of missions proposed to its Discovery and Explorer Programs. This process is becoming the basis for predicting mission success in many other NASA programs as well. This paper describes the process, methodology, tools and synthesis techniques used to predict mission success for this class of mission.

Predicting Mission Success in Small Satellite Missions

NASA Technical Reports Server (NTRS)

Saunders, Mark; Richie, R. Wayne; Moore, Arlene; Rogers, John

1999-01-01

In our global society with its increasing international competition and tighter financial resources, governments, commercial entities and other organizations are becoming critically aware of the need to ensure that space missions can be achieved on time and within budget. This has become particularly true for the National Aeronautics and Space Administration's (NASA's) Office of Space Science (OSS) which has developed their Discovery and Explorer programs to meet this need. As technologies advance, space missions are becoming smaller and more capable than their predecessors. The ability to predict the mission success of these small satellite missions is critical to the continued achievement of NASA science mission objectives. The NASA Office of Space Science, in cooperation with the NASA Langley Research Center, has implemented a process to predict the likely success of missions proposed to its Discovery and Explorer Programs. This process is becoming the basis for predicting mission success in many other NASA programs as well. This paper describes the process, methodology, tools and synthesis techniques used to predict mission success for this class of mission.

Multiple models guide strategies for agricultural nutrient reductions

USGS Publications Warehouse

Scavia, Donald; Kalcic, Margaret; Muenich, Rebecca Logsdon; Read, Jennifer; Aloysius, Noel; Bertani, Isabella; Boles, Chelsie; Confesor, Remegio; DePinto, Joseph; Gildow, Marie; Martin, Jay; Redder, Todd; Robertson, Dale M.; Sowa, Scott P.; Wang, Yu-Chen; Yen, Haw

2017-01-01

In response to degraded water quality, federal policy makers in the US and Canada called for a 40% reduction in phosphorus (P) loads to Lake Erie, and state and provincial policy makers in the Great Lakes region set a load-reduction target for the year 2025. Here, we configured five separate SWAT (US Department of Agriculture's Soil and Water Assessment Tool) models to assess load reduction strategies for the agriculturally dominated Maumee River watershed, the largest P source contributing to toxic algal blooms in Lake Erie. Although several potential pathways may achieve the target loads, our results show that any successful pathway will require large-scale implementation of multiple practices. For example, one successful pathway involved targeting 50% of row cropland that has the highest P loss in the watershed with a combination of three practices: subsurface application of P fertilizers, planting cereal rye as a winter cover crop, and installing buffer strips. Achieving these levels of implementation will require local, state/provincial, and federal agencies to collaborate with the private sector to set shared implementation goals and to demand innovation and honest assessments of water quality-related programs, policies, and partnerships.

An Examination of an Information Security Framework Implementation Based on Agile Values to Achieve Health Insurance Portability and Accountability Act Security Rule Compliance in an Academic Medical Center: The Thomas Jefferson University Case Study

ERIC Educational Resources Information Center

Reis, David W.

2012-01-01

Agile project management is most often examined in relation to software development, while information security frameworks are often examined with respect to certain risk management capabilities rather than in terms of successful implementation approaches. This dissertation extended the study of both Agile project management and information…

The Impact of the Implementation of the Behavior Intervention Support CHAMPS on Reading Achievement, Discipline Referrals, and Number of Suspensions amongst Students Grades Third through Fifth within a Large Suburban Elementary School

ERIC Educational Resources Information Center

Smith, Jennifer L.

2017-01-01

The purpose of this study was to determine the impact of Randy Spricks (2009) behavior intervention support model, CHAMPS (Conversation, Help, Activity, Movement, Participation, Success), on elementary students in third through fifth grade in the areas of reading achievement, discipline referrals, and suspension numbers within a large culturally…

Turnaround Success: An Exploratory Study of Three Middle Grades Schools That Achieved Positive Contextual and Achievement Outcomes Using the Schools to Watch I3 Project

ERIC Educational Resources Information Center

Flowers, Nancy; Begum, Shahana; Carpenter, Dawn M. H.; Mulhall, Peter F.

2017-01-01

This article presents the results of a study examining the highest implementers of the Schools to Watch (STW): School Transformation Network Project, and the impact the project had on their teaching/learning practices and outcomes. The project was funded by the U.S. Department of Education's Investing in Innovation (i3) grant program and was…

Implementing a strategy to promote lifelong learning in the primary care workforce: an evaluation of leadership roles, change management approaches, interim challenges and achievements.

PubMed

McLaren, Susan; Woods, Leslie; Boudioni, Markella; Lemma, Ferew; Tavabie, Abdol

2008-01-01

To identify and explore leadership roles and responsibilities for implementing the workforce development strategy; to identify approaches used to implement and disseminate the strategy; and to identify and explore challenges and achievements in the first 18 months following implementation. A formative evaluation with qualitative methods was used. Documentary analysis, interviews (n = 29) and two focus groups (n = 12) were conducted with a purposive sample of individuals responsible for strategy implementation. Data were transcribed and analysed thematically using framework analysis. Regional health area in Kent, Surrey and Sussex: 24 primary care trusts (PCTs) and 900 general practices. Primary care workforce tutors, lifelong learning advisors, GP tutors, patch associate GP deans and chairs of PCT education committees all had vital leadership roles, some existing and others newly developed. Approaches used to implement the strategy encompassed working within and across organisational boundaries, communication and dissemination of information. Challenges encountered by implementers were resistance to change - evident in some negative attitudes to uptake of training and development opportunities - and role diversity and influence. Achievements included successes in embedding appraisal and protected learning time, and changes in educational practices and services. The use of key leadership roles and change-management approaches had brought about early indications of positive transition in lifelong learning cultures.

Successful management of risk in the hybrid OR.

PubMed

Childs, Shannon; Bruch, Paul

2015-02-01

The advent of intraoperative magnetic resonance imaging (MRI) surgery has resulted in numerous advances in minimally invasive procedures. This progress has also revealed serious environmental hazards for the patient and perioperative team. At one facility, implementation of an MRI/OR intervention suite has enhanced surgical care and outcomes. Achieving the benefits of intraoperative MRI can occur with a multidisciplinary, interdepartmental approach to the design and layout of the hybrid environment and through implementation of education and safety protocols, including patient screening and prep for scanning. Personnel, including perioperative nurses, must receive expert hands-on training to successfully mitigate risk and provide care in the hybrid OR setting. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Highly Stable Lyophilized Homogeneous Bead-Based Immunoassays for On-Site Detection of Bio Warfare Agents from Complex Matrices.

PubMed

Mechaly, Adva; Marx, Sharon; Levy, Orly; Yitzhaki, Shmuel; Fisher, Morly

2016-06-21

This study shows the development of dry, highly stable immunoassays for the detection of bio warfare agents in complex matrices. Thermal stability was achieved by the lyophilization of the complete, homogeneous, bead-based immunoassay in a special stabilizing buffer, resulting in a ready-to-use, simple assay, which exhibited long shelf and high-temperature endurance (up to 1 week at 100 °C). The developed methodology was successfully implemented for the preservation of time-resolved fluorescence, Alexa-fluorophores, and horse radish peroxidase-based bead assays, enabling multiplexed detection. The multiplexed assay was successfully implemented for the detection of Bacillus anthracis, botulinum B, and tularemia in complex matrices.

Direct-to-consumer marketing of evidence-based psychological interventions: introduction.

PubMed

Santucci, Lauren C; McHugh, R Kathryn; Barlow, David H

2012-06-01

The dissemination and implementation of evidence-based psychological interventions (EBPIs) to service provision settings has been a major challenge. Most efforts to disseminate and implement EBPIs have focused on clinicians and clinical systems as the consumers of these treatments and thus have targeted efforts to these groups. An alternative, complementary approach to achieve more widespread utilization of EBPIs is to disseminate directly to patients themselves. The aim of this special section is to explore several direct-to-consumer (i.e., patient) dissemination and education efforts currently underway. This manuscript highlights the rationale for direct-to-patient dissemination strategies as well as the application of marketing science to dissemination efforts. Achieving greater access to EBPIs will require the use of multiple approaches to overcome the many and varied barriers to successful dissemination and implementation. Copyright © 2011. Published by Elsevier Ltd.

Bridging implementation, knowledge, and ambition gaps to eliminate tuberculosis in the United States and globally.

PubMed

Castro, Kenneth G; LoBue, Philip

2011-03-01

We reflect on remarkable accomplishments in global tuberculosis (TB) control and identify persistent obstacles to the successful elimination of TB from the United States and globally. One hundred and twenty nine years after Koch's discovery of the etiologic agent of TB, this health scourge continues to account for 9.4 million cases and 1.7 million deaths annually worldwide. Implementation of the Directly Observed Treatment Short-course strategy from 1995 through 2009 has saved 6 million lives. TB control is increasingly being achieved in countries with high-income economies, yet TB continues to plague persons living in countries with low-income and lower-middle-income economies. To accelerate progress against the global effects of disease caused by TB and achieve its elimination, we must bridge 3 key gaps in implementation, knowledge, and ambition.

Redesign of Work for Educational Purposes and for Quality of Working Life

ERIC Educational Resources Information Center

Taylor, James C.

1976-01-01

Examples of successful implementation of sociotechnical design of workplaces indicate that workplaces can be redesigned to achieve a closer match between employee values and organizational work roles. Organizational effectiveness does not seem to be sacrificed as a consequence of such action. (Author/JDS)

Managing Mentoring Programs.

ERIC Educational Resources Information Center

IUME Briefs, 1992

1992-01-01

Some programs for helping at-risk youth achieve excellent results, while others do not. One reason for program success can be proper management. Mentoring is a promising strategy for helping at-risk youth. Planners who want to create effective mentoring programs should look at the implementation experiences of other youth programs. Evaluations…

Measuring Instructional Merit.

ERIC Educational Resources Information Center

Robison, Sharon S.; And Others

1993-01-01

Before implementing an instructional program in the Rowland (California) school district, planners must define success in terms of measurable student performance, calculates resources expended in relation to the expected benefits, and determine how long it will take the program to achieve the desired results. Baseline data are then compared to new…

Modeling Instruction: The Impact of Professional Development on Instructional Practices

ERIC Educational Resources Information Center

Barlow, Angela T.; Frick, Tasha M.; Barker, Heather L.; Phelps, Amy J.

2014-01-01

Modeling Instruction holds the potential for transforming science instruction and improving student achievement. Key to the success of Modeling Instruction, however, is the fidelity of implementation of its curriculum. This qualitative study examined the impact of Modeling Instruction professional development on participating teachers'…

Managing human resources for successful strategy execution.

PubMed

Arnold, Edwin

2010-01-01

Managers face difficult challenges when they implement organizational strategies to achieve important goals. Execution of strategy has become more dependent upon the effective management of human resources. This article suggests how people can be managed more effectively to facilitate the execution of strategies and improve organizational performance.

Relationship between Corporate Governance and Information Security Governance Effectiveness in United States Corporations

ERIC Educational Resources Information Center

Davis, Robert E.

2017-01-01

Cyber attackers targeting large corporations achieved a high perimeter penetration success rate during 2013, resulting in many corporations incurring financial losses. Corporate information technology leaders have a fiduciary responsibility to implement information security domain processes that effectually address the challenges for preventing…

Principals' Perceptions of Instructional Leadership Development

ERIC Educational Resources Information Center

Brabham, Carla E.

2017-01-01

Instructional leadership is an important aspect of student achievement and the overall success of schools. Principals, as instructional leaders, need continual reflection on their competency. Job-embedded professional development (JEPD) for teachers is implemented and monitored by instructional leaders. The purpose of this case study was to…

Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals.

PubMed

Assefa, Yibeltal; Damme, Wim Van; Williams, Owain D; Hill, Peter S

2017-01-01

We analysed the performance of Ethiopia in achieving the health-related millennium development goals (MDGs) with the aim of acquiring lessons for the sustainable development goals (SDGs). Ethiopia achieved most of the health MDGs: a 67% reduction in under-five mortality, a 71% decline in maternal mortality ratio, a 90% decline in new HIV infections, a decrease in malaria-related deaths by 73% and a more than 50% decline in mortality due to tuberculosis. We argue that these achievements are due to implementation of a mix of comprehensive strategies within the health system and across other sectors of the government. Scaling up of interventions by disease control programmes (including the health extension programme) and strengthening of the health system have played important roles towards the achievements. These health gains could not have been realised without progress in the other MDGs: poverty reduction, education, access to safe drinking-water and peace and stability of the country. However, the gains were not equitable, with differences between urban and rural areas, among regions and socioeconomic strata. Ethiopia's remarkable success in meeting most of the targets of the health-related MDGs could be explained by its comprehensive and multisectoral approach for health development. The inequity gap remains a challenge that achieving the health-related SDGs requires the country to implement strategies, which specifically target more marginal populations and geographic areas. This also needs peace and stability, without which it is almost impossible to improve health.

A community hospital's journey into Lean Six Sigma.

PubMed

Stuenkel, Kurt; Faulkner, Taunya

2009-01-01

The implementation of Lean Six Sigma and 100-day workouts throughout the 304-bed Floyd Medical Center community hospital organization has led to sustainable results and a marked change in culture. The organization-wide learning of such an effort is deep and intehse, and to remain focused and successful it must be a priority of top management. The workout methodology can assist the organization to carry projects to completion and to achieve rapid implementation of desired improvements.

Devising, Implementing, and Evaluating Interventions to Eliminate Health Care Disparities in Minority Children

PubMed Central

Flores, Glenn

2010-01-01

Despite an accumulating body of literature addressing racial/ethnic disparities in children’s health and health care, there have been few published studies of interventions that have been successful in eliminating these disparities. The objectives of this article, therefore, are to (1) describe 3 interventions that have been successful in eliminating racial/ethnic disparities in children’s health and health care, (2) high-light tips and pitfalls regarding devising, implementing, and evaluating pediatric disparities interventions, and (3) propose a research agenda for pediatric disparities interventions. Key characteristics of the 3 successful interventions include rigorous study designs; large sample sizes; appropriate comparison groups; community-based interventions that are culturally and linguistically sensitive and involve collaboration with participants; research staff from the same community as the participants; appropriate blinding of outcomes assessors; and statistical adjustment of outcomes for relevant covariates. On the basis of these characteristics, I propose tips, pitfalls, an approach, and a research agenda for devising, implementing, and evaluating successful pediatric disparities interventions. Examination of 3 successful interventions indicates that pediatric health care disparities can be eliminated. Achievement of this goal requires an intervention that is rigorous, evidence-based, and culturally and linguistically appropriate. The intervention must also include community collaboration, minimize attrition, adjust for potential confounders, and incorporate mechanisms for sustainability. PMID:19861473

Devising, implementing, and evaluating interventions to eliminate health care disparities in minority children.

PubMed

Flores, Glenn

2009-11-01

Despite an accumulating body of literature addressing racial/ethnic disparities in children's health and health care, there have been few published studies of interventions that have been successful in eliminating these disparities. The objectives of this article, therefore, are to (1) describe 3 interventions that have been successful in eliminating racial/ethnic disparities in children's health and health care, (2) highlight tips and pitfalls regarding devising, implementing, and evaluating pediatric disparities interventions, and (3) propose a research agenda for pediatric disparities interventions. Key characteristics of the 3 successful interventions include rigorous study designs; large sample sizes; appropriate comparison groups; community-based interventions that are culturally and linguistically sensitive and involve collaboration with participants; research staff from the same community as the participants; appropriate blinding of outcomes assessors; and statistical adjustment of outcomes for relevant covariates. On the basis of these characteristics, I propose tips, pitfalls, an approach, and a research agenda for devising, implementing, and evaluating successful pediatric disparities interventions. Examination of 3 successful interventions indicates that pediatric health care disparities can be eliminated. Achievement of this goal requires an intervention that is rigorous, evidence-based, and culturally and linguistically appropriate. The intervention must also include community collaboration, minimize attrition, adjust for potential confounders, and incorporate mechanisms for sustainability.

Career Mapping for Professional Development and Succession Planning.

PubMed

Webb, Tammy; Diamond-Wells, Tammy; Jeffs, Debra

Career mapping facilitates professional development of nurses by education specialists and nurse managers. On the basis of national Nursing Professional Development Scope and Standards, our education and professional development framework supports the organization's professional practice model and provides a foundation for the professional career map. This article describes development, implementation, and evaluation of the professional career map for nurses at a large children's hospital to support achievement of the nursing strategic goals for succession planning and professional development.

The Economics of Medicare Accountable Care Organizations

PubMed Central

Blackstone, Erwin A.; Fuhr, Joseph P.

2016-01-01

Background Accountable care organizations (ACOs) have been created to improve patient care, enhance population health, and reduce costs. Medicare in particular has focused on ACOs as a primary device to improve quality and reduce costs. Objective To examine whether the current Medicare ACOs are likely to be successful. Discussion Patients receiving care in ACOs have little incentive to use low-cost quality providers. Furthermore, the start-up costs of ACOs for providers are high, contributing to the minimal financial success of ACOs. We review issues such as reducing readmissions, palliative care, and the difficulty in coordinating care, which are major cost drivers. There are mixed incentives facing hospital-controlled ACOs, whereas physician-controlled ACOs could play hospitals against each other to obtain high quality and cost reductions. This discussion also considers whether the current structure of ACOs is likely to be successful. Conclusion The question remains whether Medicare ACOs can achieve the Triple Aim of “improving the experience of care, improving the health of populations, and reducing per capita costs of health care.” Care coordination in ACOs and information technology are proving more complicated and expensive to implement than anticipated. Even if ACOs can decrease healthcare costs and increase quality, it is unclear if the current incentives system can achieve these objectives. A better public policy may be to implement a system that encompasses the best practices of successful private integrated systems rather than promoting ACOs. PMID:27066191

The Economics of Medicare Accountable Care Organizations.

PubMed

Blackstone, Erwin A; Fuhr, Joseph P

2016-02-01

Accountable care organizations (ACOs) have been created to improve patient care, enhance population health, and reduce costs. Medicare in particular has focused on ACOs as a primary device to improve quality and reduce costs. To examine whether the current Medicare ACOs are likely to be successful. Patients receiving care in ACOs have little incentive to use low-cost quality providers. Furthermore, the start-up costs of ACOs for providers are high, contributing to the minimal financial success of ACOs. We review issues such as reducing readmissions, palliative care, and the difficulty in coordinating care, which are major cost drivers. There are mixed incentives facing hospital-controlled ACOs, whereas physician-controlled ACOs could play hospitals against each other to obtain high quality and cost reductions. This discussion also considers whether the current structure of ACOs is likely to be successful. The question remains whether Medicare ACOs can achieve the Triple Aim of "improving the experience of care, improving the health of populations, and reducing per capita costs of health care." Care coordination in ACOs and information technology are proving more complicated and expensive to implement than anticipated. Even if ACOs can decrease healthcare costs and increase quality, it is unclear if the current incentives system can achieve these objectives. A better public policy may be to implement a system that encompasses the best practices of successful private integrated systems rather than promoting ACOs.

The New Hampshire Ten Steps to Successful Breastfeeding Collaborative: A Statewide QI Initiative.

PubMed

Whalen, Bonny L; Kelly, Joyce; Holmes, Alison Volpe

2015-06-01

Despite national recognition for their breastfeeding-friendly practices, many New Hampshire hospitals are still not achieving the Ten Steps to Successful Breastfeeding. To increase achievement of the Ten Steps in New Hampshire's birthing hospitals, facilitate Baby-Friendly Hospital Initiative (BFHI) designation for interested hospitals, and improve rates of in-hospital any and exclusive breastfeeding. After a 2010 needs assessment, we conducted 2 statewide workshops targeting 6 of the Ten Steps found to be most deficient among New Hampshire birthing hospitals. Eighteen of 20 hospitals attended at least 1 workshop, and 6 participated in an intensive collaborative. In 2013, we analyzed interval Ten Step achievement and in-hospital breastfeeding trends. Staff education showed the greatest improvement, increasing step 2 achievement from 1 to 6 hospitals (P=.05). Although the number of hospitals implementing step 6 (breast milk only) and step 9 (no artificial nipples) increased, differences were not statistically significant. Intensive collaborative hospitals achieved an average of 1.5 new steps, whereas non-Baby Friendly hospitals lost 0.7 steps (P=.05). In-hospital breastfeeding rates increased in intensive collaborative hospitals and were significantly higher than those in non-Baby Friendly hospitals by the end of the study (any breastfeeding, 89% vs 73%, P=.03; exclusive breastfeeding, 84% vs 61%, P<.001). A statewide improvement collaborative facilitated increases in Ten Step achievement and in-hospital breastfeeding for hospitals participating in an intensive collaborative. Active work in Ten Step implementation, including staff education, appears to be more effective in increasing in-hospital breastfeeding than does BFHI designation alone. Copyright © 2015 by the American Academy of Pediatrics.

The challenges of lean manufacturing implementation in kitting assembly

NASA Astrophysics Data System (ADS)

Fansuri, A. F. H.; Rose, A. N. M.; Nik Mohamed, N. M. Z.; Ahmad, H.

2017-10-01

Literature studies shows that lean manufacturing goes way back with the original founder Eli Whitney in year 1799. The main purpose of lean manufacturing is to identify and eliminate waste in production. The application of lean manufacturing can be carried out in any industrial processes with regards to the understanding of lean principles, theories and practices. Kitting is one of the important aspects in a successful production. The continuous supply of materials from store to production has to be systematic and able to achieve lean standard for it to be successful. The objective of this paper is to review the implementation of lean manufacturing in kitting assembly. Previous papers show that, the implementation of lean manufacturing in kitting assembly may be beneficial to the organization such as reduce in space occupancy, part shortages, lead time and manpower. Based on previous research, some industries may tend to change between kitting and line stocking which are due to lack of understanding when implementing kitting and causes longer lead time and materials overflow in store. With a proper understanding on what to kit, where to kit, how to kit, why to kit and who kits the material with a standardised process flow may ensure the success of kitting.

Project planning, training, measurement and sustainment: the successful implementation of voice recognition.

PubMed

Antiles, S; Couris, J; Schweitzer, A; Rosenthal, D; Da Silva, R Q

2000-01-01

Computerized voice recognition systems (VR) can reduce costs and enhance service. The capital outlay required for conversion to a VR system is significant; therefore, it is incumbent on radiology departments to provide cost and service justifications to administrators. Massachusetts General Hospital (MGH) in Boston implemented VR over a two-year period and achieved annual savings of $530,000 and a 50% decrease in report throughput. Those accomplishments required solid planning and implementation strategies, training and sustainment programs. This article walks through the process, step by step, in the hope of providing a tool set for future implementations. Because VR has dramatic implications for workflow, a solid operational plan is needed when assessing vendors and planning for implementation. The goals for implementation should be to minimize operational disruptions and capitalize on efficiencies of the technology. Senior leadership--the department chair or vice-chair--must select the goals to be accomplished and oversee, manage and direct the VR initiative. The importance of this point cannot be overstated, since implementation will require behavior changes from radiologists and others who may not perceive any personal benefits. Training is the pivotal factor affecting the success of voice recognition, and practice is the only way for radiologists to enhance their skills. Through practice, radiologists will discover shortcuts, and their speed and comfort will improve. Measurement and data analysis are critical to changing and improving the voice recognition application and are vital to decision-making. Some of the issues about which valuable date can be collected are technical and educational problems, VR penetration, report turnaround time and annual cost savings. Sustained effort is indispensable to the maintenance of voice recognition. Finally, all efforts made and gains achieved may prove to be futile without ongoing sustainment of the system through retraining, education and technical support.

What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups With Stakeholders.

PubMed

Peek, Sebastiaan Theodorus Michaël; Wouters, Eveline J M; Luijkx, Katrien G; Vrijhoef, Hubertus J M

2016-05-03

There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults' needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes). Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale.

What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups With Stakeholders

PubMed Central

Wouters, Eveline JM; Luijkx, Katrien G; Vrijhoef, Hubertus JM

2016-01-01

Background There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. Objective To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? Methods Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. Results Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults’ needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes). Conclusions Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale. PMID:27143097

An Interpretative Phenomenological Study on Culturally Responsive Pedagogy in the Physical Education Practicum Setting

ERIC Educational Resources Information Center

Stratton, Jennifer Leary

2013-01-01

As the United States experiences a large demographic shift, current research demonstrates that effective educators implement culturally responsive strategies to support all students in achieving academic success with regards to race, ethnicity, language, socioeconomic status, gender, sexual orientation, religion and exceptionalities (Gollnick…

Students, Learning, Assessment and Technology: A Campus-Wide Merger.

ERIC Educational Resources Information Center

Thompson, Gary; Hoskisson, Dale; Brauner, Carolyn; Christensen, Val

In order to achieve its goal to improve learning and ensure success of students, Valley City State University (VCSU) implemented a comprehensive and multidimensional agenda for institutional change. A central component, Improving Learning with Technology (ILT), involves integration of learning and assessment that is facilitated by, and contingent…

Improving Mathematics Achievement of Exceptional Learners through Differentiated and Peer-Mediated Instruction

ERIC Educational Resources Information Center

Ivory, Tontaleya S.

2007-01-01

The purpose of this study was to implement differentiated and peer-mediated instruction to determine if these instructional interventions were successful in preparing students with disabilities for state standardized tests. In addition, this study identified how exceptional needs learners responded to techniques utilized during differentiated and…

Management and Leadership Issues for School Building Leaders

ERIC Educational Resources Information Center

Tobin, James

2014-01-01

School principals are confronted with a variety of issues as they provide leadership and organization to their schools. Evidence is growing that successful school leaders influence achievement through the support and development of effective teachers and the implementation of effective organizational practice (Davis, Darling-Hammond, LaPointe,…

Geometry Success, Brain Theory, and Community Building

ERIC Educational Resources Information Center

Antink, Suzanne B. Loyer

2010-01-01

This action research project was aimed to improve geometry students' achievement and the retention in a suburban public high school over a one-year implementation cycle. The curricular design was influenced by Dweck's (2006) theories of growth mindset, educational standards, and directives outlined by the National Council of Teachers of…

Idea Bank: Portfolios and Assessment in Music Classes

ERIC Educational Resources Information Center

Silveira, Jason M.

2013-01-01

A portfolio can document student skills, abilities, growth, achievement, and attitudes. It can also reflect students' learning processes and subsequently guide new teaching strategies. Portfolio proponents have used these arguments to justify the time and organization needed to successfully implement them in their classrooms and in their school…

After Common Core, States Set Rigorous Standards

ERIC Educational Resources Information Center

Peterson, Paul E.; Barrows, Samuel; Gift, Thomas

2016-01-01

In spite of Tea Party criticism, union skepticism, and anti-testing outcries, the campaign to implement Common Core State Standards (otherwise known as Common Core) has achieved phenomenal success in statehouses across the country. Since 2011, 45 states have raised their standards for student proficiency in reading and math, with the greatest…

Wilderness education: The ultimate commitment to quality wilderness stewardship

Treesearch

Gregory F. Hansen; Tom Carlson

2007-01-01

The effective planning, implementation, and monitoring of a wilderness education program will ultimately produce measurable results that can be instrumental in achieving wilderness management goals and objectives. This paper will provide a simple step-by-step overview of how to develop and maintain a successful wilderness education program through planning,...

Planning and Implementing Institutional Image and Promoting Academic Programs in Higher Education

ERIC Educational Resources Information Center

Cetin, Rubeena

2003-01-01

Universities face a multitude of issues and challenges in the current era of higher educational endeavors. Universities are being urged to provide high quality education, exist as a well-reputed university, achieve enrollment success, improve competitive positioning, provide contemporary and well-designed academic programs, and maintain financial…

CEC's Policy on Safe and Positive School Climate

ERIC Educational Resources Information Center

Council for Exceptional Children (NJ3), 2008

2008-01-01

The Council for Exceptional Children (CEC) recognizes the important impact a safe and positive school climate has on the personal development and academic achievement of all students. Research has shown that schools implementing supportive and positive school climate strategies are more successful in creating environments conducive to learning. As…

Stakeholder Engagement for Successful Breakfast in the Classroom Implementation

ERIC Educational Resources Information Center

Creighton, Lisa S.

2012-01-01

Childhood hunger is one of the nation's most insidious problems and can have profound negative effects on children's health and development. Often the cause of hunger, food insecurity can limit a child's cognitive and socioemotional development, thereby impairing school achievement, and diminishing long-term productivity and economic potential.…

Multi-Dimensional Parental Involvement in Schools: A Principal's Guide

ERIC Educational Resources Information Center

Rapp, Nicole; Duncan, Heather

2012-01-01

Parental involvement is an important indicator of students' success in school. When schools engage families in a manner connected to improving learning, students do make greater gains. Creating and implementing an effective parental involvement model is an essential component in increasing student achievement in school. This article addresses the…

Building Systemwide Improvement Capability: Does an Organization's Strategy for Quality Improvement Matter?

PubMed

Babich, Lauren P; Charns, Martin P; McIntosh, Nathalie; Lerner, Barbara; Burgess, James F; Stolzmann, Kelly L; VanDeusen Lukas, Carol

2016-01-01

Health care organizations have used different strategies to implement quality improvement (QI) programs but with only mixed success in implementing and spreading QI organization-wide. This suggests that certain organizational strategies may be more successful than others in developing an organization's improvement capability. To investigate this, our study examined how the primary focus of grant-funded QI efforts relates to (1) key measures of grant success and (2) organization-level measures of success in QI and organizational learning. Using a mixed-methods design, we conducted one-way analyses of variance to relate Veterans Affairs administrative survey data to data collected as part of a 3.5-year evaluation of 29 health care organization grant recipients. We then analyzed qualitative evidence from the evaluation to explain our results. We found that hospitals that focused on developing organizational infrastructure to support QI implementation compared with those that focused on training or conducting projects rated highest (at α = .05) on all 4 evaluation measures of grant success and all 3 systemwide survey measures of QI and organizational learning success. This study adds to the literature on developing organizational improvement capability and has practical implications for health care leaders. Focusing on either projects or staff training in isolation has limited value. Organizations are more likely to achieve systemwide transformation of improvement capability if their strategy emphasizes developing or strengthening organizational systems, structures, or processes to support direct improvement efforts.

Picture Archiving and Communication System (PACS) implementation, integration & benefits in an integrated health system.

PubMed

Mansoori, Bahar; Erhard, Karen K; Sunshine, Jeffrey L

2012-02-01

The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

PubMed

Fitch, Dale

2014-01-01

This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

A Plan for Revolutionary Change in Gas Turbine Engine Control System Architecture

NASA Technical Reports Server (NTRS)

Culley, Dennis E.

2011-01-01

The implementation of Distributed Engine Control technology on the gas turbine engine has been a vexing challenge for the controls community. A successful implementation requires the resolution of multiple technical issues in areas such as network communications, power distribution, and system integration, but especially in the area of high temperature electronics. Impeding the achievement has been the lack of a clearly articulated message about the importance of the distributed control technology to future turbine engine system goals and objectives. To resolve these issues and bring the technology to fruition has, and will continue to require, a broad coalition of resources from government, industry, and academia. This presentation will describe the broad challenges facing the next generation of advanced control systems and the plan which is being put into action to successfully implement the technology on the next generation of gas turbine engine systems.

A Method to Evaluate Critical Factors for Successful Implementation of Clinical Pathways.

PubMed

Dong, W; Huang, Z

2015-01-01

Clinical pathways (CPs) have been viewed as a multidisciplinary tool to improve the quality and efficiency of evidence-based care. Despite widespread enthusiasm for CPs, research has shown that many CP initiatives are unsuccessful. To this end, this study provides a methodology to evaluate critical success factors (CSFs) that can aid healthcare organizations to achieve successful CP implementation. This study presents a new approach to evaluate CP implementation CSFs, with the aims being: (1) to identify CSFs for implementation of CPs through a comprehensive literature review and interviews with collaborative experts; (2) to use a filed study data with a robust fuzzy DEMATEL (the decision making trial and evaluation laboratory) approach to visualize the structure of complicated causal relationships between CSFs and obtain the influence level of these factors. The filed study data is provided by ten clinical experts of a Chinese hospital. 23 identified CSF factors which are initially identified through a review of the literature and interviews with collaborative experts. Then, a number of direct and indirect relationships are derived from the data such that different perceptions can be integrated into a compromised cause and effect model of CP implementation. The results indicate that the proposed approach can systematically evaluate CSFs and realize the importance of each factor such that the most common causes of failure of CP implementation could be eliminated or avoided. Therefore, the tool proposed would help healthcare organizations to manage CP implementation in a more effective and proactive way.

Project management practice and its effects on project success in Malaysian construction industry

NASA Astrophysics Data System (ADS)

Haron, N. A.; Devi, P.; Hassim, S.; Alias, A. H.; Tahir, M. M.; Harun, A. N.

2017-12-01

The rapid economic development has increased the demand for construction of infrastructure and facilities globally. Sustainable development and globalization are the new ‘Zeitgeist’ of the 21st century. In order to implement these projects successfully and to meet the functional aim of the projects within their lifetime, an efficient project management practice is needed. The aim of this study is to identify the critical success factors (CSFs) and the extent of use of project management practice which affects project success, especially during the implementation stage. Data were obtained from self-administered questionnaires with 232 respondents. A mixed method of data collection was adopted using semi-structured interview and questionnaire approach. The result of the analysis of data obtained showed that new and emerging criteria such as customer satisfaction, competency of the project team, and performance of subcontractors/suppliers are becoming measures of success in addition to the classic iron triangle’s view of time, cost and quality. An insight on the extent of use of different project management practice in the industry was also achieved from the study.

Increase the success of weight loss programs by creating an environment for change.

PubMed

Churchill, Julie

2010-12-01

Veterinary professionals frequently recommend weight loss programs for pets, but success is often elusive. By learning techniques to assess clients' readiness for change, the veterinary team can apply communication tools and strategies to help clients overcome obstacles and barriers to sustainable change. With a better assessment of a client's ability to change, a weight loss plan can be implemented at the right time in the right way to achieve better adherence to the agreed-upon plan and improve patient health.

Repeat-until-success cubic phase gate for universal continuous-variable quantum computation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marshall, Kevin; Pooser, Raphael; Siopsis, George

2015-03-24

We report that to achieve universal quantum computation using continuous variables, one needs to jump out of the set of Gaussian operations and have a non-Gaussian element, such as the cubic phase gate. However, such a gate is currently very difficult to implement in practice. Here we introduce an experimentally viable “repeat-until-success” approach to generating the cubic phase gate, which is achieved using sequential photon subtractions and Gaussian operations. Ultimately, we find that our scheme offers benefits in terms of the expected time until success, as well as the fact that we do not require any complex off-line resource state,more » although we require a primitive quantum memory.« less

The role of certification in the buyer/planner position: a case study at Harley-Davidson Motor Company.

PubMed

Orange, V J; Robinson, D E

1999-02-01

The use of buyer/planners may becoming more popular. If they are, the reason is probably that many companies are integrating materiel management skill sets as a way of increasing the effectiveness of their supply chains. Harley-Davidson recently created a supply management function composed of buyer/planners. This article describes the method it used to achieve the transition, the training plan it implemented to support the process, and the role management played in achieving success.

A real time microcomputer implementation of sensor failure detection for turbofan engines

NASA Technical Reports Server (NTRS)

Delaat, John C.; Merrill, Walter C.

1989-01-01

An algorithm was developed which detects, isolates, and accommodates sensor failures using analytical redundancy. The performance of this algorithm was demonstrated on a full-scale F100 turbofan engine. The algorithm was implemented in real-time on a microprocessor-based controls computer which includes parallel processing and high order language programming. Parallel processing was used to achieve the required computational power for the real-time implementation. High order language programming was used in order to reduce the programming and maintenance costs of the algorithm implementation software. The sensor failure algorithm was combined with an existing multivariable control algorithm to give a complete control implementation with sensor analytical redundancy. The real-time microprocessor implementation of the algorithm which resulted in the successful completion of the algorithm engine demonstration, is described.

Interventions in Early Mathematics: Avoiding Pollution and Dilution.

PubMed

Sarama, Julie; Clements, Douglas H

2017-01-01

Although specific interventions in early mathematics have been successful, few have been brought to scale successfully, especially across the challenging diversity of populations and contexts in the early childhood system in the United States. In this chapter, we analyze a theoretically based scale-up model for early mathematics that was designed to avoid the pollution and dilution that often plagues efforts to achieve broad success. We elaborate the theoretical framework by noting the junctures that are susceptible to dilution or pollution. Then we expatiate the model's guidelines to describe specifically how they were designed and implemented to mitigate pollution and dilution. Finally, we provide evidence regarding the success of these efforts. © 2017 Elsevier Inc. All rights reserved.

Language and the Cultural Life of a Child. (Lenguaje y Cultura de La Vida de un Nino).

ERIC Educational Resources Information Center

Buckenmeyer, Robert

These guidelines offer information necessary to define, organize, and implement a screening program for preschool children that identifies suspected physical, behavioral, and educational problems that may interfere with children's ability to achieve success in school. An Early Screening Program (ESP) utilizes testing devices to aid problem…

Building the Capacity of School Leaders and Teachers to Implement Reform at All Levels

ERIC Educational Resources Information Center

Southern Regional Education Board (SREB), 2010

2010-01-01

Leaders of successful high schools, middle grades schools and technology centers are strengthening their skills and involving the entire school in plans to raise student achievement. The best school leaders establish an environment of continuous progress in which teachers and leaders work together to upgrade curriculum and instruction, examine…

Successful Transition to Elementary School and the Implementation of Facilitative Practices Specified in the Reggio-Emilia Philosophy

ERIC Educational Resources Information Center

Schneider, Barry H.; Manetti, Mara; Frattini, Laura; Rania, Nadia; Santo, Jonathan Bruce; Coplan, Robert J.; Cwinn, Eli

2014-01-01

Systematic, mandated facilitation of school transitions is an important but understudied aspect of the Reggio-Emilia approach to early childhood education admired internationally as best practice. We studied the links between Northern Italian transition practices and academic achievement, school liking, cooperativeness, and problem behaviors. We…

An Evaluation of Enrollment Management Models of the 28 Florida Community Colleges

ERIC Educational Resources Information Center

LoBasso, Thomas

2006-01-01

The purpose of this study was to determine the extent to which enrollment management models have been successfully implemented within the 28 Florida community colleges. The study also sought to determine when enrollment management structures began and whether expected benefits were achieved. Analysis of the data collected in this study indicated…

Athletic Participation and "New England Common Assessment Program" Scores

ERIC Educational Resources Information Center

Powers, Timothy J.

2011-01-01

In many schools, standardized tests are used to determine school effectiveness in instruction. School districts spend money, implement research, and look for new ways to improve on these metrics of academic achievement. Researchers have shown that athletic participation has helped to lead to academic success at a macro level; however less is known…

Motivating Students for Excellence. The Best of ERIC on Educational Management, Number 73.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Educational Management, Eugene, OR.

The first 2 of the 12 publications reviewed in this annotated bibliography use Abraham Maslow's hierarchy of needs to address problems, respectively, of teaching composition and of motivating students by teaching them how to set goals, formulate goal-achievement strategies, and successfully implement their plans. Subsequent reports suggest ways of…

Electronic Invoice in Costa Rica: Challenges for Its Implementation

ERIC Educational Resources Information Center

Ramírez-Jiménez, Juan José; De La O-Selva, Mario; Cortés-Morales, Roberto

2016-01-01

This paper discusses the current situation that Costa Rica faces around fiscal issues and high evasion rates. Using actors and multidimensional analysis, it proposes the electronic invoice as an e-government strategic solution that will close the gap around tax evasion and the government incomes. The success achieved by Brazil in this area…

Social Dynamics in Adult and Community Education Networks: Insights from a Case Study

ERIC Educational Resources Information Center

Dollhausen, Karin; Alke, Matthias

2014-01-01

Implementing network type structures has become a widely appreciated strategy to promote actor-relationships in the field of adult and community education and to coordinate them purposefully. However, there is still a lack of knowledge on how a "successful" coordination of actor-relationships can actually be achieved. This paper offers…

Accepting the Utopian Challenge: A Student Perspective

ERIC Educational Resources Information Center

Carman, Breanna R.

2013-01-01

The scholarship of teaching and learning (SoTL) allows institutions to achieve the goals required for student learning and success. The purpose of this paper is to address recommendations for the implementation of SoTL that should have relevant input from students. These include, but are not limited to, better communication, evaluation, continuing…

From Professional Development to Implementation: What Teachers Say Makes Change Happen

ERIC Educational Resources Information Center

Depka, Eileen M.

2012-01-01

The success of students across the nation is reliant on the expertise and talents of teachers. Continuous growth and lifelong learning are expectations within the teaching profession. Learning new strategies in order to meet student needs and boost achievement is a constant target. Each year school districts spend millions of dollars on…

Making Academics Count: Action Guide. Successful Strategies.

ERIC Educational Resources Information Center

McMahon, Amanda Sodoma; Meeder, Hans; Rosen, Linda P.; Silver, Steve; Williams, Andra

This document is intended to help communities plan and implement initiatives modeled after Making Academics Count, a campaign that was launched in 1997 by the Business Coalition for Education Reform (BCER) to encourage employers to ask job applicants for their school records and thereby help motivate students to achieve at higher levels. The guide…

Adaptive management areas: achieving the promise, avoiding the peril.

Treesearch

George H. Stankey; Bruce Shindler

1997-01-01

Ten Adaptive Management Areas (AMAs) were created in compliance with the Northwest Forest Plan. Although the essence of adaptive management is to treat management as an experiment and to "learn how to learn," several barriers affect the successful implementation of AMAs. Four propositions are identified that address these potential barriers: (1) area...

Best Practices of Award-Winning Public School Principals: Implications for University Preparation Programs

ERIC Educational Resources Information Center

Harris, Sandra L.

2006-01-01

There is no doubt that quality administrator preparation is critical because research has documented that successful school leaders have a strong influence on student achievement as they set direction, support and develop effective teachers, and as they implement effective organizational processes. Yet, it seems that every day the media reports…

Academic Performance: A Case Study of Mathematics and Science Educators from Rural Washington High Schools

ERIC Educational Resources Information Center

Hancock, Tira K.

2009-01-01

A qualitative descriptive case study explored courses of action for educators and leaders of math and science educators to implement to help students achieve state assessment standard and postsecondary success. The problem focused on two demographically similar rural high schools in Southwest Washington that demonstrated inadequate rates of…

Achievements of the ITB's--Furniture and Timber Industry Training Board

ERIC Educational Resources Information Center

Industrial Training International, 1974

1974-01-01

The Furniture and Industry Training Board set out in 1965 to find a means of successfully implementing management training in small firms. The author describes research efforts undertaken by the Board which led to the development of the training program now in use--management development based on company appraisal. (AJ)

Get Me to the Meet on Time: Challenges of High School Coaching

ERIC Educational Resources Information Center

Jenny, Seth E.

2015-01-01

In order to achieve success, there is little doubt that sport coaches must overcome a plethora of challenges beyond simply designing and implementing effective training schedules and competition strategies. The United States high school interscholastic sports environment is no different. The purpose of this short essay is to provide a personal…

Public Internet Access Points (PIAPs) and Their Social Impact: A Case Study from Turkey

ERIC Educational Resources Information Center

Afacan, Gulgun; Er, Erkan; Arifoglu, Ali

2013-01-01

Building public Internet access points (PIAPs) is a significant contribution of governments towards achieving an information society. While many developing countries are investing great amounts to establish PIAPs today, people may not use PIAPs effectively. Yet, the successful implementation of PIAPs is the result of citizens' acceptance to use…

Post-Adoption Issues Related to Cloud-Based IT Solutions: A Multi-Method Investigation

ERIC Educational Resources Information Center

Xiao, Xiao

2013-01-01

Due to their low cost of implementation and considerable elasticity, cloud-based IT solutions are being widely adopted or considered in organizations across various industries. However, such IT solutions bring forth several unique challenges--challenges that make it difficult for organizations to achieve successful utilization of cloud-based…

Meeting the Challenge of Limited Literacy Resources for Adolescents and Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Morgan, Michelle F.; Moni, Karen B.

2008-01-01

For adolescents and adults with mild to moderate intellectual disabilities (or, in the UK, learning disabilities or learning difficulties), the achievement of successful engagement with, and construction of meaning from, texts necessitates the implementation and use of specifically designed and adapted teaching strategies and resources. The…

Improving Student Academic Success through the Promotion of Listening Skills.

ERIC Educational Resources Information Center

Owca, Sally; Pawlak, Emmie; Pronobis, Melanie

This action research project implemented and evaluated a program for improving listening skills in order to improve academic achievement. The targeted population consisted of sixth- and eighth-grade students of three upper/middle class communities located near a large Midwestern city. The problem of poor listening skills was observed when students…

Challenges in Implementation of Early Childhood Education in Nigeria: The Way Forward

ERIC Educational Resources Information Center

Akinrotimi, Adenike A.; Olowe, Peter K.

2016-01-01

Early Childhood Education (ECE) comprises essential programmes and activities which are critical to holistic development, academic success and future achievements of children. ECE is recognised by the federal government of Nigeria as a foundational and essential programme that Nigerian children must experience. This is why the government has given…

Development and implementation of a balanced scorecard in an academic hospitalist group.

PubMed

Hwa, Michael; Sharpe, Bradley A; Wachter, Robert M

2013-03-01

Academic hospitalist groups (AHGs) are often expected to excel in multiple domains: quality improvement, patient safety, education, research, administration, and clinical care. To be successful, AHGs must develop strategies to balance their energies, resources, and performance. The balanced scorecard (BSC) is a strategic management system that enables organizations to translate their mission and vision into specific objectives and metrics across multiple domains. To date, no hospitalist group has reported on BSC implementation. We set out to develop a BSC as part of a strategic planning initiative. Based on a needs assessment of the University of California, San Francisco, Division of Hospital Medicine, mission and vision statements were developed. We engaged representative faculty to develop strategic objectives and determine performance metrics across 4 BSC perspectives. There were 41 metrics identified, and 16 were chosen for the initial BSC. It allowed us to achieve several goals: 1) present a broad view of performance, 2) create transparency and accountability, 3) communicate goals and engage faculty, and 4) ensure we use data to guide strategic decisions. Several lessons were learned, including the need to build faculty consensus, establish metrics with reliable measureable data, and the power of the BSC to drive goals across the division. We successfully developed and implemented a BSC in an AHG as part of a strategic planning initiative. The BSC has been instrumental in allowing us to achieve balanced success in multiple domains. Academic groups should consider employing the BSC as it allows for a data-driven strategic planning and assessment process. Copyright © 2013 Society of Hospital Medicine.

Implementing Lean Manufacturing in Malaysian Small and Medium Startup Pharmaceutical Company

NASA Astrophysics Data System (ADS)

Ibrahim, Wan Mohd Khairi bin Wan; Rahman, Mohamed Abdul; Abu Bakar, Mohd Rushdi bin

2017-03-01

Domestic pharmaceutical industry has been identified by the Malaysian government as an industry to be developed under its 11th economic development plan. Most homegrown pharmaceutical companies fall under the category of small and medium enterprises (SME) and therefore need to be highly efficient in their operations to compete with the multinationals. Though lean manufacturing is a well-known methodology to achieve an efficient operation, only a small percentage of the local SMEs implement it. The study aims to determine the real success factors in lean implementation through systematic review of relevant literature on lean manufacturing implementation in local companies, onsite observation of a selected SME company, Global Factor Sdn. Bhd. (GFSB), that successfully implemented lean manufacturing followed by actual implementation of lean project at IKOP Sdn. Bhd., a small startup pharmaceutical company. Lean tools like Gemba, value stream map (VSM) and spaghetti diagram were used to analyze and improve a process at IKOP Sdn. Bhd. The literature review showed that the implementation of lean manufacturing at Malaysian SMEs involved in pharmaceutical industry is at its infancy. Study at GFSB indicated that successful implementation of lean manufacturing stems from management support, employee’s commitment, government support and knowledge on lean among employees. Application of lean tools in IKOP Sdn. Bhd. to improve the process cycle efficiency of hand sanitizer, i-Hand 4.0, has shown that the GMP guidelines are not jeopardized. The Kaizen improvement project resulted in 46.3% reduction in lead time. It may be concluded that implementing lean manufacturing in any small local startup pharmaceutical company is beneficial in reducing operational costs and increasing the efficiency and effectiveness and does not conflict with the existing GMP guidelines.

What works in implementation of integrated care programs for older adults with complex needs? A realist review

PubMed Central

Kirst, Maritt; Im, Jennifer; Burns, Tim; Baker, G. Ross; Goldhar, Jodeme; O'Campo, Patricia; Wojtak, Anne; Wodchis, Walter P

2017-01-01

Abstract Purpose A realist review of the evaluative evidence was conducted on integrated care (IC) programs for older adults to identify key processes that lead to the success or failure of these programs in achieving outcomes such as reduced healthcare utilization, improved patient health, and improved patient and caregiver experience. Data sources International academic literature was searched in 12 indexed, electronic databases and gray literature through internet searches, to identify evaluative studies. Study selection Inclusion criteria included evaluative literature on integrated, long-stay health and social care programs, published between January 1980 and July 2015, in English. Data extraction Data were extracted on the study purpose, period, setting, design, population, sample size, outcomes, and study results, as well as explanations of mechanisms and contextual factors influencing outcomes. Results of data synthesis A total of 65 articles, representing 28 IC programs, were included in the review. Two context-mechanism-outcome configurations (CMOcs) were identified: (i) trusting multidisciplinary team relationships and (ii) provider commitment to and understanding of the model. Contextual factors such as strong leadership that sets clear goals and establishes an organizational culture in support of the program, along with joint governance structures, supported team collaboration and subsequent successful implementation. Furthermore, time to build an infrastructure to implement and flexibility in implementation, emerged as key processes instrumental to success of these programs. Conclusions This review included a wide range of international evidence, and identified key processes for successful implementation of IC programs that should be considered by program planners, leaders and evaluators. PMID:28992156

Implementation of clinical decision rules in the emergency department.

PubMed

Stiell, Ian G; Bennett, Carol

2007-11-01

Clinical decision rules (CDRs) are tools designed to help clinicians make bedside diagnostic and therapeutic decisions. The development of a CDR involves three stages: derivation, validation, and implementation. Several criteria need to be considered when designing and evaluating the results of an implementation trial. In this article, the authors review the results of implementation studies evaluating the effect of four CDRs: the Ottawa Ankle Rules, the Ottawa Knee Rule, the Canadian C-Spine Rule, and the Canadian CT Head Rule. Four implementation studies demonstrated that the implementation of CDRs in the emergency department (ED) safely reduced the use of radiography for ankle, knee, and cervical spine injuries. However, a recent trial failed to demonstrate an impact on computed tomography imaging rates. Well-developed and validated CDRs can be successfully implemented into practice, efficiently standardizing ED care. However, further research is needed to identify barriers to implementation in order to achieve improved uptake in the ED.

Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals.

PubMed

Shamsuddin Alaraki, Mohammad

The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation. A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals. The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve "customer satisfaction" nor to achieve measurable improvements in "quality results" scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi hospitals. It appears that the most important contributing factors to the successful implementation of QI in Saudi hospitals are proper human resources utilization and effective quality management. Through careful planning, change management, proper utilization of human resources, supportive quality information systems, focus on processes and systems, structural support, and an organizational culture that is compatible with QI philosophy, Saudi hospitals will be more capable in achieving sustained measureable improvements in the quality and safety of patient care.

Recruitment and retention of Alaska natives into nursing: elements enabling educational success.

PubMed

Rearden, Annette K

2012-01-01

In response to the underrepresentation of Alaska Native/American Indian nurses, nursing programs have implemented recruitment and retention efforts to support undergraduate Alaska Native/American Indian nursing students. The objective of this project was to provide graduates from the Recruitment and Retention of Alaska Natives into Nursing (RRANN) program the opportunity to identify program elements important to achieving academic success, levels of satisfaction, and make recommendations for future program direction. Findings suggest RRANN graduates viewed the program as vital to academic success. Recommendations include utilizing former graduates in recruitment and retention efforts, as mentors, and extending the program to benefit graduate students.

Managing change: an overview.

PubMed

Lorenzi, N M; Riley, R T

2000-01-01

As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

Disease management interventions II: What else is in the black box?

PubMed

Linden, Ariel; Butterworth, Susan W; Roberts, Nancy

2006-04-01

The success of any disease management (DM) program ultimately depends upon the ability and willingness of participants to change and maintain desired health behaviors. To achieve those results, DM program administrators have several issues to consider, including the type of behavioral change desired, the scope of intervention that the organization is willing and capable of implementing, and whether the appropriate support structures are available to ensure successful achievement of program goals. An understanding of these issues will assist program designers in selecting the appropriate change models. This paper serves as an extension of our prior paper in which eight core psychosocial behavioral change models were described. Here, five more recently developed theory-based approaches are introduced, providing readers with up-to-date information in this area.

A Tale of Two Effective Title One Reward Charter Schools

ERIC Educational Resources Information Center

Metcalfe, Laura

2014-01-01

This research project was a study that was based on a prior dissertation study that analyzed student success, as measured by achievement tests, within local communities with high poverty rates. Two Title 1 Reward high schools in the Phoenix area were examined through qualitative case studies to determine what had been implemented to help eliminate…

When Dollars Follow Students: The Political Viability, Equity and Workability of Weighted Funding Formulas

ERIC Educational Resources Information Center

Deroche, Timothy R.; Cooper, Bruce S.; Ouchi, William G.

2004-01-01

For more than a decade, education reformers have admired the achievements of the Edmonton Public Schools in Canada, and school districts across the United States have attempted to replicate Edmonton's success with school-site decision making. However, most districts have stopped short of implementing one policy that is central to Edmonton's…

The Effects of the Elevate Math Summer Program on Math Achievement and Algebra Readiness

ERIC Educational Resources Information Center

Snipes, Jason; Huang, Chun-Wei; Jaquet, Karina; Finkelstein, Neal

2016-01-01

To raise math success rates in middle school, many schools and districts have implemented summer math programs designed to improve student preparation for algebra content in grade 8. However, little is known about the effectiveness of these programs. While students who participate typically experience learning gains, there is little rigorous…

The Soldier Fitness Tracker: Global Delivery of Comprehensive Soldier Fitness

ERIC Educational Resources Information Center

Fravell, Mike; Nasser, Katherine; Cornum, Rhonda

2011-01-01

Carefully implemented technology strategies are vital to the success of large-scale initiatives such as the U.S. Army's Comprehensive Soldier Fitness (CSF) program. Achieving the U.S. Army's vision for CSF required a robust information technology platform that was scaled to millions of users and that leveraged the Internet to enable global reach.…

Rigid and flexible organic electrochemical transistor arrays for monitoring action potentials from electrogenic cells.

PubMed

Yao, Chunlei; Li, Qianqian; Guo, Jing; Yan, Feng; Hsing, I-Ming

2015-03-11

Rigid and flexible organic electrochemical transistor arrays are successfully implemented for monitoring cardiac action potentials. Excellent signal to noise ratios are achieved with values routinely larger than 4. These devices are promising to be used in both conventional and emerging areas. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Short-Term International Service-Learning: Faculty Perceptions of and Pedagogical Strategies for the Design and Implementation of Successful Learning Experiences

ERIC Educational Resources Information Center

Van Cleave, Thomas Jacob

2013-01-01

Faculty-led short-term international service-learning (STISL) experiences are thought to have great potential in developing students' global citizenship through combining study abroad and community service pedagogies. However, thorough investigation of the pedagogical strategies employed in STISL courses to achieve such outcomes has yet to be…

Outsourcing occupational health services. Critical elements.

PubMed

Dyck, Dianne

2002-02-01

Successful management of an outsourcing relationship produces a highly interactive, flexible relationship between two organizations. The unique skills and resources of the service provider can be leveraged by the purchasing organization to achieve its business goals. Occupational and environmental health nurses can orchestrate this process and implement this important management tool in the provision of quality occupational health services.

The Implementation of the Accelerated Reader Program and Its Contribution to Success on Standardized Tests

ERIC Educational Resources Information Center

Myers, Marion

2012-01-01

This quantitative, non-experimental, correlational study investigated the effects of the Accelerated Reader (AR) program on reading achievement in elementary school students. The study also examined the perceptions of teachers and administrators about the effectiveness of the AR program. This study took place in three elementary schools located in…

Assessing Fidelity of Core Components in a Mindfulness and Yoga Intervention for Urban Youth: Applying the CORE Process

ERIC Educational Resources Information Center

Gould, Laura Feagans; Mendelson, Tamar; Dariotis, Jacinda K.; Ancona, Matthew; Smith, Ali S. R.; Gonzalez, Andres A.; Smith, Atman A.; Greenberg, Mark T.

2014-01-01

In the past years, the number of mindfulness-based intervention and prevention programs has increased steadily. In order to achieve the intended program outcomes, program implementers need to understand the essential and indispensable components that define a program's success. This chapter describes the complex process of identifying the core…

Does Implementing an Emotional Intelligence Program Guarantee Student Achievement?

ERIC Educational Resources Information Center

Wilkens, Coral L.; Wilmore, Elaine

2015-01-01

Being a 21st century learner may require a shift in the education paradigm. To be successful students may need to possess a different type of intelligence. Cherniss (2001), Goleman (1995), and O'Neil (1996), suggest that the key to positive life outcomes might consider emotional intelligence as more important than intellectual quotient (IQ).…

Qatar's K-12 Education Reform Has Achieved Success in Its Early Years. Research Brief

ERIC Educational Resources Information Center

Larson, Judy

2009-01-01

To evaluate progress made in the first years of Qatar's implementation of K-12 education reform, RAND analyzed data from school-level observations, national surveys, and national student assessments. The study found that students in the new, Independent schools were performing better than those in Ministry schools, and there was greater student…

Role Perceptions of School Administration Team Members Concerning Inclusion of Children with Disabilities in Elementary General Schools in Israel

ERIC Educational Resources Information Center

Shani, Michal; Koss, Cathie

2015-01-01

In an ideal school, where inclusion is implemented successfully, staff members collaborate and create an inclusive environment in their schools. In order to achieve such a sustainable environment of inclusion, pedagogical, organisational and psychological restructuring should occur, and a strong inclusion-oriented leadership has to be activated.…

The Effects of an Educational Video Game on Mathematical Engagement

ERIC Educational Resources Information Center

Chang, Mido; Evans, Michael A.; Kim, Sunha; Norton, Anderson; Deater-Deckard, Kirby; Samur, Yavuz

2016-01-01

In an effort to maximizing success in mathematics, our research team implemented an educational video game in fifth grade mathematics classrooms in five schools in the Eastern US. The educational game was developed by our multi-disciplinary research team to achieve a hypothetical learning trajectory of mathematical thinking of 5th grade students.…

Turnaround Schools as a U-Turn for Student Achievement: The Rotary of School Reform Efforts

ERIC Educational Resources Information Center

Mette, Ian M.

2012-01-01

This case study presents data to support the notion that turnaround school policy can improve the efficiency of how traditionally low-performing schools function. The schools that were successful in implementing the UVA Turnaround Program training developed a clear understanding of the expectations for participating in the UVA Turnaround Program…

How Do the Different Types of Computer Use Affect Math Achievement?

ERIC Educational Resources Information Center

Flores, Raymond; Inan, Fethi; Lin, Zhangxi

2013-01-01

In this study, the National Educational Longitudinal Study (ELS:2002) dataset was used and a predictive data mining technique, decision tree analysis, was implemented in order to examine which factors, in conjunction to computer use, can be used to predict high or low probability of success in high school mathematics. Specifically, this study…

Achieving the Dream: An Examination of Success Factors with a Focus on Cultural Changes

ERIC Educational Resources Information Center

Cornelius, Cathy D.

2013-01-01

This study examines the change process to enhance student persistence and graduation rates in four North Carolina community colleges. Using a qualitative research methodology, Lewin's change model is presented as a framework to investigate the acceptance and implementation of AtD principles in two community colleges. Processes to enhance student…

Foundations for High Achievement: Safety, Civility, Literacy. K-12 Public Education.

ERIC Educational Resources Information Center

Colorado State Dept. of Education, Denver. Research and Evaluation Unit.

The state of Colorado has set high standards for students based on three fundamental principles: safety, civility, and literacy. How these standards were integrated into the schools is the subject of this report. It opens with an overview of the foundations of academic success and the process involved in implementing standards-based education. The…

The Impact of Teacher Attitudes and Perceptions of Direct Instruction on Student Achievement in Reading

ERIC Educational Resources Information Center

Collum, Sharon P.

2012-01-01

According to the National Center for Education Statistics (2004), 37% of America's fourth graders are not reading at grade level. This statistic has remained unchanged for over a decade (NCES, 2004). Findings from multiple studies indicate more research on successfully implementing reading interventions is needed (Begeny & Silber, 2006;…

Implementation Intention and Reminder Effects on Behavior Change in a Mobile Health System: A Predictive Cognitive Model

PubMed Central

Mohan, Shiwali; Venkatakrishnan, Anusha; Nelson, Les; Silva, Michael; Springer, Aaron

2017-01-01

Background Implementation intentions are mental representations of simple plans to translate goal intentions into behavior under specific conditions. Studies show implementation intentions can produce moderate to large improvements in behavioral goal achievement. Human associative memory mechanisms have been implicated in the processes by which implementation intentions produce effects. On the basis of the adaptive control of thought-rational (ACT-R) theory of cognition, we hypothesized that the strength of implementation intention effect could be manipulated in predictable ways using reminders delivered by a mobile health (mHealth) app. Objective The aim of this experiment was to manipulate the effects of implementation intentions on daily behavioral goal success in ways predicted by the ACT-R theory concerning mHealth reminder scheduling. Methods An incomplete factorial design was used in this mHealth study. All participants were asked to choose a healthy behavior goal associated with eat slowly, walking, or eating more vegetables and were asked to set implementation intentions. N=64 adult participants were in the study for 28 days. Participants were stratified by self-efficacy and assigned to one of two reminder conditions: reminders-presented versus reminders-absent. Self-efficacy and reminder conditions were crossed. Nested within the reminders-presented condition was a crossing of frequency of reminders sent (high, low) by distribution of reminders sent (distributed, massed). Participants in the low frequency condition got 7 reminders over 28 days; those in the high frequency condition were sent 14. Participants in the distributed conditions were sent reminders at uniform intervals. Participants in the massed distribution conditions were sent reminders in clusters. Results There was a significant overall effect of reminders on achieving a daily behavioral goal (coefficient=2.018, standard error [SE]=0.572, odds ratio [OR]=7.52, 95% CI 0.9037-3.2594, P<.001). As predicted by ACT-R, using default theoretical parameters, there was an interaction of reminder frequency by distribution on daily goal success (coefficient=0.7994, SE=0.2215, OR=2.2242, 95% CI 0.3656-1.2341, P<.001). The total number of times a reminder was acknowledged as received by a participant had a marginal effect on daily goal success (coefficient=0.0694, SE=0.0410, OR=1.0717, 95% CI −0.01116 to 0.1505, P=.09), and the time since acknowledging receipt of a reminder was highly significant (coefficient=−0.0490, SE=0.0104, OR=0.9522, 95% CI −0.0700 to −0.2852], P<.001). A dual system ACT-R mathematical model was fit to individuals’ daily goal successes and reminder acknowledgments: a goal-striving system dependent on declarative memory plus a habit-forming system that acquires automatic procedures for performance of behavioral goals. Conclusions Computational cognitive theory such as ACT-R can be used to make precise quantitative predictions concerning daily health behavior goal success in response to implementation intentions and the dosing schedules of reminders. PMID:29191800

Improving cancer care in Europe: Which institutional health structures might be beneficial and why? 1. European Roundtable Meeting (ERTM), 16th May 2014, Berlin, Germany.

PubMed

Ortmann, Olaf; Helbig, U; Torode, J

2016-01-01

Bringing the knowledge and expertise of different European countries and the European Commission together for an analysis of the different factors being beneficent or rather opposing for high quality in cancer care. A specific focus is set on the structures and views in European nations on implementation processes. Due to the variation of National Cancer Control Plans (NCCPs) the preferences for implementation strategies differ. For quality achievement the involvement of the different stakeholders is beneficial. Common sense was the importance of NCCPs. However, it was consensus between participants that a bottom-up approach that considers the needs of different professional groups involved in cancer care and also the views of patients is of critical importance for successful implementation. Functioning cancer registries and evidence-based guidelines with standard of care are fundamental for quality measurement. There is consensus between participants of the meeting that NCCPs are essential for improvement of cancer care. However, national preferences and the views of patients and caregivers have to be included to guarantee successful implementation.

An Agent Inspired Reconfigurable Computing Implementation of a Genetic Algorithm

NASA Technical Reports Server (NTRS)

Weir, John M.; Wells, B. Earl

2003-01-01

Many software systems have been successfully implemented using an agent paradigm which employs a number of independent entities that communicate with one another to achieve a common goal. The distributed nature of such a paradigm makes it an excellent candidate for use in high speed reconfigurable computing hardware environments such as those present in modem FPGA's. In this paper, a distributed genetic algorithm that can be applied to the agent based reconfigurable hardware model is introduced. The effectiveness of this new algorithm is evaluated by comparing the quality of the solutions found by the new algorithm with those found by traditional genetic algorithms. The performance of a reconfigurable hardware implementation of the new algorithm on an FPGA is compared to traditional single processor implementations.

Stratospheric cruise emission reduction program

NASA Technical Reports Server (NTRS)

Diehl, L. A.; Reck, G. M.; Marek, C. J.; Szaniszlo, A. J.

1977-01-01

A recently implemented NASA effort specifically aimed at reducing cruise oxides of nitrogen from high-altitude aircraft is discussed. The desired emission levels and the combustor technology required to achieve them are discussed. A brief overview of the SCERP operating plan is given. Lean premixed-prevaporized combustion and some of the potential difficulties that are associated with applying this technique to gas turbine combustors are examined. Base technology was developed in several key areas. These fundamental studies are viewed as a requirement for successful implementation of the lean premixed combustion technique.

Carolina Care at University of North Carolina Health Care: Implementing a Theory-Driven Care Delivery Model Across a Healthcare System.

PubMed

Tonges, Mary; Ray, Joel D; Herman, Suzanne; McCann, Meghan

2018-04-01

Patient satisfaction is a key component of healthcare organizations' performance. Providing a consistent, positive patient experience across a system can be challenging. This article describes an organization's approach to achieving this goal by implementing a successful model developed at the flagship academic healthcare center across an 8-hospital system. The Carolina Care at University of North Carolina Health Care initiative has resulted in substantive qualitative and quantitative benefits including higher patient experience scores for both overall rating and nurse communication.

Total quality through computer integrated manufacturing in the pharmaceutical industry.

PubMed

Ufret, C M

1995-01-01

The role of Computer Integrated Manufacturing (CIM) in the pursue of total quality in pharmaceutical manufacturing is assessed. CIM key objectives, design criteria, and performance measurements, in addition to its scope and implementation in a hierarchical structure, are explored in detail. Key elements for the success of each phase in a CIM project and a brief status of current CIM implementations in the pharmaceutical industry are presented. The role of World Class Manufacturing performance standards and other key issues to achieve full CIM benefits are also addressed.

Financial Analysis of a Selected Company

NASA Astrophysics Data System (ADS)

Baran, Dušan; Pastýr, Andrej; Baranová, Daniela

2016-06-01

The success of every business enterprise is directly related to the competencies of business management. The business enterprise can, as a result, create variations of how to approach the new complex and changing situations of success in the market. Therefore managers are trying during negative times to change their management approach, to ensure long-term and stable running of the business enterprise. They are forced to continuously maintain and obtain customers and suppliers. By implementing these measures they have the opportunity to achieve a competitive advantage over other business enterprises.

Process control systems: integrated for future process technologies

NASA Astrophysics Data System (ADS)

Botros, Youssry; Hajj, Hazem M.

2003-06-01

Process Control Systems (PCS) are becoming more crucial to the success of Integrated Circuit makers due to their direct impact on product quality, cost, and Fab output. The primary objective of PCS is to minimize variability by detecting and correcting non optimal performance. Current PCS implementations are considered disparate, where each PCS application is designed, deployed and supported separately. Each implementation targets a specific area of control such as equipment performance, wafer manufacturing, and process health monitoring. With Intel entering the nanometer technology era, tighter process specifications are required for higher yields and lower cost. This requires areas of control to be tightly coupled and integrated to achieve the optimal performance. This requirement can be achieved via consistent design and deployment of the integrated PCS. PCS integration will result in several benefits such as leveraging commonalities, avoiding redundancy, and facilitating sharing between implementations. This paper will address PCS implementations and focus on benefits and requirements of the integrated PCS. Intel integrated PCS Architecture will be then presented and its components will be briefly discussed. Finally, industry direction and efforts to standardize PCS interfaces that enable PCS integration will be presented.

Achievements and challenges of the World Bank Loan/Department for International Development grant-assisted Tuberculosis Control Project in China.

PubMed

Kong, Peng; Jiang, Xu; Zhang, Ben; Jiang, Shi-wen; Liu, Bo

2011-07-01

In March 2002, the government of China launched the World Bank Loan/ Department for International Development-supported Tuberculosis (TB) Control Project to reduce the prevalence and mortality of TB. The project generated promising results in policy development, strengthening of TB control systems, patient treatment success, funds management, and the introduction of legislation. In light of the global TB epidemic and control environment, it is useful to review the TB control priorities of the project, summarize the achievements and experiences around its implementation.

Design and implementation of a laboratory-based drug design and synthesis advanced pharmacy practice experience.

PubMed

Philip, Ashok; Stephens, Mark; Mitchell, Sheila L; Watkins, E Blake

2015-04-25

To provide students with an opportunity to participate in medicinal chemistry research within the doctor of pharmacy (PharmD) curriculum. We designed and implemented a 3-course sequence in drug design or drug synthesis for pharmacy students consisting of a 1-month advanced elective followed by two 1-month research advanced pharmacy practice experiences (APPEs). To maximize student involvement, this 3-course sequence was offered to third-year and fourth-year students twice per calendar year. Students were evaluated based on their commitment to the project's success, productivity, and professionalism. Students also evaluated the course sequence using a 14-item course evaluation rubric. Student feedback was overwhelmingly positive. Students found the experience to be a valuable component of their pharmacy curriculum. We successfully designed and implemented a 3-course research sequence that allows PharmD students in the traditional 4-year program to participate in drug design and synthesis research. Students report the sequence enhanced their critical-thinking and problem-solving skills and helped them develop as independent learners. Based on the success achieved with this sequence, efforts are underway to develop research APPEs in other areas of the pharmaceutical sciences.

Fast and Flexible Successive-Cancellation List Decoders for Polar Codes

NASA Astrophysics Data System (ADS)

Hashemi, Seyyed Ali; Condo, Carlo; Gross, Warren J.

2017-11-01

Polar codes have gained significant amount of attention during the past few years and have been selected as a coding scheme for the next generation of mobile broadband standard. Among decoding schemes, successive-cancellation list (SCL) decoding provides a reasonable trade-off between the error-correction performance and hardware implementation complexity when used to decode polar codes, at the cost of limited throughput. The simplified SCL (SSCL) and its extension SSCL-SPC increase the speed of decoding by removing redundant calculations when encountering particular information and frozen bit patterns (rate one and single parity check codes), while keeping the error-correction performance unaltered. In this paper, we improve SSCL and SSCL-SPC by proving that the list size imposes a specific number of bit estimations required to decode rate one and single parity check codes. Thus, the number of estimations can be limited while guaranteeing exactly the same error-correction performance as if all bits of the code were estimated. We call the new decoding algorithms Fast-SSCL and Fast-SSCL-SPC. Moreover, we show that the number of bit estimations in a practical application can be tuned to achieve desirable speed, while keeping the error-correction performance almost unchanged. Hardware architectures implementing both algorithms are then described and implemented: it is shown that our design can achieve 1.86 Gb/s throughput, higher than the best state-of-the-art decoders.

Measuring Success in Health Care Value-Based Purchasing Programs

PubMed Central

Damberg, Cheryl L.; Sorbero, Melony E.; Lovejoy, Susan L.; Martsolf, Grant R.; Raaen, Laura; Mandel, Daniel

2014-01-01

Abstract Value-based purchasing (VBP) refers to a broad set of performance-based payment strategies that link financial incentives to health care providers' performance on a set of defined measures in an effort to achieve better value. The U.S. Department of Health and Human Services is advancing the implementation of VBP across an array of health care settings in the Medicare program in response to requirements in the 2010 Patient Protection and Affordable Care Act, and policymakers are grappling with many decisions about how best to design and implement VBP programs so that they are successful in achieving stated goals. This article summarizes the current state of knowledge about VBP based on a review of the published literature, a review of publicly available documentation from VBP programs, and discussions with an expert panel composed of VBP program sponsors, health care providers and health systems, and academic researchers with VBP evaluation expertise. Three types of VBP models were the focus of the review: (1) pay-for-performance programs, (2) accountable care organizations, and (3) bundled payment programs. The authors report on VBP program goals and what constitutes success; the evidence on the impact of these programs; factors that characterize high– and low–performing providers in VBP programs; the measures, incentive structures, and benchmarks used by VBP programs; evidence on spillover effects and unintended consequences; and gaps in the knowledge base. PMID:28083347

Becoming a health promoting school: evaluating the process of effective implementation in Scotland.

PubMed

Inchley, Jo; Muldoon, Janine; Currie, Candace

2007-03-01

Increasingly, researchers are exploring alternative ways of assessing the impact of 'Health Promoting School' (HPS) initiatives, in recognition of the model's emphasis on achieving change that is both enduring and far-reaching. However, it is still assumed that initiatives will lead to immediate change at the individual level. This paper challenges that view and argues that potential markers of success associated with process need to be identified earlier as a means of supporting schools and teachers. Notwithstanding differences in the way the HPS is conceptualized and implemented, four themes are highlighted that have relevance beyond any one school or country. These were drawn from a process evaluation of a European Network of HPSs Project in Scotland. They highlight the ways in which schools were able to successfully adopt HPS principles and the conditions that need to be in place for the HPS concept to flourish. Such indicators need to be given greater recognition as HPS outcomes if schools are to progress beyond the early stages of project implementation.

Social Return on Investment (SROI): An Innovative Approach to Sustainable Development Goals for Sexual and Reproductive Health Programming in sub-Saharan Africa.

PubMed

Kumar, Shubha R; Banke-Thomas, Aduragbemi

2016-09-01

Despite efforts, sub-Saharan Africa did not achieve many key Sexual and Reproductive Health (SRH) targets under the Millennium Development Goals. In the post 2015 era, the Sustainable Development Goals (SDGs) will frame decisions on donor priorities and resource allocations. Successfully addressing SRH challenges in sub-Saharan Africa have been blunted due to fragmentation of SRH interventions in planning and implementation, lack of coherence between policies and program implementation, resulting in poor program performance and lack of accountability. We suggest the Social Return on Investment (SROI) framework offers a strategic approach for sub-Saharan Africa in support of the implementation, monitoring and evaluation of SRH programs given its capacity to capture social and economic impacts, stakeholder participation, and sensitivity towards key human rights concerns relevant to SRH. SROI disrupts a -business as usual‖ approach for one that is systematic, participatory, and supportive of economic and human rights needs for success in the SDG era.

The experience of implementing a 'TB village' for a pastoralist population in Cherrati, Ethiopia.

PubMed

Tayler-Smith, K; Khogali, M; Keiluhu, K; Jemmy, J-P; Ayada, L; Weyeyso, T; Issa, A M; De Maio, G; Harries, A D; Zachariah, R

2011-10-01

In Cherrati District, Somali Regional State (SRS), Ethiopia, despite a high burden of tuberculosis (TB), TB control activities are virtually absent. The majority of the population is pastoralist with a mobile lifestyle. TB care and treatment were offered using a 'TB village' approach that included traditional style residential care, community empowerment and awareness raising, provision of essential social amenities and essential food and non-food items. To describe 1) key aspects of the implementation of the TB village approach, 2) TB treatment outcomes and 3) the lessons learnt during implementation. Descriptive study. A total of 297 patients entered the TB village between September 2006 and October 2008; 271 (91%) patients were treated successfully, nine (3%) defaulted and 13 (4%) died. For pastoralist populations, a TB village approach may be effective for improving access to TB care, ensuring proper adherence to treatment and achieving good overall TB outcomes. The successes and challenges of this approach are discussed.

Job sharing in clinical nutrition management: a plan for successful implementation.

PubMed

Visocan, B J; Herold, L S; Mulcahy, M J; Schlosser, M F

1993-10-01

While women continue to enter the American work force in record numbers; many experience difficulty in juggling career and family obligations. Flexible scheduling is one option used to ease work and family pressures. Women's changing work roles have potentially noteworthy implications for clinical nutrition management, a traditionally female-dominated profession where the recruitment and retention of valued, experienced registered dietitians can prove to be a human resources challenge. Job sharing, one type of flexible scheduling, is applicable to the nutrition management arena. This article describes and offers a plan for overcoming obstacles to job sharing, including determining feasibility, gaining support of top management, establishing program design, announcing the job share program, and using implementation, monitoring, and fine-tuning strategies. Benefits that can be derived from a successful job share are reduced absenteeism, decreased turnover, enhanced recruitment, improved morale, increased productivity, improved job coverage, and enhanced skills and knowledge base. A case study illustrates one method for achieving job sharing success in clinical nutrition management.

Systematic and progressive implementation of the centers of excellence for rheumatoid arthritis: a methodological proposal.

PubMed

Santos-Moreno, Pedro; Caballero-Uribe, Carlo V; Massardo, Maria Loreto; Maldonado, Claudio Galarza; Soriano, Enrique R; Pineda, Carlos; Cardiel, Mario; Benavides, Juan Alberto; Beltrán, Paula Andrea

2017-12-01

The implementation of excellence centers in specific diseases has been gaining recognition in the field of health; specifically in rheumatoid arthritis, where the prognosis of the disease is related to an early diagnosis and a timely intervention, it is necessary that the provision of health services is developed in an environment of quality, opportunity, and safety with the highest standards of care. A methodology that allows this implementation in such a way that is achievable by the most of the care centers is a priority to achieve a better attention to populations with this disease. In this paper, we propose a systematic and progressive methodology that will help all the institutions to develop successful models without faltering in the process. The expected impact on public health is defined by a better effective coverage of high-quality treatments, obtaining better health outcomes with safety and accessibility that reduces the budgetary impact for the health systems of our countries.

Implementation of secondary fracture prevention services after hip fracture: a qualitative study using extended Normalization Process Theory.

PubMed

Drew, Sarah; Judge, Andrew; May, Carl; Farmer, Andrew; Cooper, Cyrus; Javaid, M Kassim; Gooberman-Hill, Rachael

2015-04-23

National and international guidance emphasizes the need for hospitals to have effective secondary fracture prevention services, to reduce the risk of future fractures in hip fracture patients. Variation exists in how hospitals organize these services, and there remain significant gaps in care. No research has systematically explored reasons for this to understand how to successfully implement these services. The objective of this study was to use extended Normalization Process Theory to understand how secondary fracture prevention services can be successfully implemented. Forty-three semi-structured interviews were conducted with healthcare professionals involved in delivering secondary fracture prevention within 11 hospitals that receive patients with acute hip fracture in one region in England. These included orthogeriatricians, fracture prevention nurses and service managers. Extended Normalization Process Theory was used to inform study design and analysis. Extended Normalization Process Theory specifies four constructs relating to collective action in service implementation: capacity, potential, capability and contribution. The capacity of healthcare professionals to co-operate and co-ordinate their actions was achieved using dedicated fracture prevention co-ordinators to organize important processes of care. However, participants described effective communication with GPs as challenging. Individual potential and commitment to operationalize services was generally high. Shared commitments were promoted through multi-disciplinary team working, facilitated by fracture prevention co-ordinators. Healthcare professionals had capacity to deliver multiple components of services when co-ordinators 'freed up' time. As key agents in its intervention, fracture prevention coordinators were therefore indispensable to effective implementation. Aside from difficulty of co-ordination with primary care, the intervention was highly workable and easily integrated into practice. Nevertheless, implementation was threatened by under-staffed and under-resourced services, lack of capacity to administer scans and poor patient access. To ensure ongoing service delivery, the contributions of healthcare professionals were shaped by planning, in multi-disciplinary team meetings, the use of clinical databases to identify patients and define the composition of clinical work and monitoring to improve clinical practice. Findings identify and describe elements needed to implement secondary fracture prevention services successfully. The study highlights the value of Normalization Process Theory to achieve comprehensive understanding of healthcare professionals' experiences in enacting a complex intervention.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ely, J.W.; Brown, T.D.; Reed, S.D.

A common trend in our industry is to minimize gel concentrations and utilize the lowest viscosity fluid available to place proppant. Barrett Resources Corporation has found, for lenticular microdarcy formations, that one of the keys for success is enhanced proppant transport. This is achieved incorporating stable gels which maintain greater than 1000 cps viscosity at bottomhole static temperature for the duration of the treatment. An extensive case study has been completed, involving over 500 fracture stimulation treatments in more than 175 wells, that illustrates the poor results achieved in the Williams Formation of the Mesaverde Group using low viscosity fluids.more » Low viscosity fluids invariably exhibit poor proppant transport. The statistical study shows that larger treatments utilizing {open_quotes}perfect proppant transport{close_quotes} fluids gain superior results. Based upon the case study, 100% economic success has been achieved upon incorporating stable fluids containing delayed breakers, reducing pad volumes to less than 5% of total job size, and minimizing echelon fractures while implementing a limited entry stimulation technique.« less

Time Overrun in Construction Project

NASA Astrophysics Data System (ADS)

Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

2017-12-01

Timely completion is the key criteria to achieve success in any project despite the industry. Unfortunately construction industry in Malaysia has been labelled as industry facing poor performance leading to failure in achieving effective time management. As the consequence most of the project face huge amount of time overrun. This study assesses the causes of construction projects time overrun in Malaysia using structured questionnaire survey. Each respondent is asked to assign a one-to-five rating for each of the 18 time factors identified from literature review. Out of the 50 questionnaires sent out, 33 were received back representing 68% of the response rate. Data received from the questionnaires were analysed and processed using the descriptive statistics procedures. Findings from the study revealed that design and documentation issues, project management and contract administration, ineffective project planning and scheduling, contractor’s site management, financial resource management were the major factors that cause the time overrun. This study is hoped to help the practitioners to implement the mitigation measure at planning stage in order to achieve successful construction projects.

Designing, implementing and monitoring social impact mitigation strategies: Lessons from Forest Industry Structural Adjustment Packages

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loxton, Edwina A., E-mail: Edwina.Loxton@anu.edu.au; Schirmer, Jacki, E-mail: Jacki.Schirmer@canberra.edu.au; Cooperative Research Centre for Forestry, Hobart, 7001

2013-09-15

Social impact mitigation strategies are implemented by the proponents of policies and projects with the intent of reducing the negative, and increasing the positive social impacts of their activities, and facilitating the achievement of policy/project goals. Evaluation of mitigation strategies is critical to improving their future success and cost-effectiveness. This paper evaluates two Forest Industry Structural Adjustment Packages (FISAP) implemented in Australia in the 1990s to 2000s as part of broader policy changes that reduced access to timber from publicly owned native forests. It assesses the effectiveness of the structure, design, implementation and monitoring of the FISAPs, and highlights themore » interactions between these four elements and their influence on social impacts. The two FISAPs were found to be effective in terms of reducing negative impacts, encouraging positive impacts and contributing towards policy goals, although they did not mitigate negative impacts in all cases, and sometimes interacted with external factors and additional policy changes to contribute to significant short and long term negative impacts. -- Highlights: ► Mitigation strategies aim to reduce negative and enhance positive social impacts ► Mitigation strategy design, implementation, and monitoring are critical to success ► Effective mitigation enhanced the capacity of recipients to respond to change ► Mitigation strategies influenced multiple interacting positive and negative impacts ► Success required good communication, transparency, support, resources and timing.« less

Factors Supporting Implementation among CDSMP Organizations

PubMed Central

Paone, Deborah

2015-01-01

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP – citing the alignment between the program and their organizations’ mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption – particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program. PMID:25964928

Factors Supporting Implementation among CDSMP Organizations.

PubMed

Paone, Deborah

2014-01-01

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP - citing the alignment between the program and their organizations' mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption - particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program.

The impact of SOA for achieving healthcare interoperability. An empirical investigation based on a hypothetical adoption.

PubMed

Daskalakis, S; Mantas, J

2009-01-01

The evaluation of a service-oriented prototype implementation for healthcare interoperability. A prototype framework was developed, aiming to exploit the use of service-oriented architecture (SOA) concepts for achieving healthcare interoperability and to move towards a virtual patient record (VPR) paradigm. The prototype implementation was evaluated for its hypothetical adoption. The evaluation strategy was based on the initial proposition of the DeLone and McLean model of information systems (IS) success [1], as modeled by Iivari [2]. A set of SOA and VPR characteristics were empirically encapsulated within the dimensions of IS success model, combined with measures from previous research works. The data gathered was analyzed using partial least squares (PLS). The results highlighted that system quality is a partial predictor of system use but not of user satisfaction. On the contrary, information quality proved to be a significant predictor of user satisfaction and partially a strong significant predictor of system use. Moreover, system use did not prove to be a significant predictor of individual impact whereas the bi-directional relation between use and user satisfaction did not confirm. Additionally, user satisfaction was found to be a strong significant predictor of individual impact. Finally, individual impact proved to be a strong significant predictor of organizational impact. The empirical study attempted to obtain hypothetical, but still useful beliefs and perceptions regarding the SOA prototype implementation. The deduced observations can form the basis for further investigation regarding the adaptability of SOA implementations with VPR characteristics in the healthcare domain.

Success and Failure in Dynamic Decision Environments: Understanding Treatment Strategies for Patients with a Chronic Disease

ERIC Educational Resources Information Center

Ramsey, Gregory W.

2010-01-01

This dissertation proposes and tests a theory explaining how people make decisions to achieve a goal in a specific task environment. The theory is represented as a computational model and implemented as a computer program. The task studied was primary care physicians treating patients with type 2 diabetes. Some physicians succeed in achieving…

Exploring the Degree of Support by PMOs for New Project Management Techniques and Methods

ERIC Educational Resources Information Center

Lopez, Kathleen P.

2012-01-01

An organization tends to seek out the best set of practices in order to achieve project success. Many organizations are implementing a Project Management Office (PMO) to serve as a central post for organizing and disseminating best practices. The PMO responsibilities in part is to examine all practices, old and new, to best determine which…

Adolescents' Comprehension about Sustainable Development as a Device to Study Socio-Economic Knowledge Related to Citizenship

ERIC Educational Resources Information Center

Diez-Martinez, Evelyn

2013-01-01

Environmental education has been included in the school curricula of many countries in the last 15 years. Implementation has been not as successful as expected due to various constraints reported in several research projects. Its achievement remains uncertain and more research is required in all areas of education. In order to propose a curriculum…

Fostering Success among Traditionally Underrepresented Student Groups: Hartnell College's Approach to Implementation of the Math, Engineering, and Science Achievement (Mesa) Program

ERIC Educational Resources Information Center

Kane, Michael A.; Beals, Chuck; Valeau, Edward J.; Johnson, M. J.

2004-01-01

Hartnell College is an accredited California Community College serving Salinas and the Salinas Valley, a vast 1,000 square mile agricultural region. The district is characterized by large numbers of migrant workers and their families, chronically high unemployment, high rates of poverty, and low educational attainment. Hartnell's 10,000 students…

Interactive Read-Alouds--An Avenue for Enhancing Children's Language for Thinking and Understanding: A Review of Recent Research

ERIC Educational Resources Information Center

Lennox, Sandra

2013-01-01

Enhancing young children's early literacy achievement is a top priority in many countries. There is a considerable body of research demonstrating young children's language development as a critical factor in reading and later academic success. Implementation of high quality literacy instruction has the potential to improve literacy…

A Qualitative Study of Systemic Factors Contributing to Successful Implementation of Response to Intervention Programs in Elementary Schools

ERIC Educational Resources Information Center

White, Sheila B.

2017-01-01

Response to intervention (RTI), an educational reform effort designed to meet the needs of struggling learners, has been adopted by an increasing number of states as a primary component of their educational service delivery model for low-achieving students (Burns et al., 2013; Castillo & Batsche, 2012). RTI models are multi-tiered…

Institutional Incorporation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Residency Training: Achieving a Sustainable Curriculum

ERIC Educational Resources Information Center

Scott, Denise M.; McLaurin-Jones, TyWanda; Brown, Fannie D.; Newton, Robin; Marshall, Vanessa J.; Kalu, Nnenna; Cain, Gloria E.; Taylor, Robert E.

2012-01-01

The success of implementing a screening, brief intervention and referral to treatment (SBIRT) program within a medical residency program for sustainability is contingent upon a well-crafted training curriculum that incorporates substance abuse education and clinical practice skills. The goal of the Howard University (HU) SBIRT program is to train…

The Implementation of Research-Based Instructional Strategies Using Technology: An Action Research Study

ERIC Educational Resources Information Center

Hoff, Paula

2014-01-01

Students are entering a suburban middle school with significant achievement gaps. The skill deficits that students bring to the school setting must be addressed based on data that reflect their greatest area of need. At the middle school level, it is critical to address the learning gaps and prepare students for success at the high school level.…

Preparing Young Children for Success: Guideposts for Achieving Our First National Goal. An America 2000 Education Strategy.

ERIC Educational Resources Information Center

Department of Education, Washington, DC. Office of Planning, Budget, and Evaluation.

This paper discusses major issues having to do with definition of terms and implementation strategies implicit in the first national education goal, which states: "By the year 2000, all children in America will start school ready to learn." The principles articulated in the paper by a collaboration of agencies and the private sector are…

Using research and education to implement practical bed bug control programs in multifamily housing.

PubMed

Bennett, Gary W; Gondhalekar, Ameya D; Wang, Changlu; Buczkowski, Grzegorz; Gibb, Timothy J

2016-01-01

Multifamily housing facilities serving low-income populations have been at the forefront of bed bug outbreaks. Research conducted in the past 8 years has consistently proven that integrated pest management (IPM) is the best approach for successful suppression of bed bug infestations. Bed bug IPM in multifamily settings is especially dependent upon a collaborative community or building-wide effort involving residents, building staff and pest control technicians. Other components of a bed bug IPM program include regular monitoring to detect early-stage bed bug infestations and combined use of non-chemical and chemical interventions. Lastly, to reduce reinfestation rates and costs associated with bed bug control, it is critical to continue periodic monitoring and implement preventive control measures even after successful elimination of bed bugs has been achieved. © 2015 Society of Chemical Industry.

Implementation fidelity of Multidimensional Family Therapy in an international trial.

PubMed

Rowe, Cynthia; Rigter, Henk; Henderson, Craig; Gantner, Andreas; Mos, Kees; Nielsen, Philip; Phan, Olivier

2013-04-01

Implementation fidelity, a critical aspect of clinical trials research that establishes adequate delivery of the treatment as prescribed in treatment manuals and protocols, is also essential to the successful implementation of effective programs into new practice settings. Although infrequently studied in the drug abuse field, stronger implementation fidelity has been linked to better outcomes in practice but appears to be more difficult to achieve with greater distance from model developers. In the INternational CAnnabis Need for Treatment (INCANT) multi-national randomized clinical trial, investigators tested the effectiveness of Multidimensional Family Therapy (MDFT) in comparison to individual psychotherapy (IP) in Brussels, Berlin, Paris, The Hague, and Geneva with 450 adolescents with a cannabis use disorder and their parents. This study reports on the implementation fidelity of MDFT across these five Western European sites in terms of treatment adherence, dose and program differentiation, and discusses possible implications for international implementation efforts. Copyright © 2013 Elsevier Inc. All rights reserved.

Interdisciplinary Concepts for Design and Implementation of Mixed Reality Interactive Neurorehabilitation Systems for Stroke

PubMed Central

Lehrer, Nicole; Duff, Margaret; Venkataraman, Vinay; Turaga, Pavan; Ingalls, Todd; Rymer, W. Zev; Wolf, Steven L.; Rikakis, Thanassis

2015-01-01

Interactive neurorehabilitation (INR) systems provide therapy that can evaluate and deliver feedback on a patient's movement computationally. There are currently many approaches to INR design and implementation, without a clear indication of which methods to utilize best. This article presents key interactive computing, motor learning, and media arts concepts utilized by an interdisciplinary group to develop adaptive, mixed reality INR systems for upper extremity therapy of patients with stroke. Two INR systems are used as examples to show how the concepts can be applied within: (1) a small-scale INR clinical study that achieved integrated improvement of movement quality and functionality through continuously supervised therapy and (2) a pilot study that achieved improvement of clinical scores with minimal supervision. The notion is proposed that some of the successful approaches developed and tested within these systems can form the basis of a scalable design methodology for other INR systems. A coherent approach to INR design is needed to facilitate the use of the systems by physical therapists, increase the number of successful INR studies, and generate rich clinical data that can inform the development of best practices for use of INR in physical therapy. PMID:25425694

Interdisciplinary concepts for design and implementation of mixed reality interactive neurorehabilitation systems for stroke.

PubMed

Baran, Michael; Lehrer, Nicole; Duff, Margaret; Venkataraman, Vinay; Turaga, Pavan; Ingalls, Todd; Rymer, W Zev; Wolf, Steven L; Rikakis, Thanassis

2015-03-01

Interactive neurorehabilitation (INR) systems provide therapy that can evaluate and deliver feedback on a patient's movement computationally. There are currently many approaches to INR design and implementation, without a clear indication of which methods to utilize best. This article presents key interactive computing, motor learning, and media arts concepts utilized by an interdisciplinary group to develop adaptive, mixed reality INR systems for upper extremity therapy of patients with stroke. Two INR systems are used as examples to show how the concepts can be applied within: (1) a small-scale INR clinical study that achieved integrated improvement of movement quality and functionality through continuously supervised therapy and (2) a pilot study that achieved improvement of clinical scores with minimal supervision. The notion is proposed that some of the successful approaches developed and tested within these systems can form the basis of a scalable design methodology for other INR systems. A coherent approach to INR design is needed to facilitate the use of the systems by physical therapists, increase the number of successful INR studies, and generate rich clinical data that can inform the development of best practices for use of INR in physical therapy. © 2015 American Physical Therapy Association.

The Getting To Outcomes Demonstration and Evaluation: An Illustration of the Prevention Support System

PubMed Central

Hunter, Sarah B.; Ebener, Patricia; Paddock, Susan M.; Stillman, Lindsey; Imm, Pamela; Wandersman, Abraham

2010-01-01

Communities are increasingly being required by state and federal funders to achieve outcomes and be accountable, yet are often not provided the guidance or the tools needed to successfully meet this challenge. To improve the likelihood of achieving positive outcomes, the Getting To Outcomes (GTO) intervention (manual, training, technical assistance) is designed to provide the necessary guidance and tools, tailored to community needs, in order to build individual capacity and program performance. GTO is an example of a Prevention Support System intervention, which as conceptualized by the Interactive Systems Framework, plays a key role in bridging the gap between prevention science (Prevention Synthesis and Translation System) and prevention practice (Prevention Delivery System). We evaluated the impact of GTO on individual capacity and program performance using survey- and interview-based methods. We tracked the implementation of GTO and gathered user feedback about its utility and acceptability. The evaluation of GTO suggests that it can build individual capacity and program performance and as such demonstrates that the Prevention Support System can successfully fulfill its intended role. Lessons learned from the implementation of GTO relevant to illuminating the framework are discussed. PMID:18278551

Agriculture and food systems in sub-Saharan Africa in a 4°C+ world.

PubMed

Thornton, Philip K; Jones, Peter G; Ericksen, Polly J; Challinor, Andrew J

2011-01-13

Agricultural development in sub-Saharan Africa faces daunting challenges, which climate change and increasing climate variability will compound in vulnerable areas. The impacts of a changing climate on agricultural production in a world that warms by 4°C or more are likely to be severe in places. The livelihoods of many croppers and livestock keepers in Africa are associated with diversity of options. The changes in crop and livestock production that are likely to result in a 4°C+ world will diminish the options available to most smallholders. In such a world, current crop and livestock varieties and agricultural practices will often be inadequate, and food security will be more difficult to achieve because of commodity price increases and local production shortfalls. While adaptation strategies exist, considerable institutional and policy support will be needed to implement them successfully on the scale required. Even in the 2°C+ world that appears inevitable, planning for and implementing successful adaptation strategies are critical if agricultural growth in the region is to occur, food security be achieved and household livelihoods be enhanced. As part of this effort, better understanding of the critical thresholds in global and African food systems requires urgent research.

Implementation of projective measurements with linear optics and continuous photon counting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Takeoka, Masahiro; Sasaki, Masahide; Loock, Peter van

2005-02-01

We investigate the possibility of implementing a given projection measurement using linear optics and arbitrarily fast feedforward based on the continuous detection of photons. In particular, we systematically derive the so-called Dolinar scheme that achieves the minimum-error discrimination of binary coherent states. Moreover, we show that the Dolinar-type approach can also be applied to projection measurements in the regime of photonic-qubit signals. Our results demonstrate that for implementing a projection measurement with linear optics, in principle, unit success probability may be approached even without the use of expensive entangled auxiliary states, as they are needed in all known (near-)deterministic linear-opticsmore » proposals.« less

Interdisciplinary shared governance: a partnership model for high performance in a managed care environment.

PubMed

Anderson, D A; Bankston, K; Stindt, J L; Weybright, D W

2000-09-01

Today's managed care environment is forcing hospitals to seek new and innovative ways to deliver a seamless continuum of high-quality care and services to defined populations at lower costs. Many are striving to achieve this goal through the implementation of shared governance models that support point-of-service decision making, interdisciplinary partnerships, and the integration of work across clinical settings and along the service delivery continuum. The authors describe the key processes and strategies used to facilitate the design and successful implementation of an interdisciplinary shared governance model at The University Hospital, Cincinnati, Ohio. Implementation costs and initial benefits obtained over a 2-year period also are identified.

How Should I Study for the Exam? Self-Regulated Learning Strategies and Achievement in Introductory Biology

PubMed Central

Sebesta, Amanda J.; Bray Speth, Elena

2017-01-01

In college introductory science courses, students are challenged with mastering large amounts of disciplinary content while developing as autonomous and effective learners. Self-regulated learning (SRL) is the process of setting learning goals, monitoring progress toward them, and applying appropriate study strategies. SRL characterizes successful, “expert” learners, and develops with time and practice. In a large, undergraduate introductory biology course, we investigated: 1) what SRL strategies students reported using the most when studying for exams, 2) which strategies were associated with higher achievement and with grade improvement on exams, and 3) what study approaches students proposed to use for future exams. Higher-achieving students, and students whose exam grades improved in the first half of the semester, reported using specific cognitive and metacognitive strategies significantly more frequently than their lower-achieving peers. Lower-achieving students more frequently reported that they did not implement their planned strategies or, if they did, still did not improve their outcomes. These results suggest that many students entering introductory biology have limited knowledge of SRL strategies and/or limited ability to implement them, which can impact their achievement. Course-specific interventions that promote SRL development should be considered as integral pedagogical tools, aimed at fostering development of students’ lifelong learning skills. PMID:28495934

Integrating: A managerial practice that enables implementation in fragmented health care environments.

PubMed

Kerrissey, Michaela; Satterstrom, Patricia; Leydon, Nicholas; Schiff, Gordon; Singer, Sara

How some organizations improve while others remain stagnant is a key question in health care research. Studies identifying how organizations can implement improvement despite barriers are needed, particularly in primary care. This inductive qualitative study examines primary care clinics implementing improvement efforts in order to identify mechanisms that enable implementation despite common barriers, such as lack of time and fragmentation across stakeholder groups. Using an embedded multiple case study design, we leverage a longitudinal data set of field notes, meeting minutes, and interviews from 16 primary care clinics implementing improvement over 15 months. We segment clinics into those that implemented more versus those that implemented less, comparing similarities and differences. We identify interpersonal mechanisms promoting implementation, develop a conceptual model of our key findings, and test the relationship with performance using patient surveys conducted pre-/post-implementation. Nine clinics implemented more successfully over the study period, whereas seven implemented less. Successfully implementing clinics exhibited the managerial practice of integrating, which we define as achieving unity of effort among stakeholder groups in the pursuit of a shared and mutually developed goal. We theorize that integrating is critical in improvement implementation because of the fragmentation observed in health care settings, and we extend theory about clinic managers' role in implementation. We identify four integrating mechanisms that clinic managers enacted: engaging groups, bridging communication, sensemaking, and negotiating. The mean patient survey results for integrating clinics improved by 0.07 units over time, whereas the other clinics' survey scores declined by 0.08 units on a scale of 5 (p = .02). Our research explores an understudied element of how clinics can implement improvement despite barriers: integrating stakeholders within and outside the clinic into the process. It provides clinic managers with an actionable path for implementing improvement.

Essential conditions for the implementation of comprehensive school health to achieve changes in school culture and improvements in health behaviours of students.

PubMed

Storey, Kate E; Montemurro, Genevieve; Flynn, Jenn; Schwartz, Marg; Wright, Erin; Osler, Jill; Veugelers, Paul J; Roberts, Erica

2016-11-02

Comprehensive School Health (CSH) is an internationally recognized framework that holistically addresses school health by transforming the school culture. It has been shown to be effective in enhancing health behaviours among students while also improving educational outcomes. Despite this effectiveness, there is a need to focus on how CSH is implemented. Previous studies have attempted to uncover the conditions necessary for successful operationalization, but none have described them in relation to a proven best practice model of implementation that has demonstrated positive changes to school culture and improvements in health behaviours. The purpose of this research was to identify the essential conditions of CSH implementation utilizing secondary analysis of qualitative interview data, incorporating a multitude of stakeholder perspectives. This included inductive content analysis of teacher (n = 45), principal (n = 46), and school health facilitator (n = 34) viewpoints, all of whom were employed within successful CSH project schools in Alberta, Canada between 2008 and 2013. Many themes were identified, here called conditions, that were divided into two categories: 'core conditions' (students as change agents, school-specific autonomy, demonstrated administrative leadership, dedicated champion to engage school staff, community support, evidence, professional development) and 'contextual conditions' (time, funding and project supports, readiness and prior community connectivity). Core conditions were defined as those conditions necessary for CSH to be successfully implemented, whereas contextual conditions had a great degree of influence on the ability for the core conditions to be obtained. Together, and in consideration of already established 'process conditions' developed by APPLE Schools (assess, vision, prioritize; develop and implement an action plan; monitor, evaluate, celebrate), these represent the essential conditions of successful CSH implementation. Overall, the present research contributes to the evidence-base of CSH implementation, ultimately helping to shape its optimization by providing school communities with a set of understandable essential conditions for CSH implementation. Such research is important as it helps to support and bolster the CSH framework that has been shown to improve the education, health, and well-being of school-aged children.

Identifying governance strategies that effectively support ecosystem services, resource sustainability, and biodiversity

PubMed Central

Kenward, R. E.; Whittingham, M. J.; Arampatzis, S.; Manos, B. D.; Hahn, T.; Terry, A.; Simoncini, R.; Alcorn, J.; Bastian, O.; Donlan, M.; Elowe, K.; Franzén, F.; Karacsonyi, Z.; Larsson, M.; Manou, D.; Navodaru, I.; Papadopoulou, O.; Papathanasiou, J.; von Raggamby, A.; Sharp, R. J. A.; Söderqvist, T.; Soutukorva, Å.; Vavrova, L.; Aebischer, N. J.; Leader-Williams, N.; Rutz, C.

2011-01-01

Conservation scientists, national governments, and international conservation groups seek to devise, and implement, governance strategies that mitigate human impact on the environment. However, few studies to date have systematically investigated the performance of different systems of governance in achieving successful conservation outcomes. Here, we use a newly-developed analytic framework to conduct analyses of a suite of case studies, linking different governance strategies to standardized scores for delivering ecosystem services, achieving sustainable use of natural resources, and conserving biodiversity, at both local and international levels. Our results: (i) confirm the benefits of adaptive management; and (ii) reveal strong associations for the role of leadership. Our work provides a critical step toward implementing empirically justified governance strategies that are capable of improving the management of human-altered environments, with benefits for both biodiversity and people. PMID:21402916

A multi-disciplinary approach to implementation science: the NIH-PEPFAR PMTCT implementation science alliance.

PubMed

Sturke, Rachel; Harmston, Christine; Simonds, R J; Mofenson, Lynne M; Siberry, George K; Watts, D Heather; McIntyre, James; Anand, Nalini; Guay, Laura; Castor, Delivette; Brouwers, Pim; Nagel, Joan D

2014-11-01

In resource-limited countries, interventions to prevent mother-to-child HIV transmission (PMTCT) have not yet realized their full potential health impact, illustrating the common gap between the scientific proof of an intervention's efficacy and effectiveness and its successful implementation at scale into routine health services. For PMTCT, this gap results, in part, from inadequate adaptation of PMTCT interventions to the realities of the implementation environment, including client and health care worker behaviors and preferences, health care policies and systems, and infrastructure and resource constraints. Elimination of mother-to-child HIV transmission can only be achieved through understanding of key implementation barriers and successful adaptation of scientifically proven interventions to the local environment. Central to such efforts is implementation science (IS), which aims to investigate and address major bottlenecks that impede effective implementation and to test new approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions. Advancing IS will require deliberate and strategic efforts to facilitate collaboration, communication, and relationship-building among researchers, implementers, and policy-makers. To speed the translation of effective PMTCT interventions into practice and advance IS more broadly, the US National Institutes of Health, in collaboration with the President's Emergency Plan for AIDS Relief launched the National Institutes of Health/President's Emergency Plan for AIDS Relief PMTCT IS Alliance, comprised of IS researchers, PMTCT program implementers, and policy-makers as an innovative platform for interaction and coordination.

Identifying critical success factors (CSFs) of Facilities Management (FM) in non-low cost high-rise residential buildings

NASA Astrophysics Data System (ADS)

Dahlan, F. M.; Zainuddin, A.

2018-02-01

Critical success factors (CSFs) are important key areas of activity that must be performed well in any Facilities Management (FM) organisation to achieve its missions, objectives or goals. Before implementing CSFs, an FM organisation must identify the key areas where things must be done properly to enable the business to flourish. Although many performance measurements in FM organisation have been discussed in previous research, not much research has been done on CSFs from the perspective of FM business in non-low cost high-rise residential buildings. The purpose of this study is to develop a methodology in developing the CSFs group and CSFs for FM organisation in non-low cost residential buildings. This research will involve three (3) phases of research strategy to achieve the objective of this research.

A system management methodology for building successful resource management systems

NASA Technical Reports Server (NTRS)

Hornstein, Rhoda Shaller; Willoughby, John K.

1989-01-01

This paper presents a system management methodology for building successful resource management systems that possess lifecycle effectiveness. This methodology is based on an analysis of the traditional practice of Systems Engineering Management as it applies to the development of resource management systems. The analysis produced fifteen significant findings presented as recommended adaptations to the traditional practice of Systems Engineering Management to accommodate system development when the requirements are incomplete, unquantifiable, ambiguous and dynamic. Ten recommended adaptations to achieve operational effectiveness when requirements are incomplete, unquantifiable or ambiguous are presented and discussed. Five recommended adaptations to achieve system extensibility when requirements are dynamic are also presented and discussed. The authors conclude that the recommended adaptations to the traditional practice of Systems Engineering Management should be implemented for future resource management systems and that the technology exists to build these systems extensibly.

CE: Original Research: Napping on the Night Shift: A Two-Hospital Implementation Project.

PubMed

Geiger-Brown, Jeanne; Sagherian, Knar; Zhu, Shijun; Wieroniey, Margaret Ann; Blair, Lori; Warren, Joan; Hinds, Pamela S; Szeles, Rose

2016-05-01

: Nurses who work the night shift often experience high levels of sleepiness. Napping has been adopted as an effective countermeasure to sleepiness and fatigue in other safety-sensitive industries, but has not had widespread acceptance in nursing. To assess the barriers to successful implementation of night-shift naps and to describe the nap experiences of night-shift nurses who took naps. In this two-hospital pilot implementation project, napping on the night shift was offered to six nursing units for which the executive nursing leadership had given approval. Unit nurse managers' approval was sought, and where granted, further explanation was given to the unit's staff nurses. A nap experience form, which included the Karolinska Sleepiness Scale, was used to assess pre-nap sleepiness level, nap duration and perceived sleep experience, post-nap sleep inertia, and the perceived helpfulness of the nap. Nurse managers and staff nurses were also interviewed at the end of the three-month study period. Successful implementation occurred on only one of the six units, with partial success seen on a second unit. Barriers primarily occurred at the point of seeking the unit nurse managers' approval. On the successful unit, 153 30-minutes naps were taken during the study period. A high level of sleepiness was present at the beginning of 44% of the naps. For more than half the naps, nurses reported achieving either light (43%) or deep (14%) sleep. Sleep inertia was rare. The average score of helpfulness of napping was high (7.3 on a 1-to-10 scale). Nurses who napped reported being less drowsy while driving home after their shift. These data suggest that when barriers to napping are overcome, napping on the night shift is feasible and can reduce nurses' workplace sleepiness and drowsy driving on the way home. Addressing nurse managers' perceptions of and concerns about napping may be essential to successful implementation.

Special Topic Interoperability and EHR: Combining openEHR, SNOMED, IHE, and Continua as approaches to interoperability on national eHealth.

PubMed

Beštek, Mate; Stanimirović, Dalibor

2017-08-09

The main aims of the paper comprise the characterization and examination of the potential approaches regarding interoperability. This includes openEHR, SNOMED, IHE, and Continua as combined interoperability approaches, possibilities for their incorporation into the eHealth environment, and identification of the main success factors in the field, which are necessary for achieving required interoperability, and consequently, for the successful implementation of eHealth projects in general. The paper represents an in-depth analysis regarding the potential application of openEHR, SNOMED, IHE and Continua approaches in the development and implementation process of eHealth in Slovenia. The research method used is both exploratory and deductive in nature. The methodological framework is grounded on information retrieval with a special focus on research and charting of existing experience in the field, and sources, both electronic and written, which include interoperability concepts and related implementation issues. The paper will try to answer the following inquiries that are complementing each other: 1. Scrutiny of the potential approaches, which could alleviate the pertinent interoperability issues in the Slovenian eHealth context. 2. Analyzing the possibilities (requirements) for their inclusion in the construction process for individual eHealth solutions. 3. Identification and charting the main success factors in the interoperability field that critically influence development and implementation of eHealth projects in an efficient manner. Provided insights and identified success factors could serve as a constituent of the strategic starting points for continuous integration of interoperability principles into the healthcare domain. Moreover, the general implementation of the identified success factors could facilitate better penetration of ICT into the healthcare environment and enable the eHealth-based transformation of the health system especially in the countries which are still in an early phase of eHealth planning and development and are often confronted with differing interests, requirements, and contending strategies.

Successful international collaboration improves family donation conversations resulting in increased organ donation.

PubMed

Mulvania, P; Mehakovic, E; Wise, C; Cass, Y; Daly, T A; Nathan, H M

2014-01-01

Australian donation leaders recognized that to increase organ donation outcomes, health professionals conducting family donation conversations (FDCs) required support and specialist training. An international training institute with programs based on proven results was engaged to create and implement a customized training program to influence change in FDC practice and culture. The goal was to increase donation rates by developing and implementing a customized, self-sustaining training program to enhance FDC practices of health professionals. Other goals included providing training and communications skills to lead FDC, supporting families in making decisions, and influencing health professionals to adopt FDC practices. To gain support and determine program suitability, two 1-day pilot training sessions were provided to 45 Australian donation leaders in 2011. Training was further customized with an emphasis on creating changes to achieve and sustain desired results. A comprehensive national training plan was implemented over 18 months. Twenty-six 2-day FDC training workshops were held in 8 cities (646 participants). Program evaluations and debriefings showed distinct shifts in perspectives and an enthusiasm to implement new processes. In 2012 to 2013, an instructor program was developed to transition training facilitation. The training institute remains involved in development and training to build and sustain skill and expertise. There was a 58% increase in organ donors in Australia from 2009 to 2013 (data reflect 2013 Australian end-of-year organ donation information). This represents a 36% increase in organ donors (2009-2011); the remaining 22% increase was achieved in the 2 years since the FDC training was implemented in Australia (2011-2013). Improved skills training in the conduct of FDCs seem to have contributed to improved donation outcomes in national identification, request, and consent rates. The integration of another organization's process poses distinct challenges; thoughtful collaboration, sensitive to cultural aspects and family care, communication, and donation practices, can result in successful customized training that shifts perspectives, provides new skills, and achieves and sustains an increase in organ donation rates. Copyright © 2014 Elsevier Inc. All rights reserved.

A Rule-Based System Implementing a Method for Translating FOL Formulas into NL Sentences

NASA Astrophysics Data System (ADS)

Mpagouli, Aikaterini; Hatzilygeroudis, Ioannis

In this paper, we mainly present the implementation of a system that translates first order logic (FOL) formulas into natural language (NL) sentences. The motivation comes from an intelligent tutoring system teaching logic as a knowledge representation language, where it is used as a means for feedback to the students-users. FOL to NL conversion is achieved by using a rule-based approach, where we exploit the pattern matching capabilities of rules. So, the system consists of rule-based modules corresponding to the phases of our translation methodology. Facts are used in a lexicon providing lexical and grammatical information that helps in producing the NL sentences. The whole system is implemented in Jess, a java-implemented rule-based programming tool. Experimental results confirm the success of our choices.

Process evaluation of the project P.A.T.H.S. (secondary 2 program): findings based on the co-walker scheme.

PubMed

Shek, Daniel T L; Tam, Suet-yan

2009-01-01

To understand the implementation quality of the Tier 1 Program (Secondary 2 Curriculum) of the P.A.T.H.S. Project, process evaluation was carried out by co-walkers through classroom observation of 195 units in 131 schools. Results showed that the overall level of program adherence was generally high with an average of 84.55%, and different factors of the implementation process were evaluated as positive. Quality of program implementation and achievement of program objectives were predicted by students' participation and involvement, strategies to enhance students' motivation, opportunity for reflection, time management, and class preparation. Success in program implementation was predicted by students' participation and involvement, classroom control, interactive delivery method, strategies to enhance students' motivation, opportunity for reflection, and lesson preparation.

Earned Value Management (EVM) Implementation Handbook

NASA Technical Reports Server (NTRS)

2013-01-01

The purpose of this handbook is to provide Earned Value Management (EVM) guidance for the effective application, implementation, and utilization of EVM on NASA programs, projects, major contracts and subcontracts in a consolidated reference document. EVM is a project management process that effectively integrates a project s scope of work with schedule and cost elements for optimum project planning and control. The goal is to achieve timely and accurate quantification of progress that will facilitate management by exception and enable early visibility into the nature and the magnitude of technical problems as well as the intended course and success of corrective actions.

Earned Value Management (EVM) Implementation Handbook

NASA Technical Reports Server (NTRS)

Terrell, Stefanie M.; Richards, Brad W.

2018-01-01

The purpose of this handbook is to provide Earned Value Management (EVM) guidance for the effective application, implementation, and utilization of EVM on NASA programs, projects, major contracts and subcontracts in a consolidated reference document. EVM is a project management process that effectively integrates a project?s scope of work with schedule and cost elements for optimum project planning and control. The goal is to achieve timely and accurate quantification of progress that will facilitate management by exception and enable early visibility into the nature and the magnitude of technical problems as well as the intended course and success of corrective actions.

Magnetic Leviation System Design and Implementation for Wind Tunnel Application

NASA Technical Reports Server (NTRS)

Lin, Chin E.; Sheu, Yih-Ran; Jou, Hui-Long

1996-01-01

This paper presents recent work in magnetic suspension wind tunnel development in National Cheng Kung University. In this phase of research, a control-based study is emphasized to implement a robust control system into the experimental system under study. A ten-coil 10 cm x 10 cm magnetic suspension wind tunnel is built using a set of quadrant detectors for six degree of freedom control. To achieve the attitude control of suspended model with different attitudes, a spacial electromagnetic field simulation using OPERA 3D is studied. A successful test for six degree of freedom control is demonstrated in this paper.

Implementation Intention and Reminder Effects on Behavior Change in a Mobile Health System: A Predictive Cognitive Model.

PubMed

Pirolli, Peter; Mohan, Shiwali; Venkatakrishnan, Anusha; Nelson, Les; Silva, Michael; Springer, Aaron

2017-11-30

Implementation intentions are mental representations of simple plans to translate goal intentions into behavior under specific conditions. Studies show implementation intentions can produce moderate to large improvements in behavioral goal achievement. Human associative memory mechanisms have been implicated in the processes by which implementation intentions produce effects. On the basis of the adaptive control of thought-rational (ACT-R) theory of cognition, we hypothesized that the strength of implementation intention effect could be manipulated in predictable ways using reminders delivered by a mobile health (mHealth) app. The aim of this experiment was to manipulate the effects of implementation intentions on daily behavioral goal success in ways predicted by the ACT-R theory concerning mHealth reminder scheduling. An incomplete factorial design was used in this mHealth study. All participants were asked to choose a healthy behavior goal associated with eat slowly, walking, or eating more vegetables and were asked to set implementation intentions. N=64 adult participants were in the study for 28 days. Participants were stratified by self-efficacy and assigned to one of two reminder conditions: reminders-presented versus reminders-absent. Self-efficacy and reminder conditions were crossed. Nested within the reminders-presented condition was a crossing of frequency of reminders sent (high, low) by distribution of reminders sent (distributed, massed). Participants in the low frequency condition got 7 reminders over 28 days; those in the high frequency condition were sent 14. Participants in the distributed conditions were sent reminders at uniform intervals. Participants in the massed distribution conditions were sent reminders in clusters. There was a significant overall effect of reminders on achieving a daily behavioral goal (coefficient=2.018, standard error [SE]=0.572, odds ratio [OR]=7.52, 95% CI 0.9037-3.2594, P<.001). As predicted by ACT-R, using default theoretical parameters, there was an interaction of reminder frequency by distribution on daily goal success (coefficient=0.7994, SE=0.2215, OR=2.2242, 95% CI 0.3656-1.2341, P<.001). The total number of times a reminder was acknowledged as received by a participant had a marginal effect on daily goal success (coefficient=0.0694, SE=0.0410, OR=1.0717, 95% CI -0.01116 to 0.1505, P=.09), and the time since acknowledging receipt of a reminder was highly significant (coefficient=-0.0490, SE=0.0104, OR=0.9522, 95% CI -0.0700 to -0.2852], P<.001). A dual system ACT-R mathematical model was fit to individuals' daily goal successes and reminder acknowledgments: a goal-striving system dependent on declarative memory plus a habit-forming system that acquires automatic procedures for performance of behavioral goals. Computational cognitive theory such as ACT-R can be used to make precise quantitative predictions concerning daily health behavior goal success in response to implementation intentions and the dosing schedules of reminders. ©Peter Pirolli, Shiwali Mohan, Anusha Venkatakrishnan, Les Nelson, Michael Silva, Aaron Springer. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.11.2017.

Construction of a Urologic Robotic Surgery Training Curriculum: How Many Simulator Sessions Are Required for Residents to Achieve Proficiency?

PubMed

Wiener, Scott; Haddock, Peter; Shichman, Steven; Dorin, Ryan

2015-11-01

To define the time needed by urology residents to attain proficiency in computer-aided robotic surgery to aid in the refinement of a robotic surgery simulation curriculum. We undertook a retrospective review of robotic skills training data acquired during January 2012 to December 2014 from junior (postgraduate year [PGY] 2-3) and senior (PGY4-5) urology residents using the da Vinci Skills Simulator. We determined the number of training sessions attended and the level of proficiency achieved by junior and senior residents in attempting 11 basic or 6 advanced tasks, respectively. Junior residents successfully completed 9.9 ± 1.8 tasks, with 62.5% completing all 11 basic tasks. The maximal cumulative success rate of junior residents completing basic tasks was 89.8%, which was achieved within 7.0 ± 1.5 hours of training. Of senior residents, 75% successfully completed all six advanced tasks. Senior residents attended 6.3 ± 3.5 hours of training during which 5.1 ± 1.6 tasks were completed. The maximal cumulative success rate of senior residents completing advanced tasks was 85.4%. When designing and implementing an effective robotic surgical training curriculum, an allocation of 10 hours of training may be optimal to allow junior and senior residents to achieve an acceptable level of surgical proficiency in basic and advanced robotic surgical skills, respectively. These data help guide the design and scheduling of a residents training curriculum within the time constraints of a resident's workload.

Fire fighters as basic life support responders: a study of successful implementation.

PubMed

Høyer, Christian Bjerre; Christensen, Erika Frischknecht

2009-04-02

First responders are recommended as a supplement to the Emergency Medical Services (EMS) in order to achieve early defibrillation. Practical and organisational aspects are essential when trying to implement new parts in the "Chain of Survival"; areas to address include minimizing dispatch time, ensuring efficient and quick communication, and choosing areas with appropriate driving distances. The aim of this study was to implement a system using Basic Life Support (BLS) responders equipped with an automatic external defibrillator in an area with relatively short emergency medical services' response times. Success criteria for implementation was defined as arrival of the BLS responders before the EMS, attachment (and use) of the AED, and successful defibrillation. This was a prospective observational study from September 1, 2005 to December 31, 2007 (28 months) in the city of Aarhus, Denmark. The BLS responder system was implemented in an area up to three kilometres (driving distance) from the central fire station, encompassing approximately 81,500 inhabitants. The team trained on each shift and response times were reduced by choice of area and by sending the alarm directly to the fire brigade dispatcher. The BLS responders had 1076 patient contacts. The median response time was 3.5 minutes (25th percentile 2.75, 75th percentile 4.25). The BLS responders arrived before EMS in 789 of the 1076 patient contacts (73%). Cardiac arrest was diagnosed in 53 cases, the AED was attached in 29 cases, and a shockable rhythm was detected in nine cases. Eight were defibrillated using an AED. Seven of the eight obtained return of spontaneous circulation (ROSC). Six of the seven obtaining ROSC survived more than 30 days. In this study, the implementation of BLS responders may have resulted in successful resuscitations. On basis of the close corporation between all participants in the chain of survival this project contributed to the first link: short response time and trained personnel to ensure early defibrillation.

Fire fighters as basic life support responders: A study of successful implementation

PubMed Central

Høyer, Christian Bjerre; Christensen, Erika Frischknecht

2009-01-01

Background First responders are recommended as a supplement to the Emergency Medical Services (EMS) in order to achieve early defibrillation. Practical and organisational aspects are essential when trying to implement new parts in the "Chain of Survival"; areas to address include minimizing dispatch time, ensuring efficient and quick communication, and choosing areas with appropriate driving distances. The aim of this study was to implement a system using Basic Life Support (BLS) responders equipped with an automatic external defibrillator in an area with relatively short emergency medical services' response times. Success criteria for implementation was defined as arrival of the BLS responders before the EMS, attachment (and use) of the AED, and successful defibrillation. Methods This was a prospective observational study from September 1, 2005 to December 31, 2007 (28 months) in the city of Aarhus, Denmark. The BLS responder system was implemented in an area up to three kilometres (driving distance) from the central fire station, encompassing approximately 81,500 inhabitants. The team trained on each shift and response times were reduced by choice of area and by sending the alarm directly to the fire brigade dispatcher. Results The BLS responders had 1076 patient contacts. The median response time was 3.5 minutes (25th percentile 2.75, 75th percentile 4.25). The BLS responders arrived before EMS in 789 of the 1076 patient contacts (73%). Cardiac arrest was diagnosed in 53 cases, the AED was attached in 29 cases, and a shockable rhythm was detected in nine cases. Eight were defibrillated using an AED. Seven of the eight obtained return of spontaneous circulation (ROSC). Six of the seven obtaining ROSC survived more than 30 days. Conclusion In this study, the implementation of BLS responders may have resulted in successful resuscitations. On basis of the close corporation between all participants in the chain of survival this project contributed to the first link: short response time and trained personnel to ensure early defibrillation. PMID:19341457

Plant-Based Diets: A Physician’s Guide

PubMed Central

Hever, Julieanna

2016-01-01

Because of the ever-increasing body of evidence in support of the health advantages of plant-based nutrition, there is a need for guidance on implementing its practice. This article provides physicians and other health care practitioners an overview of the myriad benefits of a plant-based diet as well as details on how best to achieve a well-balanced, nutrient-dense meal plan. It also defines notable nutrient sources, describes how to get started, and offers suggestions on how health care practitioners can encourage their patients to achieve goals, adhere to the plan, and experience success. PMID:27400178

Cassini Attitude Control Flight Software: from Development to In-Flight Operation

NASA Technical Reports Server (NTRS)

Brown, Jay

2008-01-01

The Cassini Attitude and Articulation Control Subsystem (AACS) Flight Software (FSW) has achieved its intended design goals by successfully guiding and controlling the Cassini-Huygens planetary mission to Saturn and its moons. This paper describes an overview of AACS FSW details from early design, development, implementation, and test to its fruition of operating and maintaining spacecraft control over an eleven year prime mission. Starting from phases of FSW development, topics expand to FSW development methodology, achievements utilizing in-flight autonomy, and summarize lessons learned during flight operations which can be useful to FSW in current and future spacecraft missions.

Multi-site implementation of nutrition screening and diagnosis in medical care units: Success of the More-2-Eat project.

PubMed

Keller, Heather H; Valaitis, Renata; Laur, Celia V; McNicholl, Tara; Xu, Yingying; Dubin, Joel A; Curtis, Lori; Obiorah, Suzanne; Ray, Sumantra; Bernier, Paule; Gramlich, Leah; Stickles-White, Marilee; Laporte, Manon; Bell, Jack

2018-03-22

Improving the detection and treatment of malnourished patients in hospital is needed to promote recovery. To describe the change in rates of detection and triaging of care for malnourished patients in 5 hospitals that were implementing an evidence-based nutrition care algorithm. To demonstrate that following this algorithm leads to increased detection of malnutrition and increased treatment to mitigate this condition. Sites worked towards implementing the Integrated Nutrition Pathway for Acute Care (INPAC), including screening (Canadian Nutrition Screening Tool) and triage (Subjective Global Assessment; SGA) to detect and diagnose malnourished patients. Implementation occurred over a 24-month period, including developmental (Period 1), implementation (Periods 2-5), and sustainability (Period 6) phases. Audits (n = 36) of patient health records (n = 5030) were conducted to identify nutrition care practices implemented with a variety of strategies and behaviour change techniques. All sites increased nutrition screening from Period 1, with three achieving the goal of 75% of admitted patients being screened by Period 3, and the remainder achieving a rate of 70% by end of implementation. No sites were conducting SGA at Period 1, and sites reached the goal of a 75% completion rate or referral for those identified to be at nutrition risk, by Period 3 or 4. By Period 2, 100% of patients identified as SGA C (severely malnourished) were receiving a comprehensive nutritional assessment. In Period 1, the nutrition diagnosis and documentation by the dietitian of 'malnutrition' was a modest 0.37%, increasing to over 5% of all audited health records. The overall use of any Advanced Nutrition Care practices increased from 31% during Period 1 to 63% during Period 6. The success of this multi-site study demonstrated that implementation of nutrition screening and diagnosis is feasible and leads to appropriate care. INPAC promotes efficiency in nutrition care while minimizing the risk of missing malnourished patients. Retrospectively registered ClinicalTrials.gov Identifier: NCT02800304, June 7, 2016. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Meeting the challenge: implementing the Baby Friendly Hospital Initiative in a culturally diverse country.

PubMed

Edwards, Grace; Abdulali, Jane; Kumar, Rajakumari Ravi

2011-06-01

This paper describes the successful implementation of the WHO/Unicef Baby Friendly Hospital initiative (BFHI) in a large, culturally diverse hospital in the United Arab Emirates (UAE). Breastfeeding rates in the UAE are high (>90 per cent), although mixed feeding is considered the norm. Traditional religious practices for birth are common which may inhibit exclusive breastfeeding. An action research methodology was chosen as the most appropriate method in which to implement BFHI and a five stage cyclic approach was used. Staff knowledge around breastfeeding and BFHI varied enormously because of the diversity of ethnicity amongst staff. It was initially difficult to engage staff, particularly staff in the delivery suite and theatres, as breastfeeding was not seen as a high priority. There was a great resistance to closing the nurseries as both women and staff felt it was a benefit for the women to have some rest away from their babies, and the concepts of bonding and early feeding cues were unknown. By the time of the assessment for BFHI there was a theory-practice transformation. The implementation of BFHI and the successful achievement of the award can be attributed to ownership.

A Computer for Every Student and Teacher: Lessons Learned about Planning and Implementing a Successful 1:1 Learning Initiative in Schools

ERIC Educational Resources Information Center

Corn, Jenifer O.; Oliver, Kevin M.; Hess, Clara E.; Halstead, Elizabeth O.; Argueta, Rodolfo; Patel, Ruchi K.; Tingen, Jennifer; Huff, Jessica D.

2010-01-01

Twelve high schools in North Carolina piloted a 1:1 learning initiative, where every student and teacher received a laptop computer with wireless Internet access provided throughout the school. The overall goals of the initiative were to improve teaching practices; increase student achievement; and better prepare students for work, citizenship,…

Incentivizing the Medical Home

DTIC Science & Technology

2011-01-25

Outcomes of Implementing Patient -Centered Medical Home Interventions: A Review of the Evidence From Prospective Evaluation Studies in the United States...The Quadruple Aim: Working Together, Achieving Success 2011 Military Health System Conference Incentivizing the Medical Home 25 January 2011 CAPT...TITLE AND SUBTITLE Incentivizing the Medical Home 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER

A Small Learning Community's Impact on Students' Success Assessed by State Test Scores in Reading and Math

ERIC Educational Resources Information Center

Smith, Christiana Helen Croson

2013-01-01

Drastic reform measures have taken place at Howard High School of Technology to incorporate a 10th grade small learning community. Due to the costs and resources associated with implementing small learning communities, it is important to examine if the 10th graders' achievement on the state tests in reading and math were significantly different…

STEM-Focused Technology-Mediated Advising Reform: Plans for Implementation by Four Colleges. CCRC Research Brief No. 64

ERIC Educational Resources Information Center

Grant, Markeisha

2016-01-01

In 2015 "The Helmsley Charitable Trust" provided grants to four Achieving the Dream (ATD) Leader Colleges to engage in STEM-specific iPASS reform beginning in fall 2016. iPASS, or Integrated Planning and Advising for Student Success, is a whole-school reform approach that uses technology to promote, support, and sustain long-term,…

The central role of national programme management for the achievement of malaria elimination: a cross case-study analysis of nine malaria programmes.

PubMed

Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D

2016-09-22

A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring implementation quality and coverage; however analysis and feedback to those implementing malaria elimination in the periphery was not well described. Political commitment and sustained financing contributed to malaria programme success. Consistency of malaria programmes depends on political commitment, human and financial resources, and leadership. Operational capacity of the programme and the overall health system structure and strength are also important aspects. Malaria eradication will require adaptive, well-managed malaria programmes that are able to tailor implementation of evidence-based strategies, founded upon strong sub-national surveillance and response, with adequate funding and human resources.

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program.

PubMed

Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S

2006-10-26

Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

What are the implications of implementation science for medical education?

PubMed Central

Price, David W.; Wagner, Dianne P.; Krane, N. Kevin; Rougas, Steven C.; Lowitt, Nancy R.; Offodile, Regina S.; Easdown, L. Jane; Andrews, Mark A. W.; Kodner, Charles M.; Lypson, Monica; Barnes, Barbara E.

2015-01-01

Background Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible. Methods This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings. Results IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed. Conclusions Utilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work. PMID:25911282

What are the implications of implementation science for medical education?

PubMed

Price, David W; Wagner, Dianne P; Krane, N Kevin; Rougas, Steven C; Lowitt, Nancy R; Offodile, Regina S; Easdown, L Jane; Andrews, Mark A W; Kodner, Charles M; Lypson, Monica; Barnes, Barbara E

2015-01-01

Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible. This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings. IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed. Utilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work.

Initial Development and Pilot Study Design of Interactive Lecture Demonstrations for ASTRO 101

NASA Astrophysics Data System (ADS)

Schwortz, Andria C.; French, D. A; Gutierrez, Joseph V; Sanchez, Richard L; Slater, Timothy F.; Tatge, Coty

2014-06-01

Interactive lecture demonstrations (ILDs) have repeatedly shown to be effective tools for improving student achievement in the context of learning physics. As a first step toward systematic development of interactive lecture demonstrations in ASTRO 101, the introductory astronomy survey course, a systematic review of education research, describing educational computer simulations (ECSs) reveals that initial development requires a targeted study of how ASTRO 101 students respond to ECSs in the non-science majoring undergraduate lecture setting. In this project we have adopted the process by which ILDs were designed, pilot-tested, and successfully implemented in the context of physics teaching (Sokoloff & Thornton, 1997; Sokoloff & Thornton, 2004). We have designed the initial pilot-test set of ASTRO 101 ILD instructional materials relying heavily on ECSs. Both an instructor’s manual and a preliminary classroom-ready student workbook have been developed, and we are implementing a pilot study to explore their effectiveness in communicating scientific content, and the extent to which they might enhance students’ knowledge of and perception about astronomy and science in general. The study design uses a pre-/post-test quasi-experimental study design measuring students’ normalized gain scores, calculated as per Hake (1998) and Prather (2009), using a slightly modified version of S. Slater’s (2011) Test Of Astronomy STandards TOAST combined with other instruments. The results of this initial study will guide the iterative development of ASTRO 101 ILDs that are intended to both be effective at enhancing student achievement and easy for instructors to successfully implement.

Achieving excellence in veterans healthcare--a balanced scorecard approach.

PubMed

Biro, Lawrence A; Moreland, Michael E; Cowgill, David E

2003-01-01

This article provides healthcare administrators and managers with a framework and model for developing a balanced scorecard and demonstrates the remarkable success of this process, which brings focus to leadership decisions about the allocation of resources. This scorecard was developed as a top management tool designed to structure multiple priorities of a large, complex, integrated healthcare system and to establish benchmarks to measure success in achieving targets for performance in identified areas. Significant benefits and positive results were derived from the implementation of the balanced scorecard, based upon benchmarks considered to be critical success factors. The network's chief executive officer and top leadership team set and articulated the network's primary operating principles: quality and efficiency in the provision of comprehensive healthcare and support services. Under the weighted benchmarks of the balanced scorecard, the facilities in the network were mandated to adhere to one non-negotiable tenet: providing care that is second to none. The balanced scorecard approach to leadership continuously ensures that this is the primary goal and focal point for all activity within the network. To that end, systems are always in place to ensure that the network is fully successful on all performance measures relating to quality.

Telehealth: seven strategies to successfully implement disruptive technology and transform health care.

PubMed

Schwamm, Lee H

2014-02-01

"Telehealth" refers to the use of electronic services to support a broad range of remote services, such as patient care, education, and monitoring. Telehealth must be integrated into traditional ambulatory and hospital-based practices if it is to achieve its full potential, including addressing the six domains of care quality defined by the Institute of Medicine: safe, effective, patient-centered, timely, efficient, and equitable. Telehealth is a disruptive technology that appears to threaten traditional health care delivery but has the potential to reform and transform the industry by reducing costs and increasing quality and patient satisfaction. This article outlines seven strategies critical to successful telehealth implementation: understanding patients' and providers' expectations, untethering telehealth from traditional revenue expectations, deconstructing the traditional health care encounter, being open to discovery, being mindful of the importance of space, redesigning care to improve value in health care, and being bold and visionary.

Beyond the computer-based patient record: re-engineering with a vision.

PubMed

Genn, B; Geukers, L

1995-01-01

In order to achieve real benefit from the potential offered by a Computer-Based Patient Record, the capabilities of the technology must be applied along with true re-engineering of healthcare delivery processes. University Hospital recognizes this and is using systems implementation projects, such as the catalyst, for transforming the way we care for our patients. Integration is fundamental to the success of these initiatives and this must be explicitly planned against an organized systems architecture whose standards are market-driven. University Hospital also recognizes that Community Health Information Networks will offer improved quality of patient care at a reduced overall cost to the system. All of these implementation factors are considered up front as the hospital makes its initial decisions on to how to computerize its patient records. This improves our chances for success and will provide a consistent vision to guide the hospital's development of new and better patient care.

Analysis on critical success factors for agile manufacturing evaluation in original equipment manufacturing industry-an AHP approach

NASA Astrophysics Data System (ADS)

Ajay Guru Dev, C.; Senthil Kumar, V. S.

2016-09-01

Manufacturing industries are facing challenges in the implementation of agile manufacturing in their products and processes. Agility is widely accepted as a new competitive concept in the manufacturing sector in fulfilling varying customer demand. Thus, evaluation of agile manufacturing in industries has become a necessity. The success of an organisation depends on its ability to manage finding the critical success factors and give them special and continued attention in order to bring about high performance. This paper proposes a set of critical success factors (CSFs) for evaluating agile manufacturing considered appropriate for the manufacturing sector. The analytical hierarchy process (AHP) method is applied for prioritizing the success factors, by summarizing the opinions of experts. It is believed that the proposed CSFs enable and assist manufacturing industries to achieve a higher performance in agile manufacturing so as to increase competitiveness.

Implementing China's circular economy concept at the regional level: a review of progress in Dalian, China.

PubMed

Geng, Yong; Zhu, Qinghua; Doberstein, Brent; Fujita, Tsuyoshi

2009-02-01

The circular economy (CE) concept was introduced in China to address environmental degradation and resource scarcity associated with rapid economic development. Chosen as a demonstration city, Dalian has implemented the CE strategy as a means of conserving water, materials, energy and land. This paper outlines some of the regional CE initiatives that have been successful to date in Dalian, including those focusing on conserving energy and water resources and others focusing on reduced industrial emissions. The paper details the approach used in implementing the CE concept in Dalian, tracing the foci and goals of the program, and the sectoral approach used to implement a CE. Although Dalian municipality has achieved many successes in implementing a CE, our paper identifies several challenges that, until recently, have held back complete implementation. These include: the lack of incentives for older industries to 'green' their operations, the lack of financial support to expand the CE concept, and a broad-based need for heightened public awareness and participation in CE initiatives. Our paper then identifies several responses by Dalian municipality to overcome these challenges, including pricing and tax reforms that serve as conservation incentives, the provision of financial support for CE promotion through budget reorganization, and the organization of CE training programs. Our paper concludes that, although CE initiatives have been successful in Dalian, more is possible and more is needed before Dalian can be designated a true 'eco-city'. The approach used by Dalian can provide guidance for other Chinese cities, although it is recognized that each city must tailor its own approach for differing contexts and conditions.

Using the Whole School, Whole Community, Whole Child Model: Implications for Practice

PubMed Central

Rooney, Laura E; Videto, Donna M; Birch, David A

2015-01-01

BACKGROUND Schools, school districts, and communities seeking to implement the Whole School, Whole Community, Whole Child (WSCC) model should carefully and deliberately select planning, implementation, and evaluation strategies. METHODS In this article, we identify strategies, steps, and resources within each phase that can be integrated into existing processes that help improve health outcomes and academic achievement. Implementation practices may vary across districts depending upon available resources and time commitments. RESULTS Obtaining and maintaining administrative support at the beginning of the planning phase is imperative for identifying and implementing strategies and sustaining efforts to improve student health and academic outcomes. Strategy selection hinges on priority needs, community assets, and resources identified through the planning process. Determining the results of implementing the WSCC is based upon a comprehensive evaluation that begins during the planning phase. Evaluation guides success in attaining goals and objectives, assesses strengths and weaknesses, provides direction for program adjustment, revision, and future planning, and informs stakeholders of the effect of WSCC, including the effect on academic indicators. CONCLUSIONS With careful planning, implementation, and evaluation efforts, use of the WSCC model has the potential of focusing family, community, and school education and health resources to increase the likelihood of better health and academic success for students and improve school and community life in the present and in the future. PMID:26440824

Costs and Effects of a Telephonic Diabetes Self-Management Support Intervention Using Health Educators

PubMed Central

Schechter, Clyde B.; Walker, Elizabeth A.; Ortega, Felix M.; Chamany, Shadi; Silver, Lynn D.

2015-01-01

Background Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Methods Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. Oneway sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. Results The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Conclusions Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. PMID:26750743

Costs and effects of a telephonic diabetes self-management support intervention using health educators.

PubMed

Schechter, Clyde B; Walker, Elizabeth A; Ortega, Felix M; Chamany, Shadi; Silver, Lynn D

2016-03-01

Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. One-way sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. Copyright © 2016 Elsevier Inc. All rights reserved.

Training and capacity building evaluation: Maximizing resources and results with Success Case Method.

PubMed

Medina, L; Acosta-Pérez, E; Velez, C; Martínez, G; Rivera, M; Sardiñas, L; Pattatucci, A

2015-10-01

This article describes the use of Success Case Method (Brinkerhoff, 2003) to evaluate health promotion and public health training programs. The goal of the Office Community Research and Engagement (OCRE) of the Puerto Rico Clinical and Translational Research Consortium (PRCTRC) is to establish a stable and sustainable translational research capacity. Early efforts toward achieving this goal included sponsoring two independent research training programs. A description of the implementation of the five step Success Case Method is presented. Results reveal that SCM would deem both trainings as highly successful, based upon the overall impact of a low number of success cases. However, a traditional summative evaluation would consider this disappointing. Strengths of SCM are discussed. It was concluded that the Success Case Method is a useful and valuable evaluative method for measuring the success of health promotion and public health training initiatives and provides sufficient information for decision-making processes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Early warning systems and rapid response to the deteriorating patient in hospital: A realist evaluation.

PubMed

McGaughey, Jennifer; O'Halloran, Peter; Porter, Sam; Trinder, John; Blackwood, Bronagh

2017-12-01

To test the Rapid Response Systems programme theory against actual practice components of the Rapid Response Systems implemented to identify those contexts and mechanisms which have an impact on the successful achievement of desired outcomes in practice. Rapid Response Systems allow deteriorating patients to be recognized using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. Realist evaluation. The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation. We used various mixed methods including individual and focus group interviews, observation of nursing practice between June-November 2010 and document analysis of Early Warning Systems audit data between May-October 2010 and hospital acute care training records over 4.5 years from 2003-2008. Data were analysed using NiVivo8 and SPPS. A cross-case analysis highlighted similar patterns of factors which enabled or constrained successful recognition, referral and response to deteriorating patients in practice. Key enabling factors were the use of clinical judgement by experienced nurses and the empowerment of nurses as a result of organizational change associated with implementation of Early Warning System protocols. Key constraining factors were low staffing and inappropriate skill mix levels, rigid implementation of protocols and culturally embedded suboptimal communication processes. Successful implementation of Rapid Response Systems was dependent on adopting organizational and cultural changes that facilitated staff empowerment, flexible implementation of protocols and ongoing experiential learning. © 2017 John Wiley & Sons Ltd.

The likelihood of achieving quantified road safety targets: a binary logistic regression model for possible factors.

PubMed

Sze, N N; Wong, S C; Lee, C Y

2014-12-01

In past several decades, many countries have set quantified road safety targets to motivate transport authorities to develop systematic road safety strategies and measures and facilitate the achievement of continuous road safety improvement. Studies have been conducted to evaluate the association between the setting of quantified road safety targets and road fatality reduction, in both the short and long run, by comparing road fatalities before and after the implementation of a quantified road safety target. However, not much work has been done to evaluate whether the quantified road safety targets are actually achieved. In this study, we used a binary logistic regression model to examine the factors - including vehicle ownership, fatality rate, and national income, in addition to level of ambition and duration of target - that contribute to a target's success. We analyzed 55 quantified road safety targets set by 29 countries from 1981 to 2009, and the results indicate that targets that are in progress and with lower level of ambitions had a higher likelihood of eventually being achieved. Moreover, possible interaction effects on the association between level of ambition and the likelihood of success are also revealed. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Study to Identify the Critical Success Factors for ERP Implementation in an Indian SME: A Case Based Approach

NASA Astrophysics Data System (ADS)

Upadhyay, Parijat; Dan, Pranab K.

To achieve synergy across product lines, businesses are implementing a set of standard business applications and consistent data definitions across all business units. ERP packages are extremely useful in integrating a global company and provide a "common language" throughout the company. Companies are not only implementing a standardized application but is also moving to a common architecture and infrastructure. For many companies, a standardized software rollout is a good time to do some consolidation of their IT infrastructure across various locations. Companies are also finding that the ERP solutions help them get rid of their legacy systems, most of which may not be compliant with the modern day business requirements.

Achieving the Framework Convention on Tobacco Control's potential by investing in national capacity.

PubMed

Wipfli, H; Stillman, F; Tamplin, S; da Costa e Silva, V Luiza; Yach, D; Samet, J

2004-12-01

May 2003 marked a critical achievement in efforts to stem the global tobacco epidemic, as the member states of the World Health Organization unanimously endorsed the Framework Convention on Tobacco Control (FCTC). However, the adoption of the FCTC signifies only the end of the beginning of effective global action to control tobacco. Over the next several years the utility of the FCTC process and the treaty itself will be tested as individual countries seek to ratify and implement the treaty's obligations. Significant barriers to the treaty's long term success exist in many countries. It is crucial that the international tobacco control community now refocuses its efforts on national capacity building and ensures that individual countries have the knowledge, tools, data, people, and organisations needed to implement the convention and develop sustained tobacco control programmes. This paper provides a model of national tobacco control capacity and offers a prioritised agenda for action.

A Review of Supply Chain Collaboration Practices for Small and Medium-sized Manufacturers

NASA Astrophysics Data System (ADS)

Wee, SY; Thoo, AC; Z, Sulaiman; FM, Muharam

2016-05-01

For the decades, organizations have endeavored to look for external sources for opportunities to achieve efficient and responsive supply chain with their partners especially for small and medium manufacturers (SMM). In this scenario, supply chain collaboration (SCC) is an interaction between supply chain members with the purpose of utilizes the knowledge and resources of customers and suppliers, and integrates the flows of products and information in order to achieve a common goal and obtain mutual benefit. The essential SCC dimensions for SMMs comprised of information sharing, joint knowledge creation, joint decision making, goal congruence and incentive sharing. The successful implementation of SCC can give SMMs an edge over their competitors. This paper aims to introduce a review of SCC practices for SMM. Overall, the findings provide managerial insights for the SMM in SCC implementation owing to resource scarcity and the need to draw SCC in order to ensure a sustainable competitive advantage.

Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality.

PubMed

Backman, Chantal; Vanderloo, Saskia; Forster, Alan John

2016-09-01

Measuring and monitoring overall health system performance is complex and challenging but is crucial to improving quality of care. Today's health care organizations are increasingly being held accountable to develop and implement actions aimed at improving the quality of care, reducing costs, and achieving better patient-centered care. This paper describes the development of the Collaborative for Excellence in Healthcare Quality (CEHQ), a 5-year initiative to achieve higher quality of patient care in university hospitals across Canada. This bottom-up initiative took place between 2010 and 2015, and was successful in engaging health care leaders in the development of a common framework and set of performance measures for reporting and benchmarking, as well as working on initiatives to improve performance. Despite its successes, future efforts are needed to provide clear national leadership on standards for measuring performance. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Academic performance: A case study of mathematics and science educators from rural Washington high schools

NASA Astrophysics Data System (ADS)

Hancock, Tira K.

A qualitative descriptive case study explored courses of action for educators and leaders of math and science educators to implement to help students achieve state assessment standard and postsecondary success. The problem focused on two demographically similar rural high schools in Southwest Washington that demonstrated inadequate rates of student achievement in mathematics and science. The research question investigated courses of action that may assist educators and leaders of secondary math and science educators to help students achieve WASL standards and postsecondary success in compliance with the No Child Left Behind (NCLB) Act of 2001. Senge's learning organization theory (1990, 2006) and Fullan's (2001) contributions to leading and learning in times of change provided the theoretical framework for the study. Twenty study participant responses analyzed with qualitative analysis software QSR NVivo 7 revealed six themes. Triangulation of responses with secondary data from WASL assessment scores and case study school assessment data identified 14 courses of action and three recommendations for educators and leaders of math and science educators to help students meet state standards and postsecondary success. Critical factors identified in the study as needed to assist educators to help students succeed included professional development, collaboration, teaching practices, funding, student accountability, and parental involvement.

Biomechanical factors critical for performance in the men's javelin throw.

PubMed

Morriss, C; Bartlett, R

1996-06-01

In the men's javelin event the athlete throws an 800g implement into a 40 degrees sector. The objective is to throw as far as possible. Compared with most other throwing implements, the javelin is relatively aerodynamic. Even so, the most important release parameter is still the release speed. Maximising this parameter gives the athlete the best chance of attaining success in the event. For an elite thrower, as much as 70% of the release speed of the javelin is developed in the last 0.1 second. As such, the movements of throwers during this period and immediately preceding it have received attention from researchers. It would appear that a thrower's body position at the instant of final foot strike, his ability to transfer momentum between the lower body and the upper body during the delivery, and coordination of the working body segments in the most effective manner are linked to his success in the event. This paper reviews the most important biomechanical research on the men's javelin throw and highlights findings such as these which may improve the understanding of how elite javelin throwers achieve success.

Intermediate Outcomes, Strategies, and Challenges of Eight Healthy Start Projects

PubMed Central

Walker, Deborah Klein; Hargreaves, Margaret; Rosenbach, Margo

2008-01-01

Site visits were conducted for the evaluation of the national Healthy Start program to gain an understanding of how projects design and implement five service components (outreach, case management, health education, depression screening and interconceptional care) and four system components (consortium, coordination/collaboration, local health system action plan and sustainability) as well as program staff’s perceptions of these components’ influence on intermediate outcomes. Interviews with project directors, case managers, local evaluators, clinicians, consortium members, outreach/lay workers and other stakeholders were conducted during 3-day in-depth site visits with eight Healthy Start grantees. Grantees reported that both services and systems components were related to self-reported service achievements (e.g. earlier entry into prenatal care) and systems achievements (e.g. consumer involvement). Outreach, case management, and health education were perceived as the service components that contributed most to their achievements while consortia was perceived as the most influential systems component in reaching their goals. Furthermore, cultural competence and community voice were overarching project components that addressed racial/ethnic disparities. Finally, there was great variability across sites regarding the challenges they faced, with poor service availability and limited funding the two most frequently reported. Service provision and systems development are both critical for successful Healthy Start projects to achieve intermediate program outcomes. Unique contextual and community issues influence Healthy Start project design, implementation and reported accomplishments. All eight projects implement the required program components yet outreach, case management, and health education are cited most frequently for contributing to their perceived achievements. PMID:19011959

A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester.

PubMed

Humphreys, John; Harvey, Gill; Coleiro, Michelle; Butler, Brook; Barclay, Anna; Gwozdziewicz, Maciek; O'Donoghue, Donal; Hegarty, Janet

2012-08-01

Research has demonstrated a knowledge and practice gap in the identification and management of chronic kidney disease (CKD). In 2009, published data showed that general practices in Greater Manchester had a low detection rate for CKD. A 12-month improvement collaborative, supported by an evidence-informed implementation framework and financial incentives. 19 general practices from four primary care trusts within Greater Manchester. Number of recorded patients with CKD on practice registers; percentage of patients on registers achieving nationally agreed blood pressure targets. The collaborative commenced in September 2009 and involved three joint learning sessions, interspersed with practice level rapid improvement cycles, and supported by an implementation team from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Greater Manchester. At baseline, the 19 collaborative practices had 4185 patients on their CKD registers. At final data collection in September 2010, this figure had increased by 1324 to 5509. Blood pressure improved from 34% to 74% of patients on practice registers having a recorded blood pressure within recommended guidelines. Evidence-based improvement can be implemented in practice for chronic disease management. A collaborative approach has been successful in enabling teams to test and apply changes to identify patients and improve care. The model has proved to be more successful for some practices, suggesting a need to develop more context-sensitive approaches to implementation and actively manage the factors that influence the success of the collaborative.

Lessons Learned by Community Stakeholders in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project, 2013–2014

PubMed Central

Ganter, Claudia; Aftosmes-Tobio, Alyssa; Chuang, Emmeline; Kwass, Jo-Ann; Land, Thomas

2017-01-01

Introduction Childhood obesity is a multifaceted disease that requires sustainable, multidimensional approaches that support change at the individual, community, and systems levels. The Massachusetts Childhood Obesity Research Demonstration project addressed this need by using clinical and public health evidence-based methods to prevent childhood obesity. To date, little information is known about successes and lessons learned from implementing such large-scale interventions. To address this gap, we examined perspectives of community stakeholders from various sectors on successes achieved and lessons learned during the implementation process. Methods We conducted 39 semistructured interviews with key stakeholders from 6 community sectors in 2 low-income communities from November 2013 through April 2014, during project implementation. Interviews were audio-recorded, transcribed, and analyzed by using the constant comparative method. Data were analyzed by using QSR NVivo 10. Results Successes included increased parental involvement in children’s health and education, increased connections within participating organizations and within the broader community, changes in organizational policies and environments to better support healthy living, and improvements in health behaviors in children, parents, and stakeholders. Lessons learned included the importance of obtaining administrative and leadership support, involving key stakeholders early in the program planning process, creating buffers that allow for unexpected changes, and establishing opportunities for regular communication within and across sectors. Conclusion Study findings indicate that multidisciplinary approaches support health behavior change and provide insight into key issues to consider in developing and implementing such approaches in low-income communities. PMID:28125400

Taking a unified approach to teaching and implementing quality improvements across multiple residency programs: the Atlantic Health experience.

PubMed

Daniel, Donna M; Casey, Donald E; Levine, Jeffrey L; Kaye, Susan T; Dardik, Raquel B; Varkey, Prathibha; Pierce-Boggs, Kimberly

2009-12-01

The Accreditation Council for Graduate Medical Education recently emphasized the importance of systems-based practice and systems-based learning; however, successful models of collaborative quality improvement (QI) initiatives in residency training curricula are not widely available. Atlantic Health successfully conceptualized and implemented a QI collaborative focused on medication safety across eight residency training programs representing 219 residents. During a six-month period, key faculty and resident leaders from 8 (of 10) Atlantic Health residency training programs participated in three half-day collaborative learning sessions focused on improving medication reconciliation. Each session included didactic presentations from a multidisciplinary team of clinical experts as well as the application of principles that identified challenges, barriers, and solutions to QI initiatives. The learning sessions emphasized the fundamental principles of medication reconciliation, its critical importance as a vital part of patient handoff in all health care settings, and the challenges of achieving successful medication reconciliation improvement in light of work hours restrictions and patient loads. Each residency program developed a detailed implementation and measurement plan for individual "action learning" projects, using the Plan-Do-Study-Act method of improvement. Each program then implemented its QI project, and expert faculty (e.g., physicians, nurses, pharmacists, QI staff) provided mentoring between learning sessions. Several projects resulted in permanent changes in medication reconciliation processes, which were then adopted by other programs. The structure, process, and outcomes of this effort are described in detail.

Crossing the implementation chasm: a proposal for bold action.

PubMed

Lorenzi, Nancy M; Novak, Laurie L; Weiss, Jacob B; Gadd, Cynthia S; Unertl, Kim M

2008-01-01

As health care organizations dramatically increase investment in information technology (IT) and the scope of their IT projects, implementation failures become critical events. Implementation failures cause stress on clinical units, increase risk to patients, and result in massive costs that are often not recoverable. At an estimated 28% success rate, the current level of investment defies management logic. This paper asserts that there are "chasms" in IT implementations that represent risky stages in the process. Contributors to the chasms are classified into four categories: design, management, organization, and assessment. The American College of Medical Informatics symposium participants recommend bold action to better understand problems and challenges in implementation and to improve the ability of organizations to bridge these implementation chasms. The bold action includes the creation of a Team Science for Implementation strategy that allows for participation from multiple institutions to address the long standing and costly implementation issues. The outcomes of this endeavor will include a new focus on interdisciplinary research and an inter-organizational knowledge base of strategies and methods to optimize implementations and subsequent achievement of organizational objectives.

Beyond health information technology: critical factors necessary for effective diabetes disease management.

PubMed

Ciemins, Elizabeth L; Coon, Patricia J; Fowles, Jinnet Briggs; Min, Sung-joon

2009-05-01

Electronic health records (EHRs) have been implemented throughout the United States with varying degrees of success. Past EHR implementation experiences can inform health systems planning to initiate new or expand existing EHR systems. Key "critical success factors," e.g., use of disease registries, workflow integration, and real-time clinical guideline support, have been identified but not fully tested in practice. A pre/postintervention cohort analysis was conducted on 495 adult patients selected randomly from a diabetes registry and followed for 6 years. Two intervention phases were evaluated: a "low-dose" period targeting primary care provider (PCP) and patient education followed by a "high-dose" EHR diabetes management implementation period, including a diabetes disease registry and office workflow changes, e.g., diabetes patient preidentification to facilitate real-time diabetes preventive care, disease management, and patient education. Across baseline, "low-dose," and "high-dose" postintervention periods, a significantly greater proportion of patients (a) achieved American Diabetes Association (ADA) guidelines for control of blood pressure (26.9 to 33.1 to 43.9%), glycosylated hemoglobin (48.5 to 57.5 to 66.8%), and low-density lipoprotein cholesterol (33.1 to 44.4 to 56.6%) and (b) received recommended preventive eye (26.2 to 36.4 to 58%), foot (23.4 to 40.3 to 66.9%), and renal (38.5 to 53.9 to 71%) examinations or screens. Implementation of a fully functional, specialized EHR combined with tailored office workflow process changes was associated with increased adherence to ADA guidelines, including risk factor control, by PCPs and their patients with diabetes. Incorporation of previously identified "critical success factors" potentially contributed to the success of the program, as did use of a two-phase approach. 2009 Diabetes Technology Society.

Teaching High School Physical Education According to National Standards: The 6 Verbs of Success--Demonstrate, Understand, Participate, Achieve, Exhibit and Value

ERIC Educational Resources Information Center

Bert, Greg

2010-01-01

The six national content standards from NASPE define what a student should know and be able to do as a result of a high quality physical education program. The "NASPE SIX" serve as a North Star to guide teachers as they prepare and implement programs. Simply stated, the NASPE Standards for Physical Education are all about six simple…

Demonstration, Developmental and Research Project for Programs, Materials, Facilities and Educational Technology for Undereducated Adults. Counselor Aides; Virginia State Module. Final Report Series.

ERIC Educational Resources Information Center

Morehead State Univ., KY. Appalachian Adult Basic Education Demonstration Center.

The Counselor-Aide Program is implemented by para-professionals working cooperatively with a certified counselor, in an effort to raise the economic level of the adults in Carroll County, through an improvement in the educational level of achievement. The counselor aides feel that they have been reasonably successful in meeting the objectives as…

Raising the Reading Skills of Secondary-Age Students with Severe and Persistent Reading Difficulties: Evaluation of the Efficacy and Implementation of a Phonics-Based Intervention Programme

ERIC Educational Resources Information Center

Jeffes, Ben

2016-01-01

The importance of reading skills to academic achievement, job acquisition and future success is well documented. Most of the research on reading interventions focuses on children in primary schools but many children start secondary school with very poor reading skills and schools require evidence-based interventions to support these children. The…

Astronomy and Disabled: Implementation of new technologies to communicate science to new audiences

NASA Astrophysics Data System (ADS)

García, Beatriz; Ortiz Gil, Amelia; Proust, Dominique

2015-08-01

Commission 46 proposed in 2012 the creation of an interdisciplinary WG in which astronomers work together with technicians, educators and disability specialists to develop new teaching and learning strategies devoted o generate resources of high impact among disabled populations, which are usually away from astronomy. Successful initiatives designed to research the best-practices in using new technologies to communicate science in these special audiences include the creation of models and applications, and the implementation of a data base of didactic approaches and tools. Between the achievements of this proposal, we have original development in: design of electronics, design of original software, scripts and music for Planetarium functions, design of models and their associated explanatory script, printed material in Braille and 3D, filming associated with sign language, interviews and docs recompilation and the recently project on the Sign Language Universal Encyclopedic Dictionary, based on the proposal by Proust (2009) and, which proposes the dissemination of a unique language for the deaf worldwide, associated with astronomical terms.We present, on behalf of the WG, some of the achievements, developments, successful stories of recent applications of this new approach to the science for all, thinking in the new “public of sciences”, and new challenges.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 7: supporting staff in evidence-based decision-making, implementation and evaluation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Dyer, Tim; Brooke, Vanessa; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Gust, Anthony; Farjou, Dina

2017-06-21

This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. From the literature and responses of local stakeholders it was clear that provision of expertise and education, training and support of health service staff would be required to achieve these aims. Four support services were proposed. This paper is a detailed case report of the development, implementation and evaluation of a Data Service, Capacity Building Service and Project Support Service. An Evidence Service is reported separately. Literature reviews, surveys, interviews, consultation and workshops were used to capture and process the relevant information. Existing theoretical frameworks were adapted for evaluation and explication of processes and outcomes. Surveys and interviews identified current practice in use of evidence in decision-making, implementation and evaluation; staff needs for evidence-based practice; nature, type and availability of local health service data; and preferred formats for education and training. The Capacity Building and Project Support Services were successful in achieving short term objectives; but long term outcomes were not evaluated due to reduced funding. The Data Service was not implemented at all. Factors influencing the processes and outcomes are discussed. Health service staff need access to education, training, expertise and support to enable evidence-based decision-making and to implement and evaluate the changes arising from those decisions. Three support services were proposed based on research evidence and local findings. Local factors, some unanticipated and some unavoidable, were the main barriers to successful implementation. All three proposed support services hold promise as facilitators of EBP in the local healthcare setting. The findings from this study will inform further exploration.

The outcomes of health-promoting communities: being active eating well initiative-a community-based obesity prevention intervention in Victoria, Australia.

PubMed

Bolton, K A; Kremer, P; Gibbs, L; Waters, E; Swinburn, B; de Silva, A

2017-07-01

The aim of this study is to evaluate the impact of the Health-Promoting Communities: Being Active Eating Well (HPC:BAEW, 2007-2010) initiative, which comprised community-based multi-component interventions adapted to community context in five separate communities. The intervention aimed to promote healthy eating, physical activity and stronger, healthier communities. A mixed method and multilevel quasi-experimental evaluation of the HPC:BAEW initiative captured process, impact and outcome data. The evaluation involved both cross-sectional (children and adolescents) and longitudinal designs (adults) with data collected pre- and post-intervention in intervention (n=2408 children and adolescents from 18 schools, n=501 adults from 22 workplaces) and comparison groups (n=3163 children and adolescents from 33 schools, n=318 adults from seven workplaces). Anthropometry, obesity-related behavioural and environmental data, information regarding community context and implementation factors were collected. The primary outcomes were differences in anthropometry (weight, waist, body mass index (BMI) and standardised BMI (BMI z-score)) over time compared with comparison communities. Baseline data was collected 2008/2009 and post-intervention collected in 2010 with an average intervention time frame of approximately 12 months. The strategies most commonly implemented were related to social marketing, stakeholder engagement, network and partnership development, community-directed needs assessment and capacity building. Analysis of post-intervention data showed gains in community capacity, but few impacts on environments, policy or individual knowledge, skills, beliefs and perceptions. Relative to the comparison group, one community achieved a lower prevalence of overweight/obesity, lower weight, waist circumference and BMI (P<0.005). One community achieved a higher level of healthy eating policy implementation in schools; two communities achieved improved healthy eating-related behaviours (P<0.03); one community achieved lower sedentary behaviours; and one community achieved higher levels of physical activity in schools (P<0.05). All effect sizes were in the small-to-moderate range. This was a complex and ambitious initiative, which attempted to expand a previously successful community-based intervention in Victoria into five new contexts and communities. Overall, project success was quite inconsistent, and some significant differences were in the unanticipated direction. However, there are many important learnings that should inform future health-promotion activities. The heterogeneity of outcomes of HPC:BAEW communities reflects the reality of life whereby effectiveness of intervention strategies is dependent on individual and community factors. Future health promotion should consider a systems approach whereby existing systems are modified rather than relying heavily on the addition of new activities, with longer time frames for implementation.

Early decision framework for integrating sustainable risk management for complex remediation sites: Drivers, barriers, and performance metrics.

PubMed

Harclerode, Melissa A; Macbeth, Tamzen W; Miller, Michael E; Gurr, Christopher J; Myers, Teri S

2016-12-15

As the environmental remediation industry matures, remaining sites often have significant underlying technical challenges and financial constraints. More often than not, significant remediation efforts at these "complex" sites have not achieved stringent, promulgated cleanup goals. Decisions then have to be made about whether and how to commit additional resources towards achieving those goals, which are often not achievable nor required to protect receptors. Guidance on cleanup approaches focused on evaluating and managing site-specific conditions and risks, rather than uniformly meeting contaminant cleanup criteria in all media, is available to aid in this decision. Although these risk-based cleanup approaches, such as alternative endpoints and adaptive management strategies, have been developed, they are under-utilized due to environmental, socio-economic, and risk perception barriers. Also, these approaches are usually implemented late in the project life cycle after unsuccessful remedial attempts to achieve stringent cleanup criteria. In this article, we address these barriers by developing an early decision framework to identify if site characteristics support sustainable risk management, and develop performance metrics and tools to evaluate and implement successful risk-based cleanup approaches. In addition, we address uncertainty and risk perception challenges by aligning risk-based cleanup approaches with the concepts of risk management and sustainable remediation. This approach was developed in the context of lessons learned from implementing remediation at complex sites, but as a framework can, and should, be applied to all sites undergoing remediation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Finding pathways to national-scale land-sector sustainability.

PubMed

Gao, Lei; Bryan, Brett A

2017-04-12

The 17 Sustainable Development Goals (SDGs) and 169 targets under Agenda 2030 of the United Nations map a coherent global sustainability ambition at a level of detail general enough to garner consensus amongst nations. However, achieving the global agenda will depend heavily on successful national-scale implementation, which requires the development of effective science-driven targets tailored to specific national contexts and supported by strong national governance. Here we assess the feasibility of achieving multiple SDG targets at the national scale for the Australian land-sector. We scaled targets to three levels of ambition and two timeframes, then quantitatively explored the option space for target achievement under 648 plausible future environmental, socio-economic, technological and policy pathways using the Land-Use Trade-Offs (LUTO) integrated land systems model. We show that target achievement is very sensitive to global efforts to abate emissions, domestic land-use policy, productivity growth rate, and land-use change adoption behaviour and capacity constraints. Weaker target-setting ambition resulted in higher achievement but poorer sustainability outcomes. Accelerating land-use dynamics after 2030 changed the targets achieved by 2050, warranting a longer-term view and greater flexibility in sustainability implementation. Simultaneous achievement of multiple targets is rare owing to the complexity of sustainability target implementation and the pervasive trade-offs in resource-constrained land systems. Given that hard choices are needed, the land-sector must first address the essential food/fibre production, biodiversity and land degradation components of sustainability via specific policy pathways. It may also contribute to emissions abatement, water and energy targets by capitalizing on co-benefits. However, achieving targets relevant to the land-sector will also require substantial contributions from other sectors such as clean energy, food systems and water resource management. Nations require globally coordinated, national-scale, comprehensive, integrated, multi-sectoral analyses to support national target-setting that prioritizes efficient and effective sustainability interventions across societies, economies and environments.

Finding pathways to national-scale land-sector sustainability

NASA Astrophysics Data System (ADS)

Gao, Lei; Bryan, Brett A.

2017-04-01

The 17 Sustainable Development Goals (SDGs) and 169 targets under Agenda 2030 of the United Nations map a coherent global sustainability ambition at a level of detail general enough to garner consensus amongst nations. However, achieving the global agenda will depend heavily on successful national-scale implementation, which requires the development of effective science-driven targets tailored to specific national contexts and supported by strong national governance. Here we assess the feasibility of achieving multiple SDG targets at the national scale for the Australian land-sector. We scaled targets to three levels of ambition and two timeframes, then quantitatively explored the option space for target achievement under 648 plausible future environmental, socio-economic, technological and policy pathways using the Land-Use Trade-Offs (LUTO) integrated land systems model. We show that target achievement is very sensitive to global efforts to abate emissions, domestic land-use policy, productivity growth rate, and land-use change adoption behaviour and capacity constraints. Weaker target-setting ambition resulted in higher achievement but poorer sustainability outcomes. Accelerating land-use dynamics after 2030 changed the targets achieved by 2050, warranting a longer-term view and greater flexibility in sustainability implementation. Simultaneous achievement of multiple targets is rare owing to the complexity of sustainability target implementation and the pervasive trade-offs in resource-constrained land systems. Given that hard choices are needed, the land-sector must first address the essential food/fibre production, biodiversity and land degradation components of sustainability via specific policy pathways. It may also contribute to emissions abatement, water and energy targets by capitalizing on co-benefits. However, achieving targets relevant to the land-sector will also require substantial contributions from other sectors such as clean energy, food systems and water resource management. Nations require globally coordinated, national-scale, comprehensive, integrated, multi-sectoral analyses to support national target-setting that prioritizes efficient and effective sustainability interventions across societies, economies and environments.

Embracing change: practical and theoretical considerations for successful implementation of technology assisting upper limb training in stroke

PubMed Central

2012-01-01

Background Rehabilitation technology for upper limb training of stroke patients may play an important role as therapy tool in future, in order to meet the increasing therapy demand. Currently, implementation of this technology in the clinic remains low. This study aimed at identifying criteria and conditions that people, involved in development of such technology, should take into account to achieve a (more) successful implementation of the technology in the clinic. Methods A literature search was performed in PubMed and IEEE databases, and semi-structured interviews with therapists in stroke rehabilitation were held, to identify criteria and conditions technology should meet to facilitate (implementation of) technology-assisted arm-hand skills training in rehabilitation therapy of stroke patients. In addition, an implementation strategy frequently applied in general health care was used to compose a stepwise guidance to facilitate successful implementation of this technology in therapy of stroke patients. Implementation-related criteria mentioned by therapists during the interviews were integrated in this guidance. Results Results indicate that, related to therapy content, technology should facilitate repetition of task-related movements, tailored to the patient and patient’s goals, in a meaningful context. Variability and increasing levels of difficulty in exercises should be on offer. Regarding hardware and software design of technology, the system should facilitate quick familiarisation and be easily adjustable to individual patients during therapy by therapists (and assistants). The system should facilitate adaptation to individual patients’ needs and their progression over time, should be adjustable as to various task-related variables, should be able to provide instructions and feedback, and should be able to document patient’s progression. The implementation process of technology in the clinic is provided as a stepwise guidance that consists of five phases therapists have to go through. The guidance includes criteria and conditions that motivate therapists, and make it possible for them, to actually use technology in their daily clinical practice. Conclusions The reported requirements are important as guidance for people involved in the development of rehabilitation technology for arm-hand therapy of stroke patients. The stepwise guide provides a tool for facilitating successful implementation of technology in clinical practice, thus meeting future therapy demand. PMID:22856548

Design and implementation of web-based discharge summary note based on service-oriented architecture.

PubMed

Chen, Chi-Huang; Hsieh, Sung-Huai; Su, Yu-Shuan; Hsu, Kai-Ping; Lee, Hsiu-Hui; Lai, Feipei

2012-02-01

Discharge summary note is one of the essential clinical data in medical records, and it concisely capsules a patient's status during hospitalization. In the article, we adopt web-based architecture in developing a new discharge summary system for the Healthcare Information System of National Taiwan University Hospital, to improve the traditional client/sever architecture. The article elaborates the design approaches and implementation illustrations in detail, including patients' summary query and searching, model and phrase quoted, summary check list, major editing blocks as well as other functionalities. The system has been on-line and achieves successfully since October 2009.

Aquatic invasive species: Lessons from cancer research

USGS Publications Warehouse

Sepulveda, Adam; Ray, Andrew; Al-Chokhachy, Robert K.; Muhlfeld, Clint C.; Gresswell, Robert E.; Gross, Jackson A.; Kershner, Jeffrey L.

2014-01-01

Aquatic invasive species are disrupting ecosystems with increasing frequency. Successful control of these invasions has been rare: Biologists and managers have few tools for fighting aquatic invaders. In contrast, the medical community has long worked to develop tools for preventing and fighting cancer. Its successes are marked by a coordinated research approach with multiple steps: prevention, early detection, diagnosis, treatment options and rehabilitation. The authors discuss how these steps can be applied to aquatic invasive species, such as the American bullfrog (Lithobates catesbeianus), in the Northern Rocky Mountain region of the United States, to expedite tool development and implementation along with achievement of biodiversity conservation goals.

Optical implementation of a feature-based neural network with application to automatic target recognition

NASA Technical Reports Server (NTRS)

Chao, Tien-Hsin; Stoner, William W.

1993-01-01

An optical neural network based on the neocognitron paradigm is introduced. A novel aspect of the architecture design is shift-invariant multichannel Fourier optical correlation within each processing layer. Multilayer processing is achieved by feeding back the ouput of the feature correlator interatively to the input spatial light modulator and by updating the Fourier filters. By training the neural net with characteristic features extracted from the target images, successful pattern recognition with intraclass fault tolerance and interclass discrimination is achieved. A detailed system description is provided. Experimental demonstrations of a two-layer neural network for space-object discrimination is also presented.

Applying a Consumer Behavior Lens to Salt Reduction Initiatives.

PubMed

Regan, Áine; Kent, Monique Potvin; Raats, Monique M; McConnon, Áine; Wall, Patrick; Dubois, Lise

2017-08-18

Reformulation of food products to reduce salt content has been a central strategy for achieving population level salt reduction. In this paper, we reflect on current reformulation strategies and consider how consumer behavior determines the ultimate success of these strategies. We consider the merits of adopting a 'health by stealth', silent approach to reformulation compared to implementing a communications strategy which draws on labeling initiatives in tandem with reformulation efforts. We end this paper by calling for a multi-actor approach which utilizes co-design, participatory tools to facilitate the involvement of all stakeholders, including, and especially, consumers, in making decisions around how best to achieve population-level salt reduction.

Teachers' perceptions of the effectiveness of an urban health sciences curriculum in closing the Black-White test score gap: A participatory case study

NASA Astrophysics Data System (ADS)

Prince, Joan Marie

1999-12-01

Over the past years, progress in Black academic achievement, particularly in the area of science, has generally slowed or ceased. According to the 1994 NAEP assessment, twelfth-grade Black students are performing at the level of White eighth-grade students in the discipline of science (Department of Education, 1996). These students, in their last year of required schooling, are about to graduate, yet they lag at least four years behind their white counterparts in science achievement. Despite the establishment and implementation of numerous science intervention programs, Black students still suffer from a disparate gap in standardized test score achievement. The purpose of this research is to investigate teachers' perceptions of the effectiveness of an urban sciences intervention tool that was designed to assist in narrowing the Black-White science academic achievement gap. Specifically, what factors affect teachers' personal sense of instructional efficacy, and how does this translate into their outcome expectancy for student academic success? A multiple-case, replicative design, grounded in descriptive theory, was selected for the study. Multiple sources of evidence were queried to provide robust findings. These sources included a validated health sciences self-efficacy instrument, an interview protocol, a classroom observation, and a review of archival material that included case study participants' personnel files and meeting minutes. A cross-comparative analytic approach was selected for interpretation (Yin, 1994). Findings indicate that teachers attribute the success or failure of educational intervention tools in closing the Black-White test score gap to a variety of internal and external factors. These factors included a perceived lack of both monetary and personal support by the school leadership, as well as a perceived lack of parental involvement which impacted negatively on student achievement patterns. The case study participants displayed a depressed outcome expectancy effect for successful student achievement, which they directly attributed to the barriers stated above. If educational reforms are to be successful, the issues of teachers' perceptions of factors that inhibit their personal ability to instruct, and how that translates to student academic achievement must be addressed.

Successful implementation of an enhanced recovery after surgery programme for elective colorectal surgery: a process evaluation of champions' experiences.

PubMed

Gotlib Conn, Lesley; McKenzie, Marg; Pearsall, Emily A; McLeod, Robin S

2015-07-17

Enhanced recovery after surgery (ERAS) is a multimodal evidence-based approach to patient care that has become the standard in elective colorectal surgery. Implemented globally, ERAS programmes represent a considerable change in practice for many surgical care providers. Our current understanding of specific implementation and sustainability challenges is limited. In January 2013, we began a 2-year ERAS implementation for elective colorectal surgery in 15 academic hospitals in Ontario. The purpose of this study was to understand the process enablers and barriers that influenced the success of ERAS implementation in these centres with a view towards supporting sustainable change. A qualitative process evaluation was conducted from June to September 2014. Semi-structured interviews with implementation champions were completed, and an iterative inductive thematic analysis was conducted. Following a data-driven analysis, the Normalization Process Theory (NPT) was used as an analytic framework to understand the impact of various implementation processes. The NPT constructs were used as sensitizing concepts, reviewed against existing data categories for alignment and fit. Fifty-eight participants were included: 15 surgeons, 14 anaesthesiologists, 15 nurses, and 14 project coordinators. A number of process-related implementation enablers were identified: champions' belief in the value of the programme, the fit and cohesion of champions and their teams locally and provincially, a bottom-up approach to stakeholder engagement targeting organizational relationship-building, receptivity and support of division leaders, and the normalization of ERAS as everyday practice. Technical enablers identified included effective integration with existing clinical systems and using audit and feedback to report to hospital stakeholders. There was an overall optimism that ERAS implementation would be sustained, accompanied by concern about long-term organizational support. Successful ERAS implementation is achieved by a complex series of cognitive and social processes which previously have not been well described. Using the Normalization Process Theory as a framework, this analysis demonstrates the importance of champion coherence, external and internal relationship building, and the strategic management of a project's organization-level visibility as important to ERAS uptake and sustainability.

'Pedometers cost buttons': the feasibility of implementing a pedometer based walking programme within the community

PubMed Central

2011-01-01

Background Recent studies have suggested that walking interventions may be effective (at least in the short term) at increasing physical activity amongst those people who are the most inactive. This is a leading objective of contemporary public health policy in the UK and worldwide. However, before committing money from limited budgets to implement walking interventions more widely in the community, policymakers will want to know whether similar impacts can be expected and whether any changes will be required to the process to ensure uptake and success. This paper utilises the findings from a recent community-based pedometer study (Walking for Wellbeing in the West - WWW) undertaken in Glasgow, Scotland to address issues of feasibility. Methods An economic analysis of the WWW study assessed the costs of the interventions (minimal and maximal) and combined these with the effects to present incremental cost-effectiveness ratios (cost/person achieving the target of an additional 15,000 steps/week). A qualitative evaluation, involving focus group discussions with WWW participants and short interviews with members of the WWW research team, explored perceived benefits and barriers associated with walking, as well as the successful aspects and challenges associated with the interventions. Results The incremental cost effectiveness associated with the interventions was estimated as £92 and £591 per person achieving the target for the minimal and maximal interventions respectively. The qualitative evaluation gave insight into the process by which the results were achieved, and identified several barriers and facilitators that would need to be addressed before implementing the interventions in the wider community, in order to ensure their effective transfer. These included assessing the impact of the relationship between researchers and participants on the results, and the motivational importance of monitoring and assessing performance. Conclusions The results suggest that pedometer based walking interventions may be considered cost-effective and suitable for implementation within the wider community. However, several research gaps remain, including the importance and impact of the researcher/participant relationship, the impact of assessment on motivation and effectiveness, and the longer term impact on physical and mental health, resource utilisation and quality of life. Trial registration Current Control Trials Ltd ISRCTN88907382 PMID:21453509

VHDL implementation of feature-extraction algorithm for the PANDA electromagnetic calorimeter

NASA Astrophysics Data System (ADS)

Guliyev, E.; Kavatsyuk, M.; Lemmens, P. J. J.; Tambave, G.; Löhner, H.; Panda Collaboration

2012-02-01

A simple, efficient, and robust feature-extraction algorithm, developed for the digital front-end electronics of the electromagnetic calorimeter of the PANDA spectrometer at FAIR, Darmstadt, is implemented in VHDL for a commercial 16 bit 100 MHz sampling ADC. The source-code is available as an open-source project and is adaptable for other projects and sampling ADCs. Best performance with different types of signal sources can be achieved through flexible parameter selection. The on-line data-processing in FPGA enables to construct an almost dead-time free data acquisition system which is successfully evaluated as a first step towards building a complete trigger-less readout chain. Prototype setups are studied to determine the dead-time of the implemented algorithm, the rate of false triggering, timing performance, and event correlations.

Experimental magic state distillation for fault-tolerant quantum computing.

PubMed

Souza, Alexandre M; Zhang, Jingfu; Ryan, Colm A; Laflamme, Raymond

2011-01-25

Any physical quantum device for quantum information processing (QIP) is subject to errors in implementation. In order to be reliable and efficient, quantum computers will need error-correcting or error-avoiding methods. Fault-tolerance achieved through quantum error correction will be an integral part of quantum computers. Of the many methods that have been discovered to implement it, a highly successful approach has been to use transversal gates and specific initial states. A critical element for its implementation is the availability of high-fidelity initial states, such as |0〉 and the 'magic state'. Here, we report an experiment, performed in a nuclear magnetic resonance (NMR) quantum processor, showing sufficient quantum control to improve the fidelity of imperfect initial magic states by distilling five of them into one with higher fidelity.

Implementation of a patient safety program at a tertiary health system: A longitudinal analysis of interventions and serious safety events.

PubMed

Cropper, Douglas P; Harb, Nidal H; Said, Patricia A; Lemke, Jon H; Shammas, Nicolas W

2018-04-01

We hypothesize that implementation of a safety program based on high reliability organization principles will reduce serious safety events (SSE). The safety program focused on 7 essential elements: (a) safety rounding, (b) safety oversight teams, (c) safety huddles, (d) safety coaches, (e) good catches/safety heroes, (f) safety education, and (g) red rule. An educational curriculum was implemented focusing on changing high-risk behaviors and implementing critical safety policies. All unusual occurrences were captured in the Midas system and investigated by risk specialists, the safety officer, and the chief medical officer. A multidepartmental committee evaluated these events, and a root cause analysis (RCA) was performed. Events were tabulated and serious safety event (SSE) recorded and plotted over time. Safety success stories (SSSs) were also evaluated over time. A steady drop in SSEs was seen over 9 years. Also a rise in SSSs was evident, reflecting on staff engagement in the program. The parallel change in SSEs, SSSs, and the implementation of various safety interventions highly suggest that the program was successful in achieving its goals. A safety program based on high-reliability organization principles and made a core value of the institution can have a significant positive impact on reducing SSEs. © 2018 American Society for Healthcare Risk Management of the American Hospital Association.

Additional Risk Minimisation Measures for Medicinal Products in the European Union: A Review of the Implementation and Effectiveness of Measures in the United Kingdom by One Marketing Authorisation Holder.

PubMed

Agyemang, Elaine; Bailey, Lorna; Talbot, John

2017-01-01

Additional risk minimisation measures (aRMMs) for medicinal products are necessary to address specific important safety issues which may not be practically achieved through routine risk management measures alone. The implementation and determination of effectiveness for aRMMs can be a challenge as it involves multiple stakeholders. It is therefore important to have concise objectives to avoid undue burden on patients, healthcare professionals and the healthcare system. The aim of this study was to examine how aRMMs are implemented and how effectiveness is assessed in the European Union (EU) using practical examples from Roche Products Limited in the United Kingdom (UK) (referred to as the 'Company'). Three centrally authorised products were selected from the Company's portfolio, each of which had aRMMs to address important safety concerns; specifically, teratogenicity, medication error and infections. The implementation of EU aRMMs, effectiveness checks and specific UK activities were analysed. Hard copy folders and electronic sites for Company aRMMs were used to assess process indicators. Periodic benefit-risk evaluation reports for specified time intervals and the Company safety database was used in checking safety outcomes for the selected products. For each product, the effectiveness of aRMMs was analysed based on specific process indicators and the subsequent safety outcomes. Literature searches were performed on scientific databases for the purposes of the broader study. The main process indicators in measuring effectiveness of Company aRMMs were distribution metrics for educational materials, assessment of awareness and clinical actions among healthcare professionals (HCPs). Case reports of pregnancy, medication errors and progressive multifocal leukoencephalopathy (PML) were the outcome indicators for Erivedge ® ▼, Kadcyla ® ▼ and MabThera ® (the latter specifically in autoimmune indications: rheumatoid arthritis, granulomatosis with polyangiitis and microscopic polyangiitis) respectively. No pregnancy, one medication error and 10 confirmed PML cases were reported for Erivedge ® ▼, Kadcyla ® ▼ and MabThera ® respectively. For the chosen products, a reasonable awareness of aRMMs amongst HCPs is a positive indicator of success in the use of educational materials. However, low response rates from surveys indicate that voluntary feedback may not always achieve the desired level of response in measuring effectiveness. There is a challenge in determining overall effectiveness of aRMMs due to a lack of defined success thresholds. Further regulatory guidance to outline the elements and desired outcomes of aRMMs will be useful for consistency in achieving successful outcomes.

High Efficiency Low Cost CO2 Compression Using Supersonic Shock Wave Technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, J; Aarnio, M; Grosvenor, A

2010-12-31

Development and testing results from a supersonic compressor are presented. The compressor achieved record pressure ratio for a fully-supersonic stage and successfully demonstrated the technology potential. Several tasks were performed in compliance with the DOE award objectives. A high-pressure ratio compressor was retrofitted to improve rotordynamics behavior and successfully tested. An outside review panel confirmed test results and design approach. A computational fluid dynamics code used to analyze the Ramgen supersonic flowpath was extensively and successfully modified to improve use on high-performance computing platforms. A comprehensive R&D implementation plan was developed and used to lay the groundwork for a futuremore » full-scale compressor demonstration. Conceptual design for a CO2 demonstration compressor was developed and reviewed.« less

Operational strategies of anti-malarial drug campaigns for malaria elimination in Zambia's southern province: a simulation study.

PubMed

Stuckey, Erin M; Miller, John M; Littrell, Megan; Chitnis, Nakul; Steketee, Rick

2016-03-09

Malaria elimination requires reducing both the potential of mosquitoes to transmit parasites to humans and humans to transmit parasites to mosquitoes. To achieve this goal in Southern province, Zambia a mass test and treat (MTAT) campaign was conducted from 2011-2013 to complement high coverage of long-lasting insecticide-treated nets (LLIN). To identify factors likely to increase campaign effectiveness, a modelling approach was applied to investigate the simulated effect of alternative operational strategies for parasite clearance in southern province. OpenMalaria, a discrete-time, individual-based stochastic model of malaria, was parameterized for the study area to simulate anti-malarial drug administration for interruption of transmission. Simulations were run for scenarios with a range of artemisinin-combination therapies, proportion of the population reached by the campaign, targeted age groups, time between campaign rounds, Plasmodium falciparum test protocols, and the addition of drugs aimed at preventing onward transmission. A sensitivity analysis was conducted to assess uncertainty of simulation results. Scenarios were evaluated based on the reduction in all-age parasite prevalence during the peak transmission month one year following the campaign, compared to the currently-implemented strategy of MTAT 19 % population coverage at pilot and 40 % coverage during the first year of implementation in the presence of 56 % LLIN use and 18 % indoor residual spray coverage. Simulation results suggest the most important determinant of success in reducing prevalence is the population coverage achieved in the campaign, which would require more than 1 year of campaign implementation for elimination. The inclusion of single low-dose primaquine, which acts as a gametocytocide, or ivermectin, which acts as an endectocide, to the drug regimen did not further reduce parasite prevalence one year following the campaign compared to the currently-implemented strategy. Simulation results indicate a high proportion of low-density infections were missed by rapid diagnostic tests that would be treated and cleared with mass drug administration (MDA). The optimal implementation strategy for MTAT or MDA will vary by background level of prevalence, by rate of infections imported to the area, and by ability to operationally achieve high population coverage. Overall success with new parasite clearance strategies depends on continued coverage of vector control interventions to ensure sustained gains in reduction of disease burden.

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program

PubMed Central

Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S

2006-01-01

Background and objectives Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. Methods The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. Results This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Conclusion Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity. PMID:17067388

Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings.

PubMed

Sabiiti, W; Mtafya, B; Kuchaka, D; Azam, K; Viegas, S; Mdolo, A; Farmer, E C W; Khonga, M; Evangelopoulos, D; Honeyborne, I; Rachow, A; Heinrich, N; Ntinginya, N E; Bhatt, N; Davies, G R; Jani, I V; McHugh, T D; Kibiki, G; Hoelscher, M; Gillespie, S H

2016-08-01

The World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert(®) MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.

Implementation Challenges for Ceramic Matrix Composites in High Temperature Applications

NASA Technical Reports Server (NTRS)

Singh, Mrityunjay

2004-01-01

Ceramic matrix composites are leading candidate materials for a number of applications in aeronautics, space, energy, electronics, nuclear, and transportation industries. In the aeronautics and space exploration systems, these materials are being considered for applications in hot sections of jet engines such as the combustor liner, nozzle components, nose cones, leading edges of reentry vehicles and space propulsion components. Applications in the energy and environmental industries include radiant heater tubes, heat exchangers, heat recuperators, gas and diesel particulate filters (DPFs), and components for land based turbines for power generation. These materials are also being considered for use in the first wall and blanket components of fusion reactors. There are a number of critical issues and challenges related to successful implementation of composite materials. Fabrication of net and complex shape components with high density and tailorable matrix properties is quite expensive, and even then various desirable properties are not achievable. In this presentation, microstructure and thermomechanical properties of composites fabricated by two techniques (chemical vapor infiltration and melt infiltration), will be presented. In addition, critical need for robust joining and assembly technologies in successful implementation of these systems will be discussed. Other implementation issues will be discussed along with advantages and benefits of using these materials for various components in high temperature applications.

Promotion and advocacy for improved complementary feeding: can we apply the lessons learned from breastfeeding?

PubMed

Piwoz, Ellen G; Huffman, Sandra L; Quinn, Victoria J

2003-03-01

Although many successes have been achieved in promoting breastfeeding, this has not been the case for complementary feeding. Some successes in promoting complementary feeding at the community level have been documented, but few of these efforts have expanded to a larger scale and become sustained. To discover the reasons for this difference, the key factors for the successful promotion of breastfeeding on a large scale were examined and compared with the efforts made in complementary feeding. These factors include definition and rationale, policy support, funding, advocacy, private-sector involvement, availability and use of monitoring data, integration of research into action, and the existence of a well-articulated series of steps for successful implementation. The lessons learned from the promotion of breastfeeding should be applied to complementary feeding, and the new Global Strategy for Infant and Young Child Feeding provides an excellent first step in this process.

Affordable Integrated Technology Projects Science Education towards New Horizons

NASA Astrophysics Data System (ADS)

Paoletti, Franco; Carlucci, Lisa Marie

2009-03-01

The new-era concept of education supports a type of instruction whereby technology directly acts as a conduit of change, fundamentally altering what is learned, how it is learned, and the role of the educator in the classroom. In our current world, the learning about technology itself has become a goal and a means to successful participation in today's society. Efficient integration of technology to enhance and support the educational process will: 1) provide educators with the resources and the freedom to actualize innovative educational programs; 2) allow educators to be successful in challenging each student to reach his/her highest potential to ultimately increase academic achievement. This study analyzes what technology integration into education means identifying the benefits and the challenges that educators need to meet in order to be successful in their efforts while providing examples of how to successfully implement effective programs under budgetary constraints.

Integrated active and passive control design methodology for the LaRC CSI evolutionary model

NASA Technical Reports Server (NTRS)

Voth, Christopher T.; Richards, Kenneth E., Jr.; Schmitz, Eric; Gehling, Russel N.; Morgenthaler, Daniel R.

1994-01-01

A general design methodology to integrate active control with passive damping was demonstrated on the NASA LaRC CSI Evolutionary Model (CEM), a ground testbed for future large, flexible spacecraft. Vibration suppression controllers designed for Line-of Sight (LOS) minimization were successfully implemented on the CEM. A frequency-shaped H2 methodology was developed, allowing the designer to specify the roll-off of the MIMO compensator. A closed loop bandwidth of 4 Hz, including the six rigid body modes and the first three dominant elastic modes of the CEM was achieved. Good agreement was demonstrated between experimental data and analytical predictions for the closed loop frequency response and random tests. Using the Modal Strain Energy (MSE) method, a passive damping treatment consisting of 60 viscoelastically damped struts was designed, fabricated and implemented on the CEM. Damping levels for the targeted modes were more than an order of magnitude larger than for the undamped structure. Using measured loss and stiffness data for the individual damped struts, analytical predictions of the damping levels were very close to the experimental values in the (1-10) Hz frequency range where the open loop model matched the experimental data. An integrated active/passive controller was successfully implemented on the CEM and was evaluated against an active-only controller. A two-fold increase in the effective control bandwidth and further reductions of 30 percent to 50 percent in the LOS RMS outputs were achieved compared to an active-only controller. Superior performance was also obtained compared to a High-Authority/Low-Authority (HAC/LAC) controller.

The design and implementation of a broadband digital low-level RF control system for the cyclotron accelerators at iThemba LABS

NASA Astrophysics Data System (ADS)

Duckitt, W. D.; Conradie, J. L.; van Niekerk, M. J.; Abraham, J. K.; Niesler, T. R.

2018-07-01

iThemba LABS has successfully designed a new broadband digital low-level RF control system for cyclotrons, that operates over the wide frequency range of 2-100 MHz and can achieve peak-peak amplitude and phase stabilities of 0.01% and 0.01°, respectively. The presented system performs direct digital synthesis (DDS) to directly convert the digital RF signals to analog RF and local-oscillator (LO) signals with 16-bit amplitude accuracy, programmable in steps of 1 μHz and 0.0001°. Down-conversion of the RF pick-up signals to an optimal intermediate frequency (IF) of 1 MHz and sampling of the IF channels by 16-bit, single sample-latency 10 MHz ADCs was implemented to allow digital high-speed low-latency in-phase/quadrature (I/Q) demodulation of the IF channels within the FPGA. This in turn allows efficient real-time digital closed-loop control of the amplitude and phase of the RF drive-signal to be achieved. The systems have been successfully integrated at iThemba LABS into the K = 8 and K = 10 injector cyclotrons (SPC1, and SPC2), the K = 200 separated sector cyclotron (SSC), the SSC flat-topping system, the pulse-selector system and the AX , J, and K-line RF bunchers. The systems have led to a substantial improvement in the beam quality of the SSC at iThemba LABS with a reduction in beam losses by more than 90%. The design, implementation and performance is discussed.

Description and evaluation of a hearing conservation program in use in a professional symphony orchestra.

PubMed

O'Brien, Ian; Driscoll, Tim; Ackermann, Bronwen

2015-04-01

Professional orchestral musicians risk permanent hearing loss while playing their instruments. Protecting the hearing of these musicians in the workplace is critical to their ongoing ability to play their instruments, but typical workplace hearing conservation measures can have very damaging effects on the product (music) and the musicians' abilities to hear one another sufficiently. To enable effective intervention, orchestras as employers must encourage engagement with hearing protection programs and implement controls while preserving the integrity of the music. To achieve this, typical approaches used in other industries must be redesigned to suit this unique workplace. In response to these challenges, the Queensland Symphony Orchestra (Brisbane, Australia) introduced a comprehensive hearing conservation strategy in 2005 based upon best practice at the time. This strategy-which has been regularly refined-continues to be implemented on a daily basis. This investigation aimed to assess the successes, difficulties, and practical viability of the program. To achieve this a process evaluation was carried out, incorporating archival analyses, player and management focus groups, and an interview with the program's administrator. Results show the program has successfully become integrated into the orchestra's and the musicians' daily operations and significantly contributes to managing the risk of hearing loss in this population. While there is room for improvement in the orchestra's approach-particularly regarding usable personal protective devices and improved education and training, results are encouraging. This study provides a basis for those wishing to implement or evaluate similar paradigms. © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Interprofessional education in dental education: An international perspective.

PubMed

Davis, J M; Janczukowicz, J; Stewart, J; Quinn, B; Feldman, C A

2018-03-01

Interprofessional collaborative care (IPC) is defined as working within and across healthcare disciplines and is considered essential to achieve a more inclusive, patient-centred care, provide a means to support patient safety and address global healthcare provider shortages. Interprofessional education (IPE) provides the knowledge and experience students need to achieve these goals. ADEE/ADEA held a joint international meeting 8-9 May 2017, with IPE being one of four topic areas discussed. The highly interactive workshop format, where "everyone was an expert," supported discussion, sharing and creative problem-solving of over seventy-one participants from twenty-nine countries. IPE participants broke out into five groups over a two-day period discussing three main areas: challenges and barriers to implementing IPE within their institution or country; discussion of successful models of introducing and assessing IPE initiatives, and exploring best practices and next steps for implementation for each group member. A mind-mapping model was used to graphically display participants' thoughts and suggestions. Key themes, revealed through the visual mind maps and discussion, included the following: IPE should lead to and enhance patient-centred care; student involvement is key to IPE success; faculty development and incentives can facilitate adoption and implementation of IPE; the role of a "champion" and leadership structure and commitment is important to move IPE forward; and IPE must be tailored to the unique issues found in each country. Overall, there was a high level of interest to continue both collaboration and discussion to learn from others beyond the London meeting. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessing Program Coverage of Two Approaches to Distributing a Complementary Feeding Supplement to Infants and Young Children in Ghana

PubMed Central

Aaron, Grant J.; Strutt, Nicholas; Boateng, Nathaniel Amoh; Guevarra, Ernest; Siling, Katja; Norris, Alison; Ghosh, Shibani; Nyamikeh, Mercy; Attiogbe, Antoine; Burns, Richard; Foriwa, Esi; Toride, Yasuhiko; Kitamura, Satoshi; Tano-Debrah, Kwaku; Sarpong, Daniel; Myatt, Mark

2016-01-01

The work reported here assesses the coverage achieved by two sales-based approaches to distributing a complementary food supplement (KOKO Plus™) to infants and young children in Ghana. Delivery Model 1 was conducted in the Northern Region of Ghana and used a mixture of health extension workers (delivering behavior change communications and demand creation activities at primary healthcare centers and in the community) and petty traders recruited from among beneficiaries of a local microfinance initiative (responsible for the sale of the complementary food supplement at market stalls and house to house). Delivery Model 2 was conducted in the Eastern Region of Ghana and used a market-based approach, with the product being sold through micro-retail routes (i.e., small shops and roadside stalls) in three districts supported by behavior change communications and demand creation activities led by a local social marketing company. Both delivery models were implemented sub-nationally as 1-year pilot programs, with the aim of informing the design of a scaled-up program. A series of cross-sectional coverage surveys was implemented in each program area. Results from these surveys show that Delivery Model 1 was successful in achieving and sustaining high (i.e., 86%) effective coverage (i.e., the child had been given the product at least once in the previous 7 days) during implementation. Effective coverage fell to 62% within 3 months of the behavior change communications and demand creation activities stopping. Delivery Model 2 was successful in raising awareness of the product (i.e., 90% message coverage), but effective coverage was low (i.e., 9.4%). Future programming efforts should use the health extension / microfinance / petty trader approach in rural settings and consider adapting this approach for use in urban and peri-urban settings. Ongoing behavior change communications and demand creation activities is likely to be essential to the continued success of such programming. PMID:27755554

Assessing Program Coverage of Two Approaches to Distributing a Complementary Feeding Supplement to Infants and Young Children in Ghana.

PubMed

Aaron, Grant J; Strutt, Nicholas; Boateng, Nathaniel Amoh; Guevarra, Ernest; Siling, Katja; Norris, Alison; Ghosh, Shibani; Nyamikeh, Mercy; Attiogbe, Antoine; Burns, Richard; Foriwa, Esi; Toride, Yasuhiko; Kitamura, Satoshi; Tano-Debrah, Kwaku; Sarpong, Daniel; Myatt, Mark

2016-01-01

The work reported here assesses the coverage achieved by two sales-based approaches to distributing a complementary food supplement (KOKO Plus™) to infants and young children in Ghana. Delivery Model 1 was conducted in the Northern Region of Ghana and used a mixture of health extension workers (delivering behavior change communications and demand creation activities at primary healthcare centers and in the community) and petty traders recruited from among beneficiaries of a local microfinance initiative (responsible for the sale of the complementary food supplement at market stalls and house to house). Delivery Model 2 was conducted in the Eastern Region of Ghana and used a market-based approach, with the product being sold through micro-retail routes (i.e., small shops and roadside stalls) in three districts supported by behavior change communications and demand creation activities led by a local social marketing company. Both delivery models were implemented sub-nationally as 1-year pilot programs, with the aim of informing the design of a scaled-up program. A series of cross-sectional coverage surveys was implemented in each program area. Results from these surveys show that Delivery Model 1 was successful in achieving and sustaining high (i.e., 86%) effective coverage (i.e., the child had been given the product at least once in the previous 7 days) during implementation. Effective coverage fell to 62% within 3 months of the behavior change communications and demand creation activities stopping. Delivery Model 2 was successful in raising awareness of the product (i.e., 90% message coverage), but effective coverage was low (i.e., 9.4%). Future programming efforts should use the health extension / microfinance / petty trader approach in rural settings and consider adapting this approach for use in urban and peri-urban settings. Ongoing behavior change communications and demand creation activities is likely to be essential to the continued success of such programming.

Animal reintroductions: an innovative assessment of survival

USGS Publications Warehouse

Muths, Erin L.; Bailey, Larissa L.; Watry, Mary Kay

2014-01-01

Quantitative evaluations of reintroductions are infrequent and assessments of milestones reached before a project is completed, or abandoned due to lack of funding, are rare. However, such assessments, which are promoted in adaptive management frameworks, are critical. Quantification can provide defensible estimates of biological success, such as the number of survivors from a released cohort, with associated cost per animal. It is unlikely that the global issues of endangered wildlife and population declines will abate, therefore, assurance colonies and reintroductions are likely to become more common. If such endeavors are to be successful biologically or achieve adequate funding, implementation must be more rigorous and accountable. We use a novel application of a multistate, robust design capture-recapture model to estimate survival of reintroduced tadpoles through metamorphosis (i.e., the number of individuals emerging from the pond) and thereby provide a quantitative measure of effort and success for an "in progress" reintroduction of toads. Our data also suggest that tadpoles released at later developmental stages have an increased probability of survival and that eggs laid in the wild hatched at higher rates than eggs laid by captive toads. We illustrate how an interim assessment can identify problems, highlight successes, and provide information for use in adjusting the effort or implementing a Decision-Theoretic adaptive management strategy.

Securing your financial future.

PubMed

Kachalia, Parag R

2009-04-01

Securing one's financial future requires dedication and planning. A clear plan must be implemented and continually re-examined to assure an individual remains on track to achieve this security. True success of the plan will be dependent upon taking the appropriate steps to protecting one's assets against unfortunate events along with building assets with a clear end goal in mind. This article will cover the fundamental steps an individual can take to secure their financial future.

A microwave exciter for Cs frequency standards based on a sapphire-loaded cavity oscillator.

PubMed

Koga, Y; McNeilage, C; Searls, J H; Ohshima, S

2001-01-01

A low noise and highly stable microwave exciter system has been built for Cs atomic frequency standards using a tunable sapphire-loaded cavity oscillator (SLCO), which works at room temperature. This paper discusses the successful implementation of a control system for locking the SLCO to a long-term reference signal and reports an upper limit of the achieved frequency tracking error 6 x 10(-15) at tau = 1 s.

Optimal and robust control of quantum state transfer by shaping the spectral phase of ultrafast laser pulses.

PubMed

Guo, Yu; Dong, Daoyi; Shu, Chuan-Cun

2018-04-04

Achieving fast and efficient quantum state transfer is a fundamental task in physics, chemistry and quantum information science. However, the successful implementation of the perfect quantum state transfer also requires robustness under practically inevitable perturbative defects. Here, we demonstrate how an optimal and robust quantum state transfer can be achieved by shaping the spectral phase of an ultrafast laser pulse in the framework of frequency domain quantum optimal control theory. Our numerical simulations of the single dibenzoterrylene molecule as well as in atomic rubidium show that optimal and robust quantum state transfer via spectral phase modulated laser pulses can be achieved by incorporating a filtering function of the frequency into the optimization algorithm, which in turn has potential applications for ultrafast robust control of photochemical reactions.

Monitoring HIV and AIDS Related Policy Reforms: A Road Map to Strengthen Policy Monitoring and Implementation in PEPFAR Partner Countries

PubMed Central

2016-01-01

Achieving an AIDS-free generation will require the adoption and implementation of critical health policy reforms. However, countries with high HIV burden often have low policy development, advocacy, and monitoring capacity. This lack of capacity may be a significant barrier to achieving the AIDS-free generation goals. This manuscript describes the increased focus on policy development and implementation by the United States President’s Emergency Plan for AIDS Relief (PEPFAR). It evaluates the curriculum and learning modalities used for two regional policy capacity building workshops organized around the PEPFAR Partnership Framework agreements and the Road Map for Monitoring and Implementing Policy Reforms. A total of 64 participants representing the U.S. Government, partner country governments, and civil society organizations attended the workshops. On average, participants responded that their policy monitoring skills improved and that they felt they were better prepared to monitor policy reforms three months after the workshop. When followed-up regarding utilization of the Road Map action plan, responses were mixed. Reasons cited for not making progress included an inability to meet or a lack of time, personnel, or governmental support. This lack of progress may point to a need for building policy monitoring systems in high HIV burden countries. Because the success of policy reforms cannot be measured by the mere adoption of written policy documents, monitoring the implementation of policy reforms and evaluating their public health impact is essential. In many high HIV burden countries, policy development and monitoring capacity remains weak. This lack of capacity could hinder efforts to achieve the ambitious AIDS-free generation treatment, care and prevention goals. The Road Map appears to be a useful tool for strengthening these critical capacities. PMID:26914708

The role of relationships in collaborative partnership success: Lessons from the Alaska Fourth R project.

PubMed

Crooks, Claire V; Exner-Cortens, Deinera; Siebold, Wendi; Moore, Kami; Grassgreen, Lori; Owen, Patricia; Rausch, Ann; Rosier, Mollie

2018-04-01

Collaborative partnerships are critical to achieving health equity. As such, it is important to understand what contributes to the success of such partnerships. This paper describes the Alaska Fourth R collaborative, a multisectoral group of agencies (including education, health and human services, the violence against women sector, the governor's council on domestic violence, and an external evaluator) that successfully planned, implemented and evaluated a multi-focus health education program statewide. The purpose of this paper was to explore the ways in which seven pre-identified factors contributed to the successful achievement of the collaborative's goals. This project was grounded in community-based research principles, and collectively, the group chose to use Roussos and Fawcett's (2000) seven-factor model as the basis for the project. Using this model as a guide, semi-structured interviews were conducted with five leaders from the key organizations in the collaborative. In interviews, stakeholders described how each of the seven factors functioned in the Alaska collaborative to contribute to project success, with a particular focus on the critical role of relationships. Three specific relationship facets emerged as cross-cutting themes: flexibility, transparency, and prioritization. In sum, taking the time to build deep and authentic relationships, and then developing a shared vision and mission within the context of relationships that are flexible, transparent and prioritized, provided a strong foundation for future success in this collaborative. Copyright © 2017 Elsevier Ltd. All rights reserved.

Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service.

PubMed

Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A

2016-12-01

A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P < 0.001). The improved NRS form is now incorporated into standard nursing practice and NRS is embedded in the organisation's 'Point of Care Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.

Improving the School Food Environment

PubMed Central

CULLEN, KAREN W.; HARTSTEIN, JILL; REYNOLDS, KIM D.; VU, MAIHAN; RESNICOW, KEN; GREENE, NATASHA; WHITE, MAMIE A.

2009-01-01

Our objective for this study was to examine the feasibility of instituting environmental changes during a 6-week pilot in school foodservice programs, with long-term goals of improving dietary quality and preventing obesity and type 2 diabetes in youth. Participants included students and staff from six middle schools in three states. Formative assessment with students and school staff was conducted in the spring of 2003 to inform the development of school foodservice policy changes. Thirteen potential policy goals were delineated. These formed the basis for the environmental change pilot intervention implemented during the winter/spring of 2004. Questionnaires were used to assess the extent to which the 13 foodservice goals were achieved. Success was defined as achieving 75% of goals not met at baseline. Daily data were collected on goal achievement using the schools’ daily food production and sales records. Qualitative data were also collected after the pilot study to obtain feedback from students and staff. Formative research with staff and students identified potential environmental changes. Most schools made substantial changes in the National School Lunch Program meal and snack bar/a la carte offerings. Vending goals were least likely to be achieved. Only one school did not meet the 75% goal achievement objective. Based on the objective data as well as qualitative feedback from student focus groups and interviews with students and school staff, healthful school foodservice changes in the cafeteria and snack bar can be implemented and were acceptable to the staff and students. Implementing longer-term and more ambitious changes and assessing cost issues and the potential enduring impact of these changes on student dietary change and disease risk reduction merits investigation. PMID:17324667

The successful implementation of STEM initiatives in lower income schools

NASA Astrophysics Data System (ADS)

Bakshi, Leena

The purpose of this study was to examine the leadership strategies utilized by superintendents, district administrators and school principals and the impact of these identified strategies on implementing STEM initiatives specifically for lower-income students. This study set out to determine (a) What role does district leadership play in the implementation of STEM initiatives in lower income secondary schools; (b) What internal systems of accountability exist in successful lower income secondary schools' STEM programs; (c) What leadership strategies are used to implement STEM curriculum initiatives; (d) How do school and district leadership support staff in order to achieve student engagement in STEM Initiative curriculum. This study used a mixed-methods approach to determine the impact of leadership strategies utilized by superintendents, district administrators and school principals on implementing STEM initiatives. Quantitative data analyzed survey questionnaires to determine the degree of correlation between the school districts that have demonstrated the successful implementation of STEM initiatives at the school and district levels. Qualitative data was collected using highly structured participant interviews and purposeful sampling of four district superintendents, one district-level administrator and five school leaders to capture the key strategies in implementing STEM initiatives in lower income secondary schools. Through the process of triangulation, the results of the study revealed that superintendents and principals should consider the characteristics of effective STEM initiatives that have shown a considerable degree of correlation with positive outcomes for lower income students. These included the leadership strategies of personnel's making decisions about the district's and school's instructional direction and an emphasis on the conceptual development of scientific principles using the Next Generation Science Standards coupled with the Common Core State Standards across the grade levels. It also emphasized the importance of establishing community partnerships as a primary resource. This study highlighted the criteria district and school leadership should include in implementing STEM initiatives and designing professional development models that result in meaningful instructional practices of STEM curriculum for secondary lower income students. Overall, this study provides insight for superintendents, district leaders and school administrators that can play an integral role in implementing STEM initiatives with access for socioeconomically disadvantaged students.

School nutrition guidelines: overview of the implementation and evaluation.

PubMed

Gregorič, Matej; Pograjc, Larisa; Pavlovec, Alenka; Simčič, Marjan; Gabrijelčič Blenkuš, Mojca

2015-06-01

To holistically evaluate the extent of implementation of dietary guidelines in schools and present various monitoring systems. The study comprises three methods: (i) a cross-sectional survey (process evaluation); (ii) an indicator-based evaluation (menu quality); and (iii) a 5 d weighed food record of school lunches (output evaluation). Slovenian primary schools. A total 234 food-service managers from 488 schools completed a self-administrated questionnaire for process evaluation; 177 out of 194 randomly selected schools provided menus for menu quality evaluation; and 120 school lunches from twenty-four schools were measured and nutritionally analysed for output evaluation. The survey among food-service managers revealed high levels of implementation at almost all process evaluation areas of the guidelines. An even more successful implementation of these guidelines was found in relation to organization cultural issues as compared with technical issues. Differences found in some process evaluation areas were related to location, size and socio-economic characteristics of schools. Evaluation of school menu quality demonstrated that score values followed a normal distribution. Higher (better) nutrition scores were found in larger-sized schools and corresponding municipalities with higher socio-economic status. School lunches did not meet minimum recommendations for energy, carbohydrates or dietary fibre intake, nor for six vitamins and three (macro, micro and trace) elements. The implementation of the guidelines was achieved differently at distinct levels. The presented multilevel evaluation suggests that different success in implementation might be attributed to different characteristics of individual schools. System changes might also be needed to support and improve implementation of the guidelines.

Succession Planning in the Iranian Health System: A Case Study of the Ministry of Health and Medical Education

PubMed Central

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-01-01

Background: Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. Methods: In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Results: Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. Conclusion: lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization. PMID:25168998

Succession planning in the Iranian health system: a case study of the Ministry of Health and Medical Education.

PubMed

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-05-30

Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization.

Design and Implementation of a New Real-Time Frequency Sensor Used as Hardware Countermeasure

PubMed Central

Jiménez-Naharro, Raúl; Gómez-Galán, Juan Antonio; Sánchez-Raya, Manuel; Gómez-Bravo, Fernando; Pedro-Carrasco, Manuel

2013-01-01

A new digital countermeasure against attacks related to the clock frequency is –presented. This countermeasure, known as frequency sensor, consists of a local oscillator, a transition detector, a measurement element and an output block. The countermeasure has been designed using a full-custom technique implemented in an Application-Specific Integrated Circuit (ASIC), and the implementation has been verified and characterized with an integrated design using a 0.35 μm standard Complementary Metal Oxide Semiconductor (CMOS) technology (Very Large Scale Implementation—VLSI implementation). The proposed solution is configurable in resolution time and allowed range of period, achieving a minimum resolution time of only 1.91 ns and an initialization time of 5.84 ns. The proposed VLSI implementation shows better results than other solutions, such as digital ones based on semi-custom techniques and analog ones based on band pass filters, all design parameters considered. Finally, a counter has been used to verify the good performance of the countermeasure in avoiding the success of an attack. PMID:24008285

Implementation of HIV and Tuberculosis Diagnostics: The Importance of Context

PubMed Central

Dominique, Joyelle K.; Ortiz-Osorno, Alberto A.; Fitzgibbon, Joseph; Gnanashanmugam, Devasena; Gilpin, Christopher; Tucker, Timothy; Peel, Sheila; Peter, Trevor; Kim, Peter; Smith, Steven

2015-01-01

Background. Novel diagnostics have been widely applied across human immunodeficiency virus (HIV) and tuberculosis prevention and treatment programs. To achieve the greatest impact, HIV and tuberculosis diagnostic programs must carefully plan and implement within the context of a specific healthcare system and the laboratory capacity. Methods. A workshop was convened in Cape Town in September 2014. Participants included experts from laboratory and clinical practices, officials from ministries of health, and representatives from industry. Results. The article summarizes best practices, challenges, and lessons learned from implementation experiences across sub-Saharan Africa for (1) building laboratory programs within the context of a healthcare system; (2) utilizing experience of clinicians and healthcare partners in planning and implementing the right diagnostic; and (3) evaluating the effects of new diagnostics on the healthcare system and on patient health outcomes. Conclusions. The successful implementation of HIV and tuberculosis diagnostics in resource-limited settings relies on careful consideration of each specific context. PMID:26409272

Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

PubMed Central

Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

2014-01-01

Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.

PubMed

Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

2014-02-01

Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version.

EHR implementation in South Africa: how do we get it right?

PubMed

Yogeswaran, Parimalaranie; Wright, Graham

2010-01-01

In an environment of expanding demand on the health care system to provide equitable, accessible and safe health care, usage of information communication technology is one of the strategies identified to fulfil such expectations. Electronic Health Record (EHR) is an important tool towards achieving better health care using such technology, although, across the world EHR implementation has experienced a high failure rate. Nevertheless South Africa has made a strategic decision to implement EHR system in the public health sector. An evaluation toolkit was developed, to measure the state of readiness of health institutions in South Africa in implementing EHR based on Kaplan and Norton's work on Balanced Score Card (BSC), and the subsequent variant model developed by Protti. A Critical Success Factor (CSF) scorecard to assess the state of readiness and a Balanced Score Card matrix to be used as a strategic framework was developed. These tools were validated using critiques by a panel of experts. The toolkit developed has the potential to assist the organization towards a better EHR implementation path.

Global school-based childhood obesity interventions: a review.

PubMed

Ickes, Melinda J; McMullen, Jennifer; Haider, Taj; Sharma, Manoj

2014-08-28

The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.

Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

PubMed

Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

2018-06-01

Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

A systematic review of factors that shape implementation of mass drug administration for lymphatic filariasis in sub-Saharan Africa.

PubMed

Silumbwe, Adam; Zulu, Joseph Mumba; Halwindi, Hikabasa; Jacobs, Choolwe; Zgambo, Jessy; Dambe, Rosalia; Chola, Mumbi; Chongwe, Gershom; Michelo, Charles

2017-05-22

Understanding factors surrounding the implementation process of mass drug administration for lymphatic filariasis (MDA for LF) elimination programmes is critical for successful implementation of similar interventions. The sub-Saharan Africa (SSA) region records the second highest prevalence of the disease and subsequently several countries have initiated and implemented MDA for LF. Systematic reviews have largely focused on factors that affect coverage and compliance, with less attention on the implementation of MDA for LF activities. This review therefore seeks to document facilitators and barriers to implementation of MDA for LF in sub-Saharan Africa. A systematic search of databases PubMed, Science Direct and Google Scholar was conducted. English peer-reviewed publications focusing on implementation of MDA for LF from 2000 to 2016 were considered for analysis. Using thematic analysis, we synthesized the final 18 articles to identify key facilitators and barriers to MDA for LF programme implementation. The main factors facilitating implementation of MDA for LF programmes were awareness creation through innovative community health education programmes, creation of partnerships and collaborations, integration with existing programmes, creation of morbidity management programmes, motivation of community drug distributors (CDDs) through incentives and training, and management of adverse effects. Barriers to implementation included the lack of geographical demarcations and unregistered migrations into rapidly urbanizing areas, major disease outbreaks like the Ebola virus disease in West Africa, delayed drug deliveries at both country and community levels, inappropriate drug delivery strategies, limited number of drug distributors and the large number of households allocated for drug distribution. Mass drug administration for lymphatic filariasis elimination programmes should design their implementation strategies differently based on specific contextual factors to improve implementation outcomes. Successfully achieving this requires undertaking formative research on the possible constraining and inhibiting factors, and incorporating the findings in the design and implementation of MDA for LF.

Evaluation of a countrywide implementation of the world health organisation surgical safety checklist in Madagascar

PubMed Central

White, Michelle C.; Baxter, Linden S.; Close, Kristin L.; Ravelojaona, Vaonandianina A.; Rakotoarison, Hasiniaina N.; Bruno, Emily; Herbert, Alison; Andean, Vanessa; Callahan, James; Andriamanjato, Hery H.; Shrime, Mark G.

2018-01-01

Background The 2009 World Health Organisation (WHO) surgical safety checklist significantly reduces surgical mortality and morbidity (up to 47%). Yet in 2016, only 25% of East African anesthetists regularly use the checklist. Nationwide implementation of the checklist is reported in high-income countries, but in low- and middle-income countries (LMICs) reports of successful implementations are sparse, limited to single institutions and require intensive support. Since checklist use leads to the biggest improvements in outcomes in LMICs, methods of wide-scale implementation are needed. We hypothesized that, using a three-day course, successful wide-scale implementation of the checklist could be achieved, as measured by at least 50% compliance with six basic safety processes at three to four months. We also aimed to determine predictors for checklist utilization. Materials and methods Using a blended educational implementation strategy based on prior pilot studies we designed a three-day dynamic educational course to facilitate widespread implementation of the WHO checklist. The course utilized lectures, film, small group breakouts, participant feedback and simulation to teach the knowledge, skills and behavior changes needed to implement the checklist. In collaboration with the Ministry of Health and local hospital leadership, the course was delivered to 427 multi-disciplinary staff at 21 hospitals located in 19 of 22 regions of Madagascar between September 2015 and March 2016. We evaluated implementation at three to four months using questionnaires (with a 5-point Likert scale) and focus groups. Multivariate linear regression was used to test predictors of checklist utilization. Results At three to four months, 65% of respondents reported always using the checklist, with another 13% using it in part. Participant’s years in practice, hospital size, or surgical volume did not predict checklist use. Checklist use was associated with counting instruments (p< 0.05), but not with verifying: patient identity, difficult intubation risk, risk of blood loss, prophylactic antibiotic administration, or counting needles and sponges. Conclusion Use of a multi-disciplinary three-day course for checklist implementation resulted in 78% of participants using the checklist, at three months; and an increase in counting surgical instruments. Successful checklist implementation was not predicted by participant length of medical service, hospital size or surgical volume. If reproducible in other countries, widespread implementation in LMICs becomes a realistic possibility. PMID:29401465

Evaluation of a countrywide implementation of the world health organisation surgical safety checklist in Madagascar.

PubMed

White, Michelle C; Baxter, Linden S; Close, Kristin L; Ravelojaona, Vaonandianina A; Rakotoarison, Hasiniaina N; Bruno, Emily; Herbert, Alison; Andean, Vanessa; Callahan, James; Andriamanjato, Hery H; Shrime, Mark G

2018-01-01

The 2009 World Health Organisation (WHO) surgical safety checklist significantly reduces surgical mortality and morbidity (up to 47%). Yet in 2016, only 25% of East African anesthetists regularly use the checklist. Nationwide implementation of the checklist is reported in high-income countries, but in low- and middle-income countries (LMICs) reports of successful implementations are sparse, limited to single institutions and require intensive support. Since checklist use leads to the biggest improvements in outcomes in LMICs, methods of wide-scale implementation are needed. We hypothesized that, using a three-day course, successful wide-scale implementation of the checklist could be achieved, as measured by at least 50% compliance with six basic safety processes at three to four months. We also aimed to determine predictors for checklist utilization. Using a blended educational implementation strategy based on prior pilot studies we designed a three-day dynamic educational course to facilitate widespread implementation of the WHO checklist. The course utilized lectures, film, small group breakouts, participant feedback and simulation to teach the knowledge, skills and behavior changes needed to implement the checklist. In collaboration with the Ministry of Health and local hospital leadership, the course was delivered to 427 multi-disciplinary staff at 21 hospitals located in 19 of 22 regions of Madagascar between September 2015 and March 2016. We evaluated implementation at three to four months using questionnaires (with a 5-point Likert scale) and focus groups. Multivariate linear regression was used to test predictors of checklist utilization. At three to four months, 65% of respondents reported always using the checklist, with another 13% using it in part. Participant's years in practice, hospital size, or surgical volume did not predict checklist use. Checklist use was associated with counting instruments (p< 0.05), but not with verifying: patient identity, difficult intubation risk, risk of blood loss, prophylactic antibiotic administration, or counting needles and sponges. Use of a multi-disciplinary three-day course for checklist implementation resulted in 78% of participants using the checklist, at three months; and an increase in counting surgical instruments. Successful checklist implementation was not predicted by participant length of medical service, hospital size or surgical volume. If reproducible in other countries, widespread implementation in LMICs becomes a realistic possibility.

Implementation of an all-ages mandatory helmet policy for ice skating.

PubMed

Thibault-Halman, Ginette; Fenerty, Lynne; Wheadon-Hore, Kathie; Walling, Simon; Cusimano, Michael D; Clarke, David B

2015-12-01

Ice skaters sustain a significant number of head injuries each winter. We are the first to implement an all-ages helmet policy at a university-based Canadian arena. We report our experience from a cross-sectional observational study as well as the policy's consequences on helmet use and skating participation. Educational programming was provided prior to policy implementation. Observations of helmet use, falls and skater demographics were conducted prior to education/implementation and after policy implementation. The number of skaters observed was essentially unchanged by the policy; 361 skaters were observed pre-implementation, while 358 were observed post-implementation during the same number of observation-hours. Pre-implementation, helmet use ranged from 97% among children under 12 to 10% among adults; post-implementation use in all skaters was 99%. Falls were observed among all age groups, with preponderance among those aged 4-12. An all-ages helmet policy was successful both in achieving helmet use among all skaters and in maintaining participation rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

On Federated and Proof Of Validation Based Consensus Algorithms In Blockchain

NASA Astrophysics Data System (ADS)

Ambili, K. N.; Sindhu, M.; Sethumadhavan, M.

2017-08-01

Almost all real world activities have been digitized and there are various client server architecture based systems in place to handle them. These are all based on trust on third parties. There is an active attempt to successfully implement blockchain based systems which ensures that the IT systems are immutable, double spending is avoided and cryptographic strength is provided to them. A successful implementation of blockchain as backbone of existing information technology systems is bound to eliminate various types of fraud and ensure quicker delivery of the item on trade. To adapt IT systems to blockchain architecture, an efficient consensus algorithm need to be designed. Blockchain based on proof of work first came up as the backbone of cryptocurrency. After this, several other methods with variety of interesting features have come up. In this paper, we conduct a survey on existing attempts to achieve consensus in block chain. A federated consensus method and a proof of validation method are being compared.

Lean leadership attributes: a systematic review of the literature.

PubMed

Aij, Kjeld Harald; Teunissen, Maurits

2017-10-09

Purpose Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care. The purpose of this paper is to provide insight into applicable attributes for lean leaders in health care. Design/methodology/approach The authors systematically reviewed the literature on principles of leadership and, using Dombrowski and Mielke's (2013) conceptual model of lean leadership, developed a parallel theoretical model for lean leadership in health care. Findings This work contributes to the development of a new framework for describing leadership attributes within lean management of health care. Originality/value The summary of attributes can provide a model for health-care leaders to apply lean in their organizations.

Moving Past Exploration and Adoption: Considering Priorities for Implementing Mobile Learning by Nurses.

PubMed

Mather, Carey; Cummings, Elizabeth

2017-01-01

Successful implementation of mobile technology for informal learning and continuing professional development within healthcare settings cannot be achieved or sustained, until end-users recognise that the benefits of using this innovation, outweigh the issues of non-use. At a systems level there is a need for standards, guidelines and codes of conduct to support deployment of mobile technology at an individual level. The aim of this research was to explore findings of a previous focus group study to elucidate priorities for action, provide evidence and focus impetus for advocating progression of the installation of standards and guidelines at an organisation level. The study confirms nurse supervisors' preparedness and readiness to employ mobile learning at point of care. However, successful implementation requires organisations engaging with, and embracing the evolving digital landscape, and supporting this new andragogy. Organisational level commitment will promote contemporary nursing practice, support the best clinical outcomes for patients, and provide educational support for nurses. Nurse leaders and professional bodies must drive and guide development of robust standards, guidelines, and codes of conduct to prioritise mobile learning as a component of digital professionalism within healthcare organisations.

Navigation of military and space unmanned ground vehicles in unstructured terrains

NASA Technical Reports Server (NTRS)

Lescoe, Paul; Lavery, David; Bedard, Roger

1991-01-01

Development of unmanned vehicles for local navigation in terrains unstructured by humans is reviewed. Modes of navigation include teleoperation or remote control, computer assisted remote driving (CARD), and semiautonomous navigation (SAN). A first implementation of a CARD system was successfully tested using the Robotic Technology Test Vehicle developed by Jet Propulsion Laboratory. Stereo pictures were transmitted to a remotely located human operator, who performed the sensing, perception, and planning functions of navigation. A computer provided range and angle measurements and the path plan was transmitted to the vehicle which autonomously executed the path. This implementation is to be enhanced by providing passive stereo vision and a reflex control system for autonomously stopping the vehicle if blocked by an obstacle. SAN achievements include implementation of a navigation testbed on a six wheel, three-body articulated rover vehicle, development of SAN algorithms and code, integration of SAN software onto the vehicle, and a successful feasibility demonstration that represents a step forward towards the technology required for long-range exploration of the lunar or Martian surface. The vehicle includes a passive stereo vision system with real-time area-based stereo image correlation, a terrain matcher, a path planner, and a path execution planner.

Simulation System for Making Political and Macroeconomical Decisions and Its Development

NASA Astrophysics Data System (ADS)

Vnukov, A. A.; Blinov, A. E.

2018-01-01

Object of this research are macroeconomic indicators, which are important to descript economic situation in a country. Purpose of this work is to identify these indicators and to analyze how the state can affect these figures with available instruments. Here was constructed a model where the targets can be calculated from raw data - tools in the field of economic policy. Software code that implements all relations among the indicators and allows to analyze with high accuracy, sufficiently successful economic policies and with the help of some tools, you can achieve better results. This model can be used to forecast macroeconomic scenarios. The corresponding values of the objective (outcome) variables are set as a consequence of the configuration data of the previous period, subject to external influences and depend on the instrumental variables. The results may be useful in economical predictions. The results were successfully checked on real scenarios of Russian, European and Chinese economics. Moreover, the results can be applied in the field of education. Program is available to use as “economical game” the educational process of the University, in which you can virtually implement various macroeconomic scenarios, draw conclusions about their success.

12 hour shifts the Nambour Hospital experience.

PubMed

2007-08-01

Union members have a lengthy history of campaigning for fair working hours and conditions. The success of such campaigns has led to the implementation of the eight hour working day and the 40 hour and then 38 hour week as industrial standards. More recently though, calls for greater flexibility in their shift arrangements by nurses at Nambour Hospital have led to a voluntary 12 hour shift being implemented in their Intensive Care Unit. While union members are protective of their hard won gains in achieving reduced working hours through the 8 hour day--ICU nurses at Nambour Hospital say the voluntary 12 hour shift initiative goes a way in addressing their work/life balance issues.

Seven behaviors to advance teamwork: findings from a study of innovation leadership in a simulation center.

PubMed

Weberg, Dan; Weberg, Kim

2014-01-01

Traditional notions of individual-based leadership behaviors are no longer adequate to achieve innovation in health care organizations. A major contributing factor for limited innovation is that outdated leadership practices, such as leader centricity, linear thinking, and poor readiness for innovation, are being used in health care organizations. Through a qualitative case study analysis of innovation implementation, 7 characteristics of innovation leadership, founded in team behaviors, were uncovered. The characteristics that were uncovered included boundary spanning, risk taking, visioning, leveraging opportunity, adaptation, coordination of information flow, and facilitation. These characteristics describe how leaders throughout the system were able to influence and implement innovation successfully.

[Quality management in a clinical research facility: Evaluation of changes in quality in-house figures and the appraisal of in-house quality indicators].

PubMed

Aden, Bile; Allekotte, Silke; Mösges, Ralph

2016-12-01

For long-term maintenance and improvement of quality within a clinical research institute, the implementation and certification of a quality management system is suitable. Due to the implemented quality management system according to the still valid DIN EN ISO 9001:2008 desired quality objectives are achieved effectively. The evaluation of quality scores and the appraisal of in-house quality indicators make an important contribution in this regard. In order to achieve this and draw quality assurance conclusions, quality indicators as sensible and sensitive as possible are developed. For this, own key objectives, the retrospective evaluation of quality scores, a prospective follow-up and also discussions establish the basis. In the in-house clinical research institute the measures introduced by the quality management led to higher efficiency in work processes, improved staff skills, higher customer satisfaction and overall to more successful outcomes in relation to the self-defined key objectives. Copyright © 2016. Published by Elsevier GmbH.

Design and implementation of a project-based active/cooperative engineering design course for freshmen

NASA Astrophysics Data System (ADS)

Abdulaal, R. M.; Al-Bahi, A. M.; Soliman, A. Y.; Iskanderani, F. I.

2011-08-01

A project-based active/cooperative design course is planned, implemented, assessed and evaluated to achieve several desired engineering outcomes. The course allows freshman-level students to gain professional hands-on engineering design experience through an opportunity to practise teamwork, quality principles, communication skills, life-long learning, realistic constraints and awareness of current domestic and global challenges. Throughout successive design reports and in-class assignments, the students are required by the end of the semester to communicate, clearly and concisely, the details of their design both orally and in writing through a functional artefact/prototype, a design notebook, an A0 project poster and a final oral presentation. In addition to these direct assessment tools, several indirect measures are used to ensure triangulation. Assignments are based on customer expectations using a detailed checklist. This paper shows the direct and indirect assessment tools that indicated a high level of achievement of course learning outcomes and a high level of student satisfaction.

Modeling a distributed environment for a petroleum reservoir engineering application with software product line

NASA Astrophysics Data System (ADS)

de Faria Scheidt, Rafael; Vilain, Patrícia; Dantas, M. A. R.

2014-10-01

Petroleum reservoir engineering is a complex and interesting field that requires large amount of computational facilities to achieve successful results. Usually, software environments for this field are developed without taking care out of possible interactions and extensibilities required by reservoir engineers. In this paper, we present a research work which it is characterized by the design and implementation based on a software product line model for a real distributed reservoir engineering environment. Experimental results indicate successfully the utilization of this approach for the design of distributed software architecture. In addition, all components from the proposal provided greater visibility of the organization and processes for the reservoir engineers.

The Development of a Web-Based Attendance System with RFID for Higher Education Institution in Binus University

NASA Astrophysics Data System (ADS)

Kurniali, S.; Mayliana

2014-03-01

This study focuses on the development of a web-based attendance system with RFID in a Indonesian higher education institution. The development of this system is motivated due to the fact that the students' attendance records are one of the important elements that reflect their academic achievements. However, the current manual practice implemented is causing such a hassle. Empowering the usage of the new RFID based student card, a new web based-attendance system has been built to cater the recording and reporting of not just the student's' attendances, but also the lecturer's and taught topics in the class. The development of this system is inspired by the senior management. And the system can be easily accessed through the learning management system and can generate a report in real time, This paper will discuss in details the development until the maintaining phase of the system. Result achieved is the innovation of developing the system proved reliable to support related business processes and empowered the intention to maximize the usage of the RFID card. Considered as a successful implementation, this paper will give an input for others who want to implement a similar system.

Fractional order implementation of Integral Resonant Control - A nanopositioning application.

PubMed

San-Millan, Andres; Feliu-Batlle, Vicente; Aphale, Sumeet S

2017-10-04

By exploiting the co-located sensor-actuator arrangement in typical flexure-based piezoelectric stack actuated nanopositioners, the polezero interlacing exhibited by their axial frequency response can be transformed to a zero-pole interlacing by adding a constant feed-through term. The Integral Resonant Control (IRC) utilizes this unique property to add substantial damping to the dominant resonant mode by the use of a simple integrator implemented in closed loop. IRC used in conjunction with an integral tracking scheme, effectively reduces positioning errors introduced by modelling inaccuracies or parameter uncertainties. Over the past few years, successful application of the IRC control technique to nanopositioning systems has demonstrated performance robustness, easy tunability and versatility. The main drawback has been the relatively small positioning bandwidth achievable. This paper proposes a fractional order implementation of the classical integral tracking scheme employed in tandem with the IRC scheme to deliver damping and tracking. The fractional order integrator introduces an additional design parameter which allows desired pole-placement, resulting in superior closed loop bandwidth. Simulations and experimental results are presented to validate the theory. A 250% improvement in the achievable positioning bandwidth is observed with proposed fractional order scheme. Copyright © 2017. Published by Elsevier Ltd.

Russia: update on animal experiments and alternatives in education.

PubMed

Jukes, Nick

2008-01-01

Progress continues in Russia with growing awareness and implementation of alternatives in education. Further outreach visits and negotiations for replacement have been made by InterNICHE campaigners. Russian language information resources have been complemented by the distribution of translated freeware physiology and pharmacology alternatives; and the InterNICHE Alternatives Loan Systems continue to provide valuable hands-on access to a range of learning tools. Donations of computers and alternatives have established exemplary multimedia laboratories, with software having directly replaced the annual use of several thousand animals. New agreements have been made with institutes to abandon animal experiments for teaching purposes. Work to consolidate the successes is being done, and Russian teachers have begun to present at conferences to share their experiences of implementation. Further development and implementation of alternatives is being achieved through grant funding from the InterNICHE Humane Education Award. Using a different approach, cases of determined conscientious objection have included a campaign against the use of stolen companion animals for surgery practice in the Russian Far East, and a continuing legal challenge to experiments at Moscow State University. This multi-pronged, decentralised and culturally appropriate campaigning strategy has proved to be an effective approach to achieving sustainable change in Russia.

Implementation of the 2011 Therapeutic Activity Act: will commercialization improve the financial performance of Polish hospitals?

PubMed

Sagan, Anna; Sobczak, Alicja

2014-11-01

The Therapeutic Activity Act that came into force on 1 July 2011 was aimed at achieving a large-scale transformation of public hospitals into Commercial Code companies. The change of the legal form, from a public entity to a for-profit company, was expected to improve the poor economic efficiency of the public hospital sector. However, the mere change of the legal form does not guarantee a better financial performance of hospitals and thus the success of the Act. In many cases, deep internal changes are needed to achieve improvements in the financial performance of particular hospitals. In addition, a set of other measures at the national and regional levels, such as the mapping of health needs of the population, have to accompany the legal transformations in order to improve the efficiency of the hospital sector. The recent slowdown in the rate of the transformations is another factor that renders the success of the Act uncertain. Copyright © 2014. Published by Elsevier Ireland Ltd.

A Summer Prematriculation Program: Bridging the Gap for Disadvantaged Underrepresented Minority Students Interested in a Nursing Career.

PubMed

Norris, Tommie L; Wicks, Mona N; Cowan, Patricia A; Davison, Erwin Story

2016-08-01

The nursing and health care workforce needs diverse clinicians who can provide culturally competent and high-quality care to an increasingly diverse U.S. Achieving this goal requires creating learning environments that foster the success of disadvantaged underrepresented minority (URM) students seeking nursing careers. This 4-week summer prematriculation program introduced 33 URM individuals from disadvantaged backgrounds to nursing as a career through financial support, academic enrichment, and social support to enhance nursing program admission success. Federal guidelines were used to establish URM and economically disadvantaged status. To date, one third of program participants have been admitted to nursing programs. Fundamental reforms in pre-college education systems, such as the evidence-based strategies implemented in our summer prematriculation program, may be needed to achieve a diverse, culturally competent workforce that can help eliminate persistent health and health care disparities. [J Nurs Educ. 2016;55(8):471-475.]. Copyright 2016, SLACK Incorporated.

Improving the Simplified Acquisition of Base Engineering Requirements (SABER) Delivery Order Award Process: Results of a Process Improvement Plan

DTIC Science & Technology

1991-09-01

putting all tasks directed towsrds achieving an outcome in aequence. The tasks can be viewed as steps in the process (39:2.3). Using this...improvement opportunity is investigated. A plan is developed, root causes are identified, and solutions are tested and implemented. The process is... solutions , check for actual improvement, and integrate the successful improvements into the process. ?UP 7. Check Improvement Performance. Finally, the

Perspectives of Central Office Staff, Principals, Teachers, and School Site Councils on Resource Allocation and "Budgeting for Student Achievement" Implementation in 2010-11. A Report Prepared for the Los Angeles Unified School District

ERIC Educational Resources Information Center

Haxton, Clarisse L.; Chambers, Jay G.; Manship, Karen; Cruz, Lisa; O'Neil, Caitlin

2012-01-01

As part of the evaluation of the Strategic School Funding for Results (SSFR) project (called Budgeting for Student Success, or BSA, in Los Angeles Unified School District), the American Institutes for Research (AIR) conducted surveys of principals, teachers, and members of School Site Councils (SSCs) to gather information on their attitudes and…

An Historical Review of the Integrated Logistic Support Charter

DTIC Science & Technology

1975-11-01

literature review, four tasks were described which must be accomplished to achieve the two basic objec- tives of ILS: (1) Increased supportabiHty of... Organization of Report • 3 II. HISTORY OF ILS POLICY IN DOD 4 Early DOD Policy 4 Early Efforts of the Military Services 5 DODD 4100.35 i 9...DPML be better defined, thereby Increasing the probability of successful Implementation of ILS, 1f A1r Force policy documents were rewritten

Success under duress: policies and practices managers view as keys to profitability in five California hospitals with challenging payer mix.

PubMed

Rundall, Thomas; Oberlin, Shelley; Thygesen, Brian; Janus, Katharina

2012-01-01

Hospitals with a challenging payer mix (CPM)-high proportions of uninsured and Medicaid patients and a low proportion of commercially insured patients-are an important source of care for low-income, uninsured people. Achieving profitability is difficult for CPM hospitals. From 2005 through 2008, only one-third of 67 CPM hospitals in California reported positive total margins. In-depth group interviews were completed with the management leadership teams of a diverse group of five profitable CPM hospitals to identify the management strategies and practices that the hospitals' leadership teams credited for their financial success. Twelve management policy and practice topics were identified. Four of the policies and practices that managers identified involve organizational actions to increase hospital revenue or operational efficiency. These factors are consistent with those identified in previous research. However, managers also identified eight factors not previously revealed in research on hospital profitability, including management policies and practices that establish the organizational culture, workforce, relationships, monitoring systems, and governance necessary to ensure that hospital employees and affiliated physicians support and successfully implement organizational actions necessary to achieve profitability.

Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives

PubMed Central

Grol, Richard PTM; Bosch, Marije C; Hulscher, Marlies EJL; Eccles, Martin P; Wensing, Michel

2007-01-01

A consistent finding in articles on quality improvement in health care is that change is difficult to achieve. According to the research literature, the majority of interventions are targeted at health care professionals. But success in achieving change may be influenced by factors other than those relating to individual professionals, and theories may help explain whether change is possible. This article argues for a more systematic use of theories in planning and evaluating quality-improvement interventions in clinical practice. It demonstrates how different theories can be used to generate testable hypotheses regarding factors that influence the implementation of change, and it shows how different theoretical assumptions lead to different quality-improvement strategies. PMID:17319808

Applying a Consumer Behavior Lens to Salt Reduction Initiatives

PubMed Central

Potvin Kent, Monique; Raats, Monique M.; McConnon, Áine; Wall, Patrick; Dubois, Lise

2017-01-01

Reformulation of food products to reduce salt content has been a central strategy for achieving population level salt reduction. In this paper, we reflect on current reformulation strategies and consider how consumer behavior determines the ultimate success of these strategies. We consider the merits of adopting a ‘health by stealth’, silent approach to reformulation compared to implementing a communications strategy which draws on labeling initiatives in tandem with reformulation efforts. We end this paper by calling for a multi-actor approach which utilizes co-design, participatory tools to facilitate the involvement of all stakeholders, including, and especially, consumers, in making decisions around how best to achieve population-level salt reduction. PMID:28820449

Social Media and Mentoring in Biomedical Research Faculty Development.

PubMed

Teruya, Stacey Alan; Bazargan-Hejazi, Shahrzad

2014-09-01

To determine how effective and collegial mentoring in biomedical research faculty development may be implemented and facilitated through social media. The authors reviewed the literature for objectives, concerns, and limitations of career development for junior research faculty. They tabularized these as developmental goals, and aligned them with relevant social media strengths and capabilities facilitated through traditional and/or peer mentoring. The authors derived a model in which social media is leveraged to achieve developmental goals reflected in independent and shared projects, and in the creation and expansion of support and research networks. Social media may be successfully leveraged and applied in achieving developmental goals for biomedical research faculty, and potentially for those in other fields and disciplines.

Health impact assessment in a network of European cities.

PubMed

Ison, Erica

2013-10-01

The methodology of health impact assessment (HIA) was introduced as one of four core themes for Phase IV (2003-2008) of the World Health Organization European Healthy Cities Network (WHO-EHCN). Four objectives for HIA were set at the beginning of the phase. We report on the results of the evaluation of introducing and implementing this methodology in cities from countries across Europe with widely differing economies and sociopolitical contexts. Two main sources of data were used: a general questionnaire designed for the Phase IV evaluation and the annual reporting template for 2007-2008. Sources of bias included the proportion of non-responders and the requirement to communicate in English. Main barriers to the introduction and implementation of HIA were a lack of skill, knowledge and experience of HIA, the newness of the concept, the lack of a legal basis for implementation and a lack of political support. Main facilitating factors were political support, training in HIA, collaboration with an academic/public health institution or local health agency, a pre-existing culture of intersectoral working, a supportive national policy context, access to WHO materials about or expertise in HIA and membership of the WHO-EHCN, HIA Sub-Network or a National Network. The majority of respondents did not feel that they had had the resources, knowledge or experience to achieve all of the objectives set for HIA in Phase IV. The cities that appear to have been most successful at introducing and implementing HIA had pre-existing experience of HIA, came from a country with a history of applying HIA, were HIA Sub-Network members or had made a commitment to implementing HIA during successive years of Phase IV. Although HIA was recognised as an important component of Healthy Cities' work, the experience in the WHO-EHCN underscores the need for political buy-in, capacity building and adequate resourcing for the introduction and implementation of HIA to be successful.

FOAM: the modular adaptive optics framework

NASA Astrophysics Data System (ADS)

van Werkhoven, T. I. M.; Homs, L.; Sliepen, G.; Rodenhuis, M.; Keller, C. U.

2012-07-01

Control software for adaptive optics systems is mostly custom built and very specific in nature. We have developed FOAM, a modular adaptive optics framework for controlling and simulating adaptive optics systems in various environments. Portability is provided both for different control hardware and adaptive optics setups. To achieve this, FOAM is written in C++ and runs on standard CPUs. Furthermore we use standard Unix libraries and compilation procedures and implemented a hardware abstraction layer in FOAM. We have successfully implemented FOAM on the adaptive optics system of ExPo - a high-contrast imaging polarimeter developed at our institute - in the lab and will test it on-sky late June 2012. We also plan to implement FOAM on adaptive optics systems for microscopy and solar adaptive optics. FOAM is available* under the GNU GPL license and is free to be used by anyone.

The Design and Implementation of Indoor Localization System Using Magnetic Field Based on Smartphone

NASA Astrophysics Data System (ADS)

Liu, J.; Jiang, C.; Shi, Z.

2017-09-01

Sufficient signal nodes are mostly required to implement indoor localization in mainstream research. Magnetic field take advantage of high precision, stable and reliability, and the reception of magnetic field signals is reliable and uncomplicated, it could be realized by geomagnetic sensor on smartphone, without external device. After the study of indoor positioning technologies, choose the geomagnetic field data as fingerprints to design an indoor localization system based on smartphone. A localization algorithm that appropriate geomagnetic matching is designed, and present filtering algorithm and algorithm for coordinate conversion. With the implement of plot geomagnetic fingerprints, the indoor positioning of smartphone without depending on external devices can be achieved. Finally, an indoor positioning system which is based on Android platform is successfully designed, through the experiments, proved the capability and effectiveness of indoor localization algorithm.

Integration at the round table: marine spatial planning in multi-stakeholder settings.

PubMed

Olsen, Erik; Fluharty, David; Hoel, Alf Håkon; Hostens, Kristian; Maes, Frank; Pecceu, Ellen

2014-01-01

Marine spatial planning (MSP) is often considered as a pragmatic approach to implement an ecosystem based management in order to manage marine space in a sustainable way. This requires the involvement of multiple actors and stakeholders at various governmental and societal levels. Several factors affect how well the integrated management of marine waters will be achieved, such as different governance settings (division of power between central and local governments), economic activities (and related priorities), external drivers, spatial scales, incentives and objectives, varying approaches to legislation and political will. We compared MSP in Belgium, Norway and the US to illustrate how the integration of stakeholders and governmental levels differs among these countries along the factors mentioned above. Horizontal integration (between sectors) is successful in all three countries, achieved through the use of neutral 'round-table' meeting places for all actors. Vertical integration between government levels varies, with Belgium and Norway having achieved full integration while the US lacks integration of the legislature due to sharp disagreements among stakeholders and unsuccessful partisan leadership. Success factors include political will and leadership, process transparency and stakeholder participation, and should be considered in all MSP development processes.

Integration at the Round Table: Marine Spatial Planning in Multi-Stakeholder Settings

PubMed Central

Olsen, Erik; Fluharty, David; Hoel, Alf Håkon; Hostens, Kristian; Maes, Frank; Pecceu, Ellen

2014-01-01

Marine spatial planning (MSP) is often considered as a pragmatic approach to implement an ecosystem based management in order to manage marine space in a sustainable way. This requires the involvement of multiple actors and stakeholders at various governmental and societal levels. Several factors affect how well the integrated management of marine waters will be achieved, such as different governance settings (division of power between central and local governments), economic activities (and related priorities), external drivers, spatial scales, incentives and objectives, varying approaches to legislation and political will. We compared MSP in Belgium, Norway and the US to illustrate how the integration of stakeholders and governmental levels differs among these countries along the factors mentioned above. Horizontal integration (between sectors) is successful in all three countries, achieved through the use of neutral ‘round-table’ meeting places for all actors. Vertical integration between government levels varies, with Belgium and Norway having achieved full integration while the US lacks integration of the legislature due to sharp disagreements among stakeholders and unsuccessful partisan leadership. Success factors include political will and leadership, process transparency and stakeholder participation, and should be considered in all MSP development processes. PMID:25299595

Success or failure of hospital information systems of public hospitals affiliated with Zahedan University of Medical Sciences: A cross sectional study in the Southeast of Iran.

PubMed

Alipour, Jahanpour; Karimi, Afsaneh; Ebrahimi, Saeid; Ansari, Fatemeh; Mehdipour, Yousef

2017-12-01

After implementation, evaluation of hospital information systems (HISs) is critical to ensure the fulfillment of the system goals. This study aimed to assess the success or failure of HISs in public hospitals affiliated with Zahedan University of Medical Sciences. A cross-sectional descriptive and analytic study was performed in 2016. The study population comprised IT and HIS authorities and hospital information system users. The sample consisted of 468 participants. The data were collected using two questionnaires and analyzed with the SPSS software using descriptive and analytical statistics. The mean score of functional, behavioral, ethical, organizational, cultural and educational factors from the users' perspective was 3.14±0.66, 2.97± 0.60, 3.39±0.70, 2.96±0.642, 3.09±0.63, and 2.95±0.74, respectively. The mean score of organizational, behavioral, cultural, technological, educational and legal factors from IT and HIS authorities' perspective was 3.51±0.54, 3.35±0.45, 2.75±0.61, 3.58±0.32, and 3.96±0.59, respectively. The evaluated hospital information systems were considered relatively successful in terms of functional, ethical, and cultural factors but were considered as a relative failure in terms of behavioral, organizational, and educational factors form the users' perspective. Only the legal factor showed success, while organizational, behavioral, technical and educational factors showed relative success and the cultural factor showed relative failure from HIS and IT authorities' perspective. Therefore, assessing the users' needs before implementing the system, involving them in various stages of implementation, training them, and improving their computer skills seem to be necessary to achieve a better level of system success. Copyright © 2017 Elsevier B.V. All rights reserved.

The real-world navigator

NASA Technical Reports Server (NTRS)

Balabanovic, Marko; Becker, Craig; Morse, Sarah K.; Nourbakhsh, Illah R.

1994-01-01

The success of every mobile robot application hinges on the ability to navigate robustly in the real world. The problem of robust navigation is separable from the challenges faced by any particular robot application. We offer the Real-World Navigator as a solution architecture that includes a path planner, a map-based localizer, and a motion control loop that combines reactive avoidance modules with deliberate goal-based motion. Our architecture achieves a high degree of reliability by maintaining and reasoning about an explicit description of positional uncertainty. We provide two implementations of real-world robot systems that incorporate the Real-World Navigator. The Vagabond Project culminated in a robot that successfully navigated a portion of the Stanford University campus. The Scimmer project developed successful entries for the AIAA 1993 Robotics Competition, placing first in one of the two contests entered.

Using a framework to implement large-scale innovation in medical education with the intent of achieving sustainability.

PubMed

Hudson, Judith N; Farmer, Elizabeth A; Weston, Kathryn M; Bushnell, John A

2015-01-16

Particularly when undertaken on a large scale, implementing innovation in higher education poses many challenges. Sustaining the innovation requires early adoption of a coherent implementation strategy. Using an example from clinical education, this article describes a process used to implement a large-scale innovation with the intent of achieving sustainability. Desire to improve the effectiveness of undergraduate medical education has led to growing support for a longitudinal integrated clerkship (LIC) model. This involves a move away from the traditional clerkship of 'block rotations' with frequent changes in disciplines, to a focus upon clerkships with longer duration and opportunity for students to build sustained relationships with supervisors, mentors, colleagues and patients. A growing number of medical schools have adopted the LIC model for a small percentage of their students. At a time when increasing medical school numbers and class sizes are leading to competition for clinical supervisors it is however a daunting challenge to provide a longitudinal clerkship for an entire medical school class. This challenge is presented to illustrate the strategy used to implement sustainable large scale innovation. A strategy to implement and build a sustainable longitudinal integrated community-based clerkship experience for all students was derived from a framework arising from Roberto and Levesque's research in business. The framework's four core processes: chartering, learning, mobilising and realigning, provided guidance in preparing and rolling out the 'whole of class' innovation. Roberto and Levesque's framework proved useful for identifying the foundations of the implementation strategy, with special emphasis on the relationship building required to implement such an ambitious initiative. Although this was innovation in a new School it required change within the school, wider university and health community. Challenges encountered included some resistance to moving away from traditional hospital-centred education, initial student concern, resource limitations, workforce shortage and potential burnout of the innovators. Large-scale innovations in medical education may productively draw upon research from other disciplines for guidance on how to lay the foundations for successfully achieving sustainability.

Implementing an Injury Prevention Briefing to aid delivery of key fire safety messages in UK children's centres: qualitative study nested within a multi-centre randomised controlled trial.

PubMed

Beckett, Kate; Goodenough, Trudy; Deave, Toity; Jaeckle, Sally; McDaid, Lisa; Benford, Penny; Hayes, Mike; Towner, Elizabeth; Kendrick, Denise

2014-12-10

To improve the translation of public health evidence into practice, there is a need to increase practitioner involvement in initiative development, to place greater emphasis on contextual knowledge, and to address intervention processes and outcomes. Evidence that demonstrates the need to reduce childhood fire-related injuries is compelling but its translation into practice is inconsistent and limited. With this knowledge the Keeping Children Safe programme developed an "Injury Prevention Briefing (IPB)" using a 7 step process to combine scientific evidence with practitioner contextual knowledge. The IPB was designed specifically for children's centres (CCs) to support delivery of key fire safety messages to parents. This paper reports the findings of a nested qualitative study within a clustered randomised controlled trial of the IPB, in which staff described their experiences of IPB implementation to aid understanding of why or how the intervention worked. Interviews were conducted with key staff at 24 CCs participating in the two intervention arms: 1) IPB supplemented by initial training and regular facilitation; 2) IPB sent by post with no facilitation. Framework Analysis was applied to these interview data to explore intervention adherence including; exposure or dose; quality of delivery; participant responsiveness; programme differentiation; and staff experience of IPB implementation. This included barriers, facilitators and suggested improvements. 83% of CCs regarded the IPB as a simple, accessible tool which raised awareness, and stimulated discussion and behaviour change. 15 CCs suggested minor modifications to format and content. Four levels of implementation were identified according to content, frequency, duration and coverage. Most CCs (75%) achieved 'extended' or 'essential' IPB implementation. Three universal factors affected all CCs: organisational change and resourcing; working with hard to engage groups; additional demands of participating in a research study. Six specific factors were associated with the implementation level achieved: staff engagement and training; staff continuity; adaptability and flexibility; other agency support; conflicting priorities; facilitation. CCs achieving high implementation levels increased from 58% (no facilitation) to 92% with facilitation. Incorporating service provider perspectives and scientific evidence into health education initiatives enhances potential for successful implementation, particularly when supplemented by ongoing training and facilitation.

Easier Said Than Done: Keys to Successful Implementation of the Distress Assessment and Response Tool (DART) Program.

PubMed

Li, Madeline; Macedo, Alyssa; Crawford, Sean; Bagha, Sabira; Leung, Yvonne W; Zimmermann, Camilla; Fitzgerald, Barbara; Wyatt, Martha; Stuart-McEwan, Terri; Rodin, Gary

2016-05-01

Systematic screening for distress in oncology clinics has gained increasing acceptance as a means to improve cancer care, but its implementation poses enormous challenges. We describe the development and implementation of the Distress Assessment and Response Tool (DART) program in a large urban comprehensive cancer center. DART is an electronic screening tool used to detect physical and emotional distress and practical concerns and is linked to triaged interprofessional collaborative care pathways. The implementation of DART depended on clinician education, technological innovation, transparent communication, and an evaluation framework based on principles of change management and quality improvement. There have been 364,378 DART surveys completed since 2010, with a sustained screening rate of > 70% for the past 3 years. High staff satisfaction, increased perception of teamwork, greater clinical attention to the psychosocial needs of patients, patient-clinician communication, and patient satisfaction with care were demonstrated without a resultant increase in referrals to specialized psychosocial services. DART is now a standard of care for all patients attending the cancer center and a quality performance indicator for the organization. Key factors in the success of DART implementation were the adoption of a programmatic approach, strong institutional commitment, and a primary focus on clinic-based response. We have demonstrated that large-scale routine screening for distress in a cancer center is achievable and has the potential to enhance the cancer care experience for both patients and staff. Copyright © 2016 by American Society of Clinical Oncology.

Executive onboarding: ensuring the success of the newly hired department chair.

PubMed

Ross, Warren E; Huang, Karen H C; Jones, Greg H

2014-05-01

The success of newly recruited medical school department chairs has become increasingly important for achievement of organizational goals. An effective onboarding program for these chairs can greatly facilitate early success, as well as satisfaction of the new hire with the position and the school. Onboarding programs can include traditional orientation items such as payroll signup and parking details, but should focus heavily on sharing organizational structure, culture, and how things get done. The goals of onboarding will be well served by implementation of three roles in the process. An Orientation Navigator can assist the new chair in the orientation phase, completing new employee documents and navigating the day-to-day challenges of working at the location. A Peer Mentor, generally a sitting chair, serves as both "buddy" and mentor, providing moral support as well as ensuring that the new chair gains an understanding of the people and processes important for getting things done. A Transition Mentor serves over a longer term as a sounding board and coach outside the peer group, assisting in a variety of ways to promote the chair's growth, development, and success as a leader. Finally, any onboarding process is significantly compromised without the active participation of the dean, meeting regularly with the chair to clarify expectations, promote assimilation, and solve problems. Successful onboarding begins with a mindfulness of the needs of the newly hired chair, and a well-designed and well-implemented plan will have wide-ranging benefits for the chair and the organization.

Stages of change: A qualitative study on the implementation of a perinatal audit programme in South Africa.

PubMed

Belizán, María; Bergh, Anne-Marie; Cilliers, Carolé; Pattinson, Robert C; Voce, Anna

2011-09-30

Audit and feedback is an established strategy for improving maternal, neonatal and child health. The Perinatal Problem Identification Programme (PPIP), implemented in South African public hospitals in the late 1990s, measures perinatal mortality rates and identifies avoidable factors associated with each death. The aim of this study was to elucidate the processes involved in the implementation and sustainability of this programme. Clinicians' experiences of the implementation and maintenance of PPIP were explored qualitatively in two workshop sessions. An analytical framework comprising six stages of change, divided into three phases, was used: pre-implementation (create awareness, commit to implementation); implementation (prepare to implement, implement) and institutionalisation (integrate into routine practice, sustain new practices). Four essential factors emerged as important for the successful implementation and sustainability of an audit system throughout the different stages of change: 1) drivers (agents of change) and team work, 2) clinical outreach visits and supervisory activities, 3) institutional perinatal review and feedback meetings, and 4) communication and networking between health system levels, health care facilities and different role-players.During the pre-implementation phase high perinatal mortality rates highlighted the problem and indicated the need to implement an audit programme (stage 1). Commitment to implementing the programme was achieved by obtaining buy-in from management, administration and health care practitioners (stage 2).Preparations in the implementation phase included the procurement and installation of software and training in its use (stage 3). Implementation began with the collection of data, followed by feedback at perinatal review meetings (stage 4).The institutionalisation phase was reached when the results of the audit were integrated into routine practice (stage 5) and when data collection had been sustained for a longer period (stage 6). Insights into the factors necessary for the successful implementation and maintenance of an audit programme and the process of change involved may also be transferable to similar low- and middle-income public health settings where the reduction of the neonatal mortality rate is a key objective in reaching Millennium Development Goal 4. A tool for reflecting on the implementation and maintenance of an audit programme is also proposed.

Stages of change: A qualitative study on the implementation of a perinatal audit programme in South Africa

PubMed Central

2011-01-01

Background Audit and feedback is an established strategy for improving maternal, neonatal and child health. The Perinatal Problem Identification Programme (PPIP), implemented in South African public hospitals in the late 1990s, measures perinatal mortality rates and identifies avoidable factors associated with each death. The aim of this study was to elucidate the processes involved in the implementation and sustainability of this programme. Methods Clinicians' experiences of the implementation and maintenance of PPIP were explored qualitatively in two workshop sessions. An analytical framework comprising six stages of change, divided into three phases, was used: pre-implementation (create awareness, commit to implementation); implementation (prepare to implement, implement) and institutionalisation (integrate into routine practice, sustain new practices). Results Four essential factors emerged as important for the successful implementation and sustainability of an audit system throughout the different stages of change: 1) drivers (agents of change) and team work, 2) clinical outreach visits and supervisory activities, 3) institutional perinatal review and feedback meetings, and 4) communication and networking between health system levels, health care facilities and different role-players. During the pre-implementation phase high perinatal mortality rates highlighted the problem and indicated the need to implement an audit programme (stage 1). Commitment to implementing the programme was achieved by obtaining buy-in from management, administration and health care practitioners (stage 2). Preparations in the implementation phase included the procurement and installation of software and training in its use (stage 3). Implementation began with the collection of data, followed by feedback at perinatal review meetings (stage 4). The institutionalisation phase was reached when the results of the audit were integrated into routine practice (stage 5) and when data collection had been sustained for a longer period (stage 6). Conclusion Insights into the factors necessary for the successful implementation and maintenance of an audit programme and the process of change involved may also be transferable to similar low- and middle-income public health settings where the reduction of the neonatal mortality rate is a key objective in reaching Millennium Development Goal 4. A tool for reflecting on the implementation and maintenance of an audit programme is also proposed. PMID:21958353

Policy implementation of the Republic Act (RA) No. 9003 in the Philippines: a case study of Cebu City.

PubMed

Premakumara, Dickella Gamaralalage Jagath; Canete, Aloysius Mariae L; Nagaishi, Masaya; Kurniawan, Tonni Agustiono

2014-06-01

Municipal Solid Waste Management (MSWM) is considered to be one of the most serious environmental issues in the Philippines. The annual waste generation was estimated at 10.6 million tonnes in 2012 and this is expected to double in 2025. The Republic Act (RA) No. 9003, widely known as the Ecological Solid Waste Management Act of 2000, provides the required policy framework, institutional mechanisms and mandate to the Local Government Units (LGUs) to achieve 25% waste reduction target through establishing an integrated solid waste management plan based on the 3Rs (reduce, reuse and recycling). Although the initial impact of the LGUs is still very limited in implementing the national mandate, this article highlights the successful experiences of Cebu, the second largest city in the Philippines, in reducing its MSW generation by more than 30% in the past three years. This study also explores the implementation process, innovative actions taken by the Cebu City Government in implementing the national mandate at local level and identifies the factors that influence the policy implementation. The findings suggest that the impacts of the national mandate can be achieved if the LGUs have the high degree of political commitment, planning and development of effective local strategies in a collaborative manner to meet with local conditions, partnership building with other stakeholders, capacity development, adequate financing and incentives, and in the close monitoring and evaluation of performance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme.

PubMed

Nathwani, Dilip; Sneddon, Jacqueline; Malcolm, William; Wiuff, Camilla; Patton, Andrea; Hurding, Simon; Eastaway, Anne; Seaton, R Andrew; Watson, Emma; Gillies, Elizabeth; Davey, Peter; Bennie, Marion

2011-07-01

In 2008, the Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP) was published by the Scottish Government. One of the key actions was initiation of the Scottish Antimicrobial Prescribing Group (SAPG), hosted within the Scottish Medicines Consortium, to take forward national implementation of the key recommendations of this action plan. The primary objective of SAPG is to co-ordinate and deliver a national framework or programme of work for antimicrobial stewardship. This programme, led by SAPG, is delivered by NHS National Services Scotland (Health Protection Scotland and Information Services Division), NHS Quality Improvement Scotland, and NHS National Education Scotland as well as NHS board Antimicrobial Management Teams. Between 2008 and 2010, SAPG has achieved a number of early successes, which are the subject of this review: (i) through measures to optimise prescribing in hospital and primary care, combined with infection prevention measures, SAPG has contributed significantly to reducing Clostridium difficile infection rates in Scotland; (ii) there has been engagement of all key stakeholders at local and national levels to ensure an integrated approach to antimicrobial stewardship within the wider healthcare-associated infection agenda; (iii) development and implementation of data management systems to support quality improvement; (iv) development of training materials on antimicrobial stewardship for healthcare professionals; and (v) improving clinical management of infections (e.g. community-acquired pneumonia) through quality improvement methodology. The early successes achieved by SAPG demonstrate that this delivery model is effective and provides the leadership and focus required to implement antimicrobial stewardship to improve antimicrobial prescribing and infection management across NHS Scotland. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Facilitating Ambulatory Electronic Health Record System Implementation: Evidence from a Qualitative Study

PubMed Central

Hefner, Jennifer; Robbins, Julie; Huerta, Timothy R.

2013-01-01

Background. Ambulatory care practices have increasing interest in leveraging the capabilities of electronic health record (EHR) systems, but little information is available documenting how organizations have successfully implemented these systems. Objective. To characterize elements of successful electronic health record (EHR) system implementation and to synthesize the key informants' perspectives about successful implementation practices. Methods. Key informant interviews and focus groups were conducted with a purposive sample of individuals from US healthcare organizations identified for their success with ambulatory EHR implementation. Rigorous qualitative data analyses used both deductive and inductive methods. Results. Participants identified personal and system-related barriers, at both the individual and organization levels, including poor computer skills, productivity losses, resistance to change, and EHR system failure. Implementation success was reportedly facilitated by careful planning and consistent communication throughout distinct stages of the implementation process. A significant element of successful implementation was an emphasis on optimization, both during “go-live” and, subsequently, when users had more experience with the system. Conclusion. Successful EHR implementation requires both detailed planning and clear mechanisms to deal with unforeseen or unintended consequences. Focusing on user buy-in early and including plans for optimization can facilitate greater success. PMID:24228257

Implementing a successful tuberculosis programme within primary care services in a conflict area using the stop TB strategy: Afghanistan case study

PubMed Central

2014-01-01

Introduction Afghanistan has faced health consequences of war including those due to displacement of populations, breakdown of health and social services, and increased risks of disease transmission for over three decades. Yet it was able to restructure its National Tuberculosis Control Programme (NTP), integrate tuberculosis treatment into primary health care and achieve most of its targets by the year 2011. What were the processes that enabled the programme to achieve its targets? More importantly, what were the underpinning factors that made this success possible? We addressed these important questions through a case study. Case description We adopted a processes and outcomes framework for this study, which began with examining the change in key programme indicators, followed by backwards tracing of the processes and underlying factors, responsible for this change. Methods included review of the published and grey literature along with in-depth interviews of 15 key informants involved with the care of tuberculosis patients in Afghanistan. Discussion and evaluation TB incidence and mortality per 100,000 decreased from 325 and 92 to 189 and 39 respectively, while case notification and treatment success improved during the decade under study. Efficient programme structures were enabled through high political commitment from the Government, strong leadership from the programme, effective partnership and coordination among stakeholders, and adequate technical and financial support from the development partners. Conclusions The NTP Afghanistan is an example that public health programmes can be effectively implemented in fragile states. High political commitment and strong local leadership are essential factors for such programmes. To ensure long-term effectiveness of the NTP, the international support should be withdrawn in a phased manner, coupled with a sequential increase in resources allocated to the NTP by the Government of Afghanistan. PMID:24507446

Scaling up of HIV-TB collaborative activities: Achievements and challenges in India.

PubMed

Deshmukh, Rajesh; Shah, Amar; Sachdeva, K S; Sreenivas, A N; Gupta, R S; Khaparde, S D

2016-01-01

India has been implementing HIV/TB collaborative activities since 2001 with rapid scale-up of infrastructure across the country during past decade in National AIDS Control Programme and Revised National TB Control Programme. India has shown over 50% reduction in new infections and around 35% reduction in AIDS-related deaths, thereby being one of the success stories globally. Substantial progress in the implementation of collaborative TB/HIV activities has occurred in India and it is marching towards target set out in the Global Plan to Stop TB and endorsed by the UN General Assembly to halve HIV associated TB deaths by 2015. While the successful approaches have led to impressive gains in HIV/TB control in India, there are emerging challenges including newer pockets with rising HIV trends in North India, increasing drug resistance, high mortality among co-infected patients, low HIV testing rates among TB patients in northern and eastern states in India, treatment delays and drop-outs, stigma and discrimination, etc. In spite of these difficulties, established HIV/TB coordination mechanisms at different levels, rapid scale-up of facilities with decentralisation of treatment services, regular joint supervision and monitoring, newer initiatives like use of rapid diagnostics for early diagnosis of TB among people living with HIV, TB notification, etc. have led to success in combating the threat of HIV/TB in India. This article highlights the steps taken by India, one of the largest HIV/TB programmes in world, in scaling up of the joint HIV-TB collaborative activities, the achievements so far and discusses the emerging challenges which could provide important lessons for other countries in scaling up their programmes. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Determinants of successful public-private partnerships in the context of overweight prevention in Dutch youth.

PubMed

Leenaars, Karlijn; Jacobs-van der Bruggen, Monique; Renders, Carry

2013-07-11

A public-private partnership (PPP) is an essential component of the Dutch community-based approach toward overweight prevention, Youth on Healthy Weight (JOGG). Beginning in 2010, 25 Dutch municipalities have implemented JOGG, but little is known about determinants of successful partnerships. This study aims to identify these determinants to guide other municipalities or communities in creating successful partnerships. Semistructured interviews were held in Veghel, a town in the southeast of the Netherlands, with private (n=7) and public (n=5) partners from the PPP involved in JOGG. We developed a themes and topics list that fit the purpose of our study. The interviews focused on the formation, functioning, and output of the partnership. Recruitment of partners was facilitated by using preexisting networks. Corporate social responsibility, belief in the JOGG approach, importance of the health issue, and strengthened contacts with other partners were important motivations for partners to participate. In addition to partnership functioning and output, enthusiastic and decisive management, shared commitment, joint responsibility, and effective internal communication were important to the partners, as were clear goals and concrete actions to achieve these goals. To create successful partnerships, the program and its goals should appeal to the motivations of the partners. Involving partners in defining local program objectives can help to create shared commitment and joint responsibility. Further evaluation of partnerships' impact on achieving program goals is a subsequent step to be taken to identify long-term determinants of successful PPPs.

MS PHD'S PDP: Vision, Design, Implementation, and Outcomes of a Minority-Focused Earth System Sciences Program

NASA Astrophysics Data System (ADS)

Habtes, S. Y.; Mayo, M.; Ithier-Guzman, W.; Pyrtle, A. J.; Williamson Whitney, V.

2007-05-01

As minorities are predicted to comprise at least 33% of the US population by the year 2010, their representation in the STEM fields, including the ocean sciences, is still poorly established. In order to advance the goal of better decision making, the Ocean Sciences community must achieve greater levels of diversity in membership. To achieve this objective of greater diversity in the sciences, the Minorities Striving and Pursuing Higher Degrees of Success in Earth System Science® Professional Development Program (MS PHD'S PDP), which was launched in 2003, is supported via grants from NASA's Office of Earth Science, and NSF's Directorate for Geosciences. The MS PHD'S PDP is designed to provide professional and mentoring experiences that facilitate the advancement of minorities committed to achieving outstanding Earth System Science careers. The MS PHD'S PDP is structured in three phases, connected by engagement in a virtual community, continuous peer and mentor to mentee interactions, and the professional support necessary for ensuring the educational success of the student participants. Since the pilot program in 2003, the MSPHD'S PDP, housed at the University of South Florida's College of Marine Science, has produced 4 cohorts of students. Seventy-five have completed the program; of those 6 have earned their doctoral degrees. Of the 45 current participants 10 are graduate students in Marine Science and 15 are still undergraduates, the remaining 10 participants are graduate students in other STEM fields. Since the implementation of the MSPHD'S PDP a total of 87 students and 33 scientist mentors have become part of the MSPHD'S virtual community, helping to improve the learning environment for current and future participants as well as build a community of minority students that encourages each other to pursue their academic degrees.

Prevention of childhood obesity and food policies in Latin America: from research to practice.

PubMed

Pérez-Escamilla, R; Lutter, C K; Rabadan-Diehl, C; Rubinstein, A; Calvillo, A; Corvalán, C; Batis, C; Jacoby, E; Vorkoper, S; Kline, L; Ewart-Pierce, E; Rivera, J A

2017-07-01

Addressing childhood obesity in Latin America requires a package of multisectoral, evidence-based policies that enable environments conducive to healthy lifestyles. Identify and examine key elements to translating research into effective obesity policies in Latin America. We examined obesity prevention policies through case studies developed with an expert in the specific policy. Policies were selected based on their level of implementation, visibility and potential impact to reduce childhood obesity. They include: (i) excise taxes on sugar sweetened beverages and energy-dense foods; (ii) front-of-package food label legislation; (iii) trans fatty acids removal from processed foods; and (iv) Ciclovías recreativas or 'open streets'. Case studies were coded to identify components that explained successful implementation and sustainability using the Complex Adaptive Health Systems framework. The analysis identified key elements for effective and sustainable policy, including evidence justifying policy; evidence-based advocacy by civil society; political will; and legislation and skillful negotiations across government, academia, the private sector and civil society. Scientific evidence and evaluation played an important role in achieving tipping points for policies' launch and sustain effective implementation. Well-coordinated, intersectoral partnerships are needed to successfully implement evidence-based anti-obesity policies. Prospective policy research may be useful for advancing knowledge translation. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

Successes and Challenges in School Meal Reform: Qualitative Insights From Food Service Directors.

PubMed

Asada, Yuka; Ziemann, Margaret; Zatz, Lara; Chriqui, Jamie

2017-08-01

The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) directed the US Department of Agriculture (USDA) to revise school meal standards to increase healthy food offerings. A critical stakeholder in the implementation of standards is Food Service Directors (FSDs). We sought to examine FSDs' perspectives on revised school meal standards to gain insight into successful implementation strategies. Semistructured interviews were conducted with FSDs (N = 9) from high schools that had achieved HealthierUS Schools Challenge: Smarter Lunchrooms (HUSSC: SL) status. Qualitative interview data were team coded in Atlas.ti v7 and analyzed with principles of constant comparative analysis. FSDs reported overall positive perceptions of the revised school meal standards and its potential impacts, as well as improved fruit and vegetable consumption, despite initial challenges with plate waste, procurement of whole grain-rich products, and fast paced sodium targets. Implementation was described as complex, ongoing processes; with time and in-service trainings, student acceptance to these changes improved. These findings are directly relevant to future reauthorization of the Child Nutrition Act and to revisions to the implementation time line for the federal school meal standards related to sodium, whole grains, and flavored milk. Insights into FSDs' strategies suggest that more time and targeted technical assistance at federal, state, and local levels is warranted. © 2017, American School Health Association.

Fiery Spirits in the context of institutional entrepreneurship in Swedish healthcare.

PubMed

Eriksson, Nomie; Ujvari, Sandor

2015-01-01

Clinical governance and leadership concepts can lead to more or less successful implementations of new clinical practice. The purpose of this paper is to examine how Fiery Spirits, as institutional entrepreneurs can, working in a team, implement sustained change in hospital clinical practice. This paper describes two case studies, conducted at two Swedish hospitals over a period of two years, in which changes in clinical practice were implemented. In both cases, key-actors, termed Fiery Spirits, played critical roles in these changes. The authors use a qualitative approach and take an intra-organizational perspective with semi-structured in-depth interviews and document analysis. The new clinical practices were successfully implemented with a considerable influence of the Fiery Spirits who played a pivotal role in the change efforts. The Fiery Spirits persuasively, based on their structural and normative legitimacy and the adoption of learning processes, advocated, and supported change. Fiery Spirits, given flexibility and opportunity, can be powerful forces for change outside the trajectory of management-inspired and management-directed change. Team members, when inspired and encouraged by Fiery Spirits, are less resistant to change and more willing to test new clinical practices. The paper complements literature on how the Fiery Spirit concept aligns with concepts of clinical governance and leadership and how change can be achieved. Additionally, the findings show the effects of legitimacy and learning processes on change in clinical practice.

Universal health coverage in Turkey: enhancement of equity.

PubMed

Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem; Gürol, Ipek; Nazlıoğlu, Serpil; Ozgülcü, Senay; Aydoğan, Ulger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

2013-07-06

Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with continuous learning, and simultaneous improvements in the health system, on both the demand side (increased health insurance coverage, expanded benefits, and reduced cost-sharing) and the supply side (expansion of infrastructure, health human resources, and health services). Copyright © 2013 Elsevier Ltd. All rights reserved.

An Indigenous Framework for Science, Technology, Engineering and Mathematics

NASA Astrophysics Data System (ADS)

Monette, G.

2003-12-01

The American Indian Higher Education Consortium, composed of 35 American Indian tribally-controlled Colleges and Universities in the U.S. and Canada, is leading a comprehensive effort to improve American Indian student achievement in STEM. A key component of this effort is the synthesis of indigenous ways of knowing and western education systems. This presentation will provide an overview of culturally responsive, place-based teaching, learning, and research and will discuss potential opportunities and strategies for helping to ensure that education systems and research programs reflect our diversity and respect our cultures. One example to be discussed is the NSF-funded "Tribal College Rural Systemic Initiative." Founded on the belief that all students can learn and should be given the opportunity to reach their full potential, Tribal Colleges are leading this effort to achieve successful and sustainable improvement of science, math, and technology education at the K-14 level in rural, economically disadvantaged, geographically challenged areas. Working with parents, tribal governments, schools and the private sector, the colleges are helping to implement math and science standards-based curriculum for students and standards-based assessment for schools; provide math and science standards-based professional development for teachers, administrators, and community leaders; and integrate local Native culture into math and science standards-based curriculum. The close working relationship between the Tribal Colleges and K-12 is paying off. According to the National Science Foundation, successful systemic reform has resulted in enhanced student achievement and participation in science and math; reductions in the achievement disparities among students that can be attributed to socioeconomic status, race, ethnicity, gender, or learning styles; implementation of a comprehensive, standards-based curriculum aligned with instructions and assessment; development of a coherent, consistent set of policies that supports high quality math and science education for each student; convergence of science and math resource; and broad-based support from parents and the community.

Touchscreen questionnaire patient data collection in rheumatology practice: development of a highly successful system using process redesign.

PubMed

Newman, Eric D; Lerch, Virginia; Jones, J B; Stewart, Walter

2012-04-01

While questionnaires have been developed to capture patient-reported outcomes (PROs) in rheumatology practice, these instruments are not widely used. We developed a touchscreen interface designed to provide reliable and efficient data collection. Using the touchscreen to obtain PROs, we compared 2 different workflow models implemented separately in 2 rheumatology clinics. The Plan-Do-Study-Act methodology was used in 2 cycles of workflow redesign. Cycle 1 relied on off-the-shelf questionnaire builder software, and cycle 2 relied on a custom programmed software solution. During cycle 1, clinic 1 (private practice model, resource replete, simple flow) demonstrated a high completion rate at the start, averaging between 74% and 92% for the first 12 weeks. Clinic 2 (academic model, resource deficient, complex flow) did not achieve a consistent completion rate above 60%. The revised cycle 2 implementation protocol incorporated a 15-minute "nurse visit," an instant messaging system, and a streamlined authentication process, all of which contributed to substantial improvement in touchscreen questionnaire completion rates of ∼80% that were sustained without the need for any additional clinic staff support. Process redesign techniques and touchscreen technology were used to develop a highly successful, efficient, and effective process for the routine collection of PROs in a busy, complex, and resource-depleted academic practice and in typical private practice. The successful implementation required both a touchscreen questionnaire, human behavioral redesign, and other technical solutions. Copyright © 2012 by the American College of Rheumatology.

An Improved Search Approach for Solving Non-Convex Mixed-Integer Non Linear Programming Problems

NASA Astrophysics Data System (ADS)

Sitopu, Joni Wilson; Mawengkang, Herman; Syafitri Lubis, Riri

2018-01-01

The nonlinear mathematical programming problem addressed in this paper has a structure characterized by a subset of variables restricted to assume discrete values, which are linear and separable from the continuous variables. The strategy of releasing nonbasic variables from their bounds, combined with the “active constraint” method, has been developed. This strategy is used to force the appropriate non-integer basic variables to move to their neighbourhood integer points. Successful implementation of these algorithms was achieved on various test problems.

Achieving design reuse: a case study

NASA Astrophysics Data System (ADS)

Young, Peter J.; Nielsen, Jon J.; Roberts, William H.; Wilson, Greg M.

2008-08-01

The RSAA CICADA data acquisition and control software package uses an object-oriented approach to model astronomical instrumentation and a layered architecture for implementation. Emphasis has been placed on building reusable C++ class libraries and on the use of attribute/value tables for dynamic configuration. This paper details how the approach has been successfully used in the construction of the instrument control software for the Gemini NIFS and GSAOI instruments. The software is again being used for the new RSAA SkyMapper and WiFeS instruments.

Thermo-Mechanical Methodology for Stabilizing Shape Memory Alloy Response

NASA Technical Reports Server (NTRS)

Padula, Santo

2013-01-01

This innovation is capable of significantly reducing the amount of time required to stabilize the strain-temperature response of a shape memory alloy (SMA). Unlike traditional stabilization processes that take days to weeks to achieve stabilized response, this innovation accomplishes stabilization in a matter of minutes, thus making it highly useful for the successful and practical implementation of SMA-based technologies in real-world applications. The innovation can also be applied to complex geometry components, not just simple geometries like wires or rods.

Bit-serial neuroprocessor architecture

NASA Technical Reports Server (NTRS)

Tawel, Raoul (Inventor)

2001-01-01

A neuroprocessor architecture employs a combination of bit-serial and serial-parallel techniques for implementing the neurons of the neuroprocessor. The neuroprocessor architecture includes a neural module containing a pool of neurons, a global controller, a sigmoid activation ROM look-up-table, a plurality of neuron state registers, and a synaptic weight RAM. The neuroprocessor reduces the number of neurons required to perform the task by time multiplexing groups of neurons from a fixed pool of neurons to achieve the successive hidden layers of a recurrent network topology.

Reshaping the Sword and Chrysanthemum: Regional Implications of Expanding the Mission of the Japan Self Defense Forces

DTIC Science & Technology

2005-03-01

I could not have achieved the level success that I have without her. Finally, I would like to thank our little girl , for waiting until after this...MAJOR QUESTIONS AND ARGUMENTS This thesis investigates causal factors in determining how the changing mission of the JSDF affects the regional...to not only understand the changes called for in these documents, but also how the implementation has been carried out as perceptions can change

Frapid: achieving full automation of FRAP for chemical probe validation

PubMed Central

Yapp, Clarence; Rogers, Catherine; Savitsky, Pavel; Philpott, Martin; Müller, Susanne

2016-01-01

Fluorescence Recovery After Photobleaching (FRAP) is an established method for validating chemical probes against the chromatin reading bromodomains, but so far requires constant human supervision. Here, we present Frapid, an automated open source code implementation of FRAP that fully handles cell identification through fuzzy logic analysis, drug dispensing with a custom-built fluid handler, image acquisition & analysis, and reporting. We successfully tested Frapid on 3 bromodomains as well as on spindlin1 (SPIN1), a methyl lysine binder, for the first time. PMID:26977352

Research Required for the Effective Implementation of the Framework Convention on Tobacco Control, Articles 9 and 10

PubMed Central

2013-01-01

This paper is part of a series of articles intended to set out the research questions that are relevant to the successful implementation of the various provisions of the Framework Convention on Tobacco Control (FCTC). This paper focuses on issues affecting Articles 9 and 10 of the FCTC. This paper focuses on the research that is most important for most countries, rather than on what is desirable in countries with high levels of research capacity. Articles 9 and 10 of the FCTC address the regulation of contents and emissions of tobacco products and regulation of tobacco product disclosure. Such regulation will be essential if the long-term objective of reducing the danger of tobacco products is to be achieved. There are many components of tobacco and tobacco smoke that are excessively toxic and dangerous to the user. Many of these components are carcinogenic and addictive and can be removed or reduced substantially with current known technology. The fact that these components remain in tobacco and tobacco smoke at levels that are unnecessarily dangerous is precisely the reason why the successful implementation of Articles 9 and 10 of the FCTC is important to tobacco control. This paper discusses the scientific challenges involved in successfully implementing Articles 9 and 10 of the FCTC, which focuses on regulating carcinogens and toxins in tobacco and tobacco smoke, the abuse liability of tobacco products, and the additives and engineering features in tobacco products that make tobacco products appealing to future consumers. The research issues we focus on are those required to support the early stages of regulation. As regulation proceeds, new and more sophisticated research questions will undoubtedly emerge. PMID:23024247

An object-oriented, technology-adaptive information model

NASA Technical Reports Server (NTRS)

Anyiwo, Joshua C.

1995-01-01

The primary objective was to develop a computer information system for effectively presenting NASA's technologies to American industries, for appropriate commercialization. To this end a comprehensive information management model, applicable to a wide variety of situations, and immune to computer software/hardware technological gyrations, was developed. The model consists of four main elements: a DATA_STORE, a data PRODUCER/UPDATER_CLIENT and a data PRESENTATION_CLIENT, anchored to a central object-oriented SERVER engine. This server engine facilitates exchanges among the other model elements and safeguards the integrity of the DATA_STORE element. It is designed to support new technologies, as they become available, such as Object Linking and Embedding (OLE), on-demand audio-video data streaming with compression (such as is required for video conferencing), Worldwide Web (WWW) and other information services and browsing, fax-back data requests, presentation of information on CD-ROM, and regular in-house database management, regardless of the data model in place. The four components of this information model interact through a system of intelligent message agents which are customized to specific information exchange needs. This model is at the leading edge of modern information management models. It is independent of technological changes and can be implemented in a variety of ways to meet the specific needs of any communications situation. This summer a partial implementation of the model has been achieved. The structure of the DATA_STORE has been fully specified and successfully tested using Microsoft's FoxPro 2.6 database management system. Data PRODUCER/UPDATER and PRESENTATION architectures have been developed and also successfully implemented in FoxPro; and work has started on a full implementation of the SERVER engine. The model has also been successfully applied to a CD-ROM presentation of NASA's technologies in support of Langley Research Center's TAG efforts.

Implementation of an electromagnetic imaging system to facilitate nasogastric and post-pyloric feeding tube placement in patients with and without critical illness.

PubMed

Windle, E M; Beddow, D; Hall, E; Wright, J; Sundar, N

2010-02-01

Artificial nutrition support is required to optimise nutritional status in many patients. Traditional methods of placing feeding tubes may incur clinical risk and financial costs. A technique facilitating placement of nasogastric and post-pyloric tubes via electromagnetic visual guidance may reduce the need for X-ray exposure, endoscopy time and the use of parenteral nutrition. The present study aimed to audit use of such a system at initial implementation in patients within an acute NHS Trust. A retrospective review was undertaken of dietetic and medical records for the first 14 months of using the Cortrak system. Data were collected on referral origin, preparation of the patient prior to insertion, placement success rates and need for X-ray. Cost analysis was also performed. Referrals were received from primary consultants or consultant intensivists, often on the advice of the dietitian. Fifty-nine percent of patients received prokinetic therapy at the time of placement. Thirty-nine tube placements were attempted. Sixty-nine percent of referrals for post-pyloric tube placement resulted in successful placement. X-ray films were requested for 22% of all attempted post-pyloric placements. Less than half of nasogastric tubes were successfully passed, although none of these required X-ray confirmation. The mean cost per tube insertion attempt was 111 pounds. This system confers advantages, particularly in terms of post-pyloric tube placement, even at this early stage of implementation. A reduction in clinical risk and cost avoidance related to X-ray exposure, the need for endoscopic tube placement and parenteral nutrition have been achieved. The implementation of this system should be considered in other centres.

Rural primary care practices and meaningful use of electronic health records: the role of Regional Extension Centers.

PubMed

Casey, Michelle M; Moscovice, Ira; McCullough, Jeffrey

2014-01-01

To examine the role of Regional Extension Centers (RECs) in helping rural physician practices adopt electronic health records (EHRs) and achieve meaningful use. Using data from the Office of the National Coordinator for Health Information Technology, we conducted a county-level regression analysis using ordinary least squares to better understand rural-urban differences in REC participation, EHR implementation, and meaningful use, controlling for counties' economic conditions. We prepared case studies of 2 RECs that are serving a large number of rural practices, based on interviews with key individuals at the RECs, their partner organizations, and rural primary care practices that received assistance from the RECs. RECs are largely achieving their objective of targeting providers in communities that face barriers to EHRs. REC participants are disproportionately rural and more likely to come from high poverty and low employment communities. The case study RECs had long-standing relationships with rural providers, as well as extensive staff expertise in quality improvement and EHR implementation, and employed a variety of strategies to successfully assist rural providers. Rural providers report that REC assistance was invaluable in helping them implement EHRs and achieve meaningful use status. Modifying the criteria for Medicare and Medicaid EHR incentives could help additional rural providers pay for EHRs. REC federal funding is scheduled to end in 2014, but practices that have not yet adopted EHRs may need significant, ongoing assistance to receive meaningful use. © 2013 National Rural Health Association.

Achieving the triple bottom line in the face of inherent trade-offs among social equity, economic return, and conservation

PubMed Central

Halpern, Benjamin S.; Klein, Carissa J.; Brown, Christopher J.; Beger, Maria; Grantham, Hedley S.; Mangubhai, Sangeeta; Ruckelshaus, Mary; Tulloch, Vivitskaia J.; Watts, Matt; White, Crow; Possingham, Hugh P.

2013-01-01

Triple–bottom-line outcomes from resource management and conservation, where conservation goals and equity in social outcomes are maximized while overall costs are minimized, remain a highly sought-after ideal. However, despite widespread recognition of the importance that equitable distribution of benefits or costs across society can play in conservation success, little formal theory exists for how to explicitly incorporate equity into conservation planning and prioritization. Here, we develop that theory and implement it for three very different case studies in California (United States), Raja Ampat (Indonesia), and the wider Coral Triangle region (Southeast Asia). We show that equity tends to trade off nonlinearly with the potential to achieve conservation objectives, such that similar conservation outcomes can be possible with greater equity, to a point. However, these case studies also produce a range of trade-off typologies between equity and conservation, depending on how one defines and measures social equity, including direct (linear) and no trade-off. Important gaps remain in our understanding, most notably how equity influences probability of conservation success, in turn affecting the actual ability to achieve conservation objectives. Results here provide an important foundation for moving the science and practice of conservation planning—and broader spatial planning in general—toward more consistently achieving efficient, equitable, and effective outcomes. PMID:23530207

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries

PubMed Central

Stillman, Frances A.; David, Annette M.; Kibria, Naseeb; Phan, Hai Thi

2014-01-01

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve ‘quality’ outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC. PMID:23411160

Hierarchical specification of the SIFT fault tolerant flight control system

NASA Technical Reports Server (NTRS)

Melliar-Smith, P. M.; Schwartz, R. L.

1981-01-01

The specification and mechanical verification of the Software Implemented Fault Tolerance (SIFT) flight control system is described. The methodology employed in the verification effort is discussed, and a description of the hierarchical models of the SIFT system is given. To meet the objective of NASA for the reliability of safety critical flight control systems, the SIFT computer must achieve a reliability well beyond the levels at which reliability can be actually measured. The methodology employed to demonstrate rigorously that the SIFT computer meets as reliability requirements is described. The hierarchy of design specifications from very abstract descriptions of system function down to the actual implementation is explained. The most abstract design specifications can be used to verify that the system functions correctly and with the desired reliability since almost all details of the realization were abstracted out. A succession of lower level models refine these specifications to the level of the actual implementation, and can be used to demonstrate that the implementation has the properties claimed of the abstract design specifications.

Comparison of student success using "atoms first" versus "traditional" curricula

NASA Astrophysics Data System (ADS)

Hillesheim, Christina S.

The purpose of this study was to investigate the difference between the "atoms first" and the "traditional" curricula. Specifically focusing on which curriculum better aligns to curricular expectations, leads to higher student success when students are grouped together, and when students are differentiated based on several factors. The main difference between the two approaches being the sequence of topics presented in the first semester general chemistry course. This study involves more than 9,500 general chemistry I and II students over 7 semesters with about half of them being taught using the "atoms first" approach. Student success was measured using the American Chemical Society's (ACS) final examination scores and the final letter grades. Alignment to curricular expectations was determined via a qualitative review of textbooks written for each of the approaches. This showed that the "atoms first" approach better aligns to research supported best practices. An analysis of covariance (ANCOVA) was performed to determine if there is a significant difference between the "atoms first" and the "traditional" curricula. The "traditional" approach was found to lead to higher student achievement for both measures of student success in both chemistry I and II courses. Lastly, multiple linear, multinomial logistic, and binary logistic regressions were run using all of the subgroups---gender, race/ethnicity, major, ACT composite, math ACT, overall GPA, and classroom size---as predictor variables to determine if any significant interactions between the curricular methods and the different subgroups existed. Results found that the relationship between gender, GPA, and classroom size groupings significantly impact student achievement in general chemistry. Specifically, the "traditional" approach lead to higher student success compared to the "atoms first" approach for males, females, below average GPA students, above average GPA students, and students in large classroom settings. However, there are several factors---final examination content, new teacher impact, teacher's view of science, and withdrawal rate and timing---that need to be taken into account when implementing these findings. Overall, the results of this study provides a cautionary reminder of the many impacts affecting curriculum implementation and the importance of professional development and training during a curriculum transitional period.

Assessing the link between implementation fidelity and health outcomes for a trial of intensive case management by community health workers: a mixed methods study protocol.

PubMed

Schmidt, Barbara; Watt, Kerrianne; McDermott, Robyn; Mills, Jane

2017-07-17

Better systems of care are required to address chronic disease in Indigenous people to ensure they can access all their care needs. Health research has produced evidence about effective models of care and chronic disease strategies to address Indigenous health, however the transfer of research findings into routine clinical practice has proven challenging. Complex interventions, such as those related to chronic disease, have many components that are often poorly implemented and hence rarely achieve implementation fidelity. Implementation fidelity is "the degree to which programs are implemented as intended by the program developer". Knowing if an intervention was implemented as planned is fundamental to knowing what has contributed to the success of an intervention. The aim of this study is to adapt the implementation fidelity framework developed by Keith et al. and apply it to the intervention implemented in phase 1 of the Getting Better at Chronic Care in North Queensland study. The objectives are to quantify the level of implementation fidelity achieved during phase 1 of the study, measure the association between implementation fidelity and health outcomes and to explore the features of the primary health care system that contributed to improved health outcomes. A convergent parallel mixed methods study design will be used to develop a process for assessing implementation fidelity. Information collected via a questionnaire and routine data generated during phase 1 of the study will be used to explain the context for the intervention in each site and develop an implementation fidelity score for each component of the intervention. A weighting will be applied to each component of the intervention to calculate the overall implementation score for each participating community. Statistical analysis will assess the level of association between implementation fidelity scores and health outcomes. Health services research seeks to find solutions to social and technical problems to improve health outcomes. The development of a tool and methodology for assessing implementation fidelity in the Indigenous primary health care context will help address some of the barriers to the translation of research into practice. ACTRN12610000812099 : 29.9.2010.

Clinical and financial considerations for implementing an ICU telemedicine program.

PubMed

Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

2014-06-01

As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

The push for increased coal injection rates -- Blast furnace experience at AK Steel Corporation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dibert, W.A.; Duncan, J.H.; Keaton, D.E.

1994-12-31

An effort has been undertaken to increase the coal injection rate on Amanda blast furnace at AK Steel Corporation`s Ashland Works in Ashland, Kentucky to decrease fuel costs and reduce coke demand. Operating practices have been implemented to achieve a sustained coal injection rate of 140 kg/MT, increased from 100--110 kg/MT. In order to operate successfully at the 140 kg/MT injection rate; changes were implemented to the furnace charging practice, coal rate control methodology, orientation of the injection point, and the manner of distribution of coal to the multiple injection points. Additionally, changes were implemented in the coal processing facilitymore » to accommodate the higher demand of pulverized coal; grinding 29 tonnes per hour, increased from 25 tonnes per hour. Further increases in injection rate will require a supplemental supply of fuel.« less

Challenges and opportunities for meningococcal vaccination in the developing world.

PubMed

Shaker, Rouba; Fayad, Danielle; Dbaibo, Ghassan

2018-05-04

Meningococcal disease continues to be a life threatening infection with high morbidity and mortality even in appropriately treated patients. Meningococcal vaccination plays a major role in the control of the disease; however, implementing vaccination remains problematic in the developing world. The objective of this review is to identify the challenges facing the use of meningococcal vaccines in the developing world in order to discuss the opportunities and available solutions to improve immunization in these countries. Inadequate epidemiologic information necessary to implement vaccination and financial challenges predominate. Multiple measures are needed to achieve the successful implementation of meningococcal conjugate vaccination programs that protect against circulating serogroups in developing countries including enhanced surveillance systems, financial support and aid through grants, product development partnerships that are the end result of effective collaboration and communication between different interdependent stakeholders to develop affordable vaccines, and demonstration of the cost-effectiveness of new meningococcal vaccines.

Constrained Aerothermodynamic Design of Hypersonic Vehicles

NASA Technical Reports Server (NTRS)

Gally, Tom; Campbell, Dick

2002-01-01

An investigation was conducted into possible methods of incorporating a hypersonic design capability with aerothermodynamic constraints into the CDISC aerodynamic design tool. The work was divided into two distinct phases: develop relations between surface curvature and hypersonic pressure coefficient which are compatible with CDISC's direct-iterative design method; and explore and implement possible methods of constraining the heat transfer rate over all or portions of the design surface. The main problem in implementing this method has been the weak relationship between surface shape and pressure coefficient at the stagnation point and the need to design around the surface blunt leading edge where there is a slope singularity. The final results show that some success has been achieved, but further improvements are needed.

Medical Data Transmission Using Cell Phone Networks

NASA Astrophysics Data System (ADS)

Voos, J.; Centeno, C.; Riva, G.; Zerbini, C.; Gonzalez, E.

2011-12-01

A big challenge in telemedicine systems is related to have the technical requirements needed for a successful implementation in remote locations where the available hardware and communication infrastructure is not adequate for a good medical data transmission. Despite of the wide standards availability, methodologies, applications and systems integration facilities in telemedicine, in many cases the implementation requirements are not achievable to allow the system execution in remote areas of our country. Therefore, this paper presents an alternative for the messages transmission related to medical studies using the cellular network and the standard HL7 V3 [1] for data modeling. The messages are transmitted to a web server and stored in a centralized database which allows data sharing with other specialists.

Preventing HIV: determinants of sexual behaviour.

PubMed

Donovan, B; Ross, M W

2000-05-27

AIDS has Invigorated and distorted the study of sexual behaviour. Because that study began so recently, there remain many unanswered questions about why we have sex at all, why we do sex one way rather than another, or even how we define sex. Yet in every instance in which well-designed and adequately resourced behavioural Interventions have been Implemented, these have netted success in the form of falling HIV incidences or prevalences. But, despite these successes, such interventions remain patchy and poorly supported. Perhaps humankind's traditional aversion for the public discussion of sexual matters underlies this reticence. Or maybe a new era of "creeping absolutism"--in which biomedical advances are given premature credit for what they can achieve in HIV control--has arrived.

Case history of Yakin Field: its development and sand control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sawolo, N.; Krueger, R.F.; Maly, G.P.

1982-01-01

This study deals with the development of the Yakin Field in E. Kalimantan, Indonesia, with emphasis on the sand control methods used. Implementation of an effective sand control program insured the successful development of this field. Gravel packed wells had substantially lower production decline rates than the initial completions without gravel packs. Control of sand production also has been demonstrated by the lack of sand problems during the 4-1/2 yr since the sand control program was initiated. During this time there have been no failures of submersible pumps that were associated with sand production. The successful sand control program wasmore » achieved by a well coordinated and cooperative effort of drilling, reservoir engineering, production research, and service company personnel.« less

The Evaluation of Industry Practical of Mechanical Engineering in Vocational Education: A CIPP Model Approach

NASA Astrophysics Data System (ADS)

Kamaludin, M.; Munawar, W.; Mahdan, D.; Simanjuntak, M. V.; Wendi, H. F.

2018-02-01

The learning system is not only studied on campus but also practicing in the world of work. Industry Practical aims to enable students to develop their skills in accordance with the real world of work. To know the success of the implementation of industry practical program then held evaluation. The evaluation of the program in this study used the CIPP evaluation approach (Context, Input, Process, Product). The purpose of this research is to know the extent of achievement and success of industry practical program at vocational school in Bandung with descriptive research method using mix method approach. The sample in this research is students majoring in mechanical engineering in the city of Bandung who have done industry practical.

Enhancing Advocacy for Eye Care at National Levels: What Steps to Take for the Next Decade?

PubMed Central

Rabiu, Muhammad Mansur; Al Rajhi, Abdulaziz; Qureshi, Mohammed Babar; Gersbeck, Jennifer

2012-01-01

The global initiative for the elimination of avoidable blindness by the year 2020-(VISION 2020- The Right to Sight), established in 1999, is a partnership of nongovernmental organizations (NGOs), governments, bilateral organizations, corporate bodies and the World Health Organization. The goal is to eliminate the major causes of avoidable blindness by the year 2020. Significant progress has been made in the last decade. For example, the adoption of three major World Health Assembly resolutions (WHA 56.26, 59.25 and 62.1) requesting governments to increase support and funding for the prevention of blindness and eye care. Additionally, the approval of the VISION 2020 declaration, development of plans and establishment of prevention of blindness committees and a designation of a coordinator by most participating countries represent other major achievements. Furthermore there has been increased political and professional commitment to the prevention of visual impairment and an increase in the provision of high-quality, sustainable eye care. Most of these achievements have been attributed to the advocacy efforts of VISION 2020 at the international level. The full success of this global initiative will likely depend on the extent to which the WHA resolutions are implemented in each country. However, most ratifying countries have not moved forward with implementation of these resolutions. To date, only few countries have shown consistent government support and funding for eye care pursuant to the resolutions. One of the main reasons for this may be inadequate and inappropriate advocacy for eye care at the national level. As such it is believed that the success of VISION 2020 in the next decade will depend on intense advocacy campaigns at national levels. This review identified some of the countries and health programs that have had fruitful advocacy efforts, to determine the factors that dictated success. The review highlights the factors of successful advocacy in two countries (Australia and Pakistan) that secured continued government support. The review further explores the achievements of the HIV/AIDs control network advocacy in securing global and national government support. Common factors for successful advocacy at the national level were identified to include generation of evidence data and effective utilization of the data with an appropriate forum and media to develop a credible relationship with prominent decision makers. Aligning eye care programming to the broad health and development agendas was a useful advocacy effort. Also a broad all-encompassing coalition of all stakeholders provides a solid platform for effective and persistent advocacy for government support of eye care. PMID:22346118

Assessment and Verification of SLS Block 1-B Exploration Upper Stage State and Stage Disposal Performance

NASA Technical Reports Server (NTRS)

Patrick, Sean; Oliver, Emerson

2018-01-01

One of the SLS Navigation System's key performance requirements is a constraint on the payload system's delta-v allocation to correct for insertion errors due to vehicle state uncertainty at payload separation. The SLS navigation team has developed a Delta-Delta-V analysis approach to assess the effect on trajectory correction maneuver (TCM) design needed to correct for navigation errors. This approach differs from traditional covariance analysis based methods and makes no assumptions with regard to the propagation of the state dynamics. This allows for consideration of non-linearity in the propagation of state uncertainties. The Delta-Delta-V analysis approach re-optimizes perturbed SLS mission trajectories by varying key mission states in accordance with an assumed state error. The state error is developed from detailed vehicle 6-DOF Monte Carlo analysis or generated using covariance analysis. These perturbed trajectories are compared to a nominal trajectory to determine necessary TCM design. To implement this analysis approach, a tool set was developed which combines the functionality of a 3-DOF trajectory optimization tool, Copernicus, and a detailed 6-DOF vehicle simulation tool, Marshall Aerospace Vehicle Representation in C (MAVERIC). In addition to delta-v allocation constraints on SLS navigation performance, SLS mission requirement dictate successful upper stage disposal. Due to engine and propellant constraints, the SLS Exploration Upper Stage (EUS) must dispose into heliocentric space by means of a lunar fly-by maneuver. As with payload delta-v allocation, upper stage disposal maneuvers must place the EUS on a trajectory that maximizes the probability of achieving a heliocentric orbit post Lunar fly-by considering all sources of vehicle state uncertainty prior to the maneuver. To ensure disposal, the SLS navigation team has developed an analysis approach to derive optimal disposal guidance targets. This approach maximizes the state error covariance prior to the maneuver to develop and re-optimize a nominal disposal maneuver (DM) target that, if achieved, would maximize the potential for successful upper stage disposal. For EUS disposal analysis, a set of two tools was developed. The first considers only the nominal pre-disposal maneuver state, vehicle constraints, and an a priori estimate of the state error covariance. In the analysis, the optimal nominal disposal target is determined. This is performed by re-formulating the trajectory optimization to consider constraints on the eigenvectors of the error ellipse applied to the nominal trajectory. A bisection search methodology is implemented in the tool to refine these dispersions resulting in the maximum dispersion feasible for successful disposal via lunar fly-by. Success is defined based on the probability that the vehicle will not impact the lunar surface and will achieve a characteristic energy (C3) relative to the Earth such that it is no longer in the Earth-Moon system. The second tool propagates post-disposal maneuver states to determine the success of disposal for provided trajectory achieved states. This is performed using the optimized nominal target within the 6-DOF vehicle simulation. This paper will discuss the application of the Delta-Delta-V analysis approach for performance evaluation as well as trajectory re-optimization so as to demonstrate the system's capability in meeting performance constraints. Additionally, further discussion of the implementation of assessing disposal analysis will be provided.

Kids crash and burn: An analysis of freshmen failing science end of course exams

NASA Astrophysics Data System (ADS)

Godfrey, Tanya N.

The purpose of this study was to determine how various factors influence student achievement on the physical science EOCE so that students are provided every opportunity to be successful. An understanding of influences such as the type of mathematics course students are taking, participating in block scheduling, participating in freshmen academies, and the year students took the science course and the science EOCE should provide insight into its relationship on the physical science EOCE achievement level. The final goal was to find which factors correlate to high achievement on the physical science EOCE so that South Carolina can implement these factors. This was done by obtaining historical data on students who took physical science and determine which factors are associated with the high failure rates on the physical science EOCE. Correlational values were determined, when possible. An independent-samples t-test was used to determine the strength and directionality for each relationship. A five-way ANOVA was used to determine if there were any interaction effects between the variables. The first finding was that students who took algebra prior to physical science had higher achievement on the EOCE than students without algebra. Students had increased EOCE scores when they took physical science in a block class. More students were successful outside of a freshmen academy on the physical science EOCE. These results are important to educators and administrators that want to help students become more successful on the physical science EOCE. The findings of this study can lead to a positive change within schools and school districts when it comes to providing an atmosphere that helps students increase their science skills and knowledge.

Implementing quality initiatives in healthcare organizations: drivers and challenges.

PubMed

Abdallah, Abdallah

2014-01-01

Various quality initiatives seem to have successful implementation in some healthcare organizations yet fail in others. This paper sets out to study the literature trying to understand drivers and challenges facing quality initiatives implementation in healthcare organizations then compare findings from literature with those of a structured questionnaire answered by 60 representatives from 18 hospitals. Finally it proposes a framework that mitigates challenges and utilizes drivers to ensure best implementation results. Literature regarding implementing various quality initiatives in the healthcare sector was reviewed. Representatives from several healthcare organizations were surveyed. Results from both approaches are compared to highlight the key challenges and drivers facing implementers. This research reveals that internal factors related to leadership and employees greatly affect quality initiative success or failure. Design and relevance play a major role in successful implementation. PRACTICAL IMPLICATIONs: This research offers healthcare professionals greater success when implementing certain quality initiatives by taking success/failure factors into consideration. A general framework for successful implementation in the healthcare sector is provided. This article uncovers reasons behind success or failure in a comprehensive and practical way. It also explores how most popular quality initiatives are applied in hospitals.

Social Media and Mentoring in Biomedical Research Faculty Development

PubMed Central

Teruya, Stacey Alan; Bazargan-Hejazi, Shahrzad

2015-01-01

Purpose To determine how effective and collegial mentoring in biomedical research faculty development may be implemented and facilitated through social media. Method The authors reviewed the literature for objectives, concerns, and limitations of career development for junior research faculty. They tabularized these as developmental goals, and aligned them with relevant social media strengths and capabilities facilitated through traditional and/or peer mentoring. Results The authors derived a model in which social media is leveraged to achieve developmental goals reflected in independent and shared projects, and in the creation and expansion of support and research networks. Conclusions Social media may be successfully leveraged and applied in achieving developmental goals for biomedical research faculty, and potentially for those in other fields and disciplines. PMID:26120494

“Because we all trust and care about each other”: Exploring Tensions Translating a Theater-based HIV Prevention Intervention into a New Context

PubMed Central

Mouw, Mary Sherwyn; Taboada, Arianna; Steinert, Scarlett; Willis, Stephanie; Lightfoot, Alexandra F.

2016-01-01

Background A theater-based HIV prevention intervention developed in urban California was piloted with a new partnership in North Carolina. Objectives To describe the experience of translating a complex program with an enhanced partnership approach; barriers and facilitators of implementation in the new setting; and challenges and benefits of interdisciplinary, collaborative interventions. Methods We gathered perspectives of local stakeholders involved in program implementation through process evaluation interviews and focus groups with undergraduates, a college instructor, school district administrators, and high school teachers. Results Implementing the intervention in a new setting proved feasible and successful; however, mistaken assumptions and unrecognized similarities about teaching priorities, philosophies, and values produced latent tensions amongst stakeholder groups, and were a limiting factor in partnership functioning. Conclusions Implementing a cross-disciplinary intervention in a new setting is best achieved through a local community-engaged process, with active involvement of relevant stakeholders. We suggest strategies to strengthen community partnerships cooperating in implementation of complex, context-tailored interventions. PMID:27346770

Implementation of HIV and Tuberculosis Diagnostics: The Importance of Context.

PubMed

Dominique, Joyelle K; Ortiz-Osorno, Alberto A; Fitzgibbon, Joseph; Gnanashanmugam, Devasena; Gilpin, Christopher; Tucker, Timothy; Peel, Sheila; Peter, Trevor; Kim, Peter; Smith, Steven

2015-10-15

Novel diagnostics have been widely applied across human immunodeficiency virus (HIV) and tuberculosis prevention and treatment programs. To achieve the greatest impact, HIV and tuberculosis diagnostic programs must carefully plan and implement within the context of a specific healthcare system and the laboratory capacity. A workshop was convened in Cape Town in September 2014. Participants included experts from laboratory and clinical practices, officials from ministries of health, and representatives from industry. The article summarizes best practices, challenges, and lessons learned from implementation experiences across sub-Saharan Africa for (1) building laboratory programs within the context of a healthcare system; (2) utilizing experience of clinicians and healthcare partners in planning and implementing the right diagnostic; and (3) evaluating the effects of new diagnostics on the healthcare system and on patient health outcomes. The successful implementation of HIV and tuberculosis diagnostics in resource-limited settings relies on careful consideration of each specific context. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Applying TOGAF for e-government implementation based on service oriented architecture methodology towards good government governance

NASA Astrophysics Data System (ADS)

Hodijah, A.; Sundari, S.; Nugraha, A. C.

2018-05-01

As a Local Government Agencies who perform public services, General Government Office already has utilized Reporting Information System of Local Government Implementation (E-LPPD). However, E-LPPD has upgrade limitation for the integration processes that cannot accommodate General Government Offices’ needs in order to achieve Good Government Governance (GGG), while success stories of the ultimate goal of e-government implementation requires good governance practices. Currently, citizen demand public services as private sector do, which needs service innovation by utilizing the legacy system as a service based e-government implementation, while Service Oriented Architecture (SOA) to redefine a business processes as a set of IT enabled services and Enterprise Architecture from the Open Group Architecture Framework (TOGAF) as a comprehensive approach in redefining business processes as service innovation towards GGG. This paper takes a case study on Performance Evaluation of Local Government Implementation (EKPPD) system on General Government Office. The results show that TOGAF will guide the development of integrated business processes of EKPPD system that fits good governance practices to attain GGG with SOA methodology as technical approach.

Implementing the Synchronized Global Switch from Trivalent to Bivalent Oral Polio Vaccines-Lessons Learned From the Global Perspective.

PubMed

Ramirez Gonzalez, Alejandro; Farrell, Margaret; Menning, Lisa; Garon, Julie; Everts, Hans; Hampton, Lee M; Dolan, Samantha B; Shendale, Stephanie; Wanyoike, Sarah; Veira, Chantal Laroche; Châtellier, Gaël Maufras du; Kurji, Feyrouz; Rubin, Jennifer; Boualam, Liliane; Chang Blanc, Diana; Patel, Manish

2017-07-01

In 2015, the Global Commission for the Certification of Polio Eradication certified the eradication of type 2 wild poliovirus, 1 of 3 wild poliovirus serotypes causing paralytic polio since the beginning of recorded history. This milestone was one of the key criteria prompting the Global Polio Eradication Initiative to begin withdrawal of oral polio vaccines (OPV), beginning with the type 2 component (OPV2), through a globally synchronized initiative in April and May 2016 that called for all OPV using countries and territories to simultaneously switch from use of trivalent OPV (tOPV; containing types 1, 2, and 3 poliovirus) to bivalent OPV (bOPV; containing types 1 and 3 poliovirus), thus withdrawing OPV2. Before the switch, immunization programs globally had been using approximately 2 billion tOPV doses per year to immunize hundreds of millions of children. Thus, the globally synchronized withdrawal of tOPV was an unprecedented achievement in immunization and was part of a crucial strategy for containment of polioviruses. Successful implementation of the switch called for intense global coordination during 2015-2016 on an unprecedented scale among global public health technical agencies and donors, vaccine manufacturers, regulatory agencies, World Health Organization (WHO) and United Nations Children's Fund (UNICEF) regional offices, and national governments. Priority activities included cessation of tOPV production and shipment, national inventories of tOPV, detailed forecasting of tOPV needs, bOPV licensing, scaling up of bOPV production and procurement, developing national operational switch plans, securing funding, establishing oversight and implementation committees and teams, training logisticians and health workers, fostering advocacy and communications, establishing monitoring and validation structures, and implementing waste management strategies. The WHO received confirmation that, by mid May 2016, all 155 countries and territories that had used OPV in 2015 had successfully withdrawn OPV2 by ceasing use of tOPV in their national immunization programs. This article provides an overview of the global efforts and challenges in successfully implementing this unprecedented global initiative, including (1) coordination and tracking of key global planning milestones, (2) guidance facilitating development of country specific plans, (3) challenges for planning and implementing the switch at the global level, and (4) best practices and lessons learned in meeting aggressive switch timelines. Lessons from this monumental public health achievement by countries and partners will likely be drawn upon when bOPV is withdrawn after polio eradication but also could be relevant for other global health initiatives with similarly complex mandates and accelerated timelines. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Designing and Evaluating an Interprofessional Experiential Course Series Involving Medical and Pharmacy Students

PubMed Central

Dueñas, Gladys G.; Zanoni, Aileen; Grover, Anisha B.

2016-01-01

Objective. To prepare first-year and second-year pharmacy and medical students to build effective collaborative health care teams by participating in an interprofessional experiential 6-semester course series. Design. An interprofessional experiential course series was designed using a variety of teaching methods to achieve both interprofessional and experiential learning outcomes. A standardized objective behavioral assessment was developed to measure team performance of interprofessional communication and teamwork. In addition, student perceptions were measured using a validated instrument. Assessment. A majority of teams demonstrated appropriate competence with respect to interprofessional communication and teamwork. Additionally, a majority of students expressed positive perceptions of interprofessional collaboration with respect to teamwork, roles and responsibilities, and patient outcomes. Conclusion. An interprofessional experiential course series can be successfully implemented to achieve both interprofessional and experiential learning outcomes. Highly collaborative teams and positive student perceptions provide evidence of achievement of interprofessional education learning outcomes. PMID:27402988

Effects of people-centred factors on enterprise resource planning implementation project success: empirical evidence from Sri Lanka

NASA Astrophysics Data System (ADS)

Wickramasinghe, Vathsala; Gunawardena, Vathsala

2010-08-01

Extant literature suggests people-centred factors as one of the major areas influencing enterprise resource planning (ERP) implementation project success. Yet, to date, few empirical studies attempted to validate the link between people-centred factors and ERP implementation project success. The purpose of this study is to empirically identify people-centred factors that are critical to ERP implementation projects in Sri Lanka. The study develops and empirically validates a framework for people-centred factors that influence the success of ERP implementation projects. Survey research methodology was used and collected data from 74 ERP implementation projects in Sri Lanka. The people-centred factors of 'project team competence', 'rewards' and 'communication and change' were found to predict significantly the ERP implementation project success.

Sustainability of knowledge implementation in a low- and middle- income context: Experiences from a facilitation project in Vietnam targeting maternal and neonatal health

PubMed Central

Bergström, Anna; Hoa, Dinh Thi Phuong; Nga, Nguyen Thu; Eldh, Ann Catrine

2017-01-01

Background In a previous trial in Vietnam, a facilitation strategy to secure evidence-based practice in primary care resulted in reduced neonatal mortality over a period of three years. While little is known as to what ensures sustainability in the implementation of community-based strategies, the aim of this study was to investigate factors promoting or hindering implementation, and sustainability of knowledge implementation strategies, by means of the former Neonatal Knowledge Into Practice (NeoKIP) trial. Methods In 2014 we targeted all levels in the Vietnamese healthcare system: six individual interviews with representatives at national, provincial and district levels, and six focus group discussions with representatives at the commune level. The interviews were transcribed verbatim, translated to English, and analysed using inductive and deductive thematic analysis. Results To achieve successful implementation and sustained effect of community-based knowledge implementation strategies, engagement of leaders and key stakeholders at all levels of the healthcare system is vital–prior to, during and after a project. Implementation and sustainability require thorough needs assessment, tailoring of the intervention, and consideration of how to attain and manage funds. The NeoKIP trial was characterised by a high degree of engagement at the primary healthcare system level. Further, three years post trial, maternal and neonatal care was still high on the agenda for healthcare workers and leaders, even though primary aspects such as stakeholder engagement at all levels, and funding had been incomplete or lacking. Conclusions The current study illustrates factors to support successful implementation and sustain effects of community-based strategies in projects in low- and middle-income settings; some but not all factors were represented during the post-NeoKIP era. Most importantly, trials in this and similar contexts require deliberate management throughout and beyond the project lifetime, and engagement of key stakeholders, in order to promote and sustain knowledge implementation. PMID:28806744

Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

PubMed Central

Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

2017-01-01

ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. PMID:28146177

How change management can prevent the failure of information systems implementation among Malaysian government hospitals?

NASA Astrophysics Data System (ADS)

ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu

2017-10-01

Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.

Shuttle Propulsion System Major Events and the Final 22 Flights

NASA Technical Reports Server (NTRS)

Owen, James W.

2011-01-01

Numerous lessons have been documented from the Space Shuttle Propulsion elements. Major events include loss of the Solid Rocket Boosters (SRB's) on STS-4 and shutdown of a Space Shuttle Main Engine (SSME) during ascent on STS-51F. On STS-112 only half the pyrotechnics fired during release of the vehicle from the launch pad, a testament for redundancy. STS-91 exhibited freezing of a main combustion chamber pressure measurement and on STS-93 nozzle tube ruptures necessitated a low liquid level oxygen cut off of the main engines. A number of on pad aborts were experienced during the early program resulting in delays. And the two accidents, STS-51L and STS-107, had unique heritage in history from early program decisions and vehicle configuration. Following STS-51L significant resources were invested in developing fundamental physical understanding of solid rocket motor environments and material system behavior. And following STS-107, the risk of ascent debris was better characterized and controlled. Situational awareness during all mission phases improved, and the management team instituted effective risk assessment practices. The last 22 flights of the Space Shuttle, following the Columbia accident, were characterized by remarkable improvement in safety and reliability. Numerous problems were solved in addition to reduction of the ascent debris hazard. The Shuttle system, though not as operable as envisioned in the 1970's, successfully assembled the International Space Station (ISS). By the end of the program, the remarkable Space Shuttle Propulsion system achieved very high performance, was largely reusable, exhibited high reliability, and was a heavy lift earth to orbit propulsion system. During the program a number of project management and engineering processes were implemented and improved. Technical performance, schedule accountability, cost control, and risk management were effectively managed and implemented. Award fee contracting was implemented to provide performance incentives. The Certification of Flight Readiness and Mission Management processes became very effective. A key to the success of the propulsion element projects was related to relationships between the MSFC project office and support organizations with their counterpart contractor organizations. The teams worked diligently to understand and satisfy requirements and achieve mission success.

Designing and implementing a socioeconomic intervention to enhance TB control: operational evidence from the CRESIPT project in Peru.

PubMed

Wingfield, Tom; Boccia, Delia; Tovar, Marco A; Huff, Doug; Montoya, Rosario; Lewis, James J; Gilman, Robert H; Evans, Carlton A

2015-08-21

Cash transfers are key interventions in the World Health Organisation's post-2015 global TB policy. However, evidence guiding TB-specific cash transfer implementation is limited. We designed, implemented and refined a novel TB-specific socioeconomic intervention that included cash transfers, which aimed to support TB prevention and cure in resource-constrained shantytowns in Lima, Peru for: the Community Randomized Evaluation of a Socioeconomic Intervention to Prevent TB (CRESIPT) project. Newly-diagnosed TB patients from study-site healthposts were eligible to receive the intervention consisting of economic and social support. Economic support was provided to patient households through cash transfers on meeting the following conditions: screening for TB in household contacts and MDR TB in patients; adhering to TB treatment and chemoprophylaxis; and engaging with CRESIPT social support (household visits and community meetings). To evaluate project acceptability, quantitative and qualitative feedback was collected using a mixed-methods approach during formative activities. Formative activities included consultations, focus group discussions and questionnaires conducted with the project team, project participants, civil society and stakeholders. Over 7 months, 135 randomly-selected patients and their 647 household contacts were recruited from 32 impoverished shantytown communities. Of 1299 potential cash transfers, 964 (74 %) were achieved, 259 (19 %) were not achieved, and 76 (7 %) were yet to be achieved. Of those achieved, 885/964 (92 %) were achieved optimally and 79/964 (8 %) sub-optimally. Key project successes were identified during 135 formative activities and included: strong multi-sectorial collaboration; generation of new evidence for TB-specific cash transfer; and the project being perceived as patient-centred and empowering. Challenges included: participant confidence being eroded through cash transfer delays, hidden account-charges and stigma; access to the initial bank-provider being limited; and conditions requiring participation of all TB-affected household members (e.g. community meetings) being hard to achieve. Refinements were made to improve project acceptability and future impact: the initial bank-provider was changed; conditional and unconditional cash transfers were combined; cash transfer sums were increased to a locally-appropriate, evidence-based amount; and cash transfer size varied according to patient household size to maximally reduce mitigation of TB-related costs and be more responsive to household needs. A novel TB-specific socioeconomic intervention including conditional cash transfers has been designed, implemented, refined and is ready for impact assessment, including by the CRESIPT project. The lessons learnt during this research will inform policy-makers and decision-makers for future implementation of related interventions.

Improving academic self-efficacy, school connectedness, and identity in struggling middle school girls: a preliminary study of the REAL girls program.

PubMed

Mann, Michael J; Smith, Megan L; Kristjansson, Alfgeir L

2015-02-01

Girls struggling to be successful in middle school are often dealing with negative life experiences that affect their ability to achieve academically. Frequently, their academic failures and problem behaviors are associated with feeling overwhelmed by difficult and challenging life circumstances. In the absence of intervention, these patterns may contribute to girls chronically underperforming in school, dropping out of school, and becoming involved in delinquent and high-risk behaviors. This article describes a quasi-experimental, mixed-methods study of the REAL Girls program. REAL Girls was designed to help struggling middle school girls develop resilience--particularly academic self-efficacy, school connectedness, and identity--and achieve successful outcomes in school and life. In this study, using a crossover design, 48 girls identified as experiencing academic failure, school behavior problems, or truancy participated in one of two implementations of this 3-day intervention. Findings based on both quantitative and qualitative data suggest that REAL Girls contributed to positive increases in academic self-efficacy, school connectedness, and identity. Repeated measures analysis of variance and paired t tests suggest significant increases in each outcome variable, both immediately after program delivery and 2 weeks later, and effect size estimates suggest moderate to large program impact. Focus groups conducted 90 days after implementation of the program confirmed the quantitative findings and support the efficacy of the REAL Girls program and approach. © 2014 Society for Public Health Education.

Disease management in healthcare organizations: results of in-depth interviews with disease management decision makers.

PubMed

Whellan, David J; Cohen, Elizabeth J; Matchar, David B; Califf, Robert M

2002-07-01

Despite the widening use of disease management (DM) programs throughout the country, little is understood about the "state of DM" in healthcare systems and managed care organizations. To better characterize the range of users of DM in healthcare and to identify critical issues, both present and future, for DM. Qualitative survey. Forty-seven healthcare systems (n = 22) and managed care organizations (n = 25) were randomly selected. Decision makers were identified and interviewed between January 1, 2000, and March 31, 2000. We limited quantitative analysis to tabulations of suitable responses, without statistical testing. Responses were organized around 3 themes: models for DM, implementation strategies, and measurements of success. Of 47 decision makers surveyed, 42 (89%) reported that their organizations currently have (75%) or are working to develop (14%) DM programs. Although the goals of DM programs were similar, organizations took a variety of approaches to achieving these ends. There were typically 3 steps in implementing a DM program: analysis of patient data, external analysis, and organizational analysis. Decision makers believed that DM programs had only achieved partial success in reaching the 2 main goals of improved quality of care and cost savings. Given the variety of DM programs, there is a need to develop a classification scheme to allow for better comparison between programs. Further quantitative studies of decision makers' opinions would be helpful in developing programs and in designing necessary studies of patient management strategies.

Co-design of software and hardware to implement remote sensing algorithms

NASA Astrophysics Data System (ADS)

Theiler, James P.; Frigo, Janette R.; Gokhale, Maya; Szymanski, John J.

2002-01-01

Both for offline searches through large data archives and for onboard computation at the sensor head, there is a growing need for ever-more rapid processing of remote sensing data. For many algorithms of use in remote sensing, the bulk of the processing takes place in an ``inner loop'' with a large number of simple operations. For these algorithms, dramatic speedups can often be obtained with specialized hardware. The difficulty and expense of digital design continues to limit applicability of this approach, but the development of new design tools is making this approach more feasible, and some notable successes have been reported. On the other hand, it is often the case that processing can also be accelerated by adopting a more sophisticated algorithm design. Unfortunately, a more sophisticated algorithm is much harder to implement in hardware, so these approaches are often at odds with each other. With careful planning, however, it is sometimes possible to combine software and hardware design in such a way that each complements the other, and the final implementation achieves speedup that would not have been possible with a hardware-only or a software-only solution. We will in particular discuss the co-design of software and hardware to achieve substantial speedup of algorithms for multispectral image segmentation and for endmember identification.

The Implementation of Collaborative Learning Using AfL through Giving Feedback Strategy for Improving Students’ Attention to Mathematics Lesson

NASA Astrophysics Data System (ADS)

Kurniasih, R.; Sujadi, I.; Pramesti, G.

2016-02-01

This research aims to describe the process of implementation collaborative learning with AfL through giving feedback strategy for improving students’ attention to mathematics lesson. Data which is collected in this research are students’ attention towards learning and students’ achievement. The result of this research showed that the learning steps by using collaborative learning with AfL through giving feedback strategy which can improve students’ attention are: 1) pre activity: the teacher delivers the purpose of the learning, successful criteria, apperception, and motivation. 2) main activity: the teacher gives the background of learning activity, explains learning materials at a glance, divides students discuss, the teacher observes and guides students to the problem solving, present their discussion result, gives feedback, the students do AfL problem and the answer is collected and result will be given before next meeting. 3) post activity: the teacher with students concludes the material. Test result, the percentage of students who complete the examination in the second cycle is 77.27%. Based on those results can be concluded that the implementation of collaborative learning using AfL through giving feedback can improve students’ attention towards learning and students’ achievement of XI IPA Students MA Al-Islam Jamsaren Surakarta academic year 2013/2014.

Goal-setting to Promote a Healthier Lifestyle in Later Life: Qualitative Evaluation of the AgeWell Trial

PubMed Central

Nelis, Sharon M.; Thom, Jeanette M.; Jones, Ian Rees; Hindle, John V.

2018-01-01

ABSTRACT Objective: We report a mixed method evaluation of the feasibility and implementation of the AgeWell goal-setting intervention to promote healthy ageing later life. Method: Researcher field notes, goal-setting interview content, and semi-structured interviews with participants were content analysed to review trial implementation and participants’ perspective on the goal-setting and mentoring intervention. Results: 75 people were recruited: 21 in the goal-setting and 22 in the goal-setting with mentoring arms of the intervention. Goal-setting was feasible in the main domains of interest. Adherence to the protocol was good and the mentoring schedule was adhered to. Participants reported satisfaction with their goal attainment, but barriers for non-achievement were also identified. Recommendations for small changes to the intervention included reducing the number of goals. Conclusions: Participants understood the goal-setting process, and were able to set realistic and achievable lifestyle goals. The intervention and the procedures were acceptable but changes in how goal-setting is both introduced and monitored are needed for wider implementation. Clinical Implications: Goal-setting can be a useful process to help people alter their lifestyle to allow them to age more successfully and reduce risk factors associated with dementia. PMID:29308992

Measles control and elimination in Somalia: the good, the bad, and the ugly.

PubMed

Kamadjeu, Raoul; Assegid, Kebede; Naouri, Boubker; Mirza, Imran Raza; Hirsi, Abdurazak; Mohammed, Abdurahman; Omer, Mohammed; Dualle, Abdi Hassan; Mulugeta, Abraham

2011-07-01

Despite enormous challenges, Somalia has been successfully implementing accelerated measles control activities since 2005. Through innovative strategies and with the support of local and international partners, the country has shown potentials of implementing measles mortality reduction activities in complex emergencies. Measles incidence has been reduced by >80% after the measles catch-up campaigns of 2005-2007, and national reported measles routine immunization coverage with first dose measles containing vaccine has reached 59% for the first time in 2009. However, the near collapse of the health care system and the ongoing insecurity continue to hamper the implementation of recommended measles control and elimination strategies in some parts of the country, making these achievements fragile. Somalia exemplifies the challenges in meeting measles elimination goals in the World Health Organization Eastern Mediterranean region. As the region is entering its 2010 measles elimination goals, it appears necessary to establish realistic and flexible interim goals for measles control in Somalia that will take into consideration the specificities of the country. Maintaining flexibility in conducting field operations, securing financial resources, multiplying opportunities for measles vaccination, and improving disease monitoring systems will remain vital to sustain and improve current achievements. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

The state of municipal solid waste management in Israel.

PubMed

Daskal, Shira; Ayalon, Ofira; Shechter, Mordechai

2018-06-01

Regulation is a key tool for implementing municipal solid waste (MSW) management strategies and plans. While local authorities in Israel are responsible for the storage, collection, and disposal of MSW, Israel's Ministry of Environmental Protection (MoEP) is responsible for the formulation and implementation of waste management policies and legislation. For the past 12 years, about 80% of the MSW in Israel has been landfilled and recycling rates have not increased, despite regulations. This paper presents the state of MSW management in Israel in light of the MoEP's strategic goal of landfilling reduction, the regulations and legislation designed and implemented for achieving this goal, and the ensuing results. Among other things, the results indicate the importance of monitoring and assessing policy and regulations to examine whether regulation is in fact effective and whether it keeps track of its own targets and goals or not. It is also concluded that even when there is an extensive regulation that includes a wide range of laws, economic penalties and financial incentives (such as landfill levy and financing of MSW separation at source arrangements), this does not guarantee proper treatment or even an improvement in waste management. The key to success is first and foremost a suitable infrastructure that will enable achievement of the desired results.

Universal health insurance coverage for 1.3 billion people: What accounts for China's success?

PubMed

Yu, Hao

2015-09-01

China successfully achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history. While the achievement is widely recognized, it is still largely unexplored why China was able to attain it within a short period. This study aims to fill the gap. Through a systematic political and socio-economic analysis, it identifies seven major drivers for China's success, including (1) the SARS outbreak as a wake-up call, (2) strong public support for government intervention in health care, (3) renewed political commitment from top leaders, (4) heavy government subsidies, (5) fiscal capacity backed by China's economic power, (6) financial and political responsibilities delegated to local governments and (7) programmatic implementation strategy. Three of the factors seem to be unique to China (i.e., the SARS outbreak, the delegation, and the programmatic strategy.) while the other factors are commonly found in other countries' insurance expansion experiences. This study also discusses challenges and recommendations for China's health financing, such as reducing financial risk as an immediate task, equalizing benefit across insurance programs as a long-term goal, improving quality by tying provider payment to performance, and controlling costs through coordinated reform initiatives. Finally, it draws lessons for other developing countries. Copyright © 2015 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

Mission operations management

NASA Technical Reports Server (NTRS)

Rocco, David A.

1994-01-01

Redefining the approach and philosophy that operations management uses to define, develop, and implement space missions will be a central element in achieving high efficiency mission operations for the future. The goal of a cost effective space operations program cannot be realized if the attitudes and methodologies we currently employ to plan, develop, and manage space missions do not change. A management philosophy that is in synch with the environment in terms of budget, technology, and science objectives must be developed. Changing our basic perception of mission operations will require a shift in the way we view the mission. This requires a transition from current practices of viewing the mission as a unique end product, to a 'mission development concept' built on the visualization of the end-to-end mission. To achieve this change we must define realistic mission success criteria and develop pragmatic approaches to achieve our goals. Custom mission development for all but the largest and most unique programs is not practical in the current budget environment, and we simply do not have the resources to implement all of our planned science programs. We need to shift our management focus to allow us the opportunity make use of methodologies and approaches which are based on common building blocks that can be utilized in the space, ground, and mission unique segments of all missions.

Hospital admission avoidance through the introduction of a virtual ward.

PubMed

Jones, Joanne; Carroll, Andrea

2014-07-01

The ageing British population is placing increased demands on the delivery of care in mainstream health-care institutions. While people are living longer, a significant percentage is also living with one or more long-term conditions. These issues, alongside continuing financial austerity measures, require a radical improvement in the care of patients away from hospitals. The Wyre Forest Clinical Commissioning Group introduced a virtual ward model for two main purposes: to save on spiralling costs of hospital admissions, and, secondly, to ensure the preferred wishes of most patients to be cared for and even die at home were achieved. This commentary describes how the virtual ward model was implemented and the impact of preventing unplanned emergency admissions to hospitals. The setting up of enhanced care services and virtual wards in one county is discussed, aiming to highlight success points and potential pitfalls to avoid. The results from the implementation of the virtual ward model show a significant reduction in emergency and avoidable patient admissions to hospital. The success of virtual wards is dependent on integrated working between different health-care disciplines.

Lessons learned in the deployment of a HIV counseling and testing management information system on a new project.

PubMed

Makinde, Olusesan A; Ezomike, Chioma F; Lehmann, Harold P; Ibanga, Iko J

2011-11-28

To share our experience on how we used simple but detailed processes and deployed a management information system on a new HIV counseling and testing (HCT) project in Nigeria. The procedures used in this study were adopted for their strength in identifying areas of continuous improvement as the project was implemented. We used an iterative brainstorming technique among 30 participants (volunteer counselors and project management staff) as well as iterative quality audits to identify several limitations to the success of the project and to propose solutions. We then implemented the solutions and reevaluated for performance. Findings from the evaluations were then reintroduced into the brainstorming and planning sessions. Several limitations were identified with the most prominent being the poor documentation of records at the site and the lack of a document transfer trail for audit purposes. Communication, cohesion and team focus are necessary to achieve success on any new project. Institutionalizing routine HIV behavioral surveillance using data collected at HCT will help in streamlining interventions that will be evidence-based. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Creating and Supporting a Mixed Methods Health Services Research Team

PubMed Central

Bowers, Barbara; Cohen, Lauren W; Elliot, Amy E; Grabowski, David C; Fishman, Nancy W; Sharkey, Siobhan S; Zimmerman, Sheryl; Horn, Susan D; Kemper, Peter

2013-01-01

Objective. To use the experience from a health services research evaluation to provide guidance in team development for mixed methods research. Methods. The Research Initiative Valuing Eldercare (THRIVE) team was organized by the Robert Wood Johnson Foundation to evaluate The Green House nursing home culture change program. This article describes the development of the research team and provides insights into how funders might engage with mixed methods research teams to maximize the value of the team. Results. Like many mixed methods collaborations, the THRIVE team consisted of researchers from diverse disciplines, embracing diverse methodologies, and operating under a framework of nonhierarchical, shared leadership that required new collaborations, engagement, and commitment in the context of finite resources. Strategies to overcome these potential obstacles and achieve success included implementation of a Coordinating Center, dedicated time for planning and collaborating across researchers and methodologies, funded support for in-person meetings, and creative optimization of resources. Conclusions. Challenges are inevitably present in the formation and operation of effective mixed methods research teams. However, funders and research teams can implement strategies to promote success. PMID:24138774

Creating and supporting a mixed methods health services research team.

PubMed

Bowers, Barbara; Cohen, Lauren W; Elliot, Amy E; Grabowski, David C; Fishman, Nancy W; Sharkey, Siobhan S; Zimmerman, Sheryl; Horn, Susan D; Kemper, Peter

2013-12-01

To use the experience from a health services research evaluation to provide guidance in team development for mixed methods research. The Research Initiative Valuing Eldercare (THRIVE) team was organized by the Robert Wood Johnson Foundation to evaluate The Green House nursing home culture change program. This article describes the development of the research team and provides insights into how funders might engage with mixed methods research teams to maximize the value of the team. Like many mixed methods collaborations, the THRIVE team consisted of researchers from diverse disciplines, embracing diverse methodologies, and operating under a framework of nonhierarchical, shared leadership that required new collaborations, engagement, and commitment in the context of finite resources. Strategies to overcome these potential obstacles and achieve success included implementation of a Coordinating Center, dedicated time for planning and collaborating across researchers and methodologies, funded support for in-person meetings, and creative optimization of resources. Challenges are inevitably present in the formation and operation of effective mixed methods research teams. However, funders and research teams can implement strategies to promote success. © Health Research and Educational Trust.

A partnership model for implementing electronic health records in resource-limited primary care settings: experiences from two nurse-managed health centers

PubMed Central

Dennehy, Patricia; White, Mary P; Hamilton, Andrew; Pohl, Joanne M; Tanner, Clare; Onifade, Tiffiani J

2011-01-01

Objective To present a partnership-based and community-oriented approach designed to ease provider anxiety and facilitate the implementation of electronic health records (EHR) in resource-limited primary care settings. Materials and Methods The approach, referred to as partnership model, was developed and iteratively refined through the research team's previous work on implementing health information technology (HIT) in over 30 safety net practices. This paper uses two case studies to illustrate how the model was applied to help two nurse-managed health centers (NMHC), a particularly vulnerable primary care setting, implement EHR and get prepared to meet the meaningful use criteria. Results The strong focus of the model on continuous quality improvement led to eventual implementation success at both sites, despite difficulties encountered during the initial stages of the project. Discussion There has been a lack of research, particularly in resource-limited primary care settings, on strategies for abating provider anxiety and preparing them to manage complex changes associated with EHR uptake. The partnership model described in this paper may provide useful insights into the work shepherded by HIT regional extension centers dedicated to supporting resource-limited communities disproportionally affected by EHR adoption barriers. Conclusion NMHC, similar to other primary care settings, are often poorly resourced, understaffed, and lack the necessary expertise to deploy EHR and integrate its use into their day-to-day practice. This study demonstrates that implementation of EHR, a prerequisite to meaningful use, can be successfully achieved in this setting, and partnership efforts extending far beyond the initial software deployment stage may be the key. PMID:21828225

Why won't they listen: Negotiating the technological and social context for science teaching

NASA Astrophysics Data System (ADS)

Liuzzo, Anna M.

The purpose of this study was to gather information to identify the obstacles and the impact an implementation of technology had in a middle school science classroom. This study explored a teaching environment where the teacher planned on using a variety of technology tools including laptops, probeware, hardware and software to promote scientific study. This study took place in two phases consisting of three consecutive years. In phase one the teacher reported great success. In phase two a shift in the school implementation created a significant impact on the learning taking place. This study identified the obstacles faced by a teacher providing an environment that combined her pedagogy with technology implementation. This teacher's pedagogy included research-based practices such a authentic problem-based learning, scientific inquiry, conceptual understanding of problem solving, connections to real-life situations and the use of metacognition in her practice. This study looked to determined if this implementation had an effect on student engagement and achievement; how the nature of technical and professional development impacted the implementation; and the barriers that were faced in creating a student-centered, technology rich approach to science. This qualitative study was conducted meeting the criteria of a case study of one teacher. The participant teacher's accounts of events through interviews were the primary source of data. In addition, multiple sources of information were also gathered. These included the teacher's reflective journal, student interviews, student focus groups, student artifacts, classroom observations, field notes, e-mail correspondences and students' test scores. This study proposes to contribute to the growing research evidence of implementation in the classroom and to identify specific obstacles that hinder success. The current state of education is calling for reform.

Predictors of Success for Electronic Health Record Implementation in Small Physician Practices

PubMed Central

Ancker, J.S.; Singh, M.P.; Thomas, R.; Edwards, A.; Snyder, A.; Kashyap, A.; Kaushal, R.

2013-01-01

Background The federal government is promoting adoption of electronic health records (EHRs) through financial incentives for EHR use and implementation support provided by regional extension centers. Small practices have been slow to adopt EHRs. Objectives Our objective was to measure time to EHR implementation and identify factors associated with successful implementation in small practices receiving financial incentives and implementation support. This study is unique in exploiting quantitative implementation time data collected prospectively as part of routine project management. Methods This mixed-methods study includes interviews of key informants and a cohort study of 544 practices that had worked with the Primary Care Information Project (PCIP), a publicly funded organization that since 2007 has subsidized EHRs and provided implementation support similar to that supplied by the new regional extension centers. Data from a project management database were used for a cohort study to assess time to implementation and predictors of implementation success. Results Four hundred and thirty practices (79%) implemented EHRs within the analysis period, with a median project time of 24.7 weeks (95% CI: 23.3 – 26.4). Factors associated with implementation success were: fewer providers, practice sites, and patients; fewer Medicaid and uninsured patients; having previous experience with scheduling software; enrolling in 2010 rather than earlier; and selecting an integrated EHR plus practice management product rather than two products. Interviews identified positive attitude toward EHRs, resources, and centralized leadership as additional practice-level predictors of success. Conclusions A local initiative similar to current federal programs successfully implemented EHRs in primary care practices by offsetting software costs and providing implementation assistance. Nevertheless, implementation success was affected by practice size and other characteristics, suggesting that the federal programs can reduce barriers to EHR implementation but may not eliminate them. PMID:23650484

Comparison of Quality Engineering Practices in Malaysian and Indonesian Automotive Related Companies

NASA Astrophysics Data System (ADS)

Putri, Nilda Tri; Sha'ri Mohd, Yusof; Irianto, Dradjad

2016-02-01

The main motivating factor driving this research is to find differences between the automotive related companies in Malaysia and Indonesia with regard to quality engineering (QE) implementation. A comparative study between Malaysia and Indonesia provides the opportunity to gain perspective and thorough understanding of the similarities and differences on the critical factors for successful QE practices in the context of both these countries. Face to face interviews are used to compare the QE practices in two automotive companies in Malaysia and Indonesia, respectively. The findings of study showed that both countries have clear quality objectives to achieving zero defects in processes and products and total customer satisfaction. Top and middle management in both countries were found to be directly involved in quality improvement on the shop floor to provide On-The-Job training and actively encourage team members to perform quality problem solving through the formation of quality control circles (QCC) particularly in Indonesia automotive industry. In Malaysia automotive industry, the implementation was not fully effective, but they have started to cultivate those values in the daily execution. Based on the case study results and analysis, the researcher has provided suggestions for both countries as an improvement plan for successful QE implementation. These recommendations will allow management to implement appropriate strategies for better QE implementation which hopefully can improve company's performance and ultimately the making the automotive industry in both countries to reach world class quality. It is strongly believed that the findings of this study can help Malaysia and Indonesia automotive industries in their efforts to become more effective and competitive.

Case Study: Using Contemporary Behaviour Change Science to Design and Implement an Effective Nutritional Intervention within Professional Rugby League.

PubMed

Costello, Nessan; McKenna, Jim; Sutton, Louise; Deighton, Kevin; Jones, Ben

2018-01-18

Designing and implementing successful dietary intervention is integral to the role of sport nutrition professionals as they attempt to positively change the dietary behaviour of athletes. High-performance sport is a time-pressured environment where immediate results can often supersede pursuit of the most effective evidence-based practice. However, efficacious dietary intervention necessitates comprehensive, systematic and theoretical behavioural design and implementation if the habitual dietary behaviours of athletes are to be positively changed. Therefore, this case study demonstrates how the Behaviour Change Wheel was used to design and implement an effective nutritional intervention within professional rugby league. The eight-step intervention targeted athlete consumption of a high quality dietary intake of 25.1 MJ each day, to achieve an overall body mass increase of 5 kg across a twelve-week intervention period. The Capability, Opportunity, Motivation-Behaviour model and APEASE criteria were used to identify population-specific intervention functions, policy categories, behaviour change techniques and modes of intervention delivery. The resulting intervention was successful, increasing the average daily energy intake of the athlete to 24.5 MJ, which corresponded in a 6.2 kg body mass gain. Despite consuming 0.6 MJ less per day than targeted, secondary outcome measures of diet quality, strength, body composition and immune function all substantially improved, supporting a sufficient energy intake and the overall efficacy of a behavioural approach. Ultimately, the Behaviour Change Wheel provides sport nutrition professionals with an effective and practical step-wise method via which to design and implement effective nutritional interventions for use within high-performance sport.

Regional media coverage influences the public's negative attitudes to policy implementation success in Sweden.

PubMed

Fredriksson, Mio; Tiainen, Anne; Hanning, Marianne

2015-12-01

One central aspect of health literacy is knowledge of patients' rights. Being an important source of information about health and health care, the media may influence health literacy and act as a policy implementer. To investigate whether regional news media coverage in Sweden is linked to (i) the public's awareness and knowledge of a patient's rights policy, the waiting-time guarantee and (ii) the public's attitudes to how the guarantee's time limits are met, that is, implementation success. Three types of data are used. First, a national telephone survey of the public's awareness, knowledge and attitudes; second, media coverage information from digital media monitoring; and third, official waiting-time statistics. Bivariate and multivariate regression analyses are performed with the 21 Swedish county councils/regions as a base. In the county councils/regions, non-awareness ranged from 1 to 15% and knowledge from 47 to 67%. There are relatively large differences between population groups. The amount of regional media coverage shows no significant correlation to the level of awareness and knowledge. There is, however, a significant correlation to both positive and negative attitudes; the latter remains after controlling for actual waiting times. At the national level, the media function as a policy implementer, being the primary source of information. At the regional level, the media are part of the political communication, reporting more extensively in county councils/regions where the population holds negative views towards the achievement in implementing the guarantee. We conclude that Swedish authorities should develop its communication strategies to bridge health literacy inequalities. © 2014 John Wiley & Sons Ltd.

A Technology-Mediated Approach to the Implementation of an Evidence-Based Child Maltreatment Prevention Program.

PubMed

Self-Brown, Shannon R; C Osborne, Melissa; Rostad, Whitney; Feil, Ed

2017-11-01

Implementation of evidence-based parenting programs is critical for parents at-risk for child maltreatment perpetration; however, widespread use of effective programs is limited in both child welfare and prevention settings. This exploratory study sought to examine whether a technology-mediated approach to SafeCare ® delivery can feasibly assist newly trained providers in achieving successful implementation outcomes. Thirty-one providers working in child welfare or high-risk prevention settings were randomized to either SafeCare Implementation with Technology-Assistance (SC-TA) or SafeCare Implementation as Usual (SC-IU). SC-TA providers used a web-based program during session that provided video-based psychoeducation and modeling directly to parents and overall session guidance to providers. Implementation outcome data were collected from providers for six months. Data strongly supported the feasibility of SC-TA. Further, data indicated that SC-TA providers spent significantly less time on several activities in preparation, during, and in follow-up to SafeCare sessions compared to SC-IU providers. No differences were found between the groups with regard to SafeCare fidelity and certification status. Findings suggest that technology can augment implementation by reducing the time and training burden associated with implementing new evidence-based practices for at-risk families.

Surviving the Implementation of a New Science Curriculum

NASA Astrophysics Data System (ADS)

Lowe, Beverly; Appleton, Ken

2015-12-01

Queensland schools are currently teaching with the first National Curriculum for Australia. This new curriculum was one of a number of political responses to address the recurring low scores in literacy, mathematics, and science that continue to hold Australia in poor international rankings. Teachers have spent 2 years getting to know the new science curriculum through meetings, training, and exploring the new Australian curriculum documents. This article examines the support and preparation for implementation provided in two regional schools, with a closer look at six specific teachers and their science teaching practices as they attempted to implement the new science curriculum. The use of a survey, field observations, and interviews revealed the schools' preparation practices and the teachers' practices, including the support provided to implement the new science curriculum. A description and analysis of school support and preparation as well as teachers' views of their experiences implementing the new science curriculum reveal both achievements and shortcomings. Problematic issues for the two schools and teachers include time to read and comprehend the curriculum documents and content expectations as well as time to train and change the current processes effectively. The case teachers' experiences reveal implications for the successful and effective implementation of new curriculum and curriculum reform.

Understanding BIM Adoption in the AEC Industry: The Case of Jordan

NASA Astrophysics Data System (ADS)

Btoush, M.; Haron, AT

2017-11-01

Building information modelling (BIM) is a new and powerful technology implemented by many countries. The construction industry in Jordan plays a vital role and contributes immensely to the economic growth and development. In order to boost the industry and the economy, many industry players including engineers and contractors have recommended the implementation of BIM in Jordan. However, research demonstrates that successful BIM implementation is possible through the awareness of the different levels of BIM, which is a basic precondition for BIM implementation. Without a clear understanding of BIM, many companies would be unable to fully achieve BIM potentials or implement BIM in their building lifecycle. The objective of this study is to assess the current awareness of BIM technology in the Jordanian construction industry. A field interviews were conducted and 15 responses were collected and. The findings indicate that a significant proportion of respondents have little or no understanding of the concept of BIM. Also, the usage was found to be very low. Based on the results, a holistic roadmap was developed to spread the BIM adoption through the Jordanian construction industry. It is expected that this roadmap would lead to a better understanding and enable the industry towards more extensive implementation of BIM.

Diabetes mellitus disease management in a safety net hospital system: translating evidence into practice.

PubMed

Butler, Michael K; Kaiser, Michael; Johnson, Jolene; Besse, Jay; Horswell, Ronald

2010-12-01

The Louisiana State University Health Care Services Division system assessed the effectiveness of implementing a multisite disease management program targeting diabetes mellitus in an indigent patient population. A population-based disease management program centered on evidence-based clinical care guidelines was applied from the system level. Specific clinic modifications and models were used, as well as ancillary services such as medication assistance and equipment subsidies. Marked improvement in process goals led to improved clinical outcomes. From 2001 to 2008, the percentage of patients with a hemoglobin A1c < 7.0 increased from 45% to 55% on the system level, with some sites experiencing a more dramatic shift. Results were similar across sites, which included both small provider groups and academic health centers. In order to achieve these results, the clinical environment changed to promote those evidence-based interventions. Even in complex environments such as academic health centers with several provider levels, or those environments with limited care resources, disease management programs can be successfully implemented and achieve statistically significant results.

Capacities for the Risk Assessment of GMOs: Challenges to Build Sustainable Systems.

PubMed

Fernández Ríos, Danilo; Rubinstein, Clara; Vicién, Carmen

2018-01-01

The need for functional risk assessment bodies in general, and in the biosafety field in particular, demands continued efforts and commitment from regulatory agencies, if results that are sustainable in time are to be achieved. The lack of formal processes that ensure continuity in the application of state of the art scientific criteria, the high rotation in some cases or the lack of experienced professionals, in others, is a challenge to be addressed. Capacity building initiatives with different approaches and degrees of success have been implemented in many countries over the years, supported by diverse governmental and non-governmental organizations. This document summarizes some capacity building experiences in developing countries and concludes that risk assessors taking ownership and regulatory authorities fully committed to developing and retaining highly qualified bodies are a sine qua non to achieve sustainable systems. To this end, it is essential to implement "in-house" continuing education mechanisms supported by external experts and organizations, and inter-institutional cooperation. It has to be noted that these recommendations could only be realized if policy makers understand and appreciate the value of professional, independent regulatory bodies.

Implementation of algebraic stress models in a general 3-D Navier-Stokes method (PAB3D)

NASA Technical Reports Server (NTRS)

Abdol-Hamid, Khaled S.

1995-01-01

A three-dimensional multiblock Navier-Stokes code, PAB3D, which was developed for propulsion integration and general aerodynamic analysis, has been used extensively by NASA Langley and other organizations to perform both internal (exhaust) and external flow analysis of complex aircraft configurations. This code was designed to solve the simplified Reynolds Averaged Navier-Stokes equations. A two-equation k-epsilon turbulence model has been used with considerable success, especially for attached flows. Accurate predicting of transonic shock wave location and pressure recovery in separated flow regions has been more difficult. Two algebraic Reynolds stress models (ASM) have been recently implemented in the code that greatly improved the code's ability to predict these difficult flow conditions. Good agreement with Direct Numerical Simulation (DNS) for a subsonic flat plate was achieved with ASM's developed by Shih, Zhu, and Lumley and Gatski and Speziale. Good predictions were also achieved at subsonic and transonic Mach numbers for shock location and trailing edge boattail pressure recovery on a single-engine afterbody/nozzle model.

Multifamily Group Psychoeducation in New York State: Implementation and Fidelity Outcomes.

PubMed

Kealey, Edith M; Leckman-Westin, Emily; Jewell, Thomas C; Finnerty, Molly T

2015-11-01

The study examined implementation outcomes from a large state initiative to support dissemination of multifamily group (MFG) psychoeducation in outpatient mental health settings. Thirty-one sites participated in the project. Baseline training in the MFG model was followed by monthly expert consultation delivered in either a group (16 sites) or individual format (15 sites). Research staff assessed fidelity to the MFG model by telephone at baseline and 12, 18, and 24 months and documented time to completion of three key milestones: holding a family joining session, a family educational workshop, and an MFG meeting. Intent-to-train analyses found that 12 sites (39%) achieved high fidelity to the MFG model, and 20 (65%) achieved moderate or high fidelity. Mean scores on the Family Psychoeducation Fidelity Assessment Scale increased over time. Twenty-five sites (81%) conducted at least one joining session, and 20 (65%) conducted at least one MFG. Mean±SD time from baseline to the first group was 11.75±4.78 months. Programs that held the first joining session within four to 12 months after training were significantly more likely than programs that did not to conduct a group (p<.05). No significant differences were found by consultation format. Implementation of moderate- to high-fidelity MFG programs in routine outpatient mental health settings is feasible. Sites that moved very quickly or very slowly in early implementation stages were less likely to be successful in conducting an MFG. More research on the efficiency and effectiveness of consultation formats is needed to guide future implementation efforts.

Achieving the national health objective for influenza immunization: success of an institution-wide vaccination program.

PubMed

Nichol, K L; Korn, J E; Margolis, K L; Poland, G A; Petzel, R A; Lofgren, R P

1990-08-01

To enhance influenza vaccination rates for high-risk outpatients at the Department of Veterans Affairs Medical Center (VAMC) in Minneapolis, Minnesota, an institution-wide immunization program was implemented during 1987. The program consisted of: (1) a hospital policy allowing nurses to vaccinate without a signed physician's order; (2) stamped reminders on all clinic progress notes; (3) a 2-week walk-in flu shot clinic; (4) influenza vaccination "stations" in the busiest clinic areas; and (5) a mailing to all outpatients. Risk characteristics and vaccination rates for patients were estimated from a validated self-administered postcard questionnaire mailed to 500 randomly selected outpatients. For comparison, 500 patients were surveyed from each of three other Midwestern VAMCs without similar programs. Overall, 70.6% of Minneapolis patients were high-risk and 58.3% of them were vaccinated. In contrast, 69.9% of patients at the comparison medical centers were high-risk, but only 29.9% of them were vaccinated. The Minneapolis VAMC influenza vaccination program was highly successful and may serve as a useful model for achieving the national health objective for influenza immunization.

Critical success factor (CSF) service delivery for tahfiz institution teaching & learning environment

NASA Astrophysics Data System (ADS)

Ridza, B. H.; Jalil, R. A.; Sipan, I.; Nukman, Y.

2017-11-01

The exceptional existence of tahfiz institutions (TI) by a government and the private sector in Malaysia indicates that tahfiz education at par to fill mainstream education. Nevertheless, the level of TI facilities management (FM) provided is unstandardized since its infrastructure and establishment is initiated by the varied background of TI organizer. Thus, the effectiveness of TI education system is immeasurable. The significance of this research is to explore the critical success factor (CSF) of service delivery for TI teaching and learning environment. This research adopts both qualitative and quantitative method through survey instrument in order to review and analyze to achieve the research goal. The findings showed several important criteria for a transformation of TI education teaching and learning environment such top management of TI needs to be more responsible in providing better FM practice to achieve efficiency of manpower in providing a conducive learning environment for students for producing excellent huffaz. Thus, TI education system needs to have clear standard guidelines in operating their activities in producing huffaz that capable implement Islamic knowledge to the development of the country.

Barriers to Implementing the Response to Intervention Framework in Secondary Schools: Interviews with Secondary Principals

ERIC Educational Resources Information Center

Bartholomew, Mitch; De Jong, David

2017-01-01

Despite the successful implementation of the Response to Intervention (RtI) framework in many elementary schools, there is little evidence of successful implementation in high school settings. Several themes emerged from the interviews of nine secondary principals, including a lack of knowledge and training for successful implementation, the…

Improving the Nuclear Reform Implementation for Success

DTIC Science & Technology

2016-09-15

IMPROVING THE NUCLEAR REFORM IMPLEMENTATION FOR SUCCESS GRADUATE RESEARCH PAPER Allen Y. Agnes...United States. AFIT-ENS-MS-16-S-023 IMPROVING THE NUCLEAR REFORM IMPLMENTATION FOR SUCCESS GRADUATE RESEARCH PAPER Presented to the...AFIT-ENS-MS-16-S-023 IMPROVING THE NUCLEAR REFORM IMPLEMENTATION FOR SUCCESS Allen Y. Agnes, BS, MS Major, USAF

How Should I Study for the Exam? Self-Regulated Learning Strategies and Achievement in Introductory Biology.

PubMed

Sebesta, Amanda J; Bray Speth, Elena

2017-01-01

In college introductory science courses, students are challenged with mastering large amounts of disciplinary content while developing as autonomous and effective learners. Self-regulated learning (SRL) is the process of setting learning goals, monitoring progress toward them, and applying appropriate study strategies. SRL characterizes successful, "expert" learners, and develops with time and practice. In a large, undergraduate introductory biology course, we investigated: 1) what SRL strategies students reported using the most when studying for exams, 2) which strategies were associated with higher achievement and with grade improvement on exams, and 3) what study approaches students proposed to use for future exams. Higher-achieving students, and students whose exam grades improved in the first half of the semester, reported using specific cognitive and metacognitive strategies significantly more frequently than their lower-achieving peers. Lower-achieving students more frequently reported that they did not implement their planned strategies or, if they did, still did not improve their outcomes. These results suggest that many students entering introductory biology have limited knowledge of SRL strategies and/or limited ability to implement them, which can impact their achievement. Course-specific interventions that promote SRL development should be considered as integral pedagogical tools, aimed at fostering development of students' lifelong learning skills. © 2017 A. J. Sebesta and E. Bray Speth. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Six steps to a successful dose-reduction strategy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bennett, M.

1995-03-01

The increased importance of demonstrating achievement of the ALARA principle has helped produce a proliferation of dose-reduction ideas. Across a company there may be many dose-reduction items being pursued in a variety of areas. However, companies have a limited amount of resource and, therefore, to ensure funding is directed to those items which will produce the most benefit and that all areas apply a common policy, requires the presence of a dose-reduction strategy. Six steps were identified in formulating the dose-reduction strategy for Rolls-Royce and Associates (RRA): (1) collating the ideas; (2) quantitatively evaluating them on a common basis; (3)more » prioritizing the ideas in terms of cost benefit, (4) implementation of the highest priority items; (5) monitoring their success; (6) periodically reviewing the strategy. Inherent in producing the dose-reduction strategy has been a comprehensive dose database and the RRA-developed dose management computer code DOMAIN, which allows prediction of dose rates and dose. The database enabled high task dose items to be identified, assisted in evaluating dose benefits, and monitored dose trends once items had been implemented. The DOMAIN code was used both in quantifying some of the project dose benefits and its results, such as dose contours, used in some of the dose-reduction items themselves. In all, over fifty dose-reduction items were evaluated in the strategy process and the items which will give greatest benefit are being implemented. The strategy has been successful in giving renewed impetus and direction to dose-reduction management.« less

Barriers to the implementation of the SAFE strategy to combat hyperendemic trachoma in Australia.

PubMed

Wright, Heathcote R; Keeffe, Jill E; Taylor, Hugh R

2010-12-01

Australia is the only developed country in the world that still has endemic levels of blinding trachoma. The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy is an effective public health intervention that has been successfully used to eliminate blinding trachoma in some of the poorest countries of the world. Yet the SAFE strategy has not been systematically implemented in Australia. We undertook semi-structured interviews to identify some of barriers to the implementation of the SAFE strategy within remote indigenous communities of Australia. Health care professionals who were responsible for delivering trachoma control programs throughout the Northern Territory were asked to participate in a semi-structured interview. Quantitative analysis was performed using an existing strategic management framework. Fourteen individuals were interviewed. Responses were grouped into 19 categories; 12 from the existing strategic management framework and 7 additional categories that were created for ideas unique to the trachoma control program in Australia. A number of key themes emerged from the interview and are presented in a literary style. From these key themes critical success factors for the implementation of a sustainable trachoma control program were identified. With the election of the Rudd government there has been a renewed interest in "closing the gap" between the health of indigenous and non-indigenous Australians. A federal government funding package of $58 million over four years has just been announced to tackle trachoma. It is hoped that the findings of this research can assist in making sure that money achieves its goal.

Implementation of an Inpatient Pediatric Sepsis Identification Pathway.

PubMed

Bradshaw, Chanda; Goodman, Ilyssa; Rosenberg, Rebecca; Bandera, Christopher; Fierman, Arthur; Rudy, Bret

2016-03-01

Early identification and treatment of severe sepsis and septic shock improves outcomes. We sought to identify and evaluate children with possible sepsis on a pediatric medical/surgical unit through successful implementation of a sepsis identification pathway. The sepsis identification pathway, a vital sign screen and subsequent physician evaluation, was implemented in October 2013. Quality improvement interventions were used to improve physician and nursing adherence with the pathway. We reviewed charts of patients with positive screens on a monthly basis to assess for nursing recognition/physician notification, physician evaluation for sepsis, and subsequent physician diagnosis of sepsis and severe sepsis/septic shock. Adherence data were analyzed on a run chart and statistical process control p-chart. Nursing and physician pathway adherence of >80% was achieved over a 6-month period and sustained for the following 6 months. The direction of improvements met standard criteria for special causes. Over a 1-year period, there were 963 admissions to the unit. Positive screens occurred in 161 (16.7%) of these admissions and 38 (23.5%) of these had a physician diagnosis of sepsis, severe sepsis, or septic shock. One patient with neutropenia and septic shock had a negative sepsis screen due to lack of initial fever. Using quality improvement methodology, we successfully implemented a sepsis identification pathway on our pediatric unit. The pathway provided a standardized process to identify and evaluate children with possible sepsis requiring timely evaluation and treatment. Copyright © 2016 by the American Academy of Pediatrics.

Achievement orientation and fear of success in Asian American college students.

PubMed

Lew, A S; Allen, R; Papouchis, N; Ritzler, B

1998-01-01

One hundred eighty-five Asian American undergraduates participated in a study designed to examine the relationships among gender, acculturation, achievement orientation, and fear of academic success. Acculturation was modestly correlated with achievement orientation. Endorsement of Asian and Anglo values were significantly related to individual-oriented achievement. Marginal significance, however, was obtained for endorsement of Asian values and beliefs to social-oriented achievement. These findings suggest that persons with a bicultural identity tend to adopt a multifaceted achievement style. Achievement orientation, in turn, predicted fear of academic success, with gender and perceived discrepancies from parental achievement values contributing minimal additional variance. Social-oriented achievement was related to high fear of academic success, whereas an individualistic orientation buffered against such conflicts.

Service management at CERN with Service-Now

NASA Astrophysics Data System (ADS)

Toteva, Z.; Alvarez Alonso, R.; Alvarez Granda, E.; Cheimariou, M.-E.; Fedorko, I.; Hefferman, J.; Lemaitre, S.; Clavo, D. Martin; Martinez Pedreira, P.; Pera Mira, O.

2012-12-01

The Information Technology (IT) and the General Services (GS) departments at CERN have decided to combine their extensive experience in support for IT and non-IT services towards a common goal - to bring the services closer to the end user based on Information Technology Infrastructure Library (ITIL) best practice. The collaborative efforts have so far produced definitions for the incident and the request fulfilment processes which are based on a unique two-dimensional service catalogue that combines both the user and the support team views of all services. After an extensive evaluation of the available industrial solutions, Service-now was selected as the tool to implement the CERN Service-Management processes. The initial release of the tool provided an attractive web portal for the users and successfully implemented two basic ITIL processes; the incident management and the request fulfilment processes. It also integrated with the CERN personnel databases and the LHC GRID ticketing system. Subsequent releases continued to integrate with other third-party tools like the facility management systems of CERN as well as to implement new processes such as change management. Independently from those new development activities it was decided to simplify the request fulfilment process in order to achieve easier acceptance by the CERN user community. We believe that due to the high modularity of the Service-now tool, the parallel design of ITIL processes e.g., event management and non-ITIL processes, e.g., computer centre hardware management, will be easily achieved. This presentation will describe the experience that we have acquired and the techniques that were followed to achieve the CERN customization of the Service-Now tool.

Effectiveness and acceptance of a health care-based mandatory vaccination program.

PubMed

Leibu, Rachel; Maslow, Joel

2015-01-01

To decrease the risk of transmission of hospital-associated transmission of influenza and pertussis through mandatory vaccination of staff. A mandatory influenza and toxoid-diphtheria toxoid-acellular pertussis program was implemented systemwide. A structured vaccine exemption program was implemented for those requesting a medical and/or religious/moral/ethical exemption. Systemwide influenza vaccination rates increased from 67% historically, 76.2% in the 2012 to 2013 influenza season, to 94.7% in 2013 to 2014 with an overall compliance rate of 97.8%. Toxoid-diphtheria toxoid-acellular pertussis vaccination rates systemwide reached 94.9%, with an overall compliance rate of 98%. Higher rates were experienced at individual hospital facilities compared with the corporate location. Successful vaccination campaign outcomes can be achieved through diligent enforcement of mandatory vaccination, masking, and other infection prevention procedures.

Health information technology needs help from primary care researchers.

PubMed

Krist, Alex H; Green, Lee A; Phillips, Robert L; Beasley, John W; DeVoe, Jennifer E; Klinkman, Michael S; Hughes, John; Puro, Jon; Fox, Chester H; Burdick, Tim

2015-01-01

While health information technology (HIT) efforts are beginning to yield measurable clinical benefits, more is needed to meet the needs of patients and clinicians. Primary care researchers are uniquely positioned to inform the evidence-based design and use of technology. Research strategies to ensure success include engaging patient and clinician stakeholders, working with existing practice-based research networks, and using established methods from other fields such as human factors engineering and implementation science. Policies are needed to help support primary care researchers in evaluating and implementing HIT into everyday practice, including expanded research funding, strengthened partnerships with vendors, open access to information systems, and support for the Primary Care Extension Program. Through these efforts, the goal of improved outcomes through HIT can be achieved. © Copyright 2015 by the American Board of Family Medicine.

Strong tobacco control program requirements and secure funding are not enough: lessons from Florida.

PubMed

Kennedy, Allison; Sullivan, Sarah; Hendlin, Yogi; Barnes, Richard; Glantz, Stanton

2012-05-01

Florida's Tobacco Pilot Program (TPP; 1998-2003), with its edgy Truth media campaign, achieved unprecedented youth smoking reductions and became a model for tobacco control programming. In 2006, 3 years after the TPP was defunded, public health groups restored funding for tobacco control programming by convincing Florida voters to amend their constitution. Despite the new program's strong legal structure, Governor Charlie Crist's Department of Health implemented a low-impact program. Although they secured the program's strong structure and funding, Florida's nongovernmental public health organizations did not mobilize to demand a high-impact program. Implementation of Florida's Amendment 4 demonstrates that a strong programmatic structure and secure funding are insufficient to ensure a successful public health program, without external pressure from nongovernmental groups.

Automated subsystems control development. [for life support systems of space station

NASA Technical Reports Server (NTRS)

Block, R. F.; Heppner, D. B.; Samonski, F. H., Jr.; Lance, N., Jr.

1985-01-01

NASA has the objective to launch a Space Station in the 1990s. It has been found that the success of the Space Station engineering development, the achievement of initial operational capability (IOC), and the operation of a productive Space Station will depend heavily on the implementation of an effective automation and control approach. For the development of technology needed to implement the required automation and control function, a contract entitled 'Automated Subsystems Control for Life Support Systems' (ASCLSS) was awarded to two American companies. The present paper provides a description of the ASCLSS program. Attention is given to an automation and control architecture study, a generic automation and control approach for hardware demonstration, a standard software approach, application of Air Revitalization Group (ARG) process simulators, and a generic man-machine interface.

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

PubMed Central

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-01-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

History and utility of zeolite framework-type discovery from a data-science perspective

DOE PAGES

Zimmermann, Nils E. R.; Haranczyk, Maciej

2016-05-02

Mature applications such as fluid catalytic cracking and hydrocracking rely critically on early zeolite structures. With a data-driven approach, we find that the discovery of exceptional zeolite framework types around the new millennium was spurred by exciting new utilization routes. The promising processes have yet not been successfully implemented (“valley of death” effect), mainly because of the lack of thermal stability of the crystals. As a result, this foreshadows limited deployability of recent zeolite discoveries that were achieved by novel crystal synthesis routes.

Customizing FP-growth algorithm to parallel mining with Charm++ library

NASA Astrophysics Data System (ADS)

Puścian, Marek

2017-08-01

This paper presents a frequent item mining algorithm that was customized to handle growing data repositories. The proposed solution applies Master Slave scheme to frequent pattern growth technique. Efficient utilization of available computation units is achieved by dynamic reallocation of tasks. Conditional frequent trees are assigned to parallel workers basing on their workload. Proposed enhancements have been successfully implemented using Charm++ library. This paper discusses results of the performance of parallelized FP-growth algorithm against different datasets. The approach has been illustrated with many experiments and measurements performed using multiprocessor and multithreaded computer.

Quantum neuromorphic hardware for quantum artificial intelligence

NASA Astrophysics Data System (ADS)

Prati, Enrico

2017-08-01

The development of machine learning methods based on deep learning boosted the field of artificial intelligence towards unprecedented achievements and application in several fields. Such prominent results were made in parallel with the first successful demonstrations of fault tolerant hardware for quantum information processing. To which extent deep learning can take advantage of the existence of a hardware based on qubits behaving as a universal quantum computer is an open question under investigation. Here I review the convergence between the two fields towards implementation of advanced quantum algorithms, including quantum deep learning.

3D Cones Acquisition of Human Extremity Imaging Using a 1.5T Superconducting Magnet and an Unshielded Gradient Coil Set.

PubMed

Setoi, Ayana; Kose, Katsumi

2018-05-16

We developed ultrashort echo-time (UTE) imaging sequences with 3D Cones trajectories for a home-built compact MRI system using a 1.5T superconducting magnet and an unshielded gradient coil set. We achieved less than 7 min imaging time and obtained clear in vivo images of a human forearm with a TE of 0.4 ms. We concluded that UTE imaging using 3D Cones acquisition was successfully implemented in our 1.5T MRI system.

Developing a strategic human resources plan for the Urban Angel.

PubMed

Owen, Susan M

2011-01-01

In healthcare a significant portion of the budget is related to human resources. However, many healthcare organizations have yet to develop and implement a focused organizational strategy that ensures all human resources are managed in a way that best supports the successful achievement of corporate strategies. St. Michael's Hospital, in Toronto, Ontario, recognized the benefits of a strategic human resources management plan. During an eight-month planning process, St. Michael's Hospital undertook the planning for and development of a strategic human resources management plan. Key learnings are outlined in this paper.

Fourier optics along a hybrid optical fiber for Bessel-like beam generation and its applications in multiple-particle trapping.

PubMed

Kim, Jongki; Jeong, Yoonseob; Lee, Sejin; Ha, Woosung; Shin, Jeon-Soo; Oh, Kyunghwan

2012-02-15

Highly efficient Bessel-like beam generation was achieved based on a new all-fiber method that implements Fourier transformation of a micro annular aperture along a concatenated composite optical fiber. The beam showed unique characteristics of tilted washboard optical potential in the transverse plane and sustained a nondiffracting length over 400 μm along the axial direction. Optical trapping of multiple dielectric particles and living Jurkat cells were successfully demonstrated along the axial direction of the beam in the water.

Sinogram-based adaptive iterative reconstruction for sparse view x-ray computed tomography

NASA Astrophysics Data System (ADS)

Trinca, D.; Zhong, Y.; Wang, Y.-Z.; Mamyrbayev, T.; Libin, E.

2016-10-01

With the availability of more powerful computing processors, iterative reconstruction algorithms have recently been successfully implemented as an approach to achieving significant dose reduction in X-ray CT. In this paper, we propose an adaptive iterative reconstruction algorithm for X-ray CT, that is shown to provide results comparable to those obtained by proprietary algorithms, both in terms of reconstruction accuracy and execution time. The proposed algorithm is thus provided for free to the scientific community, for regular use, and for possible further optimization.

Teacher education professionals as partners in health science outreach.

PubMed

Houtz, Lynne E; Kosoko-Lasaki, Omofolasade; Zardetto-Smith, Andrea M; Mu, Keli; Royeen, Charlotte B

2004-01-01

Medical school and other health science outreach programs to educate and recruit precollege students always have relied on successful collaborative efforts. Creighton University shares the value, significance, and strategies of involving teacher education professionals in several of its current outreach programs, including HPPI, Brains Rule! Neuroscience Expositions, and HHMI Build a Human Project. The education department partner serves as an essential team member in the development, implementation, assessment, and dissemination of these projects to promote science and mathematics achievement and interest in medical careers. Specific examples and mistakes to avoid are included.

Assessment of cortical auditory evoked potentials in children with specific language impairment.

PubMed

Włodarczyk, Elżbieta; Szkiełkowska, Agata; Pilka, Adam; Skarżyński, Henryk

2018-02-28

The proper course of speech development heavily influences the cognitive and personal development of children. It is a condition for achieving preschool and school successes - it facilitates socializing and expressing feelings and needs. Impairment of language and its development in children represents a major diagnostic and therapeutic challenge for physicians and therapists. Early diagnosis of coexisting deficits and starting the therapy influence the therapeutic success. One of the basic diagnostic tests for children suffering from specific language impairment (SLI) is audiometry, thus far referred to as a hearing test. Auditory processing is just as important as a proper hearing threshold. Therefore, diagnosis of central auditory disorder may be a valuable supplementation of diagnosis of language impairment. Early diagnosis and implementation of appropriate treatment may contribute to an effective language therapy.

Financing Energy Upgrades for K-12 School Districts: A Guide to Tapping into Funding for Energy Efficiency and Renewable Energy Improvements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goggio Borgeson, Merrian; Zimring, Mark

This guide focuses on clean energy financing options for school administrators, facility managers, and other K-12 school decision makers who are considering investments in high performance school projects. This guide explicitly focuses on comprehensive energy upgrades, those that involve multiple measures and are targeted toward achieving significant energy savings. Successful implementation of clean energy upgrades in schools is a matter of understanding the opportunity, making the commitment, and creatively tapping into available financing. This guide attempts to provide the foundation needed for successful projects in U.S. schools. It walks through the financing options available to K-12 schools and provides casemore » studies of six school districts from around the country.« less