The dynamic of tuberculosis case finding in the era of the public–private mix strategy for tuberculosis control in Central Java, Indonesia

PubMed Central

Reviono, Reviono; Setianingsih, Wahyu; Damayanti, Kusmadewi Eka; Ekasari, Ratna

2017-01-01

ABSTRACT Background: The public–private mix (PPM) strategy has strengthened tuberculosis care and control in many countries. Indonesia, a country with a high tuberculosis burden, has a low tuberculosis case detection rate (CDR), despite PPM implementation in 2003. The PPM in Indonesia involves primary healthcare centers, hospitals, and specialized chest clinics. The long-term impact of the strategy is unknown. Objective: We aimed to explore the case detection achievements of the tuberculosis program since PPM implementation in Central Java in 2003. Methods: This retrospective cohort study covered the period 1 January 2000 to 31 December 2014. The data from tuberculosis patients treated in all health facilities in Central Java implementing directly observed treatment short-course, recorded via a standardized form, were analyzed after being validated by the Office of Health of Central Java Province. We evaluated the CDR, case notification rate, and total number of cases, using linear regression to analyze the temporal trends of those indicators in the phases of PPM implementation. Results: The CDR increased during the initial phase (2000–2005), decreased during the mid-phase (2006–2009), and increased slightly during the late phase (2010–2014), ranging from 13 to 61.72. These trends were observed despite a steady increase in the number of participating healthcare facilities. The regression analysis showed that the CDR of referral institutions contributed the most to the total CDR of Central Java Province. Many of the smear-negative tuberculosis cases recorded at primary healthcare centers may have been smear positive; this probable misclassification could have been partially avoided if more specific and sensitive diagnostic tools were available. Conclusions: The CDR remains below the national target (70%). Early awareness of a negative trend in certain program indicators is important to ensure program sustainability. Careful observation of the indicator pattern will secure the long-term success of the program. PMID:28766465

The dynamic of tuberculosis case finding in the era of the public-private mix strategy for tuberculosis control in Central Java, Indonesia.

PubMed

Reviono, Reviono; Setianingsih, Wahyu; Damayanti, Kusmadewi Eka; Ekasari, Ratna

2017-01-01

The public-private mix (PPM) strategy has strengthened tuberculosis care and control in many countries. Indonesia, a country with a high tuberculosis burden, has a low tuberculosis case detection rate (CDR), despite PPM implementation in 2003. The PPM in Indonesia involves primary healthcare centers, hospitals, and specialized chest clinics. The long-term impact of the strategy is unknown.  We aimed to explore the case detection achievements of the tuberculosis program since PPM implementation in Central Java in 2003. This retrospective cohort study covered the period 1 January 2000 to 31 December 2014. The data from tuberculosis patients treated in all health facilities in Central Java implementing directly observed treatment short-course, recorded via a standardized form, were analyzed after being validated by the Office of Health of Central Java Province. We evaluated the CDR, case notification rate, and total number of cases, using linear regression to analyze the temporal trends of those indicators in the phases of PPM implementation. The CDR increased during the initial phase (2000-2005), decreased during the mid-phase (2006-2009), and increased slightly during the late phase (2010-2014), ranging from 13 to 61.72. These trends were observed despite a steady increase in the number of participating healthcare facilities. The regression analysis showed that the CDR of referral institutions contributed the most to the total CDR of Central Java Province. Many of the smear-negative tuberculosis cases recorded at primary healthcare centers may have been smear positive; this probable misclassification could have been partially avoided if more specific and sensitive diagnostic tools were available. The CDR remains below the national target (70%). Early awareness of a negative trend in certain program indicators is important to ensure program sustainability. Careful observation of the indicator pattern will secure the long-term success of the program.

Actualizing a provider alliance to expand health services access to a low-income urban community.

PubMed

Tataw, David; Bazargan-Hejazi, Shahrzad; James, Frederick W

2011-01-01

Social change to facilitate health care access for vulnerable populations sometimes involves model-driven innovative structures and innovative planning and implementation approaches. This paper described and analyzed the rationale, conceptual framework, program components, and implementation of the South Central Health Care Alliance (SCHCA) implemented in South Los Angeles from January 2002 to December 2004. The program development and implementation was guided by an integrated framework linking the Open Systems Theory, the Social Cognitive Theory, the Health Belief Model, and the Preventive Health Education and Medical Home Project. The performance of the SCHCA as a social system, partnership, and participatory implementation program is also presented. While the SCHCA was found to be a dynamic social system that responded well to contingencies, its performance as a partnership and participatory implementation program was wanting in many respects.

Effects of a Cross-Age Peer Tutoring Intervention on English Language Oral Reading Fluency in a Belizean Grade School

ERIC Educational Resources Information Center

Sytsma, Marcia Ruth

2014-01-01

A cross-age peer tutoring program was implemented in a small rural school in west central Belize, Central America. All students at the school were native Spanish speakers, and all general instruction was conducted in English. The program was devised to supplement existing reading and language arts instruction at all grade levels. Progress of both…

Medications at school: disposing of pharmaceutical waste.

PubMed

Taras, Howard; Haste, Nina M; Berry, Angela T; Tran, Jennifer; Singh, Renu F

2014-03-01

This project quantified and categorized medications left unclaimed by students at the end of the school year. It determined the feasibility of a model medication disposal program and assessed school nurses' perceptions of environmentally responsible medication disposal. At a large urban school district all unclaimed medications were collected at the end of a school year to determine the extent and nature of this problem. Nurses documented unclaimed medications and transported them to a central district location. An environmentally responsible medication disposal program, consisting of sealed containers bound for a local hospital's disposal system, was implemented. In a school district of approximately 133,000 students, there were 926 different medications abandoned at the end of a school year brought to a central disposal area. Nurses complied with the newly implemented protocol. Information collected from nurses indicates acceptance of the program. Disposal of unclaimed medications at a central location, use of secured containers, and transportation to a hospital for environmentally responsible disposal proved to be feasible and acceptable to the staff. Unclaimed medications at school each year pose a potentially huge environmental risk when disposed of improperly. It is feasible to implement an environmentally responsible medication disposal protocol at schools. © 2014, American School Health Association.

EPA LABORATORIES IMPLEMENT EMS PROGRAM

EPA Science Inventory

This paper highlights the breadth and magnitude of carrying out an effective Environmental Management System (EMS) program at the U.S. EPA's research and development laboratories. Federal research laboratories have unique operating challenges compared to more centralized industr...

A Different Type of Test.

ERIC Educational Resources Information Center

Brady, Lisa

2003-01-01

Describes a successful random drug-testing program for athletes and students involved in school-sponsored activities at Hunterdon Central Regional High School in Flemington, New Jersey. Urges all high schools to implement a random drug-testing program. (PKP)

Community Participation on an Urban Sanitation Program: a Comparative Study

NASA Astrophysics Data System (ADS)

Rini Dwi Ari, Ismu; Nyoman Suluh Wijaya, I.; Dewanto, Aditya

2018-05-01

Sanitation development becomes one aspect, particularly the sixth pillar, of Sustainable Development Goals that aims at ensuring the access to water and sanitation for all. The success of the sanitation program will bring about significant changes in the human life. However, it is necessary to consider community involvement in the development program in all of the steps holistically – planning, implementation, operation and maintenance. This research scrutinizes the key factors of successful urban sanitation development programs in Talangagung sub-district as compared to Ardirejo sub-district in Kepanjen district in Malang regency, Indonesia. Through field observation in the two-research areas, and questionnaire survey distributed to to104 heads of households in Talangagung sub-district and 84 heads of households in Ardirejo sub-district, an evaluation on the suitability of the program as well as the social capital measurement was conducted. The result of estimation illustrates that Talangagung sub-district has higher score than Adirejo sub-district, which respectively 470 and 340 for the whole steps of the development. Then, the study continued with the social capital measurement using three indices of social network analysis – covering rate of participation, density and centrality. In general, the rate of participation and density of the residents involved in the urban sanitation program development in Talangagung sub-district was higher value than in Ardirejo sub-district. However, the residents’ participation in the development process tends to decrease from the planning – implementation – operation/maintenance. It is predicted that the low participation in the third step – operation/maintenance, is due to the lack of understanding of the whole participants, since the information is exclusively understood by the organizing committee. In other words, there is asymmetrical information occurring between the organizing committee and the residents. For the centrality, this research utilized three indices of the centrality covering degree – closeness – betweenness centrality. The estimation result at planning step draws that there are 21 central actors in Talangagung, wherein 8 of them are the committee members and 13 of them are regular residents. Meanwhile, in Ardirejo sub-disctrict, there are 5 central actors, but all of them are committee members. In the implementation step, there are 10 central actors, consisting of 7 committee members and 3 residents in Talangagung sub-district. Meanwhile, in Ardirejo sub-district, there are 7 central actors and all of them are the committee members. Finally, at the operation/maintenance step, there is no central actor for both sub-districts.

"During early implementation you just muddle through": factors that impacted a statewide arthritis program's implementation.

PubMed

Conte, Kathleen P; Marie Harvey, S; Turner Goins, R

2017-12-01

The need to scale-up effective arthritis self-management programs is pressing as the prevalence of arthritis increases. The CDC Arthritis Program funds state health departments to work with local delivery systems to embed arthritis programs into their day-to-day work. To encourage organizational ownership and sustainability of programs, funding is restricted to offset program start-up costs. The purpose of this study was to identify factors that impacted the success of implementing an evidence-based arthritis self-management program, funded by the CDC Arthritis Program, into the Oregon Extension Service. We interviewed staff and partners involved in implementation who had and had not successfully delivered Walk With Ease (N = 12) to identify barriers and facilitators to scaling-up. Document analysis of administrative records was used to triangulate and expand on findings. Delivery goals defined by the funder were not met in Year 1: only 3 of the expected 28 programs were delivered. Barriers to implementation included insufficient planning for implementation driven by pressure to deliver programs and insufficient resources to support staff time. Facilitators included centralized administration of key implementation activities and staffs' previous experience implementing new programs. The importance of planning and preparing for implementation cannot be overlooked. Funders, however, eager to see deliverables, continue to define implementation goals in terms of program reach, exclusive of capacity-building. Lack of capacity-building can jeopardize staff buy-in, implementation quality, and sustainability. Based on our findings coupled with support from implementation literature, we offer recommendations for future large-scale implementation efforts operating under such funding restrictions.

Evaluating the Australian Traineeship System.

ERIC Educational Resources Information Center

Ryan, R. J.

1987-01-01

Describes the Australian Traineeship System (ATS), a program integrating formal education and employment designed to increase options for dropouts. Discusses problems involving the centrality of ATS's educational component and implementation of a program evaluation strategy. Includes two references. (MLH)

Attitudinal Perspectives: A Factor to Implementation of a Dual Language Program

ERIC Educational Resources Information Center

Whitacre, Michael

2015-01-01

The central focus of this study was to determine the overall perceptions of school administrators, and the district bilingual coordinator on transferring theory to classroom practice, implementation, as viewed by those involved in the implementation process of the Gómez and Gómez Model of Dual Language Education. Responses were solicited from…

A Qualitative Evaluation of the Students of Service (SOS) Program for Sexual Abstinence in Louisiana

ERIC Educational Resources Information Center

Yoo, Seunghyun; Johnson, Carolyn C.; Rice, Janet; Manuel, Powlin

2004-01-01

Abstinence-only programs for preventing teen pregnancy are the only options in some states but are the programs of choice in others. Effectiveness data, however, are lacking. The SOS Adolescent Family Life Program (SOS), an abstinence-only teen pregnancy prevention program, was implemented in south central Louisiana. Peer mentoring with an…

More than attendance: the importance of after-school program quality.

PubMed

Hirsch, Barton J; Mekinda, Megan A; Stawicki, Julieann

2010-06-01

A central theme of the articles featured in this issue is the need to improve the quality of after-school programs. In this commentary, we discuss why student engagement, program characteristics and implementation, staff training, and citywide policy are key considerations in the effort to define and achieve high quality programs for youth.

Development and implementation of a pharmacist-run comprehensive medication review program in Wisconsin.

PubMed

Schoenrock, Danielle L; Hartkopf, Katherine; Boeckelman, Carrie

2016-12-01

The development and implementation of a centralized, pharmacist-run population health program were pursued within a health system to increase patient exposure to comprehensive medication reviews (CMRs) and improve visit processes. Program implementation included choosing appropriate pilot pharmacy locations, developing a feasible staffing model, standardizing the workflow, and creating a patient referral process. The impact on patient exposure, specific interventions, and the sustainability of the program were evaluated over a seven-month period. A total of 96 CMRs were scheduled during the data collection period. Attendance at scheduled CMRs was 54% (52 visits); there were 25 cancellations (26%) and 19 no-shows (20%). Since program implementation, there has been more than a twofold increase (2.08) in the number of CMRs completed within the health system. On average, all aspects of each patient visit took 1.78 hours to complete. Pharmacists spent 28% of scheduled time on CMR tasks and 72% of time on telephone calls and technical tasks to maintain appointments. A pharmacist-run CMR program helped to elevate the role of the community pharmacist in a health system and to improve patient exposure to CMRs. Sustaining a centralized CMR program requires support from other members of the health-system team so that pharmacists can spend more time providing patient care and less time on the technical tasks involved. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

PubMed

Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

2013-10-01

Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

The tuberculosis program of Catalonia's Central Health Region (1986-1993).

PubMed

Miret-Cuadras, P; Gonzalez-Fernandez, P; Lopez-Sanmartin, J L; Martin-Ramos, A; Pina Gutierrez, J M

1997-04-01

Catalonia's Central Health Region antituberculosis program, which began in 1985. To evaluate the cooperation of health staff and the program's effectiveness after 8 years. The following data from the nominal notifications and the expanded case reports were processed: epidemiological, clinical and treatment data, each patient's end results and the outcome of the contact investigation. The implementation of the program was evaluated by means of the number of notifications and contact investigations received, and its effectiveness was assessed by the percentage of sputum smear positive cases having completed treatment. There was an increase in the number of patients with an expanded case report (from 74% to 100%), with a final notification (from 61% to 99%) and with contact investigation (from 29% to 79%). The sputum smear positive cases who completed the treatment after 1990 exceeded 85%. The implementation of the program in the Region's health system is good and is improving in parallel with the control of the disease.

The value of partnerships in state obesity prevention and control programs.

PubMed

Hersey, James; Kelly, Bridget; Roussel, Amy; Curtis, LaShawn; Horne, Joseph; Williams-Piehota, Pamela; Kuester, Sarah; Farris, Rosanne

2012-03-01

State health departments funded by the Centers for Disease Control and Prevention's Nutrition, Physical Activity, and Obesity Program collaborate with multiple partners to develop and implement comprehensive obesity prevention and control programs. A mixed-methods evaluation of 28 state programs over a 5-year period assessed states' progress on program requirements, including developing statewide partnerships and coordinating with partners to support obesity prevention and control efforts. States with greater partnership involvement leveraged more funding support for their programs, passed more obesity-related policies, and were more likely to implement obesity interventions in multiple settings. Case studies provided guidance for establishing and maintaining strong partnerships. Findings from this study offer emerging evidence to support assumptions about the centrality of partnerships to states' success in obesity program development and implementation and related health promotion activities.

SOIL RADON POTENTIAL MAPPLING OF TWELVE COUNTIES IN NORTH-CENTRAL FLORIDA

EPA Science Inventory

The report describes the approach, methods, and detailed data used to prepare soil radon potential maps of 12 counties in North-Central Florida. he maps were developed under the Florida Radon Research Program to provide a scientific basis for implementing radon-protective buildin...

Implementation of a children's hospital-wide central venous catheter insertion and maintenance bundle.

PubMed

Helder, Onno; Kornelisse, René; van der Starre, Cynthia; Tibboel, Dick; Looman, Caspar; Wijnen, René; Poley, Marten; Ista, Erwin

2013-10-14

Central venous catheter-associated bloodstream infections in children are an increasingly recognized serious safety problem worldwide, but are often preventable. Central venous catheter bundles have proved effective to prevent such infections. Successful implementation requires changes in the hospital system as well as in healthcare professionals' behaviour. The aim of the study is to evaluate process and outcome of implementation of a state-of-the-art central venous catheter insertion and maintenance bundle in a large university children's hospital. An interrupted time series design will be used; the study will encompass all children who need a central venous catheter. New state-of-the-art central venous catheter bundles will be developed. The Pronovost-model will guide the implementation process. We developed a tailored multifaceted implementation strategy consisting of reminders, feedback, management support, local opinion leaders, and education. Primary outcome measure is the number of catheter-associated infections per 1000 line-days. The process outcome is degree of adherence to use of these central venous catheter bundles is the secondary outcome. A cost-effectiveness analysis is part of the study. Outcomes will be monitored during three periods: baseline, pre-intervention, and post-intervention for over 48 months. This model-based implementation strategy will reveal the challenges of implementing a hospital-wide safety program. This work will add to the body of knowledge in the field of implementation. We postulate that healthcare workers' willingness to shift from providing habitual care to state-of-the-art care may reflect the need for consistent care improvement. Trial registration: Dutch trials registry, trial # 3635. Dutch trials registry (http://www.trialregister.nl), trial # 3635.

Developing and Implementing Effective Communications Systems: Improving SEA Communication with LEAs, Partners/Vendors, and the Public. Benchmark. No. 2

ERIC Educational Resources Information Center

Brasiel, S.; Nafziger, D.

2013-01-01

State education agencies (SEAs) are central players in initiating and leading new reform efforts and in supporting and implementing Federal initiatives. Traditional approaches to providing public information are not adequate for producing public awareness and support and in supporting program implementation at the local level. With limited…

Transitional Class Program, 1979-80. OEE Evaluation Report.

ERIC Educational Resources Information Center

Opperman, Prudence Ward; And Others

This evaluation report describes the implementation and results of the 1979-80 Transitional Class Program. Although the program no longer exists as a centrally-coordinated effort, it serves as a final summary of the program's two years of operation by comparing the results from one year (1978-1979) to the next (1979-1980), and provides guidance to…

Patient Education in University Health Services: An Interdisciplinary Approach to Planning and Implementation.

ERIC Educational Resources Information Center

Bensley, Loren B., Jr.; Moffitt, Patrick B.

1978-01-01

This article looks at the patient education program and explains the role of the patient education intern at Central Michigan University. Included are helpful recommendations for persons interested in developing similar health education programs. (YG)

Analytics that Inform the University: Using Data You Already Have

ERIC Educational Resources Information Center

Dziuban, Charles; Moskal, Patsy; Cavanagh, Thomas; Watts, Andre

2012-01-01

The authors describe the University of Central Florida's top-down/bottom-up action analytics approach to using data to inform decision-making at the University of Central Florida. The top-down approach utilizes information about programs, modalities, and college implementation of Web initiatives. The bottom-up approach continuously monitors…

Assessing Child Welfare Outcomes in Central and Eastern Europe.

ERIC Educational Resources Information Center

Herczog, Maria

1998-01-01

Discusses the need to examine effectiveness of services to children and families in central and eastern Europe, focusing on programs in Hungary. Notes that financial considerations and differences in objectives have increased the importance of outcomes measurement. Reports that the pilot implementation of "Looking After Children"…

Distributed Computing with Centralized Support Works at Brigham Young.

ERIC Educational Resources Information Center

McDonald, Kelly; Stone, Brad

1992-01-01

Brigham Young University (Utah) has addressed the need for maintenance and support of distributed computing systems on campus by implementing a program patterned after a national business franchise, providing the support and training of a centralized administration but allowing each unit to operate much as an independent small business.…

Creative Faculty Development in Times of Diminishing Resources.

ERIC Educational Resources Information Center

Meyer, Don

North Central Bible College (Minnesota) has implemented a faculty development program over several years despite restricted financial resources. North Central Bible College (NCBC) is an independent, primarily residential college that is owned and operated by a group of 11 Assemblies of God districts. It offers bachelors degrees in 22 majors and…

Implementation of partnership management model of SMK (Vocational High School) with existing industries in mechanical engineering expertise in Central Java

NASA Astrophysics Data System (ADS)

Sumbodo, Wirawan; Pardjono, Samsudi, Rahadjo, Winarno Dwi

2018-03-01

This study aims to determine the existing conditions of implementation of partnership management model of SMK with the industry on the mechanical engineering expertise in Central Java. The method used is descriptive analysis. The research result shows that the implementation of partnership management model of SMK based on new existing industry produces ready graduates of 62.5% which belongs to low category, although the partnership program of SMK with the industry is done well with the average score of 3.17. As many as 37.5% of SMK graduates of Mechanical Engineering Expertise Program choose to continue their studies or to be an entrepreneur. It is expected that the partnership model of SMK with the industry can be developed into a reference for government policy in developing SMK that is able to produce graduates who are ready to work according to the needs of partner industry.

A university-sponsored home health nursing program in Karachi, Pakistan.

PubMed

Smego, Raymond A; Khan, Mohammad Aslam; Khowaja, Khurshid; Rafique, Rozina; Datoo, Farida

2005-11-01

This article describes a university-sponsored home health nursing program in a large urban center in Pakistan and details the essential elements needed in implementing such a program in a developing country. Compared to in-hospital treatment, home healthcare reduced hospital stay from 12.8 days to 3.9 days, and resulted in a net savings of Pakistani rupees (PRs) 5,374,135 (USD 89,569). A cost-effective home treatment program in a resource-limited country can be successfully implemented by using the hospital pharmacy as the central point for the preparation and distribution of medications and specialty nursing services.

76 FR 39263 - Antidumping and Countervailing Duty Proceedings: Electronic Filing Procedures; Administrative...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-06

... resulting from the Department's implementation of an electronic filing and documents management program... regulations that is entitled ``IA ACCESS Handbook On Electronic Filing Procedures'' (``IA ACCESS Handbook... management program named Import Administration Antidumping and Countervailing Duty Centralized Electronic...

Improving Prediction Accuracy of “Central Line-Associated Blood Stream Infections” Using Data Mining Models

PubMed Central

Noaman, Amin Y.; Jamjoom, Arwa; Al-Abdullah, Nabeela; Nasir, Mahreen; Ali, Anser G.

2017-01-01

Prediction of nosocomial infections among patients is an important part of clinical surveillance programs to enable the related personnel to take preventive actions in advance. Designing a clinical surveillance program with capability of predicting nosocomial infections is a challenging task due to several reasons, including high dimensionality of medical data, heterogenous data representation, and special knowledge required to extract patterns for prediction. In this paper, we present details of six data mining methods implemented using cross industry standard process for data mining to predict central line-associated blood stream infections. For our study, we selected datasets of healthcare-associated infections from US National Healthcare Safety Network and consumer survey data from Hospital Consumer Assessment of Healthcare Providers and Systems. Our experiments show that central line-associated blood stream infections (CLABSIs) can be successfully predicted using AdaBoost method with an accuracy up to 89.7%. This will help in implementing effective clinical surveillance programs for infection control, as well as improving the accuracy detection of CLABSIs. Also, this reduces patients' hospital stay cost and maintains patients' safety. PMID:29085836

Laser Technician Associate Degree Program. A Proposal Submitted to Wisconsin State Board of Vocational, Technical, and Adult Education. (Curriculum Development.) Final Report.

ERIC Educational Resources Information Center

North Central Technical Inst., Wausau, WI.

This final report contains the program proposal with supporting data for developing curriculum materials for and implementing an associate-degree laser technology program at the North Central Technical Institute. The proposal outline provides this information: (1) objectives for the program designed to prepare a technician to safely operate,…

Facilitating central line-associated bloodstream infection prevention: a qualitative study comparing perspectives of infection control professionals and frontline staff.

PubMed

McAlearney, Ann Scheck; Hefner, Jennifer L

2014-10-01

Infection control professionals (ICPs) play a critical role in implementing and managing healthcare-associated infection reduction interventions, whereas frontline staff are responsible for delivering direct and ongoing patient care. The objective of our study was to determine if ICPs and frontline staff have different perspectives about the facilitators and challenges of central line-associated bloodstream infection (CLABSI) prevention program success. We conducted key informant interviews at 8 hospitals that participated in the Agency for Healthcare Research and Quality CLABSI prevention initiative called "On the CUSP: Stop BSI." We analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to program facilitators and challenges. We identified 4 facilitators of CLABSI program success: education, leadership, data, and consistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician resistance. However, the perspective of ICPs and frontline nurses differed. Whereas ICPs tended to focus on general descriptions, frontline staff noted program specifics and often discussed concrete examples. Our results suggest that ICPs need to take into account the perspectives of staff nurses when implementing infection control and broader quality improvement initiatives. Further, the deliberate inclusion of frontline staff in the implementation of these programs may be critical to program success. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Improving Prevention Programs: First Results on the Relation between Subjectively Perceived Levels of Usefulness and Social Competencies

ERIC Educational Resources Information Center

Grumm, Mandy; Hein, Sascha; Fingerle, Michael

2013-01-01

School-based aggression prevention programs have been implemented in many educational institutions, and fostering the development of social competencies is one of the central aspects of many approaches. The aim of the present study was to assess the level of subjectively perceived usefulness of the prevention program "Faustlos" in…

Delving into Inquiry Learning in Teacher Education at the University of British Columbia

ERIC Educational Resources Information Center

Rushton, Claire; Webb, Andrea S.

2016-01-01

This paper discusses a series of inquiry-based seminars that are central to the teacher education program at the University of British Columbia. This teacher education program reflects the changing curriculum in the province. The new inquiry-based provincial curriculum is being implemented between 2015 and 2018 and the teacher education program is…

The Dual Language Program Planner: A Guide for Designing and Implementing Dual Language Programs.

ERIC Educational Resources Information Center

Howard, Elizabeth R.; Olague, Natalie; Rogers, David

This guide offers a framework to facilitate the planning process for dual language programs, assuming at least a basic working knowledge of the central characteristics and essential features of dual language models. It provides an overview of the various models that serve linguistically diverse student populations, defining the term dual language…

Inservice Teacher Education in Nigeria: A Case Study.

ERIC Educational Resources Information Center

Esu, Akon E. O.

1991-01-01

Examines the current status of in-service teacher education in Nigeria, indicating three approaches: the central office approach; the long vacation program; and the Associateship Certificate in Education distance learning approach. Recommendations for planning and implementing in-service teacher education programs in Nigeria are noted. (SM)

Impact of Implementation of Direct Cash Transfer Program 2008/2009 on Household Consumption in Central Java Province

NASA Astrophysics Data System (ADS)

Subanti, S.; Hakim, A. R.; Hakim, I. M.

2017-04-01

This study aims to see the impact of direct cash transfer program for 2008/2009 on household consumption of food, nonfood, education, and health in Central Java Province. The study is expected to provide important findings for the improvement of a similar program in the future. This study findings that (1) the increasing in food and non-food consumption for direct cash transfer recipients than non direct cash transfer recipients; (2) the impact of households expenditure on education for direct cash transfer recipients is higher than non direct cash transfer recipients; (3) the impact of households expenditure on health for direct cash transfer recipients is lower than non direct cash transfer recipients. This study recommended that (1) implementation of direct cash transfer program 2008/2009 must be managed to be better because this program can defend household welfare. It shows from several indicators of well-being such as consumption spending, education, and health; (2) data targets for poor households (very poor, poor, nearly poor) must be updated.

Cultural Awareness in Nuclear Security Programs: A Critical Link

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

Nasser, Al-Sharif Nasser bin; Auda, Jasmine; Bachner, Katherine

Nuclear security programs that offer training and capacity building opportunities to practitioners working in nuclear facilities play a central role in strengthening the global nuclear security architecture. There is often a significant divide, however, between both the development of these programs and their implementation, and between the programs’ intended and actual outcomes. This article argues that this disconnect can often be attributed to an absence of cultural awareness and an inability for internationally-designed programs to effectively resonate with local audiences. Furthermore, the importance of the role of cultural awareness in implementing nuclear security programs will be assessed, and its applicationsmore » in the Jordanian context will be presented.« less

Cultural Awareness in Nuclear Security Programs: A Critical Link

DOE PAGES

Nasser, Al-Sharif Nasser bin; Auda, Jasmine; Bachner, Katherine

2016-11-20

Nuclear security programs that offer training and capacity building opportunities to practitioners working in nuclear facilities play a central role in strengthening the global nuclear security architecture. There is often a significant divide, however, between both the development of these programs and their implementation, and between the programs’ intended and actual outcomes. This article argues that this disconnect can often be attributed to an absence of cultural awareness and an inability for internationally-designed programs to effectively resonate with local audiences. Furthermore, the importance of the role of cultural awareness in implementing nuclear security programs will be assessed, and its applicationsmore » in the Jordanian context will be presented.« less

Central-provincial relations for anti-schistosomiasis policy in china.

PubMed

Fan, Ka-Wai

2012-01-01

This paper discusses central-local relations for healthcare policy in China from a principal-agent perspective, based on schistosomiasis control. In order to control the disease, the central government produced the Outline of the Mid-Long-Term National Plan for Schistosomiasis Prevention and Control (2004-2015) in 2004. By discussing the implementation of the National Outline at the provincial level, the author uses principal-agent theory to examine conflict and coordination between the central and provincial governments. The documents were collected from the Internet. Although the central and provincial governments all want to eliminate schistosomiasis, allocating funding among them creates conflict and forms an obstacle to achieving the goal. This paper extensively discusses the topics related to central-provincial relation and schistosomiasis control program. Further case study on a single province may be needed to intensify the discussion from a micro perspective. The conflict between central and provincial relations needs to be resolved in order to implement the national policy.

Central-Provincial Relations for Anti-Schistosomiasis Policy in China

PubMed Central

FAN, Ka-wai

2012-01-01

This paper discusses central-local relations for healthcare policy in China from a principal-agent perspective, based on schistosomiasis control. In order to control the disease, the central government produced the Outline of the Mid-Long-Term National Plan for Schistosomiasis Prevention and Control (2004–2015) in 2004. By discussing the implementation of the National Outline at the provincial level, the author uses principal-agent theory to examine conflict and coordination between the central and provincial governments. The documents were collected from the Internet. Although the central and provincial governments all want to eliminate schistosomiasis, allocating funding among them creates conflict and forms an obstacle to achieving the goal. This paper extensively discusses the topics related to central-provincial relation and schistosomiasis control program. Further case study on a single province may be needed to intensify the discussion from a micro perspective. The conflict between central and provincial relations needs to be resolved in order to implement the national policy. PMID:23113188

Implementing Guided Pathways: Early Insights from the AACC Pathways Colleges

ERIC Educational Resources Information Center

Jenkins, Davis; Lahr, Hana; Fink, John

2017-01-01

Across the United States, a growing number of colleges are redesigning their programs and student support services according to the "guided pathways" model. Central to this approach are efforts to clarify pathways to program completion, career advancement, and further education. Equally essential are efforts to help students explore…

Interdisciplinary Graduate Studies in Brazil: Lessons from Sustainability and Environmental Sciences

ERIC Educational Resources Information Center

Bursztyn, Marcel; Maury, María Beatriz; Litre, Gabriela

2016-01-01

This article analyzes the process of institutionalizing interdisciplinary graduate programs in Brazil, which has over more than four decades of experience implementing masters and doctoral problem-oriented programs designed to operate outside the disciplinary structure of universities. Brazil has a high degree of centrality and government…

Factors Influencing Faculty Participation & Retention in Online & Blended Education

ERIC Educational Resources Information Center

Betts, Kristen

2014-01-01

Faculty members play a central role in the development, implementation, and long-term sustainability of online and blended education programs. Therefore, faculty recruitment and retention strategies for these programs must align with the needs of the faculty. This article highlights the results of an institutional study conducted at a public…

A 3D stand generator for central Appalachian hardwood forests

Treesearch

Jingxin Wang; Yaoxiang Li; Gary W. Miller

2002-01-01

A 3-dimensional (3D) stand generator was developed for central Appalachian hardwood forests. It was designed for a harvesting simulator to examine the interactions of stand, harvest, and machine. The Component Object Model (COM) was used to design and implement the program. Input to the generator includes species composition, stand density, and spatial pattern. Output...

Report of the Evaluation of the Race/Human Relations Program. Student and Staff Program and Long Range Goals. Baseline Year 1982-83. Evaluation Services Department Report No. 348.

ERIC Educational Resources Information Center

Tomblin, Elizabeth A.; And Others

In response to a 1982 Superior Court order, a centrally developed, sequential program for improving race/human relations in the San Diego City Schools was developed and field tested or implemented during the 1982-83 school year. This systematic evaluation reports on the student program, "Conflict"; the staff program; and baseline data…

Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors

ERIC Educational Resources Information Center

Ferguson, Jonnisa M.; Vanderpool, Robin C.

2013-01-01

As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families' participation in a home-visitation program offered by a central Kentucky…

The Introduction of Automated Chemistry at the Community High School Level.

ERIC Educational Resources Information Center

Comte, R. F.; And Others

Reported is the implementation of a science seminar program and an "8 + 2 Program" at Masters School and Hackley School in Tarrytown, New York. Senior students in the seminar program were asked to conduct ecological studies of uninhabited islands in the U.S. Virgin Island chain and studies of the nutrition value of Central American grains. The…

Aspects of the Patient-centered Medical Home currently in place: initial findings from preparing the personal physician for practice.

PubMed

Carney, Patricia A; Eiff, M Patrice; Saultz, John W; Douglass, Alan B; Tillotson, Carrie J; Crane, Steven D; Jones, Samuel M; Green, Larry A

2009-10-01

The Patient-centered Medical Home (PCMH) is a central concept in the evolving debate about American health care reform. We studied family medicine residency training programs' continuity clinics to assess baseline status of implementing PCMH components and to compare implementation status between community-based and university training programs. We conducted a survey 24 continuity clinics in 14 residency programs that are part of the Preparing the Personal Physicians for Practice (P(4)) program. We asked questions about aspects of P(4) that had been already implemented at the beginning of the P(4) program. We defined high implementation as aspects that were present in >50% of clinics and low implementation as those present in <50% of clinics. We compared features at university-based and community-based clinics. High areas of implementation were having an electronic health record (EHR), fully secured remote access, electronic patient notes/scheduling/billing, chronic disease management registries, and open-access scheduling. Low areas of implementation included hospital EHR with computerized physician order entry, asynchronous communication with patients, ongoing population-based QA using EHR, use of preventive registries, and practice-based research using EHR. Few differences were noted between university- and community-based residency programs. Many features of the PCMH were already established at baseline in programs participating in P(4).

Benefits of a comprehensive quality program for cryopreserved PBMC covering 28 clinical trials sites utilizing an integrated, analytical web-based portal

PubMed Central

Ducar, Constance; Smith, Donna; Pinzon, Cris; Stirewalt, Michael; Cooper, Cristine; McElrath, M. Juliana; Hural, John

2014-01-01

The HIV Vaccine Trials Network (HVTN) is a global network of 28 clinical trial sites dedicated to identifying an effective HIV vaccine. Cryopreservation of high-quality peripheral blood mononuclear cells (PBMC) is critical for the assessment of vaccine-induced cellular immune functions. The HVTN PBMC Quality Management Program is designed to ensure viable PBMC are processed, stored and shipped for clinical trial assays from all HVTN clinical trial sites. The program has evolved by developing and incorporating best practices for laboratory and specimen quality and implementing automated, web-based tools. These tools allow the site-affiliated processing laboratories and the central Laboratory Operations Unit to rapidly collect, analyze and report PBMC quality data. The HVTN PBMC Quality Management Program includes five key components: 1) Laboratory Assessment, 2) PBMC Training and Certification, 3) Internal Quality Control, 4) External Quality Control (EQC), and 5) Assay Specimen Quality Control. Fresh PBMC processing data is uploaded from each clinical site processing laboratory to a central HVTN Statistical and Data Management Center database for access and analysis on a web portal. Samples are thawed at a central laboratory for assay or specimen quality control and sample quality data is uploaded directly to the database by the central laboratory. Four year cumulative data covering 23,477 blood draws reveals an average fresh PBMC yield of 1.45×106 ±0.48 cells per milliliter of useable whole blood. 95% of samples were within the acceptable range for fresh cell yield of 0.8–3.2×106 cells/ml of usable blood. Prior to full implementation of the HVTN PBMC Quality Management Program, the 2007 EQC evaluations from 10 international sites showed a mean day 2 thawed viability of 83.1% and recovery of 67.5%. Since then, four year cumulative data covering 3338 specimens used in immunologic assays shows that 99.88% had acceptable viabilities (>66%) for use in cellular assays (mean, 91.46% ±4.5%), and 96.2% had acceptable recoveries (50%–130%) with a mean of recovery of 85.8% ±19.12% of the originally cryopreserved cells. EQC testing revealed that since August 2009, failed recoveries dropped from 4.1% to 1.6% and failed viabilities dropped from 1.0% to 0.3%. The HVTN PBMC quality program provides for laboratory assessment, training and tools for identifying problems, implementing corrective action and monitoring for improvements. These data support the benefits of implementing a comprehensive, web-based PBMC quality program for large clinical trials networks. PMID:24709391

Home Oxygen Program review: Regionalization in Vancouver Coastal Health and British Columbia.

PubMed

Sandberg, Dan

2015-01-01

Since its inception in the 1980s, the Home Oxygen Program in British Columbia was centrally managed by the Ministry of Health. Initially a small program with few clients across the province, it soon became a large program with many clients and increasing expenditures. A pilot program started in Victoria (British Columbia) in 1996 demonstrated that managing the program locally could offer better client care, better contract management and significant cost savings. In 2002, the pilot's model and recommendations were implemented in British Columbia's five health authorities. The present review details the experiences of regionalizing the program in the Vancouver Coastal Health authority. After fine adjustments to the model were developed and new contracts and criteria changes made, better care for clients was provided than the previous centralized model at a reduced cost to the taxpayer.

Developing and Implementing a Mobile Conservation Education Unit for Rural Primary School Children in Lao PDR

ERIC Educational Resources Information Center

Hansel, Troy; Phimmavong, Somvang; Phengsopha, Kaisone; Phompila, Chitana; Homduangpachan, Khiaosaphan

2010-01-01

In this article, the authors examine the implementation and success of a mobile conservation education unit targeting primary schools in central Lao PDR (People's Democratic Republic). The mobile unit conducted 3-hour interactive programs for school children focused on the importance of wildlife and biodiversity around the primary schools in rural…

Development and implementation of an integrated, multi-modality, user-centered interactive dietary change program

PubMed Central

Glasgow, Russell E.; Christiansen, Steve; Smith, K. Sabina; Stevens, Victor J.; Toobert, Deborah J.

2009-01-01

Computer-tailored behavior change programs offer the potential for reaching large populations at a much lower cost than individual or group-based programs. However, few of these programs to date appear to integrate behavioral theory with user choice, or combine different electronic modalities. We describe the development of an integrated CD-ROM and interactive voice response dietary change intervention that combines behavioral problem-solving theory with a high degree of user choice. The program, WISE CHOICES, is being evaluated as part of an ongoing trial. This paper describes the program development, emphasizing how user preferences are accommodated, and presents implementation and user satisfaction data. The program was successfully implemented; the linkages among the central database, the CD-ROM and the automated telephone components were robust, and participants liked the program almost as well as a counselor-delivered dietary change condition. Multi-modality programs that emphasize the strengths of each approach appear to be feasible. Future research is needed to determine the program impact and cost-effectiveness compared with counselor-delivered intervention. PMID:18711204

Value-Added and Other Methods for Measuring School Performance. Working Paper 2008-17

ERIC Educational Resources Information Center

Meyer, Robert H.; Christian, Michael S.

2008-01-01

One of the central challenges of designing and implementing a performance pay program is developing an approach for determining which schools, teachers, and administrators have performed well enough to have earned a bonus. The U.S. Department of Education's Teacher Incentive Fund (TIF) program provides grantees substantial latitude to create…

Zero to Sixty Plus in 108 Days: Launching a Central Elearning Unit and Its First Faculty Development Program

ERIC Educational Resources Information Center

Orozco, Monica; Fowlkes, James; Jerzak, Page; Musgrove, Ann

2012-01-01

The Center for eLearning was established at Florida Atlantic University (FAU) as a result of a university-wide task force. A brief overview of the center's start-up activity is followed by a thorough report of the first faculty development program created and implemented. The structure of the program is described, and data are provided showing…

Continuing Education for the Personnel of Small Public Libraries: Program Development at the Iowa State University Library and Its Collection Development/Technical Services Course.

ERIC Educational Resources Information Center

Roughton, Karen G.; Tyckoson, David A.

This report describes the planning, implementation, and evaluation of a coordinated staff development program to offer certified, non-degree credit to non-professional librarians from small public libraries. Developed through the cooperation of the Central Iowa Regional Library and the Iowa State University Library, the program resulted in a plan…

Building research ethics capacity in post-communist countries: experience of two Fogarty training programs.

PubMed

Strosberg, Martin A; Gefenas, Eugenijus; Loue, Sana; Philpott, Sean

2013-12-01

The post-Communist countries of Central and Eastern Europe and Central Asia are at various stages of development with respect to their capacity to protect human research participants. We examined the impact of two Fogarty-funded programs in this region, the Union Graduate College-Vilnius University Advanced Certificate Program and the Case Western Reserve University Master's Degree Program, by surveying these programs' graduates and by examining alumni activities. Alumni have served in leadership roles on research ethics committees, developed and taught new courses in research ethics, and contributed to scholarship. However, political, social, and economic challenges impede the ability of graduates to maximize their effectiveness. Additional curricular attention is needed in research methodology, policy development and implementation, and the interplay between research ethics and human rights.

Worksite wellness: increasing adoption of workplace health promotion programs.

PubMed

Michaels, Carol Noel; Greene, Amanda Marie

2013-07-01

Worksite wellness programs are important interventions to protect and promote employee health. They help reduce direct and indirect health care costs, absenteeism, and presenteeism; avoid illness or injury; and improve the quality of work life and morale. This Tool introduces key concepts and strategic tips for planning workplace-based wellness programs rather than individual health promotion events, while highlighting organizational change and development theories central to introducing and implementing effective proactive worksite wellness programs.

Investing in innovation: trade-offs in the costs and cost-efficiency of school feeding using community-based kitchens in Bangladesh.

PubMed

Gelli, Aulo; Suwa, Yuko

2014-09-01

School feeding programs have been a key response to the recent food and economic crises and function to some degree in nearly every country in the world. However, school feeding programs are complex and exhibit different, context-specific models or configurations. To examine the trade-offs, including the costs and cost-efficiency, of an innovative cluster kitchen implementation model in Bangladesh using a standardized framework. A supply chain framework based on international standards was used to provide benchmarks for meaningful comparisons across models. Implementation processes specific to the program in Bangladesh were mapped against this reference to provide a basis for standardized performance measures. Qualitative and quantitative data on key metrics were collected retrospectively using semistructured questionnaires following an ingredients approach, including both financial and economic costs. Costs were standardized to a 200-feeding-day year and 700 kcal daily. The cluster kitchen model had similarities with the semidecentralized model and outsourced models in the literature, the main differences involving implementation scale, scale of purchasing volumes, and frequency of purchasing. Two important features stand out in terms of implementation: the nutritional quality of meals and the level of community involvement. The standardized full cost per child per year was US$110. Despite the nutritious content of the meals, the overall cost-efficiency in cost per nutrient output was lower than the benchmark for centralized programs, due mainly to support and start-up costs. Cluster kitchens provide an example of an innovative implementation model, combining an emphasis on quality meal delivery with strong community engagement. However, the standardized costs-per child were above the average benchmarks for both low-and middle-income countries. In contrast to the existing benchmark data from mature, centralized models, the main cost drivers of the program were associated with support and start-up activities. Further research is required to better understand changes in cost drivers as programs mature.

How Well Do Health-Mediation Programs Address the Determinants of the Poor Health Status of Roma? A Longitudinal Case Study.

PubMed

Belak, Andrej; Veselska, Zuzana Dankulincova; Geckova, Andrea Madarasova; Dijk, Jitse P van; Reijneveld, Sijmen A

2017-12-13

In Central and Eastern Europe (CEE), health-mediation programs (HMPs) have become central policy instruments targeting health inequities between segregated Roma and general populations. Social determinants of health (SDH) represent the root causes behind health inequities. We therefore evaluated how an HMP based in Slovakia addressed known SDH in its agenda and its everyday implementation. To produce descriptive data on the HMP's agenda and everyday implementation we observed and consulted 70 program participants across organizational levels and 30 program recipients over the long-term. We used a World Health Organization framework on SDH to direct data acquisition and consequent data content analysis, to structure the reporting of results, and to evaluate the program's merits. In its agenda, the HMP did not address most known SDH, except for healthcare access and health-related behaviours. In the HMP's everyday implementation, healthcare access facilitation activities were well received, performed as set out and effective. The opposite was true for most educational activities targeting health-related behaviours. The HMP fieldworkers were proactive and sometimes effective at addressing most other SDH domains beyond the HMP agenda, especially material conditions and psychosocial factors, but also selected local structural aspects. The HMP leaders supported such deliberate engagement only informally, considering the program inappropriate by definition and too unstable institutionally to handle such extensions. Reports indicate that the situation in other CEE HMPs is similar. To increase the HMPs' impact on SDH, their theories and procedures should be adapted according to the programs' more promising actual practice regarding SDH.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved.

PubMed

Inrig, Stephen J; Tiro, Jasmin A; Melhado, Trisha V; Argenbright, Keith E; Craddock Lee, Simon J

2014-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. To better understand how to implement a decentralized regional delivery "hub & spoke" model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow's RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow's RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved

PubMed Central

Inrig, Stephen J.; Tiro, Jasmin A.; Melhado, Trisha V.; Argenbright, Keith E.; Craddock Lee, Simon J.

2017-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. Objectives To better understand how to implement a decentralized regional delivery “hub & spoke” model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow’s RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Methods and Design The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow’s RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. Discussion This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting. PMID:28713882

From Blue to Green: The Development and Implementation of a Therapeutic Horticulture Program for Residents of a Battered Women's Shelter.

PubMed

Renzetti, Claire M; Follingstad, Diane R

2015-01-01

The delivery of therapeutic services to clients is influenced by service providers' understanding of the "fit" of a specific program with their service mandate as well as their perceptions of the potential benefits of the program. This article discusses the development and implementation of a therapeutic horticulture (TH) program at a battered women's shelter that serves 17 counties in Central Kentucky. Through semistructured interviews, we gauge the shelter staff's perceptions of the relationship of the TH program to the shelter's overall mission; their sense of the program's benefits for residents, for the shelter as a community organization, and for themselves; and their concerns about the TH program. We consider how these findings may impact future programming at the shelter, and we discuss plans for further evaluation of the TH program in terms of its impact on shelter residents' long-term outcomes.

Social network analysis of public health programs to measure partnership.

PubMed

Schoen, Martin W; Moreland-Russell, Sarah; Prewitt, Kim; Carothers, Bobbi J

2014-12-01

In order to prevent chronic diseases, community-based programs are encouraged to take an ecological approach to public health promotion and involve many diverse partners. Little is known about measuring partnership in implementing public health strategies. We collected data from 23 Missouri communities in early 2012 that received funding from three separate programs to prevent obesity and/or reduce tobacco use. While all of these funding programs encourage partnership, only the Social Innovation for Missouri (SIM) program included a focus on building community capacity and enhancing collaboration. Social network analysis techniques were used to understand contact and collaboration networks in community organizations. Measurements of average degree, density, degree centralization, and betweenness centralization were calculated for each network. Because of the various sizes of the networks, we conducted comparative analyses with and without adjustment for network size. SIM programs had increased measurements of average degree for partner collaboration and larger networks. When controlling for network size, SIM groups had higher measures of network density and lower measures of degree centralization and betweenness centralization. SIM collaboration networks were more dense and less centralized, indicating increased partnership. The methods described in this paper can be used to compare partnership in community networks of various sizes. Further research is necessary to define causal mechanisms of partnership development and their relationship to public health outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implementing the global health security agenda: lessons from global health and security programs.

PubMed

Paranjape, Suman M; Franz, David R

2015-01-01

The Global Health Security Agenda (GHSA) describes a vision for a world that is safe and secure from infectious disease threats; it underscores the importance of developing the international capacity to prevent, detect, and respond to pandemic agents. In February 2014, the United States committed to support the GHSA by expanding and intensifying ongoing efforts across the US government. Implementing these goals will require interagency coordination and harmonization of diverse health security elements. Lessons learned from the Global Health Initiative (GHI), the President's Emergency Program for AIDS Relief (PEPFAR), and the Cooperative Threat Reduction (CTR) program underscore that centralized political, technical, and fiscal authority will be key to developing robust, sustainable, and integrated global health security efforts across the US government. In this article, we review the strengths and challenges of GHI, PEPFAR, and CTR and develop recommendations for implementing a unified US global health security program.

Constraints Militating against the Implementation of Production/Service Work in Technical Colleges in North Central Nigeria

ERIC Educational Resources Information Center

Agu, Peter A.

2016-01-01

Skill acquisition is a critical component of any vocational technical training program. When this component is missing or falls below expectation, it tends to defeat the objectives of the program. In Nigeria, many skill-oriented schools experience great challenges in trying to provide for the necessary facilities required for effective technical…

Developing a Quality Improvement Process to Optimize Faculty Success

ERIC Educational Resources Information Center

Merillat, Linda; Scheibmeir, Monica

2016-01-01

As part of a major shift to embed quality improvement processes within a School of Nursing at a medium-sized Midwestern university, a faculty enrichment program using a Plan-Do-Act-Study design was implemented. A central focus for the program was the development and maintenance of an online faculty resource center identified as "My Faculty…

Individualized Education Program Team Decisions: A Preliminary Study of Conversations, Negotiations, and Power

ERIC Educational Resources Information Center

Ruppar, Andrea L.; Gaffney, Janet S.

2011-01-01

Given the centrality of the Individualized Education Program (IEP) to services for students with disabilities, the decision-making process during the IEP meeting deserves attention in research and implementation. In this case study, IEP team decision-making is examined as a socially situated practice. Transcripts of an initial evaluation and IEP…

Providing for the Needs of New Teachers: A Study of New Teacher Induction in a Rural School District in Central North Carolina

ERIC Educational Resources Information Center

Powell, Lori T.

2016-01-01

This study evaluated the effectiveness of a new teacher induction program as implemented in a rural school district in central North Carolina. All beginning teachers with 3 or less years of experience, all school-based administrators, and all mentoring teachers were the target participants. The purpose of the study was to evaluate the…

Successfully Implementing Net-Zero Energy Policy through the Air Force Military Construction Program

DTIC Science & Technology

2013-03-01

Meets Does not meet Does not meet Meets Renewable Farms Meets Meets Meets Meets On-Site (Distributed Generation) Meets* Meets* Meets Meets...independence, nor does it allow for net-zero energy installations. Developing centralized renewable energy farms is another method for obtaining...combination of centralized renewable energy farms and distributed generation methods. The specific combination of methods an installation will utilize

Importance of Data Management in a Long-Term Biological Monitoring Program

NASA Astrophysics Data System (ADS)

Christensen, Sigurd W.; Brandt, Craig C.; McCracken, Mary K.

2011-06-01

The long-term Biological Monitoring and Abatement Program (BMAP) has always needed to collect and retain high-quality data on which to base its assessments of ecological status of streams and their recovery after remediation. Its formal quality assurance, data processing, and data management components all contribute to meeting this need. The Quality Assurance Program comprehensively addresses requirements from various institutions, funders, and regulators, and includes a data management component. Centralized data management began a few years into the program when an existing relational database was adapted and extended to handle biological data. The database's main data tables and several key reference tables are described. One of the most important related activities supporting long-term analyses was the establishing of standards for sampling site names, taxonomic identification, flagging, and other components. The implemented relational database supports the transmittal of data to the Oak Ridge Environmental Information System (OREIS) as the permanent repository. We also discuss some limitations to our implementation. Some types of program data were not easily accommodated in the central systems, and many possible data-sharing and integration options are not easily accessible to investigators. From our experience we offer data management advice to other biologically oriented long-term environmental sampling and analysis programs.

Implementing a Daily Maintenance Care Bundle to Prevent Central Line-Associated Bloodstream Infections in Pediatric Oncology Patients.

PubMed

Duffy, Elizabeth A; Rodgers, Cheryl C; Shever, Leah L; Hockenberry, Marilyn J

2015-01-01

Eliminating central line-associated bloodstream infection (CLABSI) is a national priority. Central venous catheter (CVC) care bundles are composed of a series of interventions that, when used together, are effective in preventing CLABSI. A CVC daily maintenance care bundle includes procedural guidelines for hygiene, dressing changes, and access as well as specific timeframes. Failure to complete one of the components of the care bundle predisposes the patient to a bloodstream infection. A nurse-led multidisciplinary team implemented and, for six months, sustained a daily maintenance care bundle for pediatric oncology patients. This quality improvement project focused on nursing staffs' implementation of the daily maintenance care bundle and the sustainment of the intervention. The project used a pre-post program design to evaluate outcomes of CVC daily maintenance care bundle compliancy and CLABSI. A statistically significant increase between the pre- and post-assessments of the compliance was noted with the CVC daily maintenance care bundle. CLABSI infection rates decreased during the intervention. Strategies to implement practice change and promote sustainability are discussed. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

Preparing health care organizations for successful case management programs.

PubMed

Bonvissuto, C A; Kastens, J M; Atwell, S R

1997-01-01

This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

Benefits of a comprehensive quality program for cryopreserved PBMC covering 28 clinical trials sites utilizing an integrated, analytical web-based portal.

PubMed

Ducar, Constance; Smith, Donna; Pinzon, Cris; Stirewalt, Michael; Cooper, Cristine; McElrath, M Juliana; Hural, John

2014-07-01

The HIV Vaccine Trials Network (HVTN) is a global network of 28 clinical trial sites dedicated to identifying an effective HIV vaccine. Cryopreservation of high-quality peripheral blood mononuclear cells (PBMC) is critical for the assessment of vaccine-induced cellular immune functions. The HVTN PBMC Quality Management Program is designed to ensure that viable PBMC are processed, stored and shipped for clinical trial assays from all HVTN clinical trial sites. The program has evolved by developing and incorporating best practices for laboratory and specimen quality and implementing automated, web-based tools. These tools allow the site-affiliated processing laboratories and the central Laboratory Operations Unit to rapidly collect, analyze and report PBMC quality data. The HVTN PBMC Quality Management Program includes five key components: 1) Laboratory Assessment, 2) PBMC Training and Certification, 3) Internal Quality Control, 4) External Quality Control (EQC), and 5) Assay Specimen Quality Control. Fresh PBMC processing data is uploaded from each clinical site processing laboratory to a central HVTN Statistical and Data Management Center database for access and analysis on a web portal. Samples are thawed at a central laboratory for assay or specimen quality control and sample quality data is uploaded directly to the database by the central laboratory. Four year cumulative data covering 23,477 blood draws reveals an average fresh PBMC yield of 1.45×10(6)±0.48 cells per milliliter of useable whole blood. 95% of samples were within the acceptable range for fresh cell yield of 0.8-3.2×10(6) cells/ml of usable blood. Prior to full implementation of the HVTN PBMC Quality Management Program, the 2007 EQC evaluations from 10 international sites showed a mean day 2 thawed viability of 83.1% and a recovery of 67.5%. Since then, four year cumulative data covering 3338 specimens used in immunologic assays shows that 99.88% had acceptable viabilities (>66%) for use in cellular assays (mean, 91.46% ±4.5%), and 96.2% had acceptable recoveries (50%-130%) with a mean of recovery of 85.8% ±19.12% of the originally cryopreserved cells. EQC testing revealed that since August 2009, failed recoveries dropped from 4.1% to 1.6% and failed viabilities dropped from 1.0% to 0.3%. The HVTN PBMC quality program provides for laboratory assessment, training and tools for identifying problems, implementing corrective action and monitoring for improvements. These data support the benefits of implementing a comprehensive, web-based PBMC quality program for large clinical trials networks. Copyright © 2014 Elsevier B.V. All rights reserved.

Building Research Ethics Capacity in Post-Communist Countries: Experience of Two Fogarty Training Programs

PubMed Central

Strosberg, Martin A.; Gefenas, Eugenijus; Loue, Sana; Philpott, Sean

2014-01-01

The post-Communist countries of Central and Eastern Europe and Central Asia are at various stages of development with respect to their capacity to protect human research participants. We examined the impact of two Fogarty-funded programs in this region, the Union Graduate College–Vilnius University Advanced Certificate Program and the Case Western Reserve University Master’s Degree Program, by surveying these programs’ graduates and by examining alumni activities. Alumni have served in leadership roles on research ethics committees, developed and taught new courses in research ethics, and contributed to scholarship. However, political, social, and economic challenges impede the ability of graduates to maximize their effectiveness. Additional curricular attention is needed in research methodology, policy development and implementation, and the interplay between research ethics and human rights. PMID:24384514

The School of Public Safety at Valencia College: Visioning and Implementation of a College-Wide Distributive and Collaborative Program Model for the Central Florida Community

ERIC Educational Resources Information Center

Goltz, Jeffrey W.

2016-01-01

The central Florida region, faced with record tourism, a large service population, and significant population growth over the next few decades, must rely on a community-based institution of higher education with lifelong learning offerings, a local community college, to create world class public safety education and training for the region.…

An Examination of the Outporting Ship Program Implemented in Response to the Increased Program Size of the Ready Reserve Force.

DTIC Science & Technology

1988-06-01

conjunction with the NATO exercise Wintex- Cimex 83, in February 83. The Maritime Administration conducted a survey of facilities and tugboat availability, and...BREAKOUT-85 69 32 32 21 16 WINTEX- CIMEX 83 30 3 21 6 3 During this exercise, the Maritime Administration tasked its Eastern, Central and Western

Implementing a Computer Program that Captures Students' Work on Customizable, Periodic-System Data Assignments

ERIC Educational Resources Information Center

Wiediger, Susan D.

2009-01-01

The periodic table and the periodic system are central to chemistry and thus to many introductory chemistry courses. A number of existing activities use various data sets to model the development process for the periodic table. This paper describes an image arrangement computer program developed to mimic a paper-based card sorting periodic table…

Information system for the implementation of individual rehabilitation programs for persons with disabilities in Nizhny Novgorod region.

PubMed

Besstrashnova, Yanina K; Shoshmin, Alexander V; Nosov, Valeriy A

2012-01-01

In December 2011, the first phase of the project aimed at developing an information system for the implementation of individual rehabilitation programs for persons with disabilities was finished in Nizhny Novgorod region of Russia. It included the installation of 40 workstations in the Ministry for Social Policy and 8 institutions of Nizhny Novgorod region. Accumulated data were moved to a new information system based on a distributed database. In 2012, the rest of the regional rehabilitation institutions are to join this information system. A transition to a centralized database is planned.

Using ethnography in implementation research to improve nutrition interventions in populations

PubMed Central

Neufeld, Lynnette M.; Pelto, Gretel H.

2015-01-01

Abstract ‘Implementation research in nutrition’ is an emerging area of study aimed at building evidence‐based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view – the insider's perspective – and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the ‘emic’ (insider's) perspective.Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography.Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the ‘black box’ in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. PMID:26778802

Using ethnography in implementation research to improve nutrition interventions in populations.

PubMed

Tumilowicz, Alison; Neufeld, Lynnette M; Pelto, Gretel H

2015-12-01

'Implementation research in nutrition' is an emerging area of study aimed at building evidence-based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view--the insider's perspective--and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the 'emic' (insider's) perspective. Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography. Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the 'black box' in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. © 2015 John Wiley & Sons Ltd.

Feasibility of implementing a recovery education center in a Veterans Affairs medical center.

PubMed

Peer, Jason E; Gardner, Mary; Autrey, Sophia; Calmes, Christine; Goldberg, Richard W

2018-04-30

The purpose of this study was to determine the feasibility of implementing a recovery education program in a Veterans Affairs medical center. This case study describes development and implementation of a mental health and wellness curriculum offered through a centralized location. Referral and utilization data (n = 781) from the first 18 months of implementation were used to evaluate feasibility. Access to programming with zero exclusion was prioritized and average time from referral to enrollment was 9.6 days. Fifty-six percent of veterans admitted to mental health services during the 18-month evaluation period were referred to the program, and this level of utilization continued to be sustained. A broad range of classes was available. Opportunities to change classes as recovery goals evolved was encouraged and data indicate veterans actively tailored their individual recovery curriculum. Educational recovery programming was easily incorporated into a large integrated health facility, was well received, and offered greater opportunity for choice and individualization of recovery curriculum. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

One Rural Hospital's Experience Implementing the Society for Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.

PubMed

Curlej, Maria H; Katrancha, Elizabeth

2016-01-01

In an effort to take advantage of the Highmark Quality Blue Initiative () requiring information from hospitals detailing their central line-associated blood stream infections (CLABSIs) surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Recognizing the baseline rate of 2.4 CLABSIs per 1,000 central line days and its effect on patient outcomes and medical costs, this hospital made a commitment to improve their CLABSI outcomes. As a result, the facility adopted the Society for Healthcare Epidemiology of America (SHEA) guidelines. The purpose of this article is to review the CLABSI rates and examine the prevention strategies following implementation of the SHEA guidelines. A quantitative, descriptive retrospective program evaluation examined the hospital's pre- and post-SHEA implementation methods of decreasing CLABSIs and the subsequent CLABSI rates over 3 time periods. Any patient with a CLABSI infection admitted to this hospital July 2007 to June 2010 (N = 78). CLABSI rates decreased from 1.9 to 1.3 over the study period. Compliance with specific SHEA guidelines was evaluated and measures were put into place to increase compliance where necessary. CLABSI rates at this facility remain below the baseline of 2.4 for calendar year 2013 (0.79), 2014 (0.07), and 2015 (0.33).

[Study on the overall implementation status of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Li, J J; Li, J L; Zhang, J; Jin, R R; Ma, S; Deng, G J; Su, X W; Bian, F; Qu, Y M; Hu, L L; Jiang, Y

2018-04-10

Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.

Hand-held computer operating system program for collection of resident experience data.

PubMed

Malan, T K; Haffner, W H; Armstrong, A Y; Satin, A J

2000-11-01

To describe a system for recording resident experience involving hand-held computers with the Palm Operating System (3 Com, Inc., Santa Clara, CA). Hand-held personal computers (PCs) are popular, easy to use, inexpensive, portable, and can share data among other operating systems. Residents in our program carry individual hand-held database computers to record Residency Review Committee (RRC) reportable patient encounters. Each resident's data is transferred to a single central relational database compatible with Microsoft Access (Microsoft Corporation, Redmond, WA). Patient data entry and subsequent transfer to a central database is accomplished with commercially available software that requires minimal computer expertise to implement and maintain. The central database can then be used for statistical analysis or to create required RRC resident experience reports. As a result, the data collection and transfer process takes less time for residents and program director alike, than paper-based or central computer-based systems. The system of collecting resident encounter data using hand-held computers with the Palm Operating System is easy to use, relatively inexpensive, accurate, and secure. The user-friendly system provides prompt, complete, and accurate data, enhancing the education of residents while facilitating the job of the program director.

The NASA Scientific and Technical Information (STI) Program's Implementation of Open Archives Initiation (OAI) for Data Interoperability and Data Exchange

NASA Technical Reports Server (NTRS)

Rocker, JoAnne; Roncaglia, George J.; Heimerl, Lynn N.; Nelson, Michael L.

2002-01-01

Interoperability and data-exchange are critical for the survival of government information management programs. E-government initiatives are transforming the way the government interacts with the public. More information is to be made available through web-enabled technologies. Programs such as the NASA's Scientific and Technical Information (STI) Program Office are tasked to find more effective ways to disseminate information to the public. The NASA STI Program is an agency-wide program charged with gathering, organizing, storing, and disseminating NASA-produced information for research and public use. The program is investigating the use of a new protocol called the Open Archives Initiative (OAI) as a means to improve data interoperability and data collection. OAI promotes the use of the OAI harvesting protocol as a simple way for data sharing among repositories. In two separate initiatives, the STI Program is implementing OAI In collaboration with the Air Force, Department of Energy, and Old Dominion University, the NASA STI Program has funded research on implementing the OAI to exchange data between the three organizations. The second initiative is the deployment of OAI for the NASA technical report server (TRS) environment. The NASA TRS environment is comprised of distributed technical report servers with a centralized search interface. This paper focuses on the implementation of OAI to promote interoperability among diverse data repositories.

System design and architecture for the IDTO prototype : phase II demonstration site (central Florida).

DOT National Transportation Integrated Search

2015-05-01

This report documents the System Design and Architecture for the Phase II implementation of the Integrated Dynamic Transit Operations (IDTO) Prototype bundle within the Dynamic Mobility Applications (DMA) portion of the Connected Vehicle Program. Thi...

Decentralized Modular Systems Versus Centralized Systems.

ERIC Educational Resources Information Center

Crossey, R. E.

Building design, planning, and construction programing for modular decentralized mechanical building systems are outlined in terms of costs, performance, expansion and flexibility. Design strategy, approach, and guidelines for implementing such systems for buildings are suggested, with emphasis on mechanical equipment and building element…

Association of housing first implementation and key outcomes among homeless persons with problematic substance use.

PubMed

Davidson, Clare; Neighbors, Charles; Hall, Gerod; Hogue, Aaron; Cho, Richard; Kutner, Bryan; Morgenstern, Jon

2014-11-01

Housing First is a supportive housing model for persons with histories of chronic homelessness that emphasizes client-centered services, provides immediate housing, and does not require treatment for mental illness or substance abuse as a condition of participation. Previous studies of Housing First have found reduced governmental costs and improved personal well-being among participants. However, variations in real-world program implementation require better understanding of the relationship between implementation and outcomes. This study investigated the effects of Housing First implementation on housing and substance use outcomes. Study participants were 358 individuals with histories of chronic homelessness and problematic substance use. Clients were housed in nine scatter-site Housing First programs in New York City. Program fidelity was judged across a set of core Housing First components. Client interviews at baseline and 12 months were used to assess substance use. Clients in programs with greater fidelity to consumer participation components of Housing First were more likely to be retained in housing and were less likely to report using stimulants or opiates at follow-up. Consistently implemented Housing First principles related to consumer participation were associated with superior housing and substance use outcomes among chronically homeless individuals with a history of substance use problems. The study findings suggest that program implementation is central to understanding the potential of Housing First to help clients achieve positive housing and substance use outcomes.

How Well Do Health-Mediation Programs Address the Determinants of the Poor Health Status of Roma? A Longitudinal Case Study

PubMed Central

P. van Dijk, Jitse

2017-01-01

In Central and Eastern Europe (CEE), health-mediation programs (HMPs) have become central policy instruments targeting health inequities between segregated Roma and general populations. Social determinants of health (SDH) represent the root causes behind health inequities. We therefore evaluated how an HMP based in Slovakia addressed known SDH in its agenda and its everyday implementation. To produce descriptive data on the HMP’s agenda and everyday implementation we observed and consulted 70 program participants across organizational levels and 30 program recipients over the long-term. We used a World Health Organization framework on SDH to direct data acquisition and consequent data content analysis, to structure the reporting of results, and to evaluate the program’s merits. In its agenda, the HMP did not address most known SDH, except for healthcare access and health-related behaviours. In the HMP’s everyday implementation, healthcare access facilitation activities were well received, performed as set out and effective. The opposite was true for most educational activities targeting health-related behaviours. The HMP fieldworkers were proactive and sometimes effective at addressing most other SDH domains beyond the HMP agenda, especially material conditions and psychosocial factors, but also selected local structural aspects. The HMP leaders supported such deliberate engagement only informally, considering the program inappropriate by definition and too unstable institutionally to handle such extensions. Reports indicate that the situation in other CEE HMPs is similar. To increase the HMPs’ impact on SDH, their theories and procedures should be adapted according to the programs’ more promising actual practice regarding SDH. PMID:29236067

32 CFR 154.2 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... , Director of Central Intelligence Directive (DCID) 1/14 2 and regulations of the National Security Agency. 1... Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE SECURITY DEPARTMENT OF DEFENSE PERSONNEL SECURITY PROGRAM REGULATION General Provisions § 154.2 Applicability. (a) This part implements the...

7 CFR 2003.18 - Functional organization of RHS.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Property Management Division, and Single Family Housing Centralized Servicing Center in St. Louis, Mo. (i... credit reports, and, site development. (ii) Multi-Family Housing Portfolio Management Division. Headed by... the management and servicing of the nationwide Multi-Family Housing programs. The Division implements...

Report on functional requirements and software architecture for the IDTO prototype phase 2 : central Florida demonstration.

DOT National Transportation Integrated Search

2015-05-01

This report documents the System Requirements and Architecture for the Phase 2 implementation of the Integrated Dynamic Transit Operations (IDTO) Prototype bundle within the Dynamic Mobility Applications (DMA) portion of the Connected Vehicle Program...

Dedicated Operating Room Teams and Clinical Outcomes in an Enhanced Recovery after Surgery Pathway for Colorectal Surgery.

PubMed

Grant, Michael C; Hanna, Andrew; Benson, Andrew; Hobson, Deborah; Wu, Christopher L; Yuan, Christina T; Rosen, Michael; Wick, Elizabeth C

2018-03-01

Our aim was to determine whether the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery after Surgery (ERAS) program. Enhanced Recovery after Surgery programs involve the application of bundled best practices to improve the value of perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. Development of dedicated teams of anesthesia providers was a component of ERAS implementation. Intraoperative provider team networks (surgeons, anesthesiologists, and certified registered nurse anesthetists) were developed for all cases before and after implementation of colorectal ERAS. Four measures of centrality were analyzed in each network based on case assignments, and these measures were correlated with both rates of process measure compliance and clinical outcomes. Enhanced Recovery after Surgery provider teams led to a decrease in the closeness of anesthesiologists (p = 0.04) and significant increase in the clustering coefficient of certified registered nurse anesthetists (p = 0.005) compared with the pre-ERAS network. There was no significant change in centrality among surgeons (p = NS for all measures). Enhanced Recovery after Surgery designation among anesthesiologists and nurse anesthetists-whereby individual providers received an in-service on protocol elements and received compliance data was strongly associated with high compliance (>0.6 of measures; p < 0.001 for each group). In addition, high compliance was associated with a significant reduction in length of stay (p < 0.01), surgical site infection (p < 0.002), and morbidity (p < 0.009). Dedicated operating room teams led to increased centrality among anesthesia providers, which in turn not only increased compliance, but also improved several clinical outcomes. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Central Alaska Network vital signs monitoring plan

USGS Publications Warehouse

MacCluskie, Margaret C.; Oakley, Karen L.; McDonald, Trent; Wilder, Doug

2005-01-01

Denali National Park and Preserve, Wrangell-St. Elias National Park and Preserve, and Yukon-Charley Rivers National Preserve have been organized into the Central Alaska Network (CAKN) for the purposes of carrying out ecological monitoring activities under the National Park Services’ Vital Signs Monitoring program. The Phase III Report is the initial draft of the Vital Signs Monitoring Plan for the Central Alaska Network. It includes updated material from the Phase I and II documents. This report, and draft protocols for 11 of the network’s Vital Signs, were peer reviewed early in 2005. Review comments were incorporated into the document bringing the network to the final stage of having a Vital Signs Monitoring Plan. Implementation of the program will formally begin in FY 2006. The broad goals of the CAKN monitoring program are to: (1) better understand the dynamic nature and condition of park ecosystems; and (2) provide reference points for comparisons with other, altered environments. The focus of the CAKN program will be to monitor ecosystems in order to detect change in ecological components and in the relationships among the components. Water quality monitoring is fully integrated within the CAKN monitoring program. A monitoring program for lentic (non-moving water) has been determined, and the program for lotic systems (moving water) is under development.

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

Goodwin, Malik

Reliable public lighting remains a critically important and valuable public service in Detroit, Michigan. The Downtown Detroit Energy Efficiency Lighting Program (the, “Program”) was designed and implemented to bring the latest advancements in lighting technology, energy efficiency, public safety and reliability to Detroit’s Central Business District, and the Program accomplished those goals successfully. Downtown’s nighttime atmosphere has been upgraded as a result of the installation of over 1000 new LED roadway lighting fixtures that were installed as part of the Program. The reliability of the lighting system has also improved.

Turbo Pascal Implementation of a Distributed Processing Network of MS-DOS Microcomputers Connected in a Master-Slave Configuration

DTIC Science & Technology

1989-12-01

Interrupt Procedures ....... 29 13. Support for a Larger Memory Model ................ 29 C. IMPLEMENTATION ........................................ 29...describe the programmer’s model of the hardware utilized in the microcomputers and interrupt driven serial communication considerations. Chapter III...Central Processor Unit The programming model of Table 2.1 is common to the Intel 8088, 8086 and 80x86 series of microprocessors used in the IBM PC/AT

Accessibility Considerations for Hybrid Courses

ERIC Educational Resources Information Center

Behling, Kirsten

2017-01-01

This chapter explores the central questions and issues that faculty and administrators need to consider when designing and implementing hybrid courses to ensure that all students, including those with disabilities, have equal access. The author offers resources on faculty development programs, accessibility checklists, and online resources on…

Developing an active implementation model for a chronic disease management program.

PubMed

Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter

2013-04-01

Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council's model for complex interventions and the Chronic Care Model. We used the Medical Research Council's five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council's model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial (results reported elsewhere). The combination of the theoretical model for complex interventions and the Chronic Care Model and the chosen specific implementation strategies proved feasible for a practice-based active implementation model for a chronic-disease-management-program for COPD. Using the Medical Research Council's model added transparency to the design phase which further facilitated the process of implementing the program. http://www.clinicaltrials.gov/(NCT01228708).

Programmed cell death acts at different stages of Drosophila neurodevelopment to shape the central nervous system

PubMed Central

Desplan, Claude

2016-01-01

Nervous system development is a process that integrates cell proliferation, differentiation and programmed cell death (PCD). PCD is an evolutionary conserved mechanism and a fundamental developmental process by which the final cell number in a nervous system is established. In vertebrates and invertebrates, PCD can be determined intrinsically by cell lineage and age, as well as extrinsically by nutritional, metabolic and hormonal states. Drosophila has been an instrumental model for understanding how this mechanism is regulated. We review the role of PCD in Drosophila central nervous system development from neural progenitors to neurons, its molecular mechanism and function, how it is regulated and implemented, and how it ultimately shapes the fly central nervous system from the embryo to the adult. Finally, we discuss ideas that emerge while integrating this information. PMID:27404003

Neighborhood comparison operator

NASA Technical Reports Server (NTRS)

Gennery, D. B. (Inventor)

1985-01-01

Digital values in a moving window are compared by an operator having nine comparators connected to line buffers for receiving a succession of central pixels together with eight neighborhood pixels. A single bit of program control determines whether the neighborhood pixels are to be compared with the central pixel or a threshold value. The central pixel is always compared with the threshold. The omparator output plus 2 bits indicating odd-even pixel/line information about the central pixel addresses a lookup table to provide 14 bits of information, including 2 bits which control a selector to pass either the central pixel value, the other 12 bits of table information, or the bit-wise logical OR of all nine pixels through circuit that implements a very wide OR gate.

Distributed data collection and supervision based on web sensor

NASA Astrophysics Data System (ADS)

He, Pengju; Dai, Guanzhong; Fu, Lei; Li, Xiangjun

2006-11-01

As a node in Internet/Intranet, web sensor has been promoted in recent years and wildly applied in remote manufactory, workshop measurement and control field. However, the conventional scheme can only support HTTP protocol, and the remote users supervise and control the collected data published by web in the standard browser because of the limited resource of the microprocessor in the sensor; moreover, only one node of data acquirement can be supervised and controlled in one instant therefore the requirement of centralized remote supervision, control and data process can not be satisfied in some fields. In this paper, the centralized remote supervision, control and data process by the web sensor are proposed and implemented by the principle of device driver program. The useless information of the every collected web page embedded in the sensor is filtered and the useful data is transmitted to the real-time database in the workstation, and different filter algorithms are designed for different sensors possessing independent web pages. Every sensor node has its own filter program of web, called "web data collection driver program", the collecting details are shielded, and the supervision, control and configuration software can be implemented by the call of web data collection driver program just like the use of the I/O driver program. The proposed technology can be applied in the data acquirement where relative low real-time is required.

[How to implement a unique triage system in the emergency departments of Latium, Italy].

PubMed

De Luca, A; Francia, C; Gabriele, S; Guasticchi, G

2008-01-01

Triage is an efficient system that emergency departments (EDs) use to sort out presenting patients on the basis of the speed with which they need treatment. Because triage is not used consistently in the EDs of Latium, a region in central Italy, the regional Public Health Agency (PHA) planned and implemented a regional model of triage in all EDs. This manuscript describe the regional implementation strategy. The PHA activated the "Regional Triage Program--RTP" including: development and testing of a "triage section" in the computerized EDs clinical chart; production of an operational handbook for the RTP for triage health professionals (HPs); implementation of an continuum educational program on the "RTP" in all EDs of Latium. The computerized triage section was tested and implemented in all EDs in the region. The handbook for triage HPs was produced. The educational program, has been ongoing since 2008 in all regional EDs. Selected HPs, identified as "facilitators", were trained on how to implement the RTP. They will organize, in their own EDs, small groups of nurses to conduct on-site training of the RTP. The RTP was received with enthusiasm by most HPs, however its introduction into current practice could be hampered by organizational/structural problems and conflicts between nurses and doctors. Next actions of the regional program will be to overcome the possible above mentioned troubles.

Differentiating Language Arts in Belize

ERIC Educational Resources Information Center

Cook, Pamela R.

2009-01-01

Purpose: There is limited amount of research that constitutes non-traditional curricula implemented within an institutionalized context of developing countries. An attempt is made in this project to gain a clearer understanding of a non-traditional early learning program within an orphanage campus setting of Ladyville, Belize, Central America.…

Evaluation of Rural Primary Health Care in Western China: A Cross-Sectional Study.

PubMed

Wang, Manli; Fang, Haiqing; Bishwajit, Ghose; Xiang, Yuanxi; Fu, Hang; Feng, Zhanchun

2015-10-29

China's Ministry of Health has enacted Rural Primary Health Care Program (2001-2010) (HCP) guidelines to improve the quality of people's health. However, the program's success in Western China remains unevaluated. Thus, this study aims to begin to fill that gap by analyzing the provision and utilization of Rural Primary Health Care (RPHC) in Western China. A cross-sectional study was conducted to collect secondary data on the socio-economic characteristics, system construction, services use and implementation of RPHC, and the residents' health status of the sampled areas. Four hundred counties from 31 provinces in China were selected via stratified random sampling, including 171 counties from 12 Western provinces. Twenty-seven analysis indicators, covering system construction, services use and implementation of RPHC were chosen to assess Western China's primary health quality. Analysis of Variance (ANOVA) and Least Significant Difference (LSD) methods were used to measure the RPHC disparities between Western and Eastern and Central China. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank Western, Eastern and Central internal provinces regarding quality of their RPHC. Of the 27 indicators, 13 (48.15%) were below the standard in Western China. These focused on rural health service system construction, Chinese medicine services, and public health. In the comparison between Western, Central and Eastern China, 12 indicators had statistical significance (p < 0.05), and using LSD to compare between Western and Eastern China, all indicators were statistically significant (p < 0.05), demonstrating regional disparities. Xinjiang Province's RPHC ranked highest overall, and Yunnan Province ranked the lowest, indicating the internal differences within the 12 Western provinces; and Western provinces' Ci value was lower than that of Eastern and Central China overall. Western China's RPHC has proceeded well, but remains weaker than that of Eastern and Central China. Differences within Western internal provinces threaten the successful implementation of RPHC.

One Health Integration: A Proposed Framework for a Study on Veterinarians and Zoonotic Disease Management in Ghana.

PubMed

Valeix, Sophie Françoise

2018-01-01

In parallel with the recent world-wide promotion of One Health (OH) as a policy concept, a growing body of social science studies has raised questions about how successful OH policies and programs have been in managing some global health issues, such as zoonotic diseases. This paper briefly reviews this literature to clarify its critical perspective. Much of the literature on OH also is focused on health management at an international level and has paid less attention to implementation programs and policies for OH at the national and local levels, especially in low-and-middle-income countries (LMICs). Programs to implement OH often are linked to the concept of "integration", a notion that lacks a universal definition, but is nonetheless a central tenet and goal in many OH programs. At the local and national levels, strong differences in perspectives about OH among different professions can be major barriers to integration of those professions into OH implementation. Policies based on integration among professions in sectors like animal, human and environmental health can threaten professions' identities and thus may meet with resistance. Taking into account these criticisms of OH research and implementation, this paper proposes a research framework to probe the dominant social dimensions and power dynamics among professional participants that affect OH implementation programs at the local and national levels in a low-income country. The proposed research focus is the veterinary profession and one aspect of OH in which veterinarians are necessary actors: zoonotic disease management. Results from research framed in this way can have immediate application to the programs under study and can inform more expansive research on the social determinants of successful implementation of OH programs and policies.

Contextual Information for the Potential Enhancement of Annual Radiation Protection Program Review Reports.

PubMed

Emery, Robert J; Gutiérrez, Janet M

2017-08-01

Organizations possessing sources of ionizing radiation are required to develop, document, and implement a "radiation protection program" that is commensurate with the scope and extent of permitted activities and sufficient to ensure compliance with basic radiation safety regulations. The radiation protection program must also be reviewed at least annually, assessing program content and implementation. A convenience sample assessment of web-accessible and voluntarily-submitted radiation protection program annual review reports revealed that while the reports consistently documented compliance with necessary regulatory elements, very few included any critical contextual information describing how important the ability to possess radiation sources was to the central mission of the organization. Information regarding how much radioactive material was currently possessed as compared to license limits was also missing. Summarized here are suggested contextual elements that can be considered for possible inclusion in annual radiation protection program reviews to enhance stakeholder understanding and appreciation of the importance of the ability to possess radiation sources and the importance of maintaining compliance with associated regulatory requirements.

The enhancement model of ICT competence for the teachers of SMP Terbuka in Central Java to support long distance learning program

NASA Astrophysics Data System (ADS)

Widowati, Trisnani; Purwanti, Dwi

2017-03-01

ICT-based learning for SMP Terbuka is a manifestation of the first pillar of DEPDIKNAS Strategic Plan 2005-2009, about the use of ICT as the facility of long distance learning. By implementing ICT-based learning, the communication between the teacher and the students is possible to happen although both parties are in differnet places. The problem in implementing ICT-based learning for SMP Terbuka is the low competence of the teachers in ICT mastery, because this research is aimed to formulate the enhancement model of ICT competence for the teachers of SMP Terbuka in Central Java to support long distance learning program. This research shows that Supervised-Teachers and Tutor Teachers Competence in ICT is still low with the average of Supervised-Teachers competence in operating Ms.Word application of 59.6%, Ms.Excel 55.40%, Power Point 43.40% and internet mastery of 41.8%; while the competence of Tutor Teachers is lower with the average of 40.40% in operating Ms. Word, 35.20% in Ms.Excel, 28.00% in Power Point, and 29% in internet mastery. It means that Supervised-Teachers understand ICT, but they do not master it; while Tutor Teachers have just understood ICT and have a low mastery in Ms.Word. The output of this research is: The new findings of the enhancement model of ICT competence for the teachers of SMP Terbuka in Central Java to support long distance learning program.

76 FR 22615 - Privacy Act; Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... DEPARTMENT OF DEFENSE Office of the Secretary [Docket ID: DoD-2011-OS-0003] 32 CFR Part 322... Part 322 Privacy. Accordingly, 32 CFR part 322 is amended as follows: PART 322--NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICE PROGRAM 0 1. The authority citation for 32 CFR part 322.7 continues to...

Curriculum Approaches in Language Teaching: Forward, Central, and Backward Design

ERIC Educational Resources Information Center

Richards, Jack C.

2013-01-01

The development and implementation of language teaching programs can be approached in several different ways, each of which has different implications for curriculum design. Three curriculum approaches are described and compared. Each differs with respect to when issues related to input, process, and outcomes, are addressed. Forward design starts…

Marketing and Market Research for Adult and Continuing Education.

ERIC Educational Resources Information Center

Buckmaster, Annette

Marketing is an essential part of conducting a continuing education program, but marketing consists of more than just promotion. According to Kotler, exchange is the central concept underlying marketing. Marketing involves understanding, planning, implementing, and controlling this exchange. The exchange situation contains all the elements of the…

Biological Sciences Curriculum Study Newsletter Number 39, BSCS Biology: A World View.

ERIC Educational Resources Information Center

Clark, George M.

Included are progress reports from forty-two countries, ranging from accounts of complete adaptation and implementation of Biological Sciences Curriculum Study (BSCS) materials to notes of preliminary contact with BSCS programs. Countries represented are: Afganistan, Argentina, Australia, Bolivia, Brazil, Canada, Central America, Ceylon, Chile,…

Dialogue and Training. 1975.

ERIC Educational Resources Information Center

Fritz, Gerhard; Kern, Ulrich, Ed.

Information on the German Foundation for International Development (DSE) and DSE's program events for 1975 are presented. (DSE is one of the central institutions in the Federal Republic of Germany charged with the implementation of development policy measures. Established in 1959, the objective of the DSE is to foster relations between the Federal…

Energy planning and energy efficiency assistance

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

Markel, L.

1995-12-31

Electrotek is an engineering services company specializing in energy-related programs. Clients are most utilities, large energy users, and the U.S. Electric Power Research Institute. Electrotek has directed energy projects for the U.S. Agency for International Development and the U.S. Department of Energy in Poland and other countries of Central Europe. The objective is to assist the host country organizations to identify and implement appropriate energy efficiency and pollution reduction technologies, to transfer technical and organizational knowledge, so that further implementations are market-driven, without needed continuing foreign investment. Electrotek has worked with the Silesian Power Distribution Company to design an energymore » efficiency program for industrial customers that has proven to be profitable for the company and for its customers. The program has both saved energy and costs, and reduced pollution. The program is expanding to include additional customers, without needing more funding from the U.S. government.« less

Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Russian Federation, the Western countries of the former Soviet Union, Caucasus region and Central Asia.

PubMed

Rogovskaya, Svetlana I; Shabalova, Irina P; Mikheeva, Irina V; Minkina, Galina N; Podzolkova, Nataly M; Shipulina, Olga Y; Sultanov, Said N; Kosenko, Iren A; Brotons, Maria; Buttmann, Nina; Dartell, Myassa; Arbyn, Marc; Syrjänen, Stina; Poljak, Mario

2013-12-31

Limited data are available on the burden of human papillomavirus (HPV) and its associated diseases in the Russian Federation, the Western Countries of the former Soviet Union (Belarus, Republic of Moldova, Ukraine), the Caucasus region and Central Asia (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan). Both the incidence and mortality rate of cervical cancer are higher in these countries than in most Western European countries. In this article, we review available data on HPV prevalence and type distribution in women with normal cytology, women from the general population, cervical precancerous lesions and cervical cancer, as well as data on national policies of cervical cancer screening and HPV vaccination initiatives in these countries. Based on scarce data from the 12 countries, the high-risk HPV (hrHPV) prevalence among 5226 women with normal cytology ranged from 0.0% to 48.4%. In women with low-grade cervical lesions, the hrHPV prevalence among 1062 women varied from 29.2% to 100%. HrHPV infection in 565 women with high-grade cervical lesions ranged from 77.2% to 100% and in 464 invasive cervical cancer samples from 89.8% to 100%. HPV16 was the most commonly detected hrHPV genotype in all categories. As the HPV genotype distribution in cervical diseases seems to be similar to that found in Western Europe the implementation of HPV testing in screening programs might be beneficial. Opportunistic screening programs, the lack of efficient call-recall systems, low coverage, and the absence of quality assured cytology with centralized screening registry are major reasons for low success rates of cervical cancer programs in many of the countries. Finally, HPV vaccination is currently not widely implemented in most of the twelve countries mainly due to pricing, availability, and limited awareness among public and health care providers. Country-specific research, organized nationwide screening programs, registries and well defined vaccination policies are needed. This article forms part of a Regional Report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region" Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2013 Elsevier Ltd. All rights reserved.

Lights, Camera, Action ... and Cooling - The case for centralized low carbon energy at Fox Studios

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

Robinson, Alastair; Regnier, Cindy

Fox Studios partnered with the U.S. Department of Energy (DOE) to develop and implement solutions to retrofit two production stages and one of its central cooling plants, to reduce energy consumption by at least 30% as part of DOE’s Commercial Building Partnerships (CBP) Program. Although this case study reports expected savings arising from proposed design recommendations for a unique building type and the unusual load characteristics associated with its use, the EEMs implemented for the central plant are applicable to any large campus, office and higher education facility. The intent is that by making the energy-efficiency measures (EEMs) set thatmore » were assessed as cost-effective from this project applicable to a larger number of buildings on the campus Fox Studios will be able to implement an integrated campus-wide energy strategy for the long term. The significant challenges for this project in the design phase included identifying how to assess and analyze multiple system types, develop a coherent strategy for assessment and analysis, implement the measurement and verification activities to collect the appropriate data (in terms of capturing ‘normal’ operating characteristics and granularity) and determine the best approach to providing cooling to the site buildings based on the nature of existing systems and the expected improvement in energy performance of the central cooling plant. The analytical framework adopted provides a blueprint for similar projects at other large commercial building campuses.« less

Proceedings of the Ship Control Systems Symposium (9th) Held in Bethesda, Maryland on 10-14 September 1990. Theme: Automation in Surface Ship Control Systems, Today’s Applications and Future Trends. Volume 1

DTIC Science & Technology

1990-09-14

transmission of detected variations through sound lines of communication to centrally located standard Navy computers . These computers would be programmed to...have been programmed in C language. The program runs under the operating system ,OS9 on a VME-bus computer with a 68000 microprocessor. A number of full...present practice of"add-on" supervisory controls during ship design and construction,and "fix-it" R&D programs implemented after the ship isoperational

Effectiveness of a combination prevention strategy for HIV risk reduction with men who have sex with men in Central America: a mid-term evaluation.

PubMed

Firestone, Rebecca; Rivas, Jorge; Lungo, Susana; Cabrera, Alejandra; Ruether, Susan; Wheeler, Jennifer; Vu, Lung

2014-12-04

Despite over a decade of research and programming, little evidence is available on effective strategies to reduce HIV risks among Central American men who have sex with men (MSM). The Pan-American Social Marketing Organization (PASMO) and partners are implementing a HIV Combination Prevention Program to provide key populations with an essential package of prevention interventions and services: 1) behavioral, including interpersonal communications, and online outreach; 2) biomedical services including HIV testing and counseling and screening for STIs; and 3) complementary support, including legal support and treatment for substance abuse. Two years into implementation, we evaluated this program's effectiveness for MSM by testing whether exposure to any or a combination of program components could reduce HIV risks. PASMO surveyed MSM in 10 cities across Guatemala, El Salvador, Nicaragua, Costa Rica, and Panama in 2012 using respondent-driven sampling. We used coarsened exact matching to create statistically equivalent groups of men exposed and non-exposed to the program, matching on education, measures of social interaction, and exposure to other HIV prevention programs. We estimated average treatment effects of each component and all combined to assess HIV testing and condom use outcomes, using multivariable logistic regression. We also linked survey data to routine service data to assess program coverage. Exposure to any program component was 32% in the study area (n = 3531). Only 2.8% of men received all components. Men exposed to both behavioral and biomedical components were more likely to use condoms and lubricant at last sex (AOR 3.05, 95% CI 1.08, 8.64), and those exposed to behavioral interventions were more likely to have tested for HIV in the past year (AOR 1.76, 95% CI 1.01, 3.10). PASMO's strategies to reach MSM with HIV prevention programming are still achieving low levels of population coverage, and few men are receiving the complete essential package. However, those reached are able to practice HIV prevention. Combination prevention is a promising approach in Central America, requiring expansion in coverage and intensity.

Model for the design of distributed data bases

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

Ram, S.

This research focuses on developing a model to solve the File Allocation Problem (FAP). The model integrates two major design issues, namely Concurrently Control and Data Distribution. The central node locking mechanism is incorporated in developing a nonlinear integer programming model. Two solution algorithms are proposed, one of which was implemented in FORTRAN.V. The allocation of data bases and programs are examined using this heuristic. Several decision rules were also formulated based on the results of the heuristic. A second more comprehensive heuristic was proposed, based on the knapsack problem. The development and implementation of this algorithm has been leftmore » as a topic for future research.« less

Implementation of targeted medication adherence interventions within a community chain pharmacy practice: The Pennsylvania Project.

PubMed

Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma

2014-01-01

To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.

Breeding and Selection of New Switchgrass Varieties for Increased Biomass Production

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

Taliaferro, C.M.

2003-05-27

Switchgrass breeding and genetics research was conducted from 1992-2002 at the Oklahoma State University as part of the national DOE-Bioenergy Feedstock Development Program (BFDP) effort to develop the species as a bioenergy feedstock crop. The fundamental objective of the program was to implement and conduct a breeding program to increase biomass yield capability in switchgrass and develop cultivars for the central and southern United States. Supporting research objectives included: (1) switchgrass germplasm collection, characterization, and enhancement; (2) elucidation of cytogenetic and breeding behavior; and (3) identification of best breeding procedures.

Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring.

PubMed

Park, Sang-Won; Ko, Suhui; An, Hye-Sun; Bang, Ji Hwan; Chung, Woo-Young

2017-01-01

Central line-associated bloodstream infections (CLABSIs) can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU) at a tertiary hospital. The core interventions consisted of implementation of insertion and maintenance bundles for CLABSI prevention. The overall interventions were guided and coordinated by active educational programs using peer tutoring. The CLABSI rates were compared for 9 months pre-intervention, 6 months during the intervention and 9 months post-intervention. The CLABSI rate was further observed for three years after the intervention. The rate of CLABSIs per 1000 catheter-days decreased from 6.9 infections in the pre-intervention period to 2.4 and 1.8 in the intervention (6 m; P  = 0.102) and post-intervention (9 m; P  = 0.036) periods, respectively. A regression model showed a significantly decreasing trend in the infection rate from the pre-intervention period ( P  < 0.001), with incidence-rate ratios of 0.348 (95% confidence interval [CI], 0.98-1.23) in the intervention period and 0.257 (95% CI, 0.07-0.91) in the post-intervention period. However, after the 9-month post-intervention period, the yearly CLABSI rates reverted to 3.0-5.4 infections per 1000 catheter-days over 3 years. Implementation of CLABSI prevention bundles using peer tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

Developing an active implementation model for a chronic disease management program

PubMed Central

Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter

2013-01-01

Background Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council’s model for complex interventions and the Chronic Care Model. Methods We used the Medical Research Council’s five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. Results The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council’s model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial (results reported elsewhere). Conclusion The combination of the theoretical model for complex interventions and the Chronic Care Model and the chosen specific implementation strategies proved feasible for a practice-based active implementation model for a chronic-disease-management-program for COPD. Using the Medical Research Council’s model added transparency to the design phase which further facilitated the process of implementing the program. Trial registration: http://www.clinicaltrials.gov/(NCT01228708). PMID:23882169

Parallel-Processing Software for Correlating Stereo Images

NASA Technical Reports Server (NTRS)

Klimeck, Gerhard; Deen, Robert; Mcauley, Michael; DeJong, Eric

2007-01-01

A computer program implements parallel- processing algorithms for cor relating images of terrain acquired by stereoscopic pairs of digital stereo cameras on an exploratory robotic vehicle (e.g., a Mars rove r). Such correlations are used to create three-dimensional computatio nal models of the terrain for navigation. In this program, the scene viewed by the cameras is segmented into subimages. Each subimage is assigned to one of a number of central processing units (CPUs) opera ting simultaneously.

Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa

PubMed Central

Amoussouhoui, Arnaud Setondji; Wadagni, Anita Carolle; Johnson, Roch Christian; Aoulou, Paulin; Agbo, Inès Elvire; Houezo, Jean-Gabin; Boyer, Micah; Nichter, Mark

2018-01-01

Background Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin’s most endemic districts previously served by centralized hospital-based care. Methodology/Principal findings We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. Conclusions/Significance This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control. PMID:29529087

Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa.

PubMed

Amoussouhoui, Arnaud Setondji; Sopoh, Ghislain Emmanuel; Wadagni, Anita Carolle; Johnson, Roch Christian; Aoulou, Paulin; Agbo, Inès Elvire; Houezo, Jean-Gabin; Boyer, Micah; Nichter, Mark

2018-03-01

Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care. We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control.

CDC 7600 LTSS programming stratagens: preparing your first production code for the Livermore Timesharing System

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

Fong, K. W.

1977-08-15

This report deals with some techniques in applied programming using the Livermore Timesharing System (LTSS) on the CDC 7600 computers at the National Magnetic Fusion Energy Computer Center (NMFECC) and the Lawrence Livermore Laboratory Computer Center (LLLCC or Octopus network). This report is based on a document originally written specifically about the system as it is implemented at NMFECC but has been revised to accommodate differences between LLLCC and NMFECC implementations. Topics include: maintaining programs, debugging, recovering from system crashes, and using the central processing unit, memory, and input/output devices efficiently and economically. Routines that aid in these procedures aremore » mentioned. The companion report, UCID-17556, An LTSS Compendium, discusses the hardware and operating system and should be read before reading this report.« less

Direct Instruction and Guided Practice Matter in Conflict Resolution and Social-Emotional Learning

ERIC Educational Resources Information Center

DeVoogd, Karen; Lane-Garon, Pamela; Kralowec, Charles A.

2016-01-01

Seven schools in an economically challenged area of an urban school district in central California implemented mentored peer mediation programs under the guidance of a university-K-12 partnership project, Mediator Mentors. Individual student outcomes for social-cognitive dispositions, perceptions of school climate, conflict strategy choices, and…

Filipino Women in the Workplace.

ERIC Educational Resources Information Center

Lacson, Jose D.

The Women in Nontraditional Trades (WINT) project has implemented a new skills training program for women in the Philippines. It is being pilot tested in two regional training centers of the National Manpower and Youth Council in central Mindanao and southern Luzon. A major component of the WINT project is the provision of skills training for…

77 FR 36287 - Proposed Low-Effect Habitat Conservation Plan for the California Tiger Salamander, Calaveras...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-18

...-FXES11120800000F2-123-F2] Proposed Low-Effect Habitat Conservation Plan for the California Tiger Salamander... animal, the threatened Central California Distinct Population Segment of the California tiger salamander (tiger salamander). The applicant would implement a conservation program to minimize and mitigate the...

Strengthening Collective Action to Improve Marketing Performance: Evidence from Farmer Groups in Central Africa

ERIC Educational Resources Information Center

Ochieng, Justus; Knerr, Beatrice; Owuor, George; Ouma, Emily

2018-01-01

Purpose: Several development organisations have implemented programs to enhance smallholder farmers' crop productivity and market access through collective action with mixed results. Therefore, this study examines the drivers of success of collective action initiatives as a pathway to improving farmers marketing performance using data from Rwanda…

Building School Communities: A District Success Story.

ERIC Educational Resources Information Center

Brown, Laura; Ushijima, Teri

This paper, provided by the vendor of the product being described, discusses a program implemented in the Central Oahu School District in Honolulu, Hawaii called "Tribes." The mission of Tribes is to promote the healthy development of every child in the school community so that each has the knowledge, skills, and resiliency to be…

Improving Reading Achievement through the Implementation of a Balanced Literacy Approach.

ERIC Educational Resources Information Center

Arkebauer, Cynthia; MacDonald, Christine; Palmer, Crystal

This report describes a program for increasing students' reading fluency and comprehension by giving them a variety of skills and strategies. The targeted population consisted of two elementary schools in a growing, lower to middle class community, located in central Illinois. The problems of lack of reading strategies were documented through data…

Decreasing School Suspensions among Middle School Children by Implementing a Rehabilitative In-Room Suspension.

ERIC Educational Resources Information Center

Novell, Ireneanne

This practicum report describes a 15-day in-room suspension strategy designed to reduce the increasing number of principal-initiated student suspensions resulting from inappropriate conduct. The program's distinguishing features entailed a central figure who predetermined the candidates by means of a pre-suspension interview, parental-student…

77 FR 20577 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Central Indiana...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... demonstration SIP revisions) and maintenance plans include budgets of on-road mobile source emissions for... 62188). Under section 176(c) of the CAA, transportation plans, Transportation Improvement Programs (TIPs... margin. Table 4.1-A in the submittal demonstrates how mobile source emissions decline from the attainment...

Lessons Learned from Highly Implemented Programs of Study

ERIC Educational Resources Information Center

Stipanovic, Natalie; Shumer, Rob; Stringfield, Sam

2012-01-01

American businesses and industries have long identified shortages in key career and technical areas--some of these areas require two- or four-year college degrees, whereas others simply require industry certifications. Career and technical education (CTE) has the potential to play a central role in filling these gaps. The current Carl D. Perkins…

Implementation of Submerged Arc Welding Training. Final Report.

ERIC Educational Resources Information Center

Bowick, Earl; Todd, John

A unit on submerged arc welding (SAW) was developed and integrated into the welding program at Seattle Central Community College (Washington) during the period December 1983 through May 1984. During this time, 10 major users of SAW in the area were contacted and mailed questionnaires. Follow up consisted of telephone calls and personal contact as…

Navigating Multiple ePortfolios: Lessons Learned from a Capstone Seminar

ERIC Educational Resources Information Center

Richards-Schuster, Katie; Galura, Joseph

2017-01-01

ePortfolios are a growing trend in higher education, implemented by an increasing number of curricular and co-curricular programs. Given the de-centralized nature of many colleges and universities, it is inevitable that faculty requiring ePortfolios, especially as capstone experiences, will engage with students who have completed one or more…

Challenges of Virtual and Open Distance Science Teacher Education in Zimbabwe

ERIC Educational Resources Information Center

Mpofu, Vongai; Samukange, Tendai; Kusure, Lovemore M.; Zinyandu, Tinoidzwa M.; Denhere, Clever; Huggins, Nyakotyo; Wiseman, Chingombe; Ndlovu, Shakespear; Chiveya, Renias; Matavire, Monica; Mukavhi, Leckson; Gwizangwe, Isaac; Magombe, Elliot; Magomelo, Munyaradzi; Sithole, Fungai; Bindura University of Science Education (BUSE),

2012-01-01

This paper reports on a study of the implementation of science teacher education through virtual and open distance learning in the Mashonaland Central Province, Zimbabwe. The study provides insight into challenges faced by students and lecturers on inception of the program at four centres. Data was collected from completed evaluation survey forms…

Effect of care management program structure on implementation: a normalization process theory analysis.

PubMed

Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

2016-08-15

Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice. Data collection involved semi-structured interviews and observations conducted at 25 practices in five physician organizations in Michigan, USA. Practices were selected to reflect variation in physician organizations, type of care management program, and degree of normalization. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with NPT as a guiding framework. Seventy interviews and 25 observations were completed. Two key structures for care management organization emerged: practice-based care management where the care managers were embedded in the practice as part of the practice team; and centralized care management where the care managers worked independently of the practice work flow and was located outside the practice. There were differences in normalization of care management across practices. Practice-based care management was generally better normalized as compared to centralized care management. Differences in normalization were well explained by the NPT, and in particular the collective action construct. When care managers had multiple and flexible opportunities for communication (interactional workability), had the requisite knowledge, skills, and personal characteristics (skill set workability), and the organizational support and resources (contextual integration), a trusting professional relationship (relational integration) developed between practice providers and staff and the care manager. When any of these elements were missing, care management implementation appeared to be affected negatively. Although care management can introduce many new changes into delivery of clinical practice, implementing it successfully as a new complex intervention is possible. NPT can be helpful in explaining differences in implementing a new care management program with a view to addressing them during implementation planning.

RESTful M2M Gateway for Remote Wireless Monitoring for District Central Heating Networks

PubMed Central

Cheng, Bo; Wei, Zesan

2014-01-01

In recent years, the increased interest in energy conservation and environmental protection, combined with the development of modern communication and computer technology, has resulted in the replacement of distributed heating by central heating in urban areas. This paper proposes a Representational State Transfer (REST) Machine-to-Machine (M2M) gateway for wireless remote monitoring for a district central heating network. In particular, we focus on the resource-oriented RESTful M2M gateway architecture, and present an uniform devices abstraction approach based on Open Service Gateway Initiative (OSGi) technology, and implement the resource mapping mechanism between resource address mapping mechanism between RESTful resources and the physical sensor devices, and present the buffer queue combined with polling method to implement the data scheduling and Quality of Service (QoS) guarantee, and also give the RESTful M2M gateway open service Application Programming Interface (API) set. The performance has been measured and analyzed. Finally, the conclusions and future work are presented. PMID:25436650

RESTful M2M gateway for remote wireless monitoring for district central heating networks.

PubMed

Cheng, Bo; Wei, Zesan

2014-11-27

In recent years, the increased interest in energy conservation and environmental protection, combined with the development of modern communication and computer technology, has resulted in the replacement of distributed heating by central heating in urban areas. This paper proposes a Representational State Transfer (REST) Machine-to-Machine (M2M) gateway for wireless remote monitoring for a district central heating network. In particular, we focus on the resource-oriented RESTful M2M gateway architecture, and present an uniform devices abstraction approach based on Open Service Gateway Initiative (OSGi) technology, and implement the resource mapping mechanism between resource address mapping mechanism between RESTful resources and the physical sensor devices, and present the buffer queue combined with polling method to implement the data scheduling and Quality of Service (QoS) guarantee, and also give the RESTful M2M gateway open service Application Programming Interface (API) set. The performance has been measured and analyzed. Finally, the conclusions and future work are presented.

Clinicians’ Perspectives on Cognitive Therapy in Community Mental Health Settings: Implications for Training and Implementation

PubMed Central

Gutiérrez-Colina, Ana; Toder, Katherine; Esposito, Gregory; Barg, Frances; Castro, Frank; Beck, Aaron T.; Crits-Christoph, Paul

2012-01-01

Policymakers are investing significant resources in large-scale training and implementation programs for evidence-based psychological treatments (EBPTs) in public mental health systems. However, relatively little research has been conducted to understand factors that may influence the success of efforts to implement EBPTs for adult consumers of mental health services. In a formative investigation during the development of a program to implement cognitive therapy (CT) in a community mental health system, we surveyed and interviewed clinicians and clinical administrators to identify potential influences on CT implementation within their agencies. Four primary themes were identified. Two related to attitudes towards CT: (1) ability to address client needs and issues that are perceived as most central to their presenting problems, and (2) reluctance to fully implement CT. Two themes were relevant to context: (1) agency-level barriers, specifically workload and productivity concerns and reactions to change, and (2) agency-level facilitators, specifically, treatment planning requirements and openness to training. These findings provide information that can be used to develop strategies to facilitate the implementation of CT interventions for clients being treated in public-sector settings. PMID:22426739

Results of a program to control phosphorus discharges from dairy operations in south-central Florida, USA

NASA Astrophysics Data System (ADS)

Havens, Karl E.; Flaig, Eric G.; James, R. Thomas; Lostal, Sergio; Muszick, Dera

1996-07-01

During 1987 1992, a mandatory program to control phosphorus discharges was implemented at dairy operations located to the north of Lake Okeechobee, Florida, USA. Thirty of 48 dairies participated in this program and implemented best management practices (BMPs), which included the construction of intensive animal waste management systems. Eighteen dairies closed their milkproducing operations under a government-funded buyout program. In this paper, we compare trends in runoff total phosphorus (TP) concentrations among the dairies that remained active and implemented BMPs. A central feature of the dairy waste management system is the high intensity area (HIA), defined as the milking barn and adjacent vegetation-free land, encircled by a drainage ditch and dike. Animal waste from the HIA is diverted into anaerobic lagoons and storage ponds, from which water is periodically removed and used for irrigation of field crops. The impacts of BMP construction on runoff TP concentrations were immediate and, in most cases, dramatic. Average TP concentrations declined significantly ( P < 0.001), from 9.0 to 1.2 mg TP liter-1 at dairies in one basin (Lower Kissimmee River), and from 2.6 to 1.0 mg TP liter-1 in another (Taylor Creek/Nubbin Slough). Some sites experienced greater declines in TP than others. To elucidate possible causes for the difference in response, a multivariate statistical model was utilized. Independent variables included soil pH, soil drainage characteristics, spodic horizon depth, and the areas of different BMP components (pasture, HIA, spray fields). The analysis significantly separated dairies with the highest and lowest runoff TP concentrations. Lowest TP occurred at dairies having particular soil characteristic (shallow spodic horizon) and certain BMP features (large HIA and small heard pastures).

[Forms of management of the national school meals program].

PubMed

Dos Santos, Sérgio Ribeiro; de Sousa Costa, Maria Bernadete; Torres de Paiva Bandeira, Geovanna

2016-04-01

The National School Meals Programme (PNAE in Portuguese initials) is a supplementary program to education that aims to provide school meals for pupils across the school system enrolled in public and philanthropic schools of primary education, secondary education, youth education, adult education and comprehensive education. The principles of the program are the universality and the expansion of student services in order to meet the Organic Law on Food and Nutritional Security (LOSAN), as well as the Food Security and Nutrition System. The objective of this study is to discuss forms of PNAE management to ensure that the students' right to school meals. This study is a reflection on how the resources of school meals are being managed, be it with a centralized, decentralized, semi-centralized or outsourced model. We conclude that the knowledge of the different forms of managing federal resources for food for school communities allows for making an informed choice regarding implementation and enforcement of PNAE.

The Impact of a Pay-for-Performance Program on Central Line-Associated Blood Stream Infections in Pennsylvania.

PubMed

Bastian, Nathaniel D; Kang, Hyojung; Nembhard, Harriet B; Bloschichak, Andrew; Griffin, Paul M

2016-01-01

Healthcare associated infections have significantly contributed to the rising cost of hospital care in the United States. The implementation of pay-for-performance (P4P) programs has been one approach to improve quality at a reduced cost. We quantify the impact of Highmark's Quality Blue (QB) hospital P4P program on central line-associated blood stream infections (CLABSI) in Pennsylvania. The impact of years of participation in QB on CLABSI is also evaluated. Data from 149 Pennsylvania hospitals on CLABSI from 2008-2013 are used. Negative binomial regression and fixed effects panel regression are performed. Hospitals participating in QB have 0.727 times the CLABSI as those hospitals that do not participate. Hospitals participating for four or more years have on average 3.13 fewer CLABSI per year compared to those participating for less than four years. Highmark's P4P program has shown improved outcomes with regards to CLABSI, but further research is needed to determine if QB is cost effective.

Improving management decision processes through centralized communication linkages

NASA Technical Reports Server (NTRS)

Simanton, D. F.; Garman, J. R.

1985-01-01

Information flow is a critical element to intelligent and timely decision-making. At NASA's Johnson Space Center the flow of information is being automated through the use of a centralized backbone network. The theoretical basis of this network, its implications to the horizontal and vertical flow of information, and the technical challenges involved in its implementation are the focus of this paper. The importance of the use of common tools among programs and some future concerns related to file transfer, graphics transfer, and merging of voice and data are also discussed.

2011 John M. Eisenberg Patient Safety and Quality Awards. Mentored implementation: building leaders and achieving results through a collaborative improvement model. Innovation in patient safety and quality at the national level.

PubMed

Maynard, Gregory A; Budnitz, Tina L; Nickel, Wendy K; Greenwald, Jeffrey L; Kerr, Kathleen M; Miller, Joseph A; Resnic, JoAnne N; Rogers, Kendall M; Schnipper, Jeffrey L; Stein, Jason M; Whitcomb, Winthrop F; Williams, Mark V

2012-07-01

The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs with the dual aims of educating and mentoring hospitalists and their quality improvement (QI) teams and accelerating improvement in the inpatient setting in three signature programs: Venous Thromboembolism (VTE) Prevention, Glycemic Control, and Project BOOST (Better Outcomes for Older adults through Safe Transitions). More than 300 hospital improvement teams were enrolled in SHM MI programs in a series of cohorts. Hospitalist mentors worked with individual hospitals/health systems to guide local teams through the life cycle of a QI project. Implementation Guides and comprehensive Web-based "Resource Rooms," as well as the mentor's own experience, provided best-practice definitions, practical implementation tips, measurement strategies, and other tools. E-mail interactions and mentoring were augmented by regularly scheduled teleconferences; group webinars; and, in some instances, a site visit. Performance was tracked in a centralized data tracking center. Preliminary data on all three MI programs show significant improvement in patient outcomes, as well as enhancements of communication and leadership skills of the hospitalists and their QI teams. Although objective data on outcomes and process measures for the MI program's efficacy remain preliminary at this time, the maturing data tracking system, multiple awards, and early results indicate that the MI programs are successful in providing QI training and accelerating improvement efforts.

Governance and assessment in a widely distributed medical education program in Australia.

PubMed

Solarsh, Geoff; Lindley, Jennifer; Whyte, Gordon; Fahey, Michael; Walker, Amanda

2012-06-01

The learning objectives, curriculum content, and assessment standards for distributed medical education programs must be aligned across the health care systems and community contexts in which their students train. In this article, the authors describe their experiences at Monash University implementing a distributed medical education program at metropolitan, regional, and rural Australian sites and an offshore Malaysian site, using four different implementation models. Standardizing learning objectives, curriculum content, and assessment standards across all sites while allowing for site-specific implementation models created challenges for educational alignment. At the same time, this diversity created opportunities to customize the curriculum to fit a variety of settings and for innovations that have enriched the educational system as a whole.Developing these distributed medical education programs required a detailed review of Monash's learning objectives and curriculum content and their relevance to the four different sites. It also required a review of assessment methods to ensure an identical and equitable system of assessment for students at all sites. It additionally demanded changes to the systems of governance and the management of the educational program away from a centrally constructed and mandated curriculum to more collaborative approaches to curriculum design and implementation involving discipline leaders at multiple sites.Distributed medical education programs, like that at Monash, in which cohorts of students undertake the same curriculum in different contexts, provide potentially powerful research platforms to compare different pedagogical approaches to medical education and the impact of context on learning outcomes.

Assisted outpatient treatment in New York: regional differences in New York's assisted outpatient treatment program.

PubMed

Robbins, Pamela Clark; Keator, Karli J; Steadman, Henry J; Swanson, Jeffrey W; Wilder, Christine M; Swartz, Marvin S

2010-10-01

This study sought to describe the implementation of "Kendra's Law" in New York State and examine regional differences in the application of the program. Between February 2007 and April 2008, interviews were conducted with 50 key informants across New York State. Key informants included assisted outpatient treatment (AOT) county coordinators, county directors of community services, judges, attorneys from the Mental Hygiene Legal Service (MHLS), psychiatrists, treatment providers, peer advocates, family members, and other referred individuals. Additional analyses were conducted using AOT program administrative and evaluation databases and client history data. From program inception in 1999 through 2007, a total of 8,752 initial AOT orders and 5,684 renewals were granted. Notable regional differences were found in the use of two distinct models of AOT: AOT First and Enhanced Voluntary Services First. Regional differences were also found in how the AOT program was implemented and administered. Other variations stemmed from the court proceedings themselves, the continuity and interest of the presiding judge, and the attitudes of the MHLS attorneys. Many regional adaptations of the AOT program were found. Many were the result of lack of guidance in implementing Kendra's Law. Policy makers may want to consider whether the law should change to allow for these differences or whether additional support from a central source is warranted to ensure more uniformity in the implementation of AOT and thus the fairness of its application across the state.

Development and implementation of a monitoring and information system to increase water use efficiency in arid and semi-arid areas in Limarí, Central Chile (WEIN)

NASA Astrophysics Data System (ADS)

Berger, Erich; Balmert, David; Richter, Jürgen

2016-10-01

The project WEIN was funded by the Federal Ministry of Education and Research (BMBF | Berlin, Germany) in the framework of the high-tech strategy of Germany's program "KMU-Innovativ". The project started in 2012 and was completed in 2014. In the scope of the project, an integrated system for analysis, monitoring and information at river basin level was developed, which provides relevant information for all stakeholders that are concerned with water resource issues. The main objective of the project was to improve water use efficiency and hence ensure the agricultural production in the region. The pilot region, in which this system was implemented, is the semi-arid Limarí basin in Northern Central Chile. One of the main parts of the project was the development and implementation of a web- and app-based irrigation water ordering and accounting system for local farmers.

Pharmacy-based distribution system for enteral nutrition products.

PubMed

Craig, S A; Paulson, M F

1985-12-01

A hospital pharmacy department's implementation of enteral nutrition product distribution and its proposal for an enteral nutrition product admixture service are described. Responsibility for the distribution of enteral nutrition formulations was transferred from the central distribution department to the pharmacy after problems with inventory control, billing procedures, and inappropriate administration of enteral nutrition products were recognized by personnel from the central-distribution area and nutrition services. After additional problems were identified using a multi-disciplinary approach, the pharmacy department implemented an enteral nutrition product distribution system and developed an enteral nutrition product formulary. A proposal was developed for a pharmacy-based enteral nutrition admixture service, but implementation of this service was deferred because data from a cost-effectiveness evaluation and random bacteriologic monitoring did not justify adding the service. Pharmacy-based distribution and formulary control of enteral nutrition products alleviated problems with inaccurate patient charges and accumulation of stock on the nursing units. Pharmacists at this hospital hope to develop an enteral nutrition product admixture program that will result in cost savings for the institution.

Analyzing implementation dynamics using theory-driven evaluation principles: lessons learnt from a South African centralized chronic dispensing model.

PubMed

Magadzire, Bvudzai Priscilla; Marchal, Bruno; Mathys, Tania; Laing, Richard O; Ward, Kim

2017-12-04

Centralized dispensing of essential medicines is one of South Africa's strategies to address the shortage of pharmacists, reduce patients' waiting times and reduce over-crowding at public sector healthcare facilities. This article reports findings of an evaluation of the Chronic Dispensing Unit (CDU) in one province. The objectives of this process evaluation were to: (1) compare what was planned versus the actual implementation and (2) establish the causal elements and contextual factors influencing implementation. This qualitative study employed key informant interviews with the intervention's implementers (clinicians, managers and the service provider) [N = 40], and a review of policy and program documents. Data were thematically analyzed by identifying the main influences shaping the implementation process. Theory-driven evaluation principles were applied as a theoretical framework to explain implementation dynamics. The overall participants' response about the CDU was positive and the majority of informants concurred that the establishment of the CDU to dispense large volumes of medicines is a beneficial strategy to address healthcare barriers because mechanical functions are automated and distribution of medicines much quicker. However, implementation was influenced by the context and discrepancies between planned activities and actual implementation were noted. Procurement inefficiencies at central level caused medicine stock-outs and affected CDU activities. At the frontline, actors were aware of the CDU's implementation guidelines regarding patient selection, prescription validity and management of non-collected medicines but these were adapted to accommodate practical realities and to meet performance targets attached to the intervention. Implementation success was a result of a combination of 'hardware' (e.g. training, policies, implementation support and appropriate infrastructure) and 'software' (e.g. ownership, cooperation between healthcare practitioners and trust) factors. This study shows that health system interventions have unpredictable paths of implementation. Discrepancies between planned and actual implementation reinforce findings in existing literature suggesting that while tools and defined operating procedures are necessary for any intervention, their successful application depends crucially on the context and environment in which implementation occurs. We anticipate that this evaluation will stimulate wider thinking about the implementation of similar models in low- and middle-income countries.

Exploiting graphics processing units for computational biology and bioinformatics.

PubMed

Payne, Joshua L; Sinnott-Armstrong, Nicholas A; Moore, Jason H

2010-09-01

Advances in the video gaming industry have led to the production of low-cost, high-performance graphics processing units (GPUs) that possess more memory bandwidth and computational capability than central processing units (CPUs), the standard workhorses of scientific computing. With the recent release of generalpurpose GPUs and NVIDIA's GPU programming language, CUDA, graphics engines are being adopted widely in scientific computing applications, particularly in the fields of computational biology and bioinformatics. The goal of this article is to concisely present an introduction to GPU hardware and programming, aimed at the computational biologist or bioinformaticist. To this end, we discuss the primary differences between GPU and CPU architecture, introduce the basics of the CUDA programming language, and discuss important CUDA programming practices, such as the proper use of coalesced reads, data types, and memory hierarchies. We highlight each of these topics in the context of computing the all-pairs distance between instances in a dataset, a common procedure in numerous disciplines of scientific computing. We conclude with a runtime analysis of the GPU and CPU implementations of the all-pairs distance calculation. We show our final GPU implementation to outperform the CPU implementation by a factor of 1700.

Models of research-operational collaboration for behavioral health in space.

PubMed

Palinkas, Lawrence A; Allred, Charlene A; Landsverk, John A

2005-06-01

Addressing the behavioral health needs of astronauts clearly requires collaborations involving researchers, clinicians and operational support personnel, program administrators, and the astronauts themselves. However, such collaborations are often compromised by a failure to understand the needs, priorities, constraints, and preferences of potential collaborators. This failure, in turn, can lead to research of poor quality, implementation of programs and procedures that are not evidence-based, and an increased risk of morbidity and mission failure. The experiences of social marketing strategies in health promotion and disease prevention, cultural exchange between developers of evidence-based treatments and consumers, and dissemination and implementation of evidence-based practices in mental health services offer three different models of research-operational collaboration with relevance to behavioral health in space. Central to each of these models are the patterns of interpersonal relations and the individual, social, and organizational characteristics that influence these patterns. Any program or countermeasure for behavioral health in space must be both needs-based and evidence-based. The successful development, dissemination, implementation, and sustainability of such a program require communication, collaboration, and consensus among all key stakeholders. To accomplish this, all stakeholders must participate in creating a culture of operational research.

Sustainability of ARV provision in developing countries: challenging a framework based on program history.

PubMed

Azeredo, Thiago Botelho; Oliveira, Maria Auxiliadora; Santos-Pinto, Cláudia Du Bocage; Miranda, Elaine Silva; Osorio-de-Castro, Claudia Garcia Serpa

2017-08-01

The provision of ARVs is central to HIV/AIDS programs, because of its impact on the course of the disease and on quality of life. Although first-line treatments costs have declined, treatment-associated expenses are steeper each year. Sustainability is therefore an important variable for the success of treatment programs. A conceptual framework on sustainability of ARV provision was developed, followed by data collection instruments. The pilot study was undertaken in Brazil. Bolivia, Peru and Mozambique, were visited. Key informants were identified and interviewed. Investigation of sustainability related to ARV provision involved implementation and routinization events of provision schemes. Evidence of greater sustainability potential was observed in Peru, where provision is implemented and routinized by the National HIV/AIDS program and expenditures met by the government. In Mozambique, provision is dependent on donations and external aid, but the country displays a great effort to incorporate ARV provision and care in routine healthcare activities. Bolivia, in addition to external dependence on financing and management of drug supply, presents problems regarding implementation and routinization. The conceptual framework was useful in recognizing events that influence sustainable ARV provision in these countries.

A multifaceted program for improving quality of care in intensive care units: IATROREF study.

PubMed

Garrouste-Orgeas, Maite; Soufir, Lilia; Tabah, Alexis; Schwebel, Carole; Vesin, Aurelien; Adrie, Christophe; Thuong, Marie; Timsit, Jean Francois

2012-02-01

To test the effects of three multifaceted safety programs designed to decrease insulin administration errors, anticoagulant prescription and administration errors, and errors leading to accidental removal of endotracheal tubes and central venous catheters, respectively. Medical errors and adverse events are associated with increased mortality in intensive care patients, indicating an urgent need for prevention programs. Multicenter cluster-randomized study. One medical intensive care unit in a university hospital and two medical-surgical intensive care units in community hospitals belonging to the Outcomerea Study Group. Consecutive patients >18 yrs admitted from January 2007 to January 2008 to the intensive care units. We tested three multifaceted safety programs vs. standard care in random order, each over 2.5 months, after a 1.5-month observation period. Incidence rates of medical errors/1000 patient-days in the multifaceted safety program and standard-care groups were compared using adjusted hierarchical models. In 2117 patients with 15,014 patient-days, 8520 medical errors (567.5/1000 patient-days) were reported, including 1438 adverse events (16.9%, 95.8/1000 patient-days). The insulin multifaceted safety program significantly decreased errors during implementation (risk ratio 0.65; 95% confidence interval [CI] 0.52-0.82; p = .0003) and after implementation (risk ratio 0.51; 95% CI 0.35-0.73; p = .0004). A significant Hawthorne effect was found. The accidental tube/catheter removal multifaceted safety program decreased errors significantly during implementation (odds ratio [OR] 0.34; 95% CI 0.15-0.81; p = .01]) and nonsignificantly after implementation (OR 1.65; 95% CI 0.78-3.48). The anticoagulation multifaceted safety program was not significantly effective (OR 0.64; 95% CI 0.26-1.59) but produced a significant Hawthorne effect. A multifaceted program was effective in preventing insulin errors and accidental tube/catheter removal. Significant Hawthorne effects occurred, emphasizing the need for appropriately designed studies before definitively implementing strategies. clinicaltrials.gov Identifier: NCT00461461.

Welfare Time Limits: An Update on State Policies, Implementation, and Effects on Families

ERIC Educational Resources Information Center

Farrell, Mary; Rich, Sarah; Turner, Lesley; Seith, David; Bloom, Dan

2008-01-01

Time limits on benefit receipt became a central feature of federal welfare policy in the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). Proponents of welfare reform argued that the time limits in the Temporary Assistance for Needy Families (TANF) program, would send a firm message to recipients that welfare is…

Increasing Student Motivation through the Use of Multiple Intelligences and Cooperative Learning Techniques.

ERIC Educational Resources Information Center

Charbonneau, Nancy L.; Ribar, Linda L.

This action research project implemented and evaluated a program for increasing student motivation and interest in school to improve academic growth. The targeted population consisted of 37 high school students in a rural central Illinois community. Twenty-five students were in art classes and 12 were in child care classes. Anecdotal records,…

The Decision-Making Process Used by Central Office Administrators as They Implement Full Day Kindergarten

ERIC Educational Resources Information Center

Palte, Suzanne C.

2014-01-01

The State of Michigan, as of 2012-2013, requires school districts to enroll students in full day kindergarten to receive full funding. This study investigated the decision-making process that was used by public school districts to determine kindergarten programs in their district. Specifically, how did administrators and staff members use the…

A Developmental Approach to Graduate Education Review: A New Take on a Traditional Process

ERIC Educational Resources Information Center

Hakkola, Leah; King, Jean A.

2016-01-01

In this article we describe the Graduate Review and Improvement Process (GRIP), an innovative evaluation process that makes student input central, now beginning its fifth year of implementation at the University of Minnesota. We begin by contrasting GRIP with traditional graduate program review, and we then explain the conceptual underpinnings of…

PROFILE user's guide

NASA Technical Reports Server (NTRS)

Collins, L.; Saunders, D.

1986-01-01

User information for program PROFILE, an aerodynamics design utility for refining, plotting, and tabulating airfoil profiles is provided. The theory and implementation details for two of the more complex options are also presented. These are the REFINE option, for smoothing curvature in selected regions while retaining or seeking some specified thickness ratio, and the OPTIMIZE option, which seeks a specified curvature distribution. REFINE uses linear techniques to manipulate ordinates via the central difference approximation to second derivatives, while OPTIMIZE works directly with curvature using nonlinear least squares techniques. Use of programs QPLOT and BPLOT is also described, since all of the plots provided by PROFILE (airfoil coordinates, curvature distributions) are achieved via the general purpose QPLOT utility. BPLOT illustrates (again, via QPLOT) the shape functions used by two of PROFILE's options. The programs were designed and implemented for the Applied Aerodynamics Branch at NASA Ames Research Center, Moffett Field, California, and written in FORTRAN and run on a VAX-11/780 under VMS.

Implementation of the Clinical Encounters Tracking system at the Indiana University School of Medicine.

PubMed

Hatfield, Amy J; Bangert, Michael P

2005-01-01

The Indiana University School of Medicine (IUSM) Office of Medical Education &Student Services directed the IUSM Educational Technology Unit to develop a Clinical Encounters Tracking system in response to the Liaison Committee on Medical Education's (LCME) updated accreditation standards. A personal digital assistant (PDA) and centralized database server solution was implemented. Third-year medical students are required to carry a PDA on which they record clinical encounter experiences during all clerkship clinical rotations. Clinical encounters data collected on the PDAs are routinely uploaded to the central server via the PDA HotSyncing process. Real-time clinical encounter summary reports are accessed in the school's online curriculum management system: ANGEL. The resulting IUSM Clinical Encounters Tracking program addresses the LCME accreditation standard which mandates the tracking of medical students' required clinical curriculum experiences.

Controlling Endemic Pathogens—Challenges and Opportunities

PubMed Central

Shankaran, Sunita S.; James, William L.

2016-01-01

Abstract By most measures, the University of Utah Centralized Zebrafish Animal Resource is a successful zebrafish core facility: we house ∼4000–5000 tanks for over 16 research groups; provide services and equipment for ∼150 users; are currently undergoing an expansion by 3000 tanks; and have been praised by institutional and national regulatory agencies for the cleanliness and efficiency of our facility. In recent years, we have implemented new programs to improve the overall health of our colony and believe we have seen a reduction in apparently sick fish. However, there are still deficiencies in our monitoring and pathogen control programs. Our histopathology sample sizes have been insufficient to estimate prevalence, but our sentinel tank program reveals the presence of Pseudoloma neurophilia and myxozoan, presumably Myxidium streisinger, in our facility. As we develop protocols to further reduce the burden of disease, we are focused on defining our baseline, establishing goals, and implementing methods to monitor our progress. The data generated by this approach will allow us to evaluate and implement the most cost-effective protocols to improve fish health. PMID:26982004

Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership.

PubMed

Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James

2009-01-01

The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care.

Financial implications of glycemic control: results of an inpatient diabetes management program.

PubMed

Newton, Christopher A; Young, Sandra

2006-01-01

(1) To determine the financial implications associated with changes in clinical outcomes resulting from implementation of an inpatient diabetes management program and (2) to describe the strategies involved in the formation of this program. The various factors that influence financial outcomes are examined, and previous and current outcomes are compared. Associations exist between hyperglycemia, length of stay, and hospital costs. Implementation of an inpatient diabetes management program, based on published guidelines, has been shown to increase the use of scheduled medications to treat hyperglycemia and increase the frequency of physician intervention for glucose readings outside desired ranges. Results from implementing this program have included a reduction in the average glucose level in the medical intensive care unit through use of protocols driven to initiate intravenous insulin once the glucose level exceeds 140 mg/dL. Additionally, glucose levels have been reduced throughout the hospital, primarily because of interactions between diabetes nurse care managers and the primary care team. Associated with these lower glucose levels are a decreased prevalence of central line infections and shorter lengths of stay. The reduction in the length of stay for patients with diabetes has resulted in a savings of more than 2 million dollars for the year and has yielded a 467% return on investment for the hospital. Improved blood glucose control during the hospitalization of patients with known hyperglycemia is associated with reduced morbidity, reduced hospital length of stay, and cost savings. The implementation of an inpatient diabetes management program can provide better glycemic control, thereby improving outcomes for hyperglycemic patients while saving the hospital money.

Thinking strategically: academic-practice relationships: one health system's experience.

PubMed

Wurmser, Teri; Bliss-Holtz, Jane

2011-01-01

Strategic planning and joint leverage of the strengths inherent in the academic and practice arenas of nursing are imperative to confront the challenges facing the profession of nursing and its place within the healthcare team of the future. This article presents a description and discussion of the implementation of several academic-practice partnership initiatives by Meridian Health, a health system located in central New Jersey. Included in the strategies discussed are creation of a support program for nonprofessional employees to become registered nurses; active partnership in the development of an accelerated BSN program; construction of support systems and academic partnerships for staff participation in RN-to-BSN programs; construction of on-site clinical simulation laboratories to foster interprofessional learning; and the implementation of a new BSN program, the first and only generic BSN program in two counties of the state. Outcomes of these academic-practice partnerships also are presented, including number of participants; graduation and NCLEX-RN pass rates; MH nurse vacancy rates; and nurse retention rates after first employment. Copyright © 2011 Elsevier Inc. All rights reserved.

Repurposing Waste Streams: Lessons on Integrating Hospital Food Waste into a Community Garden.

PubMed

Galvan, Adri M; Hanson, Ryan; George, Daniel R

2018-04-06

There have been increasing efforts in recent decades to divert institutional food waste into composting programs. As major producers of food waste who must increasingly demonstrate community benefit, hospitals have an incentive to develop such programs. In this article, we explain the emerging opportunity to link hospitals' food services to local community gardens in order to implement robust composting programs. We describe a partnership model at our hospital in central Pennsylvania, share preliminary outcomes establishing feasibility, and offer guidance for future efforts. We also demonstrate that the integration of medical students in such efforts can foster systems thinking in the development of programs to manage hospital waste streams in more ecologically-friendly ways.

Integrating Micro-computers with a Centralized DBMS: ORACLE, SEED AND INGRES

NASA Technical Reports Server (NTRS)

Hoerger, J.

1984-01-01

Users of ADABAS, a relational-like data base management system (ADABAS) with its data base programming language (NATURAL) are acquiring microcomputers with hopes of solving their individual word processing, office automation, decision support, and simple data processing problems. As processor speeds, memory sizes, and disk storage capacities increase, individual departments begin to maintain "their own" data base on "their own" micro-computer. This situation can adversely affect several of the primary goals set for implementing a centralized DBMS. In order to avoid this potential problem, these micro-computers must be integrated with the centralized DBMS. An easy to use and flexible means for transferring logic data base files between the central data base machine and micro-computers must be provided. Some of the problems encounted in an effort to accomplish this integration and possible solutions are discussed.

Organizational fidelity to a medication management evidence-based practice in the treatment of schizophrenia.

PubMed

El-Mallakh, Peggy; Howard, Patricia B; Rayens, Mary Kay; Roque, Autumn P; Adkins, Sarah

2013-11-01

Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successful EBP implementation in practice settings. Copyright 2013, SLACK Incorporated.

Development of Teacher Leadership: A Multi-Faceted Approach to Bringing about Improvements in Rural Elementary Schools in Pakistan

ERIC Educational Resources Information Center

Ali, Takbir

2014-01-01

This article reports on a school improvement initiative undertaken by a private university in Pakistan. The Whole School Improvement Programme, designed with the purpose to improve the quality of education appropriate to children and teachers of poor communities, is being implemented in selected elementary schools. Central to the program is…

Mobile Technology Education Laboratory: An Alternative for Elementary Technology Education in a Restructuring School District in Central California.

ERIC Educational Resources Information Center

Britton, Steven M.

The purpose of this study was to explore what options exist for a school district that has chosen to implement or reinforce an elementary technology education program. The option selected was a mobile technology education laboratory. A mobile laboratory can offer the advantages of financial flexibility, currentness, ability to serve a large…

Factors Affecting the Distribution and Access to Athletic Opportunities for New Jersey High School Students

ERIC Educational Resources Information Center

Casarico, Paul

2013-01-01

The requirement for continuous improvements and the lack of funds for schools to properly implement all the mandates puts schools in the inevitable position of having to make tough decisions with regards to programs. The central theme of NCLB requires states to adopt a plan for accountability that will lead to increased achievement for all…

Implementation of an Electronic Objective Structured Clinical Exam for Assessing Practical Skills in Pre-Professional Physiotherapy and Occupational Therapy Programs: Examiner and Course Coordinator Perspectives

ERIC Educational Resources Information Center

Snodgrass, Suzanne J.; Ashby, Samantha E.; Rivett, Darren A.; Russell, Trevor

2014-01-01

Assessment of practical clinical skills is essential in the health fields. Objective Structured Clinical Exams (OSCEs), where examiners assess students performing clinical procedures on simulated patients (actors), are central to the evaluation of practical skills. However, traditional OSCEs require considerable time-investment to administer, and…

Critical evaluation of international health programs: Reframing global health and evaluation.

PubMed

Chi, Chunhuei; Tuepker, Anaïs; Schoon, Rebecca; Núñez Mondaca, Alicia

2018-04-01

Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of "participation," is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the "who" and "how" of programming decisions; midstream evaluation focusing on the "who" and "how" of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research. Copyright © 2018 John Wiley & Sons, Ltd.

Evaluation of clinical practice guidelines.

PubMed Central

Basinski, A S

1995-01-01

Compared with the current focus on the development of clinical practice guidelines the effort devoted to their evaluation is meagre. Yet the ultimate success of guidelines depends on routine evaluation. Three types of evaluation are identified: evaluation of guidelines under development and before dissemination and implementation, evaluation of health care programs in which guidelines play a central role, and scientific evaluation, through studies that provide the scientific knowledge base for further evolution of guidelines. Identification of evaluation and program goals, evaluation design and a framework for evaluation planning are discussed. PMID:7489550

Enhance®Fitness Dissemination and Implementation,: 2010-2015: A Scoping Review.

PubMed

Petrescu-Prahova, Miruna G; Eagen, Thomas J; Fishleder, Sarah L; Belza, Basia

2017-03-01

Physical activity has many benefits for older adult physical and mental health. Enhance ® Fitness (EF) is an evidence-based group exercise program delivered by community-based organizations. The purpose of this study was to review recent evidence on the dissemination and implementation of EF. A scoping review of qualitative and quantitative studies with EF as main focus was conducted. CINAHL, PubMed, PubMed Central, SCOPUS, Web of Science, PsycINFO, and Google Scholar were searched between October and November 2015 for data-based studies on EF published in 2010-2015. Two team members abstracted each paper independently using a data abstraction tool. Results were summarized using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Seventeen publications met inclusion criteria. EF has reached and is effective across a broad population base, including individuals with low SES and diverse ethnic/racial backgrounds. EF participation may be associated with reduced risk for falls requiring medical care, and is associated with fewer hospital admissions. Analyses of medical cost savings from EF participation and program implementation costs suggest economic benefits of EF implementation for communities. Organization-level maintenance is facilitated by program-specific and organizational factors, such as instructor training and funding. Individual-level maintenance is facilitated by program structure, absence of pain, and increased quality of life. More-rigorous evidence is needed about the association between participation in EF and conditions such as falls. Evaluation of program fidelity, adaptations, and sustainability is limited; more-systematic examination across population groups and types of organizations would help ensure older adults continue to benefit from EF participation. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Institutional capacity for health systems research in East and Central Africa schools of public health: enhancing capacity to design and implement teaching programs.

PubMed

Nangami, Mabel N; Rugema, Lawrence; Tebeje, Bosena; Mukose, Aggrey

2014-06-02

The role of health systems research (HSR) in informing and guiding national programs and policies has been increasingly recognized. Yet, many universities in sub-Saharan African countries have relatively limited capacity to teach HSR. Seven schools of public health (SPHs) in East and Central Africa undertook an HSR institutional capacity assessment, which included a review of current HSR teaching programs. This study determines the extent to which SPHs are engaged in teaching HSR-relevant courses and assessing their capacities to effectively design and implement HSR curricula whose graduates are equipped to address HSR needs while helping to strengthen public health policy. This study used a cross-sectional study design employing both quantitative and qualitative approaches. An organizational profile tool was administered to senior staff across the seven SPHs to assess existing teaching programs. A self-assessment tool included nine questions relevant to teaching capacity for HSR curricula. The analysis triangulates the data, with reflections on the responses from within and across the seven SPHs. Proportions and average of values from the Likert scale are compared to determine strengths and weaknesses, while themes relevant to the objectives are identified and clustered to elicit in-depth interpretation. None of the SPHs offer an HSR-specific degree program; however, all seven offer courses in the Master of Public Health (MPH) degree that are relevant to HSR. The general MPH curricula partially embrace principles of competency-based education. Different strengths in curricula design and staff interest in HSR at each SPH were exhibited but a number of common constraints were identified, including out-of-date curricula, face-to-face delivery approaches, inadequate staff competencies, and limited access to materials. Opportunities to align health system priorities to teaching programs include existing networks. Each SPH has key strengths that can be leveraged to design and implement HSR teaching curricula. We propose networking for standardizing HSR curricula competencies, institutionalizing sharing of teaching resources, creating an HSR eLearning platform to expand access, regularly reviewing HSR teaching content to infuse competency-based approaches, and strengthening staff capacity to deliver such curricula.

Institutional capacity for health systems research in East and Central Africa schools of public health: enhancing capacity to design and implement teaching programs

PubMed Central

2014-01-01

Background The role of health systems research (HSR) in informing and guiding national programs and policies has been increasingly recognized. Yet, many universities in sub-Saharan African countries have relatively limited capacity to teach HSR. Seven schools of public health (SPHs) in East and Central Africa undertook an HSR institutional capacity assessment, which included a review of current HSR teaching programs. This study determines the extent to which SPHs are engaged in teaching HSR-relevant courses and assessing their capacities to effectively design and implement HSR curricula whose graduates are equipped to address HSR needs while helping to strengthen public health policy. Methods This study used a cross-sectional study design employing both quantitative and qualitative approaches. An organizational profile tool was administered to senior staff across the seven SPHs to assess existing teaching programs. A self-assessment tool included nine questions relevant to teaching capacity for HSR curricula. The analysis triangulates the data, with reflections on the responses from within and across the seven SPHs. Proportions and average of values from the Likert scale are compared to determine strengths and weaknesses, while themes relevant to the objectives are identified and clustered to elicit in-depth interpretation. Results None of the SPHs offer an HSR-specific degree program; however, all seven offer courses in the Master of Public Health (MPH) degree that are relevant to HSR. The general MPH curricula partially embrace principles of competency-based education. Different strengths in curricula design and staff interest in HSR at each SPH were exhibited but a number of common constraints were identified, including out-of-date curricula, face-to-face delivery approaches, inadequate staff competencies, and limited access to materials. Opportunities to align health system priorities to teaching programs include existing networks. Conclusions Each SPH has key strengths that can be leveraged to design and implement HSR teaching curricula. We propose networking for standardizing HSR curricula competencies, institutionalizing sharing of teaching resources, creating an HSR eLearning platform to expand access, regularly reviewing HSR teaching content to infuse competency-based approaches, and strengthening staff capacity to deliver such curricula. PMID:24888353

Use of hospital-related health care among Health Links enrollees in the Central Ontario health region: a propensity-matched difference-in-differences study

PubMed Central

Mondor, Luke; Walker, Kevin; Bai, Yu Qing; Wodchis, Walter P.

2017-01-01

Background: Health Links are a new model of providing care coordination for high-cost, high-needs patients in Ontario. We evaluated use of hospital-related health care services among Health Links patients in the Central Local Health Integration Network (LHIN) of Ontario in the year before versus after program enrolment and compared rates of use with those among similar patients with complex needs not enrolled in the program (comparator group). Methods: We identified all patients who received a Health Links coordinated care plan before Jan. 1, 2015, using linked registry and health administrative data. We used propensity scores to match (1:1) enrollees (registry) with comparator patients (administrative data). Using a difference-in-differences approach with generalized estimating equations, we evaluated 5 measures of Health Link performance: rates of hospital admission, emergency department visits, days in acute care, 30-day readmissions and 7-day postdischarge primary care follow-up. Results: Of the 344 enrollees in the registry, we matched 313 [91.0%] to comparator patients. All measured sociodemographic, comorbidity and health care use characteristics were balanced between the 2 groups (all standardized differences < 0.10). For enrollees, the rate of days in acute care per person-year increased by 35% (incidence rate ratio 1.35 [confidence interval 1.11-1.65]) after versus before the index date, but differences were nonsignificant for all other measures. Difference-in-differences analyses revealed greater reductions in hospital admissions, emergency department visits and acute care days after the index date in the comparator group than among enrollees. Interpretation: Initial implementation of the Health Link program in the Central LHIN did not reduce selected indicators of Health Link performance among enrollees. As the Health Link program evolves and standardization is implemented, future research may reveal effects from the initiative in other outcomes or with longer follow-up. PMID:29025737

Importance of Data Management in a Long-term Biological Monitoring Program

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

Christensen, Sigurd W; Brandt, Craig C; McCracken, Kitty

2011-01-01

The long-term Biological Monitoring and Abatement Program (BMAP) has always needed to collect and retain high-quality data on which to base its assessments of ecological status of streams and their recovery after remediation. Its formal quality assurance, data processing, and data management components all contribute to this need. The Quality Assurance Program comprehensively addresses requirements from various institutions, funders, and regulators, and includes a data management component. Centralized data management began a few years into the program. An existing relational database was adapted and extended to handle biological data. Data modeling enabled the program's database to process, store, and retrievemore » its data. The data base's main data tables and several key reference tables are described. One of the most important related activities supporting long-term analyses was the establishing of standards for sampling site names, taxonomic identification, flagging, and other components. There are limitations. Some types of program data were not easily accommodated in the central systems, and many possible data-sharing and integration options are not easily accessible to investigators. The implemented relational database supports the transmittal of data to the Oak Ridge Environmental Information System (OREIS) as the permanent repository. From our experience we offer data management advice to other biologically oriented long-term environmental sampling and analysis programs.« less

The antimicrobial resistance monitoring and research (ARMoR) program: the US Department of Defense response to escalating antimicrobial resistance.

PubMed

Lesho, Emil P; Waterman, Paige E; Chukwuma, Uzo; McAuliffe, Kathryn; Neumann, Charlotte; Julius, Michael D; Crouch, Helen; Chandrasekera, Ruvani; English, Judith F; Clifford, Robert J; Kester, Kent E

2014-08-01

Responding to escalating antimicrobial resistance (AMR), the US Department of Defense implemented an enterprise-wide collaboration, the Antimicrobial Resistance Monitoring and Research Program, to aid in infection prevention and control. It consists of a network of epidemiologists, bioinformaticists, microbiology researchers, policy makers, hospital-based infection preventionists, and healthcare providers who collaborate to collect relevant AMR data, conduct centralized molecular characterization, and use AMR characterization feedback to implement appropriate infection prevention and control measures and influence policy. A particularly concerning type of AMR, carbapenem-resistant Enterobacteriaceae, significantly declined after the program was launched. Similarly, there have been no further reports or outbreaks of another concerning type of AMR, colistin resistance in Acinetobacter, in the Department of Defense since the program was initiated. However, bacteria containing AMR-encoding genes are increasing. To update program stakeholders and other healthcare systems facing such challenges, we describe the processes and impact of the program. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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

Broadbridge, Christine C.

DOE grant used for partial fulfillment of necessary laboratory equipment for course enrichment and new graduate programs in nanotechnology at the four institutions of the Connecticut State University System (CSUS). Equipment in this initial phase included variable pressure scanning electron microscope with energy dispersive x-ray spectroscopy elemental analysis capability [at Southern Connecticut State University]; power x-ray diffractometer [at Central Connecticut State University]; a spectrophotometer and spectrofluorimeter [at Eastern Connecticut State University; and a Raman Spectrometer [at Western Connecticut State University]. DOE's funding was allocated for purchase and installation of this scientific equipment and instrumentation. Subsequently, DOE funding was allocated tomore » fund the curriculum, faculty development and travel necessary to continue development and implementation of the System's Graduate Certificate in Nanotechnology (GCNT) program and the ConnSCU Nanotechnology Center (ConnSCU-NC) at Southern Connecticut State University. All of the established outcomes have been successfully achieved. The courses and structure of the GCNT program have been determined and the program will be completely implemented in the fall of 2013. The instrumentation has been purchased, installed and has been utilized at each campus for the implementation of the nanotechnology courses, CSUS GCNT and the ConnSCU-NC. Additional outcomes for this grant include curriculum development for non-majors as well as faculty and student research.« less

Keeping the dream alive: Managing the Space Station Program, 1982 to 1986

NASA Technical Reports Server (NTRS)

Lewin, Thomas J.; Narayanan, V. K.

1990-01-01

The management is described and analyzed of the formative years of the NASA Space Station Program (1982 to 1986), beginning with the successful initiative for program approval by Administrator James M. Beggs through to the decision to bring program management to Reston, Virginia. Emphasis is on internal management issues related to the implementation of the various phases of the program. Themes examined are the problem of bringing programmatic and institutional interests together and focusing them to forward the program; centralized versus decentralized control of the program; how the history of NASA and of the individual installations affected the decisions made; and the pressure from those outside NASA. The four sections are: (1) the decision to build the space station, (2) the design of the management experiment, (3) the experiment comes to life, and (4) the decision reversal.

Management training in global health education: a Health Innovation Fellowship training program to bring healthcare to low-income communities in Central America.

PubMed

Prado, Andrea M; Pearson, Andy A; Bertelsen, Nathan S

2018-01-01

Interprofessional education is increasingly recognized as essential for health education worldwide. Although effective management, innovation, and entrepreneurship are necessary to improve health systems, business schools have been underrepresented in global health education. Central America needs more health professionals trained in health management and innovation to respond to health disparities, especially in rural communities. This paper explores the impact of the Health Innovation Fellowship (HIF), a new training program for practicing health professionals offered jointly by the Central American Healthcare Initiative and INCAE Business School, Costa Rica. Launched in 2014, HIF's goal is to create a network of highly trained interdisciplinary health professionals in competencies to improve health of Central American communities through better health management. The program's fellows carried out innovative healthcare projects in their local regions. The first three annual cohorts (total of 43 fellows) represented all health-related professions and sectors (private, public, and civil society) from six Central American countries. All fellows attended four 1-week, on-site modular training sessions, received ongoing mentorship, and stayed connected through formal and informal networks and webinars through which they exchange knowledge and support each other. CAHI stakeholders supported HIF financially. Impact evaluation of the three-year pilot training program is positive: fellows improved their health management skills and more than 50% of the projects found either financial or political support for their implementation. HIF's strengths include that both program leaders and trainees come from the Global South, and that HIF offers a platform to collaborate with partners in the Global North. By focusing on promoting innovation and management at a top business school in the region, HIF constitutes a novel capacity-building effort within global health education. HIF is a capacity-building effort that can be scaled up in the region and other low- and middle-income countries.

Introducing a curricular program culminating in a certificate for training peer tutors in medical education.

PubMed

Fellmer-Drüg, Erika; Drude, Nina; Sator, Marlene; Schultz, Jobst-Hendrik; Irniger, Erika; Chur, Dietmar; Neumann, Boris; Resch, Franz; Jünger, Jana

2014-01-01

Student tutorials are now firmly anchored in medical education. However, to date there have only been isolated efforts to establish structured teacher training for peer tutors in medicine. To close this gap, a centralized tutor training program for students, culminating in an academic certificate, was implemented at Heidelberg University Medical School. The program also counts within the scope of the post-graduate Baden-Württemberg Certificate in Academic Teaching (Baden-Württemberg Zertifikat für Hochschuldidaktik). Based on a needs assessment, a modular program comprised of four modules and a total of 200 curricular units was developed in cooperation with the Department for Key Competencies and Higher Education at Heidelberg University and implemented during the 2010 summer semester. This program covers not only topic-specific training sessions, but also independent teaching and an integrated evaluation of the learning process that is communicated to the graduates in the form of structured feedback. In addition, to evaluate the overall concept, semi-structured interviews (N=18) were conducted with the program graduates. To date, 495 tutors have been trained in the basic module on teaching medicine, which is rated with a mean overall grade of 1.7 (SW: 0.6) and has served as Module I of the program since 2010. A total of 17% (N=83) of these tutors have gone on to enroll in the subsequent training modules of the program; 27 of them (m=12, f=15) have already successfully completed them. Based on qualitative analyses, it is evident that the training program certificate and its applicability toward the advanced teacher training for university instructors pose a major incentive for the graduates. For successful program realization, central coordination, extensive coordination within the medical school, and the evaluation of the attained skills have proven to be of particular importance. The training program contributes sustainably to both quality assurance and professionalism, as well as to solving the issue of resources in medical education. The introduction and continued development of similar programs is desirable.

Environmental Consciousness and Education Relationship: Determination of How Environment-Based Concepts Are Placed in Turkish Science Curricula

ERIC Educational Resources Information Center

Ozmen, Haluk; Karamustafaoglu, Orhan

2006-01-01

Turkey has a central educational system in which all of the programs are designed by the Ministry of National Education and distributed to the implementing institutions. As a part of this system, the textbooks written by different writers need to be approved by the commission called Talim Terbiye Kurulu, and these approved books are chosen as…

Characterization and efficacy determination of commercially available Central American H5N2 avian influenza vaccines for poultry

USDA-ARS?s Scientific Manuscript database

H5N2 low pathogenicity avian influenza (LPAI) was first identified in Mexican poultry during May 1994. A vaccination program was implemented, but after 14 years and 2 billion doses, H5N2 LPAI is still present in parts of Mexico and has spread to El Salvador, Guatemala, Dominican Republic, and Haiti...

Electronic Commerce: A National Performance Review Initiative.

DTIC Science & Technology

1995-09-01

This study of the National Information Infrastructure (NII) was conducted as part of IDA’s Central Research Program. Electronic commerce is one of... commerce is nothing more than conducting business via electronic means. An outgrowth of the NPR, the electronic commerce initiative, commits the...private, and public sectors are committed to implementing electronic commerce throughout the United States. The objective ol this paper is to enhance

DoD Implementation of the Better Buying Power Initiatives

DTIC Science & Technology

2012-12-01

statutory measures (Budget Control Act of 2011), Congress has been directed to face this problem and provide a workable solution or face the evils...Defense Support Program (DSP) to provide the capabilities that the SBIRS has had problems delivering (Richelson, 2007; Werner, 2011). The purpose of the...Defense David Packard took office. They were keen on addressing the problems plaguing defense acquisition: excessive centralization, inefficiencies

Failure to Rescue, Rescue Surgery and Centralization of Postoperative Complications: A Challenge for General and Acute Care Surgeons.

PubMed

Zago, Mauro; Bozzo, Samantha; Carrara, Giulia; Mariani, Diego

2017-01-01

To explore the current literature on the failure to rescue and rescue surgery concepts, to identify the key items for decreasing the failure to rescue rate and improve outcome, to verify if there is a rationale for centralization of patients suffering postoperative complications. There is a growing awareness about the need to assess and measure the failure to rescue rate, on institutional, regional and national basis. Many factors affect failure to rescue, and all should be individually analyzed and considered. Rescue surgery is one of these factors. Rescue surgery assumes an acute care surgery background. Measurement of failure to rescue rate should become a standard for quality improvement programs. Implementation of all clinical and organizational items involved is the key for better outcomes. Preparedness for rescue surgery is a main pillar in this process. Centralization of management, audit, and communication are important as much as patient centralization. Celsius.

Healthy Families America state systems development: an emerging practice to ensure program growth and sustainability.

PubMed

Friedman, Lori; Schreiber, Lisa

2007-01-01

In an era of fiscal constraints and increased accountability for social service programs, having a centralized and efficient infrastructure is critical. A well-functioning infrastructure helps a state reduce duplication of services, creates economies of scale, coordinates resources, supports high-quality site development and promotes the self-sufficiency and growth of community-based programs. Throughout the Healthy Families America home visitation network, both program growth and contraction have been managed by in-state collaborations, referred to as "state systems." This article explores the research base that supports the rationale for implementing state systems, describes the evolution of state systems for Healthy Families America, and discusses the benefits, challenges and lessons learned of utilizing a systems approach.

Health information system model for monitoring treatment and surveillance for leprosy patients in indonesia (case study in Pekalongan District, Central Java, Indonesia).

PubMed

Rachmani, Enny; Kurniadi, Arif; Hsu, Chien Yeh

2013-01-01

After India and Brazil, Indonesia has the third highest incidence/prevalence of leprosy in the world. Every year thousands of new cases and case with grade-2 disability are reported and, while the recovery rate lingers only 80-90 %. Therefore, more than 10 % of leprosy patients drop out of treatment and can be a source of new infections in the community. Our research was aimed at determining apparent difficulties in the leprosy control program as well as how a health information system (HIS) could assist the Indonesian leprosy control program. We used qualitative method with deep interview and observation of document. One of the difficulties which the Indonesian leprosy control program faces is discontinuity of patient's data due to rotating staff as well as the treatment monitoring and queries patients which should be monitored after treatment has ceased. Technology implementation is feasible through short message service (sms) reminders and web base applications. The leprosy control program urgently needs to implement continuous monitoring and recording of patients because of the particular characteristics of this contagious disease.

Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

PubMed

Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

2014-07-01

The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

PrismTech Data Distribution Service Java API Evaluation

NASA Technical Reports Server (NTRS)

Riggs, Cortney

2008-01-01

My internship duties with Launch Control Systems required me to start performance testing of an Object Management Group's (OMG) Data Distribution Service (DDS) specification implementation by PrismTech Limited through the Java programming language application programming interface (API). DDS is a networking middleware for Real-Time Data Distribution. The performance testing involves latency, redundant publishers, extended duration, redundant failover, and read performance. Time constraints allowed only for a data throughput test. I have designed the testing applications to perform all performance tests when time is allowed. Performance evaluation data such as megabits per second and central processing unit (CPU) time consumption were not easily attainable through the Java programming language; they required new methods and classes created in the test applications. Evaluation of this product showed the rate that data can be sent across the network. Performance rates are better on Linux platforms than AIX and Sun platforms. Compared to previous C++ programming language API, the performance evaluation also shows the language differences for the implementation. The Java API of the DDS has a lower throughput performance than the C++ API.

Molten nitrate salt technology development

NASA Astrophysics Data System (ADS)

Carling, R. W.

1981-04-01

This paper presents an overview of the experimental programs underway in support of the Thermal Energy Storage for Solar Thermal Applications (TESSTA) program. The experimental programs are concentrating on molten nitrate salts which have been proposed as heat transfer and energy storage medium. The salt composition of greatest interest is drawsalt, nominally a 50-50 molar mixture of NaNO3 and KNO3 with a melting point of 220 C. Several technical uncertainties have been identified that must be resolved before nitrate based solar plants can be commercialized. Research programs at Sandia National Laboratories, universities, and industrial suppliers have been implemented to resolve these technical uncertainties. The experimental programs involve corrosion, decomposition, physical properties, and environmental cracking. Summaries of each project and how they impact central receiver applications such as the repowering/industrial retrofit and cogeneration program are presented.

A Distributed Dynamic Programming-Based Solution for Load Management in Smart Grids

NASA Astrophysics Data System (ADS)

Zhang, Wei; Xu, Yinliang; Li, Sisi; Zhou, MengChu; Liu, Wenxin; Xu, Ying

2018-03-01

Load management is being recognized as an important option for active user participation in the energy market. Traditional load management methods usually require a centralized powerful control center and a two-way communication network between the system operators and energy end-users. The increasing user participation in smart grids may limit their applications. In this paper, a distributed solution for load management in emerging smart grids is proposed. The load management problem is formulated as a constrained optimization problem aiming at maximizing the overall utility of users while meeting the requirement for load reduction requested by the system operator, and is solved by using a distributed dynamic programming algorithm. The algorithm is implemented via a distributed framework and thus can deliver a highly desired distributed solution. It avoids the required use of a centralized coordinator or control center, and can achieve satisfactory outcomes for load management. Simulation results with various test systems demonstrate its effectiveness.

Adoption of a Nationwide Shared Medical Record in France: Lessons Learnt after 5 Years of Deployment

PubMed Central

Séroussi, Brigitte; Bouaud, Jacques

2016-01-01

Information sharing among health practitioners, either for coordinated or unscheduled care, is necessary to guarantee care quality and patient safety. In most countries, nationwide programs have provided tools to support information sharing, from centralized care records to health information exchange between electronic health records (EHRs). The French personal medical record (DMP) is a centralized patient-controlled record, created according to the opt-in consent model. It contains the documents health practitioners voluntarily push into the DMP from their EHRs. Five years after the launching of the program in December 2010, there were nearly 570,000 DMPs covering only 1.5% of the target population in December 2015. Reasons for this poor level of adoption are discussed in the perspective of other countries’ initiatives. The new French governmental strategy for the DMP deployment in 2016 is outlined, with the implementation of measures similar to the US Meaningful Use. PMID:28269907

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

White-tailed deer harvest from the chronic wasting disease eradication zone in south-central Wisconsin

USGS Publications Warehouse

Blanchong, Julie A.; Joly, D.O.; Samuel, M.D.; Langenberg, J.A.; Rolley, R.E.; Sausen, J.F.

2006-01-01

Chronic wasting disease (CWD) was discovered in free-ranging white-tailed deer (Odocoileus virginianus) in south-central Wisconsin in 2002. The current control method for CWD in the state is the harvest of deer from affected areas to reduce population density and lower CWD transmission. We used spatial regression methods to identify factors associated with deer harvest across south-central Wisconsin. Harvest of deer by hunters was positively related to deer density (slope=0.003, 95% CI=0.0001-0.006), the number of landowners that requested harvest permits (slope=0.071, 95% CI=0.037-0.105), and proximity to the area of highest CWD infection (slope=-0.041, 95% CI=-0.056- -0.027). Concomitantly, harvest was not impacted in areas where landowners signed a petition protesting intensive deer reduction (slope=-0.00006, 95% CI=-0.0005-0.0003). Our results suggest that the success of programs designed to reduce deer populations for disease control or to reduce overabundance in Wisconsin are dependent on landowner and hunter participation. We recommend that programs or actions implemented to eradicate or mitigate the spread of CWD should monitor and assess deer population reduction and evaluate factors affecting program success to improve methods to meet management goals.

A decentralized software bus based on IP multicas ting

NASA Technical Reports Server (NTRS)

Callahan, John R.; Montgomery, Todd

1995-01-01

We describe decentralized reconfigurable implementation of a conference management system based on the low-level Internet Protocol (IP) multicasting protocol. IP multicasting allows low-cost, world-wide, two-way transmission of data between large numbers of conferencing participants through the Multicasting Backbone (MBone). Each conference is structured as a software bus -- a messaging system that provides a run-time interconnection model that acts as a separate agent (i.e., the bus) for routing, queuing, and delivering messages between distributed programs. Unlike the client-server interconnection model, the software bus model provides a level of indirection that enhances the flexibility and reconfigurability of a distributed system. Current software bus implementations like POLYLITH, however, rely on a centralized bus process and point-to-point protocols (i.e., TCP/IP) to route, queue, and deliver messages. We implement a software bus called the MULTIBUS that relies on a separate process only for routing and uses a reliable IP multicasting protocol for delivery of messages. The use of multicasting means that interconnections are independent of IP machine addresses. This approach allows reconfiguration of bus participants during system execution without notifying other participants of new IP addresses. The use of IP multicasting also permits an economy of scale in the number of participants. We describe the MULITIBUS protocol elements and show how our implementation performs better than centralized bus implementations.

Sexuality and life skills education. A multistrategy intervention in Mexico.

PubMed

Pick, Susan; Givaudan, Martha; Poortinga, Ype H

2003-03-01

This contribution presents a set of intervention programs in the area of reproductive health, sexuality, and life-skills education that are now widely used in Mexico and with Latin American populations elsewhere. First, the authors briefly indicate how a research-informed approach has been central to the development and implementation of these interventions. Thereafter they describe how the programs were initially designed, taking into consideration the Mexican cultural context and its implications for Mexican adolescents. They also mention subsequent evaluation-based extensions of the programs to reach other target populations, to broaden the range of issues addressed, to promote their dissemination, and to advocate society-wide sexuality and life-skills education.

Astronomy for everybody: An Approach from the CASAO/NAUH view

NASA Astrophysics Data System (ADS)

Pineda de Carias, M. C.

2006-08-01

Central America Suyapa Astronomical Observatory / National Autonomous University of Honduras, Tegucigalpa, Honduras Astronomy is a science that attracts the attention of all age people from a variety of views and interests. At the Central America Suyapa Astronomical Observatory of the National Autonomous University of Honduras (CASAO/NAUH), furthermore the formal general course of Introduction to Astronomy (AN-111) for all careers students and the regular courses for a Master in Astronomy and Astrophysics students, three different academicals outreach programs have become of importance, after less than a decade of experience. A Visiting to the CASAO/NAUH Program, aim for elementary and secondary schools, where astronomers three times per week presents to groups of fifteen up to one hundred students and its teachers, conferences on selected topics of astronomy illustrated with real sky and astronomical objects images, give the opportunity to observe the sun, the moon and planets using a small telescope, and explain how nowadays astronomers do their observations and also how the Mayas that inhabited Central America did at their times. The Astronomical Nights Program intended for general public, children, youth and adults who attend on Friday nights to the Astronomical Observatory, to learn about astronomical bodies' properties, the sky of the week and the differences of making observations using small telescopes and with a naked eye. Intro_Astro@Internet, an on line course program designed for school teachers and also for college and university students of Central America willing to learn more systematically by their own using new technologies about the sky, the solar system, the stars and the universe. In this paper we present a complete description of these programs in the ways they are currently develop at CASAO/NAUH, and a discussion of how these programs contribute to the implementation of the IAU Resolution on the Value of Astronomy Education.

Earth Observatory Satellite system definition study. Report no. 7: EOS system definition report. Appendixes A through D

NASA Technical Reports Server (NTRS)

1974-01-01

An analysis of the systems involved in the operation and support of the Earth Observatory Satellite (EOS) is presented. Among the systems considered are the following: (1) the data management system, (2) observatory to primary ground station communications links, (3) local user system, (4) techniques for recognizing ground control points, (5) the central data processing-implementation concept, and (6) program effectiveness analysis.

A Central Support System Can Facilitate Implementation and Sustainability of a Classroom-Based Undergraduate Research Experience (CURE) in Genomics

PubMed Central

Lopatto, David; Hauser, Charles; Jones, Christopher J.; Paetkau, Don; Chandrasekaran, Vidya; Dunbar, David; MacKinnon, Christy; Stamm, Joyce; Alvarez, Consuelo; Barnard, Daron; Bedard, James E. J.; Bednarski, April E.; Bhalla, Satish; Braverman, John M.; Burg, Martin; Chung, Hui-Min; DeJong, Randall J.; DiAngelo, Justin R.; Du, Chunguang; Eckdahl, Todd T.; Emerson, Julia; Frary, Amy; Frohlich, Donald; Goodman, Anya L.; Gosser, Yuying; Govind, Shubha; Haberman, Adam; Hark, Amy T.; Hoogewerf, Arlene; Johnson, Diana; Kadlec, Lisa; Kaehler, Marian; Key, S. Catherine Silver; Kokan, Nighat P.; Kopp, Olga R.; Kuleck, Gary A.; Lopilato, Jane; Martinez-Cruzado, Juan C.; McNeil, Gerard; Mel, Stephanie; Nagengast, Alexis; Overvoorde, Paul J.; Parrish, Susan; Preuss, Mary L.; Reed, Laura D.; Regisford, E. Gloria; Revie, Dennis; Robic, Srebrenka; Roecklien-Canfield, Jennifer A.; Rosenwald, Anne G.; Rubin, Michael R.; Saville, Kenneth; Schroeder, Stephanie; Sharif, Karim A.; Shaw, Mary; Skuse, Gary; Smith, Christopher D.; Smith, Mary; Smith, Sheryl T.; Spana, Eric P.; Spratt, Mary; Sreenivasan, Aparna; Thompson, Jeffrey S.; Wawersik, Matthew; Wolyniak, Michael J.; Youngblom, James; Zhou, Leming; Buhler, Jeremy; Mardis, Elaine; Leung, Wilson; Threlfall, Jennifer; Elgin, Sarah C. R.

2014-01-01

In their 2012 report, the President's Council of Advisors on Science and Technology advocated “replacing standard science laboratory courses with discovery-based research courses”—a challenging proposition that presents practical and pedagogical difficulties. In this paper, we describe our collective experiences working with the Genomics Education Partnership, a nationwide faculty consortium that aims to provide undergraduates with a research experience in genomics through a scheduled course (a classroom-based undergraduate research experience, or CURE). We examine the common barriers encountered in implementing a CURE, program elements of most value to faculty, ways in which a shared core support system can help, and the incentives for and rewards of establishing a CURE on our diverse campuses. While some of the barriers and rewards are specific to a research project utilizing a genomics approach, other lessons learned should be broadly applicable. We find that a central system that supports a shared investigation can mitigate some shortfalls in campus infrastructure (such as time for new curriculum development, availability of IT services) and provides collegial support for change. Our findings should be useful for designing similar supportive programs to facilitate change in the way we teach science for undergraduates. PMID:25452493

Existing Whole-House Solutions Case Study: Applying Best Practices to Florida Local Government Retrofit Programs - Central Florida

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

None

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This case study describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Applying Best Practices to Florida Local Government Retrofit Programs, Central Florida (Fact Sheet)

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

None, None

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Experiences of Rehabilitation Professionals with the Implementation of a Back School for Patients with Chronic Low Back Pain: A Qualitative Study.

PubMed

Peters, Stefan; Faller, Hermann; Pfeifer, Klaus; Meng, Karin

2016-01-01

A standardized curriculum back school (CBS) has been recommended for further dissemination in medical rehabilitation in Germany. However, implementation of self-management education programs into practice is challenging. In low back pain care, individual factors of professionals could be decisive regarding implementation fidelity. The study aim was to explore attitudes and experiences of professionals who conducted the back school. Qualitative interviews were led with 45 rehabilitation professionals. The data were examined using thematic analysis. Three central themes were identified: (a) "back school as a common thread," (b) "theory versus practice," and (c) "participation and patient-centeredness." The CBS and its manual were frequently described positively because they provide structure. However, specified time was mentioned critically and there were heterogeneous perceptions regarding flexibility in conducting the CBS. Theory and practice in the CBS were discussed concerning amount, distribution, and conjunction. Participation and patient-centeredness were mainly mentioned in terms of amount and heterogeneity of participation as well as the demand for competences of professionals. Factors were detected that may either positively or negatively influence the implementation fidelity of self-management education programs. The results are explorative and provide potential explanatory mechanisms for behavior and acceptance of rehabilitation professionals regarding the implementation of biopsychosocial back schools.

DPEMC: A Monte Carlo for double diffraction

NASA Astrophysics Data System (ADS)

Boonekamp, M.; Kúcs, T.

2005-05-01

We extend the POMWIG Monte Carlo generator developed by B. Cox and J. Forshaw, to include new models of central production through inclusive and exclusive double Pomeron exchange in proton-proton collisions. Double photon exchange processes are described as well, both in proton-proton and heavy-ion collisions. In all contexts, various models have been implemented, allowing for comparisons and uncertainty evaluation and enabling detailed experimental simulations. Program summaryTitle of the program:DPEMC, version 2.4 Catalogue identifier: ADVF Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADVF Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Computer: any computer with the FORTRAN 77 compiler under the UNIX or Linux operating systems Operating system: UNIX; Linux Programming language used: FORTRAN 77 High speed storage required:<25 MB No. of lines in distributed program, including test data, etc.: 71 399 No. of bytes in distributed program, including test data, etc.: 639 950 Distribution format: tar.gz Nature of the physical problem: Proton diffraction at hadron colliders can manifest itself in many forms, and a variety of models exist that attempt to describe it [A. Bialas, P.V. Landshoff, Phys. Lett. B 256 (1991) 540; A. Bialas, W. Szeremeta, Phys. Lett. B 296 (1992) 191; A. Bialas, R.A. Janik, Z. Phys. C 62 (1994) 487; M. Boonekamp, R. Peschanski, C. Royon, Phys. Rev. Lett. 87 (2001) 251806; Nucl. Phys. B 669 (2003) 277; R. Enberg, G. Ingelman, A. Kissavos, N. Timneanu, Phys. Rev. Lett. 89 (2002) 081801; R. Enberg, G. Ingelman, L. Motyka, Phys. Lett. B 524 (2002) 273; R. Enberg, G. Ingelman, N. Timneanu, Phys. Rev. D 67 (2003) 011301; B. Cox, J. Forshaw, Comput. Phys. Comm. 144 (2002) 104; B. Cox, J. Forshaw, B. Heinemann, Phys. Lett. B 540 (2002) 26; V. Khoze, A. Martin, M. Ryskin, Phys. Lett. B 401 (1997) 330; Eur. Phys. J. C 14 (2000) 525; Eur. Phys. J. C 19 (2001) 477; Erratum, Eur. Phys. J. C 20 (2001) 599; Eur. Phys. J. C 23 (2002) 311]. This program implements some of the more significant ones, enabling the simulation of central particle production through color singlet exchange between interacting protons or antiprotons. Method of solution: The Monte Carlo method is used to simulate all elementary 2→2 and 2→1 processes available in HERWIG. The color singlet exchanges implemented in DPEMC are implemented as functions reweighting the photon flux already present in HERWIG. Restriction on the complexity of the problem: The program relying extensively on HERWIG, the limitations are the same as in [G. Marchesini, B.R. Webber, G. Abbiendi, I.G. Knowles, M.H. Seymour, L. Stanco, Comput. Phys. Comm. 67 (1992) 465; G. Corcella, I.G. Knowles, G. Marchesini, S. Moretti, K. Odagiri, P. Richardson, M. Seymour, B. Webber, JHEP 0101 (2001) 010]. Typical running time: Approximate times on a 800 MHz Pentium III: 5-20 min per 10 000 unweighted events, depending on the process under consideration.

National Water-Quality Assessment Program: Central Arizona Basins

USGS Publications Warehouse

Cordy, Gail E.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface-water and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policymakers and managers at the National, State, and local levels. Studies of 60 hydrologic systems that include parts of most major river basins and aquifer systems (study-unit investigations) are the building blocks of the national assessment. The 60 study units range in size from 1,000 to about 60,000 mi2 and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty study-unit investigations were started in 1991, 20 additional studies started in 1994, and 20 more are planned to start in 1997. The Central Arizona Basins study unit began assessment activities in 1994.

The structure of the clouds distributed operating system

NASA Technical Reports Server (NTRS)

Dasgupta, Partha; Leblanc, Richard J., Jr.

1989-01-01

A novel system architecture, based on the object model, is the central structuring concept used in the Clouds distributed operating system. This architecture makes Clouds attractive over a wide class of machines and environments. Clouds is a native operating system, designed and implemented at Georgia Tech. and runs on a set of generated purpose computers connected via a local area network. The system architecture of Clouds is composed of a system-wide global set of persistent (long-lived) virtual address spaces, called objects that contain persistent data and code. The object concept is implemented at the operating system level, thus presenting a single level storage view to the user. Lightweight treads carry computational activity through the code stored in the objects. The persistent objects and threads gives rise to a programming environment composed of shared permanent memory, dispensing with the need for hardware-derived concepts such as the file systems and message systems. Though the hardware may be distributed and may have disks and networks, the Clouds provides the applications with a logically centralized system, based on a shared, structured, single level store. The current design of Clouds uses a minimalist philosophy with respect to both the kernel and the operating system. That is, the kernel and the operating system support a bare minimum of functionality. Clouds also adheres to the concept of separation of policy and mechanism. Most low-level operating system services are implemented above the kernel and most high level services are implemented at the user level. From the measured performance of using the kernel mechanisms, we are able to demonstrate that efficient implementations are feasible for the object model on commercially available hardware. Clouds provides a rich environment for conducting research in distributed systems. Some of the topics addressed in this paper include distributed programming environments, consistency of persistent data and fault-tolerance.

Implementation of a Systematic Accountability Framework in 2014 to Improve the Performance of the Nigerian Polio Program

PubMed Central

Tegegne, Sisay G.; MKanda, Pascal; Yehualashet, Yared G.; Erbeto, Tesfaye B.; Touray, Kebba; Nsubuga, Peter; Banda, Richard; Vaz, Rui G.

2016-01-01

Background. An accountability framework is a central feature of managing human and financial resources. One of its primary goals is to improve program performance through close monitoring of selected priority activities. The principal objective of this study was to determine the contribution of a systematic accountability framework to improving the performance of the World Health Organization (WHO)–Nigeria polio program staff, as well as the program itself. Methods. The effect of implementation of the accountability framework was evaluated using data on administrative actions and select process indicators associated with acute flaccid paralysis (AFP) surveillance, routine immunization, and polio supplemental immunization activities. Data were collected in 2014 during supportive supervision, using Magpi software (a company that provides service to collect data using mobile phones). A total of 2500 staff were studied. Results. Data on administrative actions and process indicators from quarters 2–4 in 2014 were compared. With respect to administrative actions, 1631 personnel (74%) received positive feedback (written or verbal commendation) in quarter 4 through the accountability framework, compared with 1569 (73%) and 1152 (61%) during quarters 3 and 2, respectively. These findings accorded with data on process indicators associated with AFP surveillance and routine immunization, showing statistically significant improvements in staff performance at the end of quarter 4, compared with other quarters. Conclusions. Improvements in staff performance and process indicators were observed for the WHO-Nigeria polio program after implementation of a systematic accountability framework. PMID:26823334

Approximation concepts for efficient structural synthesis

NASA Technical Reports Server (NTRS)

Schmit, L. A., Jr.; Miura, H.

1976-01-01

It is shown that efficient structural synthesis capabilities can be created by using approximation concepts to mesh finite element structural analysis methods with nonlinear mathematical programming techniques. The history of the application of mathematical programming techniques to structural design optimization problems is reviewed. Several rather general approximation concepts are described along with the technical foundations of the ACCESS 1 computer program, which implements several approximation concepts. A substantial collection of structural design problems involving truss and idealized wing structures is presented. It is concluded that since the basic ideas employed in creating the ACCESS 1 program are rather general, its successful development supports the contention that the introduction of approximation concepts will lead to the emergence of a new generation of practical and efficient, large scale, structural synthesis capabilities in which finite element analysis methods and mathematical programming algorithms will play a central role.

Scotland's national naloxone program: The prison experience.

PubMed

Horsburgh, Kirsten; McAuley, Andrew

2018-05-01

Launched in 2011, the Scottish national naloxone program marked an important development in public health policy. Central to its design were strategies to engage prisoners given their elevated risk of drug-related death in the weeks following liberation. Implementation across Scottish prisons has posed particular challenges linked to both operational issues within prison establishments and individual factors affecting staff delivering, and prisoners engaging, with the program. Barriers have been overcome through innovation and partnership working. This commentary has described how the development of the program in prisons has adapted to these challenges to a point where a largely consistent model is in place and where prisoners-on-release are reaping the benefits in terms of reduced opioid-related mortality. © 2017 Australasian Professional Society on Alcohol and other Drugs.

The advanced orbiting systems testbed program: Results to date

NASA Technical Reports Server (NTRS)

Newsome, Penny A.; Otranto, John F.

1993-01-01

The Consultative Committee for Space Data Systems Recommendations for Packet Telemetry and Advanced Orbiting Systems (AOS) propose standard solutions to data handling problems common to many types of space missions. The Recommendations address only space/ground and space/space data handling systems. Goddard Space Flight Center's AOS Testbed (AOST) Program was initiated to better understand the Recommendations and their impact on real-world systems, and to examine the extended domain of ground/ground data handling systems. Central to the AOST Program are the development of an end-to-end Testbed and its use in a comprehensive testing program. Other Program activities include flight-qualifiable component development, supporting studies, and knowledge dissemination. The results and products of the Program will reduce the uncertainties associated with the development of operational space and ground systems that implement the Recommendations. The results presented in this paper include architectural issues, a draft proposed standardized test suite and flight-qualifiable components.

Family-based training program improves brain function, cognition, and behavior in lower socioeconomic status preschoolers

PubMed Central

Neville, Helen J.; Stevens, Courtney; Pakulak, Eric; Bell, Theodore A.; Fanning, Jessica; Klein, Scott; Isbell, Elif

2013-01-01

Using information from research on the neuroplasticity of selective attention and on the central role of successful parenting in child development, we developed and rigorously assessed a family-based training program designed to improve brain systems for selective attention in preschool children. One hundred forty-one lower socioeconomic status preschoolers enrolled in a Head Start program were randomly assigned to the training program, Head Start alone, or an active control group. Electrophysiological measures of children’s brain functions supporting selective attention, standardized measures of cognition, and parent-reported child behaviors all favored children in the treatment program relative to both control groups. Positive changes were also observed in the parents themselves. Effect sizes ranged from one-quarter to half of a standard deviation. These results lend impetus to the further development and broader implementation of evidence-based education programs that target at-risk families. PMID:23818591

Implementation Pearls from a New Guidebook on Improving Medication Use and Outcomes with Clinical Decision Support

PubMed Central

Sirajuddin, Anwar M; Osheroff, Jerome A.; Sittig, Dean F.; Chuo, John; Velasco, Ferdinand; Collins, David A.

2012-01-01

Effective clinical decision support (CDS) is essential for addressing healthcare performance improvement imperatives, but care delivery organizations (CDO) typically struggle with CDS deployment. Ensuring safe and effective medication delivery to patients is a central focus of CDO performance improvement efforts, and this article provides an overview of best-practice strategies for applying CDS to these goals. The strategies discussed are drawn from a new guidebook, co-published and co-sponsored by more than a dozen leading organizations. Developed by scores of CDS implementers and experts, the guidebook outlines key steps and success factors for applying CDS to medication management. A central thesis is that improving outcomes with CDS interventions requires that the CDS five rights be addressed successfully. That is, the interventions must deliver the right information, to the right person, in the right format, through the right channel, at the right point in workflow. This paper provides further details about these CDS five rights, and highlights other important strategies for successful CDS programs. PMID:19894486

Research into display sharing techniques for distributed computing environments

NASA Technical Reports Server (NTRS)

Hugg, Steven B.; Fitzgerald, Paul F., Jr.; Rosson, Nina Y.; Johns, Stephen R.

1990-01-01

The X-based Display Sharing solution for distributed computing environments is described. The Display Sharing prototype includes the base functionality for telecast and display copy requirements. Since the prototype implementation is modular and the system design provided flexibility for the Mission Control Center Upgrade (MCCU) operational consideration, the prototype implementation can be the baseline for a production Display Sharing implementation. To facilitate the process the following discussions are presented: Theory of operation; System of architecture; Using the prototype; Software description; Research tools; Prototype evaluation; and Outstanding issues. The prototype is based on the concept of a dedicated central host performing the majority of the Display Sharing processing, allowing minimal impact on each individual workstation. Each workstation participating in Display Sharing hosts programs to facilitate the user's access to Display Sharing as host machine.

Turning Access into a web-enabled secure information system for clinical trials.

PubMed

Dongquan Chen; Chen, Wei-Bang; Soong, Mayhue; Soong, Seng-Jaw; Orthner, Helmuth F

2009-08-01

Organizations that have limited resources need to conduct clinical studies in a cost-effective, but secure way. Clinical data residing in various individual databases need to be easily accessed and secured. Although widely available, digital certification, encryption, and secure web server, have not been implemented as widely, partly due to a lack of understanding of needs and concerns over issues such as cost and difficulty in implementation. The objective of this study was to test the possibility of centralizing various databases and to demonstrate ways of offering an alternative to a large-scale comprehensive and costly commercial product, especially for simple phase I and II trials, with reasonable convenience and security. We report a working procedure to transform and develop a standalone Access database into a secure Web-based secure information system. For data collection and reporting purposes, we centralized several individual databases; developed, and tested a web-based secure server using self-issued digital certificates. The system lacks audit trails. The cost of development and maintenance may hinder its wide application. The clinical trial databases scattered in various departments of an institution could be centralized into a web-enabled secure information system. The limitations such as the lack of a calendar and audit trail can be partially addressed with additional programming. The centralized Web system may provide an alternative to a comprehensive clinical trial management system.

The Gateway Paper--preventive and promotive programs in Pakistan and health reforms in Pakistan.

PubMed

Nishtar, Sania

2006-12-01

Pakistan's public health interventions include a range of programs lead by the federal government with implementation arms at the provincial and district levels. Some of the programs are disease specific such as the respective programs on HIV/AIDS, Malaria, Tuberculosis, non-communicable diseases and Hepatitis; others are specific to life cycle domains such as in the case of maternal and child health whereas still others such as the National Program for Family Planning and Primary Healthcare and the National Expanded Program for Immunization are cross-cutting. Although these programs have contributed to improving health outcomes at intermediate outcomes level, a number of critical impediments to maximizing their impact have been noted. These include lack of integration, institutional impediments to the implementation of programs with particular reference to problems at the federal/provincial level and unrealized implications of federal programs at the provincial level are amongst the foremost. These have been further compounded by the addition of another service delivery tier in Pakistan's health system through the introduction of the devolution initiative. Furthermore, the unsustainable and under-utilized BHUs which serve as the service delivery base of these programs add to the problems. The Gateway Paper makes a number of recommendations to obviate these issues such as recommendations to integrate programs, strengthen surveillance systems, and with reference to obviating issues to implementation, emphasis is laid on decentralizing decision-making and central control, institutionalizing managerial audit, and prioritizing specific governance and management reforms. The Paper also stresses on the need for establishing a national coordination mechanism for fostering federal/provincial harmony and ensuring the creation of appropriate counterpart institutional arrangements in the provinces and districts. Recommendations on restructuring BHUs at a management, oversight, quality related and community participation level will play a vital role in determining the manner in which the efficiency of these public health programs can be enhanced.

Wildlife Habitat Impact Assessment, Chief Joseph Dam Project, Washington : Project Report 1992.

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

Kuehn, Douglas; Berger, Matthew

1992-01-01

Under the Pacific Northwest Electric Power Planning and Conservation Act of 1980, and the subsequent Northwest Power Planning Council`s Columbia River Basin Fish and Wildlife Program, a wildlife habitat impact assessment and identification of mitigation objectives have been developed for the US Army Corps of Engineer`s Chief Joseph Dam Project in north-central Washington. This study will form the basis for future mitigation planning and implementation.

QUALITY ASSURANCE/QUALITY CONTROL OF A PROJECT INVOLVING COOPERATIVE AGREEMENTS, INTRA-AGENCY AGREEMENTS, AGENCY STAFF AND CONTRACTS TO CONDUCT RESEARCH: ECOLOGICAL MONITORING AND ASSESSMENT OF THE GREAT RIVERS ECOSYSTEMS IN THE CENTRAL BASIN OF THE UNITED STATES (EMAP-GRE)

EPA Science Inventory

While condition reports are useful to managers, demonstrating how to implement a monitoring and assessment program in the future is also an important project goal. Better monitoring methods will make more information more widely available to better manage the nation's great rive...

A cluster randomized Hybrid Type III trial testing an implementation support strategy to facilitate the use of an evidence-based practice in VA homeless programs.

PubMed

Smelson, David A; Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Sawh, Leon; Glickman, Mark

2015-05-28

The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is one of the largest initiatives to end Veteran homelessness. However, mental health and substance use disorders continue to reduce client stability and impede program success. HUD-VASH programs do not consistently employ evidence-based practices that address co-occurring mental health and substance use disorders. This paper presents a study protocol to evaluate the implementation of an evidence-based, co-occurring disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) in HUD-VASH using an implementation strategy called Getting To Outcomes (GTO). In three large VA Medical Centers, this Hybrid Type III trial will randomize case managers and their clients by HUD-VASH sub-teams to receive either MISSION-Vet Implementation as Usual (IU-standard training and access to the MISSION-Vet treatment manuals) or MISSION-Vet implementation augmented by GTO. In addition to testing GTO, effectiveness of the treatment (MISSION-Vet) will be assessed using existing Veteran-level data from the HUD-VASH data monitoring system. This project will compare GTO and IU case managers and their clients on the following variables: (1) fidelity to the MISSION-Vet intervention; (2) proportion of time the Veteran is housed; (3) mental health, substance use, and functional outcomes among Veterans; and (4) factors key to the successful deployment of a new treatment as specified by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. This project is an important step for developing an implementation strategy to increase adoption of evidence-based practice use in VA homeless programs, and to further examine efficacy of MISSION-Vet in HUD-VASH. This project has important implications for program managers, policy makers, and researchers within the homelessness field. VA Central IRB approval for this study was granted in October 2011. The three sites were trained on MISSION-Vet and GTO in the first half of 2013. The first GTO planning meetings began after training occurred, between January 2013 and November 2013, across the three sites. The data collection-via a fidelity measure embedded into the VA Computerized Patient Record System-began as each site initiated MISSION-Vet, between April 2013 and January 2014. ClinicalTrials.gov: NCT01430741.

Meals for Good: An innovative community project to provide healthy meals to children in early care and education programs through food bank catering.

PubMed

Carpenter, Leah R; Smith, Teresa M; Stern, Katherine; Boyd, Lisa Weissenburger-Moser; Rasmussen, Cristy Geno; Schaffer, Kelly; Shuell, Julie; Broussard, Karen; Yaroch, Amy L

2017-12-01

Innovative approaches to childhood obesity prevention are warranted in early care and education (ECE) settings, since intervening early among youth is recommended to promote and maintain healthy behaviors. The objective of the Meals for Good pilot was to explore feasibility of implementing a food bank-based catering model to ECE programs to provide more nutritious meals, compared to meals brought from home (a parent-prepared model). In 2014-2015, a 12-month project was implemented by a food bank in central Florida in four privately-owned ECE programs. An explanatory sequential design of a mixed-methods evaluation approach was utilized, including a pre-post menu analysis comparing parent-prepared meals to the catered meals, and stakeholder interviews to determine benefits and barriers. The menu analysis of lunches showed daily reductions in calories, fat, and saturated fat, but an increase in sodium in catered meals when compared to parent-prepared meals. Interviews with ECE directors, teachers, parents, and food bank project staff, identified several benefits of the catered meals, including healthfulness of meals, convenience to parents, and the ECE program's ability to market this meal service. Barriers of the catered meals included the increased cost to parents, transportation and delivery logistics, and change from a 5 to a 2-week menu cycle during summer food service. This pilot demonstrated potential feasibility of a food bank-ECE program partnership, by capitalizing on the food bank's existing facilities and culinary programming, and interest in implementing strategies focused on younger children. The food bank has since leveraged lessons learned and expanded to additional ECE programs.

Ecological and socioeconomic effects of China's policies for ecosystem services.

PubMed

Liu, Jianguo; Li, Shuxin; Ouyang, Zhiyun; Tam, Christine; Chen, Xiaodong

2008-07-15

To address devastating environmental crises and to improve human well-being, China has been implementing a number of national policies on payments for ecosystem services. Two of them, the Natural Forest Conservation Program (NFCP) and the Grain to Green Program (GTGP), are among the biggest programs in the world because of their ambitious goals, massive scales, huge payments, and potentially enormous impacts. The NFCP conserves natural forests through logging bans and afforestation with incentives to forest enterprises, whereas the GTGP converts cropland on steep slopes to forest and grassland by providing farmers with grain and cash subsidies. Overall ecological effects are beneficial, and socioeconomic effects are mostly positive. Whereas there are time lags in ecological effects, socioeconomic effects are more immediate. Both the NFCP and the GTGP also have global implications because they increase vegetative cover, enhance carbon sequestration, and reduce dust to other countries by controlling soil erosion. The future impacts of these programs may be even bigger. Extended payments for the GTGP have recently been approved by the central government for up to 8 years. The NFCP is likely to follow suit and receive renewed payments. To make these programs more effective, we recommend systematic planning, diversified funding, effective compensation, integrated research, and comprehensive monitoring. Effective implementation of these programs can also provide important experiences and lessons for other ecosystem service payment programs in China and many other parts of the world.

The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in Argentina.

PubMed

Kairiyama, Eulogia; Morales Pedraza, Jorge

2009-05-01

Tissue banking activities in Argentina started in 1993. The regulatory and controlling national authority on organ, tissue and cells for transplantation activity is the National Unique Coordinating Central Institute for Ablation and Implant (INCUCAI). Three tissue banks were established under the IAEA program and nine other banks participated actively in the implementation of this program. As result of the implementation of the IAEA program in Argentina and the work done by the established tissue banks, more and more hospitals are now using, in a routine manner, radiation sterilised tissues processed by these banks. During the period 1992-2005, more than 21 016 tissues were produced and irradiated in the tissue banks participating in the IAEA program. Within the framework of the training component of the IAEA program, Argentina has been selected to host the Regional Training Centre for Latin American. In this centre, tissue bank operators and medical personal from Latin American countries were trained. Since 1999, Argentina has organised four regular regional training courses and two virtual regional training courses. More than twenty (20) tissue bank operators and medical personnel from Argentina were trained under the IAEA program in the six courses organised in the country. In general, ninety (96) tissue bank operators and medical personnel from eight Latin-American countries were trained in the Buenos Aires regional training centre. From Argentina 16 students graduated in these courses.

Local Adaptation of Central Policies: The Policymaking and Implementation of Compulsory Education for Migrant Children in China

ERIC Educational Resources Information Center

Wang, Lihua

2016-01-01

This article looks at the central and local governments' policymaking and implementation of compulsory education for migrant children in China. Three distinct models of policy implementation were identified through a case study approach. They indicated a selective adaptation of central policy objective and principles by the local governments and…

Allocative and implementation efficiency in HIV prevention and treatment for people who inject drugs.

PubMed

Benedikt, Clemens; Kelly, Sherrie L; Wilson, David; Wilson, David P

2016-12-01

Estimated global new HIV infections among people who inject drugs (PWID) remained stable over the 2010-2015 period and the target of a 50% reduction over this period was missed. To achieve the 2020 UNAIDS target of reducing adult HIV infections by 75% compared to 2010, accelerated action in scaling up HIV programs for PWID is required. In a context of diminishing external support to HIV programs in countries where most HIV-affected PWID live, it is essential that available resources are allocated and used as efficiently as possible. Allocative and implementation efficiency analysis methods were applied. Optima, a dynamic, population-based HIV model with an integrated program and economic analysis framework was applied in eight countries in Eastern Europe and Central Asia (EECA). Mathematical analyses established optimized allocations of resources. An implementation efficiency analysis focused on examining technical efficiency, unit costs, and heterogeneity of service delivery models and practices. Findings from the latest reported data revealed that countries allocated between 4% (Bulgaria) and 40% (Georgia) of total HIV resources to programs targeting PWID - with a median of 13% for the eight countries. When distributing the same amount of HIV funding optimally, between 9% and 25% of available HIV resources would be allocated to PWID programs with a median allocation of 16% and, in addition, antiretroviral therapy would be scaled up including for PWID. As a result of optimized allocations, new HIV infections are projected to decline by 3-28% and AIDS-related deaths by 7-53% in the eight countries. Implementation efficiencies identified involve potential reductions in drug procurement costs, service delivery models, and practices and scale of service delivery influencing cost and outcome. A high level of implementation efficiency was associated with high volumes of PWID clients accessing a drug harm reduction facility. A combination of optimized allocation of resources, improved implementation efficiency and increased investment of non-HIV resources is required to enhance coverage and improve outcomes of programs for PWID. Increasing efficiency of HIV programs for PWID is a key step towards avoiding implicit rationing and ensuring transparent allocation of resources where and how they would have the largest impact on the health of PWID, and thereby ensuring that funding spent on PWID becomes a global best buy in public health. Copyright © 2016. Published by Elsevier B.V.

Cost analysis of large-scale implementation of the 'Helping Babies Breathe' newborn resuscitation-training program in Tanzania.

PubMed

Chaudhury, Sumona; Arlington, Lauren; Brenan, Shelby; Kairuki, Allan Kaijunga; Meda, Amunga Robson; Isangula, Kahabi G; Mponzi, Victor; Bishanga, Dunstan; Thomas, Erica; Msemo, Georgina; Azayo, Mary; Molinier, Alice; Nelson, Brett D

2016-12-01

Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2%), followed by central program administration (37.2%), and follow-up visits (17.6%). Within Mbeya, 49 training sessions were undertaken, involving the training of 1,341 health providers from 336 health facilities in eight districts. To similarly expand the HBB program across the 25 regions of mainland Tanzania, the total economic cost is projected to be around $4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between $2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost $2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention.

Evaluation of Rural Primary Health Care in Western China: A Cross-Sectional Study

PubMed Central

Wang, Manli; Fang, Haiqing; Bishwajit, Ghose; Xiang, Yuanxi; Fu, Hang; Feng, Zhanchun

2015-01-01

Purpose: China’s Ministry of Health has enacted Rural Primary Health Care Program (2001–2010) (HCP) guidelines to improve the quality of people’s health. However, the program’s success in Western China remains unevaluated. Thus, this study aims to begin to fill that gap by analyzing the provision and utilization of Rural Primary Health Care (RPHC) in Western China. Methods: A cross-sectional study was conducted to collect secondary data on the socio-economic characteristics, system construction, services use and implementation of RPHC, and the residents’ health status of the sampled areas. Four hundred counties from 31 provinces in China were selected via stratified random sampling, including 171 counties from 12 Western provinces. Twenty-seven analysis indicators, covering system construction, services use and implementation of RPHC were chosen to assess Western China’s primary health quality. Analysis of Variance (ANOVA) and Least Significant Difference (LSD) methods were used to measure the RPHC disparities between Western and Eastern and Central China. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank Western, Eastern and Central internal provinces regarding quality of their RPHC. Results: Of the 27 indicators, 13 (48.15%) were below the standard in Western China. These focused on rural health service system construction, Chinese medicine services, and public health. In the comparison between Western, Central and Eastern China, 12 indicators had statistical significance (p < 0.05), and using LSD to compare between Western and Eastern China, all indicators were statistically significant (p < 0.05), demonstrating regional disparities. Xinjiang Province’s RPHC ranked highest overall, and Yunnan Province ranked the lowest, indicating the internal differences within the 12 Western provinces; and Western provinces’ Ci value was lower than that of Eastern and Central China overall. Conclusion: Western China’s RPHC has proceeded well, but remains weaker than that of Eastern and Central China. Differences within Western internal provinces threaten the successful implementation of RPHC.  PMID:26528993

Musculoskeletal education in physical medicine and rehabilitation residency programs.

PubMed

Smith, Jay; Krabak, Brian J; Malanga, Gerard A; Moutvic, Margaret A

2004-10-01

To characterize current musculoskeletal (MSK) education experiences in physical medicine and rehabilitation residency programs and to identify perceived barriers to providing more extensive MSK education experiences. In addition, to establish utilization patterns for the PASSOR Physical Examination Core Competencies List. Between March and November 2003, all 81 physical medicine and rehabilitation residency program directors were asked to complete an MSK education survey developed by the authors. A total of 69 of 81 program directors (86%) responded after multiple contacts. The most frequently utilized MSK education formats were MSK lecture series, MSK departmental conferences, and physical examination workshops. Potential barriers to expanded MSK education included money, time, and staff number. Given unlimited resources, most residency programs would greatly increase utilization of visiting lecturers, CD-ROMs/DVDs, objective structured clinical examinations, and physical examination videos. Of the 30 program directors who recalled receiving the Core Competencies List, only 40% (12 of 30) have formally integrated the list into their residency training. Barriers to implementation included logistical challenges and lack of direction regarding implementation. Residency program directors indicate a strong interest in expanding resident MSK education through the use of CD-ROMs/DVDs, physical examination videos, objective structured clinical examinations, and visiting lecturer programs. CD-ROMs/DVDs and videos represent particularly attractive educational formats for supplementing resident MSK education due to the advantages of central production, nominal costs, widespread distribution, multimedia capabilities, and accessibility. These educational formats should be considered for targeted educational initiatives to enhance resident MSK education, regardless of residency program size or resources.

Energy Smart Colorado, Final Report

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

Gitchell, John M.; Palmer, Adam L.

2014-03-31

Energy Smart Colorado is an energy efficiency program established in 2011 in the central mountain region of Colorado. The program was funded through a grant of $4.9 million, awarded in August 2010 by the U.S. Department of Energy’s Better Buildings Program. As primary grant recipient, Eagle County coordinated program activities, managed the budget, and reported results. Eagle County staff worked closely with local community education and outreach partner Eagle Valley Alliance for Sustainability (now Walking Mountains Science Center) to engage residents in the program. Sub-recipients Pitkin County and Gunnison County assigned local implementation of the program in their regions tomore » their respective community efficiency organizations, Community Office for Resource Efficiency (CORE) in Pitkin County, and Office for Resource Efficiency (ORE) in Gunnison County. Utility partners contributed $166,600 to support Home Energy Assessments for their customers. Program staff opened Energy Resource Centers, engaged a network of qualified contractors, developed a work-flow, an enrollment website, a loan program, and a data management system to track results.« less

Internet SCADA Utilizing API's as Data Source

NASA Astrophysics Data System (ADS)

Robles, Rosslin John; Kim, Haeng-Kon; Kim, Tai-Hoon

An Application programming interface or API is an interface implemented by a software program that enables it to interact with other software. Many companies provide free API services which can be utilized in Control Systems. SCADA is an example of a control system and it is a system that collects data from various sensors at a factory, plant or in other remote locations and then sends this data to a central computer which then manages and controls the data. In this paper, we designed a scheme for Weather Condition in Internet SCADA Environment utilizing data from external API services. The scheme was designed to double check the weather information in SCADA.

Networks consolidation program: Maintenance and Operations (M&O) staffing estimates

NASA Technical Reports Server (NTRS)

Goodwin, J. P.

1981-01-01

The Mark IV-A consolidate deep space and high elliptical Earth orbiter (HEEO) missions tracking and implements centralized control and monitoring at the deep space communications complexes (DSCC). One of the objectives of the network design is to reduce maintenance and operations (M&O) costs. To determine if the system design meets this objective an M&O staffing model for Goldstone was developed which was used to estimate the staffing levels required to support the Mark IV-A configuration. The study was performed for the Goldstone complex and the program office translated these estimates for the overseas complexes to derive the network estimates.

Parallel computation with the force

NASA Technical Reports Server (NTRS)

Jordan, H. F.

1985-01-01

A methodology, called the force, supports the construction of programs to be executed in parallel by a force of processes. The number of processes in the force is unspecified, but potentially very large. The force idea is embodied in a set of macros which produce multiproceossor FORTRAN code and has been studied on two shared memory multiprocessors of fairly different character. The method has simplified the writing of highly parallel programs within a limited class of parallel algorithms and is being extended to cover a broader class. The individual parallel constructs which comprise the force methodology are discussed. Of central concern are their semantics, implementation on different architectures and performance implications.

Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

PubMed

Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

2018-03-01

Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

A Multistate Asian-Language Tobacco Quitline: Addressing a Disparity in Access to Care.

PubMed

Cummins, Sharon E; Wong, Shiushing; Bonnevie, Erika; Lee, Hye-Ryeon; Goto, Cynthia J; McCree Carrington, Judy; Kirby, Carrie; Zhu, Shu-Hong

2015-10-01

We conducted a dissemination and implementation study to translate an intervention protocol for Asian-language smokers from an efficacy trial into an effective and sustainable multistate service. Three state tobacco programs (in California, Colorado, and Hawaii) promoted a multistate cessation quitline to 3 Asian-language-speaking communities: Chinese, Korean, and Vietnamese. The California quitline provided counseling centrally to facilitate implementation. Three more states joined the program during the study period (January 2010-July 2012). We assessed the provision of counseling, quitting outcomes, and dissemination of the program. A total of 2004 smokers called for the service, with 88.3% opting for counseling. Among those opting for counseling, the 6-month abstinence rate (18.8%) was similar to results of the earlier efficacy trial (16.4%). The intervention protocol, based on an efficacy trial, was successfully translated into a multistate service and further disseminated. This project paved the way for the establishment of a national quitline for Asian-language speakers, which serves as an important strategy to address disparities in access to care.

Central State University: Phase III Report

ERIC Educational Resources Information Center

Ohio Board of Regents, 2013

2013-01-01

This document is the final report on Central State University's implementation of Section 371 of Ohio Amended Substitute House Bill 153. Implementation of Phase I action items required that deliverables and timelines be shifted to give Central State the best opportunity for early success. In Phase II, Central State responded aggressively to a…

Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence.

PubMed

Reilly, Rachel; Evans, Katharine; Gomersall, Judith; Gorham, Gillian; Peters, Micah D J; Warren, Steven; O'Shea, Rebekah; Cass, Alan; Brown, Alex

2016-04-06

Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Given the human cost of dialysis and the growing population of people living with CKD, there is an urgent need to draw lessons from the available evidence from this and other sources, including studies in the broader population, to better serve this population with programs that address the barriers to receiving high-quality care and improve quality of life.

Piloting a Nationally Disseminated, Interactive Human Subjects Protection Program for Community Partners: Design, Content, and Evaluation

PubMed Central

Eakin, Brenda; Kirk, Rosalind; Piechowski, Patricia; Thomas, Barbara

2014-01-01

Abstract Funders, institutions, and research organizations are increasingly recognizing the need for human subjects protections training programs for those engaged in academic research. Current programs tend to be online and directed toward an audience of academic researchers. Research teams now include many nonacademic members, such as community partners, who are less likely to respond to either the method or the content of current online trainings. A team at the CTSA‐supported Michigan Institute for Clinical and Health Research at the University of Michigan developed a pilot human subjects protection training program for community partners that is both locally implemented and adaptable to local contexts, yet nationally consistent and deliverable from a central administrative source. Here, the developers and the analysts of this program discuss its development, its content, and the results of its evaluation. PMID:24720288

Thirteen years and counting: Outcomes of a concurrent ASN/BSN enrollment program.

PubMed

Heglund, Stephen; Simmons, Jessica; Wink, Diane; D'Meza Leuner, Jean

In their 2011 report, The Future of Nursing, the Institute of Medicine called for 80% of the nursing workforce to be comprised of baccalaureate prepared Registered Nurses by the year 2020. One suggested approach to achieve this goal is the creation of programs that allow students to progress through associate and baccalaureate nursing preparation simultaneously. This paper describes the University of Central Florida's 13-year experience after implementing a Concurrent Enrollment Program. Development and structure of the program, advisement and curriculum details, facilitators and barriers are described. Data on National Council Licensure Examination for Registered Nurses pass rates, completion rates, comparison with traditional RN-BSN students, and progression to graduate school are also included. The Concurrent Program model described here between a specific university and state college partners, demonstrated positive outcomes that support achievement of the Institute of Medicine's goals. Copyright © 2017 Elsevier Inc. All rights reserved.

Piloting a nationally disseminated, interactive human subjects protection program for community partners: design, content, and evaluation.

PubMed

Solomon, Stephanie; Eakin, Brenda; Kirk, Rosalind; Piechowski, Patricia; Thomas, Barbara

2014-04-01

Funders, institutions, and research organizations are increasingly recognizing the need for human subjects protections training programs for those engaged in academic research. Current programs tend to be online and directed toward an audience of academic researchers. Research teams now include many nonacademic members, such as community partners, who are less likely to respond to either the method or the content of current online trainings. A team at the CTSA-supported Michigan Institute for Clinical and Health Research at the University of Michigan developed a pilot human subjects protection training program for community partners that is both locally implemented and adaptable to local contexts, yet nationally consistent and deliverable from a central administrative source. Here, the developers and the analysts of this program discuss its development, its content, and the results of its evaluation. © 2014 Wiley Periodicals, Inc.

Interorganizational relationships within state tobacco control networks: a social network analysis.

PubMed

Krauss, Melissa; Mueller, Nancy; Luke, Douglas

2004-10-01

State tobacco control programs are implemented by networks of public and private agencies with a common goal to reduce tobacco use. The degree of a program's comprehensiveness depends on the scope of its activities and the variety of agencies involved in the network. Structural aspects of these networks could help describe the process of implementing a state's tobacco control program, but have not yet been examined. Social network analysis was used to examine the structure of five state tobacco control networks. Semi-structured interviews with key agencies collected quantitative and qualitative data on frequency of contact among network partners, money flow, relationship productivity, level of network effectiveness, and methods for improvement. Most states had hierarchical communication structures in which partner agencies had frequent contact with one or two central agencies. Lead agencies had the highest control over network communication. Networks with denser communication structures had denser productivity structures. Lead agencies had the highest financial influence within the networks, while statewide coalitions were financially influenced by others. Lead agencies had highly productive relationships with others, while agencies with narrow roles had fewer productive relationships. Statewide coalitions that received Robert Wood Johnson Foundation funding had more highly productive relationships than coalitions that did not receive the funding. Results suggest that frequent communication among network partners is related to more highly productive relationships. Results also highlight the importance of lead agencies and statewide coalitions in implementing a comprehensive state tobacco control program. Network analysis could be useful in developing process indicators for state tobacco control programs.

Organizational capacity for chronic disease prevention: a survey of Canadian public health organizations.

PubMed

Hanusaik, Nancy; O'Loughlin, Jennifer L; Kishchuk, Natalie; Paradis, Gilles; Cameron, Roy

2010-04-01

There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.

Bilingual parallel programming

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

Foster, I.; Overbeek, R.

1990-01-01

Numerous experiments have demonstrated that computationally intensive algorithms support adequate parallelism to exploit the potential of large parallel machines. Yet successful parallel implementations of serious applications are rare. The limiting factor is clearly programming technology. None of the approaches to parallel programming that have been proposed to date -- whether parallelizing compilers, language extensions, or new concurrent languages -- seem to adequately address the central problems of portability, expressiveness, efficiency, and compatibility with existing software. In this paper, we advocate an alternative approach to parallel programming based on what we call bilingual programming. We present evidence that this approach providesmore » and effective solution to parallel programming problems. The key idea in bilingual programming is to construct the upper levels of applications in a high-level language while coding selected low-level components in low-level languages. This approach permits the advantages of a high-level notation (expressiveness, elegance, conciseness) to be obtained without the cost in performance normally associated with high-level approaches. In addition, it provides a natural framework for reusing existing code.« less

Implementation of a Centralized Patient Transfer Center: Improving the Care Experience of Patients and their Families

DTIC Science & Technology

2011-01-25

Sharing Knowledge: Achieving Breakthrough Performance 2010 Military Health System Conference Implementation of a Centralized Patient Transfer...Improving the Care Experience of Patients and their Families Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the...Implementation of a Centralized Patient Transfer Center: Improving the Care Experience of Patients and their Families 5a. CONTRACT NUMBER 5b. GRANT

Social networks and community prevention coalitions.

PubMed

Feinberg, Mark E; Riggs, Nathaniel R; Greenberg, Mark T

2005-07-01

This study investigates the links between community readiness and the social networks among participants in Communities That Care (CTC), community-based prevention coalitions. The coalitions targeted adolescent behavior problems through community risk factor assessments, prioritization of risk factors, and selection/implementation of corresponding evidence-based family, school, and community programs. Key leaders (n = 219) in 23 new CTC sites completed questionnaires focusing on community readiness to implement CTC and the respondents' personal, work, and social organization links to other key leaders in the community. Outside technical assistants also completed ratings of each community's readiness and early CTC functioning. Measures of network cohesion/integration were positively associated with readiness, while centralization was negatively associated. These results suggest that non-centralized networks in which ties between members are close and direct may be an indicator of community readiness. In addition, we found different associations between readiness and different domains of social relations. EDITORS' STRATEGIC IMPLICATIONS: The authors present the promising practice of using social network analysis to characterize the functioning of local prevention coalitions and their readiness to implement a community-based prevention initiative. Researchers and community planners will benefit from the lessons in this article, which capitalizes on a large sample and multiple informants. This work raises interesting questions about how to combine the promotion of coalition functioning while simultaneously encouraging diversity of coalition membership.

41 CFR 101-26.501-9 - Centralized motor vehicle leasing program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Centralized motor vehicle...-PROCUREMENT SOURCES AND PROGRAM 26.5-GSA Procurement Programs § 101-26.501-9 Centralized motor vehicle leasing program. GSA has a centralized leasing program to provide an additional source of motor vehicle support to...

Area Health Education Center (AHEC) programs for rural and underrepresented minority students in the Alabama Black Belt.

PubMed

Patel, Ashruta; Knox, Regina J; Logan, Alicia; Summerville, Katie

2017-01-01

This paper evaluated the implementation West Central Alabama Area Health Education Center programs for high school students in grades 9-12 through participant-reported evaluations and feedback during the  September 1st, 2013 to August 31st, 2014 fiscal year. The programs targeted racial/ethnic minorities and/or rural individuals interested in pursuing a career as a healthcare provider in medically underserved counties of Alabama. Students participated in enrichment activities related to prospective health careers that included: successful college preparedness, knowledge about health careers, and the types of primary care health professions that are needed in underserved Alabama communities. The curriculum studied 593 (ACT preparation: n  = 172, AHEC 101: n  = 56, FAFSA: n  = 109, Health Career Exploration: n  = 159, College Career Readiness: n  = 67, Dixie Scholars NERD: n  = 30) baseline measures for the programs to evaluate effectiveness when rated by participants both quantitatively and qualitatively. Interactive activities with video incorporation, hands-on experiences, and group discussions paired with student motivation and interest in specific health career-related activities provided the highest program ratings. It is important to use a variety of successful program strategies when forming healthcare workforce development interventions. Student evaluations can help adapt methods for future program implementation to ultimately achieve strategies for health professional recruitment, training, and retention in areas that lack access to quality healthcare.

Research Ethics in the Context of Transition: Gaps in Policies and Programs on the Protection of Research Participants in the Selected Countries of Central and Eastern Europe.

PubMed

Famenka, Andrei

2016-12-01

This paper examines the ability of countries in Central and Eastern Europe (CEE) to ensure appropriate protection of research participants in the field of increasingly globalizing biomedical research. By applying an analytical framework for identifying gaps in policies and programs for human subjects protection to four countries of CEE-Belarus, Latvia, Lithuania, and Poland, substantial gaps in the scope and content of relevant policies and major impediments to program performance have been revealed. In these countries, public policies on the protection of research participants lack consistency and reliable mechanisms for their implementation. Impediments to program performance most often relate to inadequacies in the national research ethics systems with regard to organizational structure, budgetary support, supervision, and training. The level of research ethics capacity varies from country to country and depends on socio-economic and political factors of post-communist transition. The breadth and depth of the problems identified suggest that the current level of protection for research participants in CEE might be inadequate to the challenges posed by the globalization of biomedical research. In CEE countries, there is a need for strengthening research ethics capacity through modification of relevant policies and improvement of program management. The differences among the countries call for further research on identifying the best approaches for filling the gaps in the policies and programs aimed at ensuring effective protection of research participants.

Research ethics in the context of transition: gaps in policies and programs on the protection of research participants in the selected countries of Central and Eastern Europe

PubMed Central

Famenka, Andrei

2015-01-01

This paper examines the ability of countries in Central and Eastern Europe (CEE) to ensure appropriate protection of research participants in the field of increasingly globalizing biomedical research. By applying an analytical framework for identifying gaps in policies and programs for human subjects protection to four countries of CEE – Belarus, Latvia, Lithuania, and Poland, substantial gaps in the scope and content of relevant policies and major impediments to program performance have been revealed. In these countries, public policies on the protection of research participants lack consistency and reliable mechanisms for their implementation. Impediments to program performance most often relate to inadequacies in the national research ethics systems with regard to organizational structure, budgetary support, supervision, and training. The level of research ethics capacity varies from country to country and depends on socio-economic and political factors of post-communist transition. The breadth and depth of the problems identified suggest that the current level of protection for research participants in CEE might be inadequate to the challenges posed by the globalization of biomedical research. In CEE countries, there is a need for strengthening research ethics capacity through modification of relevant policies and improvement of program management. The differences among the countries call for further research on identifying the best approaches for filling the gaps in the policies and programs aimed at ensuring effective protection of research participants. PMID:26548313

The Vanderbilt Professional Nursing Practice Program, part 3: managing an advancement process.

PubMed

Steaban, Robin; Fudge, Mitzie; Leutgens, Wendy; Wells, Nancy

2003-11-01

Consistency of performance standards across multiple clinical settings is an essential component of a credible advancement system. Our advancement process incorporates a central committee, composed of nurses from all clinical settings within the institution, to ensure consistency of performance in inpatient, outpatient, and procedural settings. An analysis of nurses advanced during the first 18 months of the program indicates that performance standards are applicable to nurses in all clinical settings. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program underway at Vanderbilt University Medical Center. Part 2 described the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the program's inception. The purpose of this article is to review the advancement process, review the roles of those involved in the process, and to describe outcomes and lessons learned.

Leadership networks in Catholic parishes: Implications for implementation research in health

PubMed Central

Negrón, Rosalyn; Leyva, Bryan; Allen, Jennifer; Ospino, Hosffman; Tom, Laura; Rustan, Sarah

2014-01-01

Through two case studies of Catholic parishes in Massachusetts, this study explores the implications of leader-centered versus distributed leadership in Catholic parishes for the implementation of evidence-based health interventions. The two parishes involved in the study differ from each other in several ways. In the first, parishioners are less engaged in leadership activities at the decision-making level in the parish. A small group of lay volunteers work with the parish priest and other ordained leaders on parish activities. In the second parish, a large and active lay volunteer leadership have forged an organizational structure that allows more independence from the pastor's direct oversight. In this parish, lay volunteer leaders are the prime drivers of organizational programs and events. In 2012–2013, three types of networks were assessed at each parish: discussion, collaboration, and outside-of-parish ties. The contrasts between each parish include differences in density of collaboration, in frequency of discussion, and network centrality of the respective parish priests. We further identified key actors in the network structures at each parish. We discuss the implications of these findings for understanding organizational capacity in the context of health program implementation. PMID:25441317

Leadership networks in Catholic parishes: implications for implementation research in health.

PubMed

Negrón, Rosalyn; Leyva, Bryan; Allen, Jennifer; Ospino, Hosffman; Tom, Laura; Rustan, Sarah

2014-12-01

Through two case studies of Catholic parishes in Massachusetts, this study explores the implications of leader-centered versus distributed leadership in Catholic parishes for the implementation of evidence-based health interventions. The two parishes involved in the study differ from each other in several ways. In the first, parishioners are less engaged in leadership activities at the decision-making level in the parish. A small group of lay volunteers work with the parish priest and other ordained leaders on parish activities. In the second parish, a large and active lay volunteer leadership have forged an organizational structure that allows more independence from the pastor's direct oversight. In this parish, lay volunteer leaders are the prime drivers of organizational programs and events. In 2012-2013, three types of networks were assessed at each parish: discussion, collaboration, and outside-of-parish ties. The contrasts between each parish include differences in density of collaboration, in frequency of discussion, and network centrality of the respective parish priests. We further identified key actors in the network structures at each parish. We discuss the implications of these findings for understanding organizational capacity in the context of health program implementation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Tackling air pollution and extreme climate changes in China: Implementing the Paris climate change agreement.

PubMed

Tambo, Ernest; Duo-Quan, Wang; Zhou, Xiao-Nong

2016-10-01

China still depends on coal for more than 60% of its power despite big investments in the process of shifting to nuclear, solar and wind power renewable energy resources alignment with Paris climate change agreement (Paris CCA). Chinese government through the Communist Party Central Committee (CPCC) ascribes great importance and commitment to Paris CCA legacy and history landmark implementation at all levels. As the world's biggest carbon dioxide emitter, China has embarked on "SMART" pollution and climate changes programs and measures to reduce coal-fired power plants to less than 50% in the next five years include: new China model of energy policies commitment on CO2 and greenhouse gas emissions reductions to less than 20% non-fossil energy use by 2030 without undermining their economic growth, newly introduced electric vehicles transportation benefits, interactive and sustained air quality index (AQI) monitoring systems, decreasing reliance on fossil fuel economic activities, revision of energy price reforms and renewable energy to less energy efficient technologies development. Furthermore, ongoing CPCC improved environmental initiatives, implemented strict regulations and penalties on local companies and firms' pollution production management, massive infrastructures such as highways to reduce CO2 expansion of seven regional emissions trading markets and programs for CO2 emissions and other pollutants are being documented. Maximizing on the centralized nature of the China's government, implemented Chinese pollution, climate changes mitigation and adaptation initiatives, "SMART" strategies and credible measures are promising. A good and practical example is the interactive and dynamic website and database covering 367 Chinese cities and providing real time information on environmental and pollution emissions AQI. Also, water quality index (WQI), radiation and nuclear safety monitoring and management systems over time and space. These are ongoing Chinese valuable and exemplary leadership in Paris CCA implementation to the global community. Especially to pragmatic and responsible efforts to support pollution and climate changes capacity development, technology transfer and empowerment in emissions surveillance and monitoring systems and "SMART" integrated climate changes mitigation packages in global Sustainable Development Goals (SDGs) context, citizenry health and wellbeing. Copyright © 2016 Elsevier Ltd. All rights reserved.

BUCKO- A BUCKLING ANALYSIS FOR RECTANGULAR PLATES WITH CENTRALLY LOCATED CUTOUTS

NASA Technical Reports Server (NTRS)

Nemeth, M. P.

1994-01-01

BUCKO is a computer program developed to predict the buckling load of a rectangular compression-loaded orthotropic plate with a centrally located cutout. The plate is assumed to be a balanced, symmetric laminate of uniform thickness. The cutout shape can be elliptical, circular, rectangular, or square. The BUCKO package includes sample data that demonstrates the essence of the program and its ease of usage. BUCKO uses an approximate one-dimensional formulation of the classical two-dimensional buckling problem following the Kantorovich method. The boundary conditions are considered to be simply supported unloaded edges and either clamped or simply supported loaded edges. The plate is loaded in uniaxial compression by either uniformly displacing or uniformly stressing two opposite edges of the plate. The BUCKO analysis consists of two parts: calculation of the inplane stress distribution prior to buckling, and calculation of the plate axial load and displacement at buckling. User input includes plate planform and cutout geometry, plate membrane and bending stiffnesses, finite difference parameters, boundary condition data, and loading data. Results generated by BUCKO are the prebuckling strain energy, inplane stress resultants, buckling mode shape, critical end shortening, and average axial and transverse strains at buckling. BUCKO is written in FORTRAN V for batch execution and has been implemented on a CDC CYBER 170 series computer operating under NOS with a central memory requirement of approximately 343K of 60 bit words. This program was developed in 1984 and was last updated in 1990.

Toward a national fuels mapping strategy: Lessons from selected mapping programs

USGS Publications Warehouse

Loveland, Thomas R.

2001-01-01

The establishment of a robust national fuels mapping program must be based on pertinent lessons from relevant national mapping programs. Many large-area mapping programs are under way in numerous Federal agencies. Each of these programs follows unique strategies to achieve mapping goals and objectives. Implementation approaches range from highly centralized programs that use tightly integrated standards and dedicated staff, to dispersed programs that permit considerable flexibility. One model facilitates national consistency, while the other allows accommodation of locally relevant conditions and issues. An examination of the programmatic strategies of four national vegetation and land cover mapping initiatives can identify the unique approaches, accomplishments, and lessons of each that should be considered in the design of a national fuel mapping program. The first three programs are the U.S. Geological Survey Gap Analysis Program, the U.S. Geological Survey National Land Cover Characterization Program, and the U.S. Fish and Wildlife Survey National Wetlands Inventory. A fourth program, the interagency Multiresolution Land Characterization Program, offers insights in the use of partnerships to accomplish mapping goals. Collectively, the programs provide lessons, guiding principles, and other basic concepts that can be used to design a successful national fuels mapping initiative.

Izabel dos Santos and the training of the health workers.

PubMed

Paiva, Carlos Henrique Assunção

2015-06-01

This article discusses the career of Izabel dos Santos (1927-2010) as a means of examining the connections between health schools and agendas in contemporary Brazil. The article highlights dos Santos's training and her work in the Serviço Especial de Saúde Pública (SESP- Special Public Health Service), the Pan American Health Organization (PAHO) and in the formulation and implementation of national training programs for human resources within the area of health from the late 1970s onwards. The article highlights dos Santos's central role in the formulation and implementation of training policies for health workers, especially nursing technicians and assistants, and demonstrates how she occupies an important place in the history of Brazilian public health.

Feedforward Compensation Mediated by the Central and Peripheral Actions of a Single Neuropeptide Discovered Using Representational Difference Analysis

PubMed Central

Jing, Jian; Sweedler, Jonathan V; Cropper, Elizabeth C; Alexeeva, Vera; Park, Ji-Ho; Romanova, Elena V.; Xie, Fang; Dembrow, Nikolai C.; Ludwar, Bjoern C.; Weiss, Klaudiusz R; Vilim, Ferdinand S

2010-01-01

Compensatory mechanisms are often used to achieve stability by reducing variance, which can be accomplished via negative feedback during homeostatic regulation. In principle, compensation can also be implemented through feedforward mechanisms where a regulator acts to offset the anticipated output variation; however, few such neural mechanisms have been demonstrated. We provide evidence that an Aplysia neuropeptide, identified using an enhanced representational difference analysis procedure, implements feedforward compensation within the feeding network. We named the novel peptide allatotropin-related peptide (ATRP) because of its similarity to insect allatotropin. Mass spectrometry confirmed the peptide's identity, and in situ hybridization and immunostaining mapped its distribution in the Aplysia CNS. ATRP is present in the higher-order cerebral-buccal interneuron (CBI), CBI-4, but not in CBI-2. Previous work showed that CBI-4-elicited motor programs have a shorter protraction duration than those elicited by CBI-2. Here we show that ATRP shortens protraction duration of CBI-2-elicited ingestive programs, suggesting a contribution of ATRP to the parametric differences between CBI-4- and CBI-2-evoked programs. Importantly, because Aplysia muscle contractions are a graded function of motoneuronal activity, one consequence of the shortening of protraction is that it can weaken protraction movements. However, this potential weakening is offset by feedforward compensatory actions exerted by ATRP. Centrally, ATRP increases the activity of protraction motoneurons. Moreover, ATRP is present in peripheral varicosities of protraction motoneurons and enhances peripheral motoneuron-elicited protraction muscle contractions. Therefore, feedforward compensatory mechanisms mediated by ATRP make it possible to generate a faster movement with an amplitude that is not greatly reduced, thereby producing stability. PMID:21147994

Cervical carcinoma in the European Union: an update on disease burden, screening program state of activation, and coverage as of March 2014.

PubMed

Altobelli, Emma; Lattanzi, Amedeo

2015-03-01

Cervical cancer (CC) is defined as a disease of disparity. This is due to marked differences in CC incidence and mortality between developed and developing countries. As a continent, Europe is no exception. This study examines the state of activation of CC screening in the European Union as of March 2014, reviews CC incidence and mortality data, and highlights the initiatives adopted to extend program coverage to nonresponders. The present study is based on the most recent data available from PubMed-indexed journals, the Web sites of the health ministries of each member state, and the Web sites of national cancer observatories; failing these sources, information was sought in scientific journals published in the local language. In 2003, the European Council recommended that priority be given to organized screening program activation. Nonetheless, a number of European Union member states still lack population-based organized screening programs, and few have implemented programs directed at disadvantaged populations. Several investigations have demonstrated that the women at higher CC risk are unscreened and underscreened ones. Since then, several member states have made significant efforts to set up effective prevention programs by adopting international quality standards and centralizing screening organization and result evaluation. Several developed countries and some new central-eastern European member states have poorly organized prevention programs that result in poor women's health. Diagnosis of CC is emotionally traumatic, but it is highly preventable. When CC is found early, it is highly treatable and associated with long survival and good quality of life.

A Comprehensive Approach to Management of Workplace and Environmental Noise at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Cooper, Beth A.

1995-01-01

NASA Lewis Research Center is home to more than 100 experimental research testing facilities and laboratories, including large wind tunnels and engine test cells, which in combination create a varied and complex noise environment. Much of the equipment was manufactured prior to the enactment of legislation limiting product noise emissions or occupational noise exposure. Routine facility maintenance and associated construction also contributes to a noise exposure management responsibility which is equal in magnitude and scope to that of several small industrial companies. The Noise Program, centrally managed within the Office of Environmental Programs at LRC, maintains overall responsibility for hearing conservation, community noise control, and acoustical and noise control engineering. Centralized management of the LRC Noise Program facilitates the timely development and implementation of engineered noise control solutions for problems identified via either the Hearing Conservation of Community Noise Program. The key element of the Lewis Research Center Noise Program, Acoustical and Noise Control Engineering Services, is focused on developing solutions that permanently reduce employee and community noise exposure and maximize research productivity by reducing or eliminating administrative and operational controls and by improving the safety and comfort of the work environment. The Hearing Conservation Program provides noise exposure assessment, medical monitoring, and training for civil servant and contractor employees. The Community Noise Program aims to maintain the support of LRC's neighboring communities while enabling necessary research operations to accomplish their programmatic goals. Noise control engineering capability resides within the Noise Program. The noise control engineering, based on specific exposure limits, is a fundamental consideration throughout the design phase of new test facilities, labs, and office buildings. In summary, the Noise Program addresses hearing conservation, community noise control, and acoustical and noise control engineering.

Challenges and Opportunities of Air Quality Management in Mexico City

NASA Astrophysics Data System (ADS)

Paramo, V.

2013-05-01

The Mexico City Metropolitan Area (MCMA) is located in the central plateau of Mexico and is the capital of the country. Its natural characteristics present favorable conditions for air pollution formation and accumulation: mountains surrounding the city, frequent thermal inversions, high isolation all around the year and weak winds. To these natural conditions, a population of more than 20 million inhabitants, a fleet of 4.5 million vehicles and more than 4 thousands industries, make air quality management a real challenge for governments of the region. Intensive air quality improvement actions and programs began at the end of the 1980's and continued nowadays. Since then criteria air pollutants concentrations have decreased in such a way that currently most of pollutants meet the Mexican air quality standards, except for ozone and particulate matter. Applied measures comprised of fuel quality improvements, fuel replacements, regulations for combustion processes, closing of high polluting refineries and industries, regulations of emissions for new and on road vehicles, mandatory I/M programs for vehicles, circulation restrictions for vehicles (Day without car program), alert program for elevated air pollution episodes, improvement of public transportation, among others. Recent researches (MILAGRO 2006 campaign) found that currently it is necessary to implement emissions reduction actions for Volatile Organic Compounds, particulate matter with a diameter of less than 2.5 micrometers PM2.5 and Nitrogen Oxides, in order to reduce concentrations of ozone and fine particulate matter. Among the new measures to be implemented are: regulations for VOCs emissions in the industry and commercial sectors; regulation of the diesel fleet that includes fleets renewal, filters and particulate traps for in use vehicles and regulation of the cargo fleet; new schemes for reducing the number of vehicles circulating in the city; implementation of non-motorized mobility programs; among others.

A successful model to learn and implement ultrasound-guided venous catheterization in apheresis.

PubMed

Gopalasingam, Nigopan; Thomsen, Anna-Marie Eller; Folkersen, Lars; Juhl-Olsen, Peter; Sloth, Erik

2017-12-01

Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient. Apheresis nurses completed a systematic training program for ultrasound-guided vascular access. All independent catheterizations were registered during the implementation stage. The number of CVCs in the pre- and postimplementation stages of the ultrasound guidance was compared. Six nurses completed the training program within a median of 48 days (range 38-83 days). In 77 patients, 485 independent ultrasound-guided PVC placements were performed during the implementation stage. All apheresis treatments (485/485) were accomplished using PVCs without requiring CVC as rescue. During the preimplementation stage, 125 of 273 (45.8%) procedures required a CVC for completion of apheresis procedures; during the postimplementation stage only 30 of 227 (13.2%) procedures required a CVC (p < 0.001). In the postimplementation stage, no CVCs were placed as rescue caused by failed PVCs but were only placed for patients where the ultrasound machine was unavailable. It indicates an effective success rate of 100% for ultrasound-guided PVC use. This study showed that ultrasound guidance could be implemented among apheresis nurses as a routine tool eliminating the need of CVC as a rescue. © 2017 Wiley Periodicals, Inc.

Thunder and Lightning and Rain: a Latino/Hispanic diabetes media awareness campaign.

PubMed

Almendarez, Isabel S; Boysun, Michael; Clark, Kathleen

2004-01-01

The prevalence rates of diabetes in communities of color are higher than in Caucasian populations. Social marketing can be an effective approach to educating communities and encouraging visits to health care providers. This article describes Thunder and Lightning and Rain, a diabetes media awareness campaign implemented in a 5-county area in central Washington State with a large Latino/Hispanic population. The Washington State Department of Health's Diabetes Prevention and Control Program, along with national and community partners and focus groups, used a social marketing model to reach those with uncontrolled diabetes. A telephone survey-based evaluation, conducted in Spanish, provided data on demographics, media access, calls to a toll-free information line, provider visits, and recall of the campaign's central message: "Control your diabetes. For Life."

Coordination and establishment of centralized facilities and services of the University of Alaska ERTS survey of the Alaskan environment

NASA Technical Reports Server (NTRS)

Belon, A. E. (Principal Investigator); Miller, J. M.

1973-01-01

The author has identified the following significant results. The objective of this project is to provide a focus for the entire University of Alaska ERTS-1 effort (12 projects covering 10 disciplines and involving 8 research institutes and science departments). Activities have been concentrated on the implementation of the project's three primary functions: (1) coordination and management of the U of A ERTS-1 program, including management of the flow of data and data products; (2) acquisition, installation, test, operation, and maintanence of centralized facilities for processing ERTS-1, aircraft, and ground truth data; and (3) development of photographic and digital techniques for processing and interpreting ERTS-1 and aircraft data. With minor exceptions these three functions are now well-established and working smoothly.

Donor human milk bank data collection in north america: an assessment of current status and future needs.

PubMed

Brownell, Elizabeth A; Lussier, Mary M; Herson, Victor C; Hagadorn, James I; Marinelli, Kathleen A

2014-02-01

The Human Milk Banking Association of North America (HMBANA) is a nonprofit association that standardizes and facilitates the establishment and operation of donor human milk (DHM) banks in North America. Each HMBANA milk bank in the network collects data on the DHM it receives and distributes, but a centralized data repository does not yet exist. In 2010, the Food and Drug Administration recognized the need to collect and disseminate systematic, standardized DHM bank data and suggested that HMBANA develop a DHM data repository. This study aimed to describe data currently collected by HMBANA DHM banks and evaluate feasibility and interest in participating in a centralized data repository. We conducted phone interviews with individuals in different HMBANA milk banks and summarized descriptive statistics. Eight of 13 (61.5%) sites consented to participate. All respondents collected donor demographics, and half (50%; n = 4) rescreened donors after 6 months of continued donation. The definition of preterm milk varied between DHM banks (≤ 32 to ≤ 40 weeks). The specific computer program used to house the data also differed. Half (50%; n = 4) indicated that they would consider participation in a centralized repository. Without standardized data across all HMBANA sites, the creation of a centralized data repository is not yet feasible. Lack of standardization and transparency may deter implementation of donor milk programs in the neonatal intensive care unit setting and hinder benchmarking, research, and quality improvement initiatives.

Reliability of Self-Reported Mobile Phone Ownership in Rural North-Central Nigeria: Cross-Sectional Study.

PubMed

Menson, William Nii Ayitey; Olawepo, John Olajide; Bruno, Tamara; Gbadamosi, Semiu Olatunde; Nalda, Nannim Fazing; Anyebe, Victor; Ogidi, Amaka; Onoka, Chima; Oko, John Okpanachi; Ezeanolue, Echezona Edozie

2018-03-01

mHealth practitioners seek to leverage the ubiquity of the mobile phone to increase the impact and robustness of their interventions, particularly in resource-limited settings. However, data on the reliability of self-reported mobile phone access is minimal. We sought to ascertain the reliability of self-reported ownership of and access to mobile phones among a population of rural dwellers in north-central Nigeria. We contacted participants in a community-based HIV testing program by phone to determine actual as opposed to self-reported mobile phone access. A phone script was designed to conduct these calls and descriptive analyses conducted on the findings. We dialed 349 numbers: 110 (31.5%) were answered by participants who self-reported ownership of the mobile phone; 123 (35.2%) of the phone numbers did not ring at all; 28 (8.0%) rang but were not answered; and 88 (25.2%) were answered by someone other than the participant. We reached a higher proportion of male participants (68/133, 51.1%) than female participants (42/216, 19.4%; P<.001). Self-reported access to mobile phones in rural and low-income areas in north-central Nigeria is higher than actual access. This has implications for mHealth programming, particularly for women's health. mHealth program implementers and researchers need to be cognizant of the low reliability of self-reported mobile phone access. These observations should therefore affect sample-size calculations and, where possible, alternative means of reaching research participants and program beneficiaries should be established. ©William Nii Ayitey Menson, John Olajide Olawepo, Tamara Bruno, Semiu Olatunde Gbadamosi, Nannim Fazing Nalda, Victor Anyebe, Amaka Ogidi, Chima Onoka, John Okpanachi Oko, Echezona Edozie Ezeanolue. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 01.03.2018.

An international model for staffing maternal and child health research: the use of undergraduate students.

PubMed

Wallis, Anne Baber; Chereches, Răzvan; Oprescu, Florin; Brînzaniuc, Alexandra; Dungy, Claibourne I

2007-09-01

Constrained resources in Central and Eastern Europe limit the capacity of local and national health ministries to study breastfeeding practices or implement evidence-based breastfeeding support programs. This paper describes an innovative model for studying an important maternal and child health (MCH) problem by training undergraduate students to strengthen local capacity for research. An international team of researchers from Romania and the United States designed a study conducted at Babeş-Bolyai University and two academic maternity hospitals in Cluj-Napoca, Romania. The objectives were to (1) spark interest in breastfeeding research among undergraduates, (2) develop empirical knowledge about breastfeeding, and (3) train a team of undergraduate students to collect, manage, and enter study data. A team of carefully selected undergraduate students was trained in survey design, data collection, data entry, and interviewing skills. Internet technology was used to facilitate communication and to transfer data. The project resulted in a trained cadre of undergraduate students able to conduct survey research on breastfeeding practices with skills ranging from questionnaire design and implementation to descriptive data analysis. Empirical data obtained from the study will be used for student projects, to stimulate new breastfeeding support policies and programs, and to apply for research grants. Undergraduate students in developing countries in Central and Eastern Europe are a valuable, untapped resource for expanding MCH capacity. We recommend adoption of this cost-effective approach to foster high-quality MCH research.

Adapting School-Based Substance Use Prevention Curriculum Through Cultural Grounding: A Review and Exemplar of Adaptation Processes for Rural Schools

PubMed Central

Colby, Margaret; Hecht, Michael L.; Miller-Day, Michelle; Krieger, Janice L.; Syvertsen, Amy K.; Graham, John W.; Pettigrew, Jonathan

2014-01-01

A central challenge facing twenty-first century community-based researchers and prevention scientists is curriculum adaptation processes. While early prevention efforts sought to develop effective programs, taking programs to scale implies that they will be adapted, especially as programs are implemented with populations other than those with whom they were developed or tested. The principle of cultural grounding, which argues that health message adaptation should be informed by knowledge of the target population and by cultural insiders, provides a theoretical rational for cultural regrounding and presents an illustrative case of methods used to reground the keepin’ it REAL substance use prevention curriculum for a rural adolescent population. We argue that adaptation processes like those presented should be incorporated into the design and dissemination of prevention interventions. PMID:22961604

Adapting school-based substance use prevention curriculum through cultural grounding: a review and exemplar of adaptation processes for rural schools.

PubMed

Colby, Margaret; Hecht, Michael L; Miller-Day, Michelle; Krieger, Janice L; Syvertsen, Amy K; Graham, John W; Pettigrew, Jonathan

2013-03-01

A central challenge facing twenty-first century community-based researchers and prevention scientists is curriculum adaptation processes. While early prevention efforts sought to develop effective programs, taking programs to scale implies that they will be adapted, especially as programs are implemented with populations other than those with whom they were developed or tested. The principle of cultural grounding, which argues that health message adaptation should be informed by knowledge of the target population and by cultural insiders, provides a theoretical rational for cultural regrounding and presents an illustrative case of methods used to reground the keepin' it REAL substance use prevention curriculum for a rural adolescent population. We argue that adaptation processes like those presented should be incorporated into the design and dissemination of prevention interventions.

Assessment of A. I. D. environmental programs: Energy conservation in Pakistan. Technical report

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

Church, P.; Kumar, K.; Sowers, F.

1993-09-01

This report highlights a model of environmental management that appears to work in the current political and economic context of Pakistan. The model focuses on energy conservation. This evaluation examines how the U.S. Agency for International Development (A.I.D.) has assisted Pakistan in using market forces to promote the adoption of energy conservation practices and technologies. The central operating hypothesis of the evaluation is that the adoption of energy conservation practices and technologies responds to market incentives. The field study concludes that the Pakistani program of energy conservation activities, set in motion with A.I.D. support, cannot easily be reversed. With changesmore » in political and economic policies toward the environment in Pakistan, greater and more sustainable impact is possible. The experience of Pakistan energy conservation program raises three issues that merit careful examination both in the contexts of Pakistan's future program implementation and in other countries: The role of program subsidies; The role of nonproject assistance; and The involvement of nongovernmental organizations.« less

Social Interventions to Prevent Heat-Related Mortality in the Older Adult in Rome, Italy: A Quasi-Experimental Study

PubMed Central

Inzerilli, Maria Chiara; Palombi, Leonardo; Madaro, Olga; Betti, Daniela; Marazzi, Maria Cristina

2018-01-01

This study focuses on the impact of a program aimed at reducing heat-related mortality among older adults residing in central Rome by counteracting social isolation. The mortality of citizens over the age of 75 living in three Urban Areas (UAs) located in central Rome is compared with that of the residents of four adjacent UAs during the summer of 2015. The data, broken down by UA, were provided by the Statistical Office of the Municipality of Rome, which gathers them on a routine basis. During the summer of 2015, 167 deaths were recorded in those UAs in which the Long Live the Elderly (LLE) program was active and 169 in those in which it was not, implying cumulative mortality rates of 25‰ (SD ± 1.4; Cl 95%: 23–29) and 29‰ (SD ± 6.7; Cl 95%: 17–43), respectively. Relative to the summer of 2014, the increase of deaths during the summer of 2015 was greater in UAs in which the LLE program had not been implemented (+97.3% vs. +48.8%). In conclusion, the paper shows the impact of a community-based active monitoring program, focused on strengthening individual relationship networks and the social capital of the community, on mortality in those over 75 during heat waves. PMID:29641436

The development and operation of the international solar-terrestrial physics central data handling facility

NASA Technical Reports Server (NTRS)

Lehtonen, Kenneth

1994-01-01

The National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC) International Solar-Terrestrial Physics (ISTP) Program is committed to the development of a comprehensive, multi-mission ground data system which will support a variety of national and international scientific missions in an effort to study the flow of energy from the sun through the Earth-space environment, known as the geospace. A major component of the ISTP ground data system is an ISTP-dedicated Central Data Handling Facility (CDHF). Acquisition, development, and operation of the ISTP CDHF were delegated by the ISTP Project Office within the Flight Projects Directorate to the Information Processing Division (IPD) within the Mission Operations and Data Systems Directorate (MO&DSD). The ISTP CDHF supports the receipt, storage, and electronic access of the full complement of ISTP Level-zero science data; serves as the linchpin for the centralized processing and long-term storage of all key parameters generated either by the ISTP CDHF itself or received from external, ISTP Program approved sources; and provides the required networking and 'science-friendly' interfaces for the ISTP investigators. Once connected to the ISTP CDHF, the online catalog of key parameters can be browsed from their remote processing facilities for the immediate electronic receipt of selected key parameters using the NASA Science Internet (NSI), managed by NASA's Ames Research Center. The purpose of this paper is twofold: (1) to describe how the ISTP CDHF was successfully implemented and operated to support initially the Japanese Geomagnetic Tail (GEOTAIL) mission and correlative science investigations, and (2) to describe how the ISTP CDHF has been enhanced to support ongoing as well as future ISTP missions. Emphasis will be placed on how various project management approaches were undertaken that proved to be highly effective in delivering an operational ISTP CDHF to the Project on schedule and within budget. Examples to be discussed include: the development of superior teams; the use of Defect Causal Analysis (DCA) concepts to improve the software development process in a pilot Total Quality Management (TQM) initiative; and the implementation of a robust architecture that will be able to support the anticipated growth in the ISTP Program science requirements with only incremental upgrades to the baseline system. Further examples include the use of automated data management software and the implementation of Government and/or industry standards, whenever possible, into the hardware and software development life-cycle. Finally, the paper will also report on several new technologies (for example, the installation of a Fiber Data Distribution Interface network) that were successfully employed.

A Review of Medical and Substance Use Co-Morbidities in Central Asian Prisons: Implications for HIV Prevention and Treatment

PubMed Central

Polonsky, Maxim; Kerimi, Nina; Mamyrov, Mirlan; Dvoryak, Sergey; Altice, Frederick L.

2013-01-01

Background HIV incidence in Central Asia is rising rapidly. People who inject drugs (PWIDs) contribute greatest to the epidemic, with more than a quarter of all HIV cases being in the criminal justice system (CJS). This review assembled and aggregated recent data on drug-related health problems and respective healthcare services in the CJS of Central Asia and the Republic of Azerbaijan. Methods Online databases and published literature (peer-reviewed and grey) were reviewed. Additionally, prison officials in the 6 countries were invited to participate in a survey and prison administrators from Kazakhstan, Kyrgyzstan and Tajikistan completed it. Results The data on conditions and healthcare in Central Asian prisons are inconsistent and lack unbiased details. Reporting is primarily based on “official” disease registries, which markedly underestimate prevalence. Even these limited data, however, indicate that HIV prevalence and drug-related health problems are high, concentrated and, in some countries, rising rapidly. Only some of the range of HIV prevention interventions recommended by international organizations have been implemented in the region with two of the crucial interventions, needle and syringe exchange programs (NSP) and opioid substitution therapy (OST), only available in Kyrgyzstan prisons, with Tajikistan implementing a pilot NSP and contemplating introduction of prison-based OST. Conclusions Despite deficiencies in routine health reporting and insufficient HIV sentinel surveillance undertaken in prisons, the data available on the concentration of HIV within at-risk populations in prisons indicate a necessity to broaden the range and increase the scale the scale of HIV prevention and treatment services. PMID:23932844

Positive youth development programs for adolescents with greater psychosocial needs: evaluation based on program implementers.

PubMed

Shek, Daniel T L; Ng, Catalina S M; Law, Moon Y M

2017-02-01

As program implementers' views are seldom included in program evaluation and there are few related studies in different Chinese communities, this study examined the perceptions of the program implementers who implemented the Tier 2 Program of the P.A.T.H.S. Program in Hong Kong. The Tier 2 Program was designed to promote the development of adolescents with greater psychosocial needs. In the community-based P.A.T.H.S. Project, 400 program implementers completed a subjective outcome evaluation form (Form D) for program implementers. Consistent with the previous findings, program implementers generally held positive views towards the program, implementers, and program effectiveness and their views towards these three domains did not differ across grades. In line with the hypotheses, perceived program quality and perceived implementer quality predicted program effectiveness. The present findings provided an alternative perspective showing that the Tier 2 Program was well received by the program implementers and they regarded the program to be beneficial to the program participants.

Building multi-country collaboration on watershed ...

EPA Pesticide Factsheets

Community-based watershed resilience programs that bridge public health and environmental outcomes often require cross-boundary, multi-country collaboration. The CRESSIDA project, led by the Regional Environmental Center for Central and Eastern Europe (REC) and supported by the US Environmental Protection Agency (EPA), forwards a resilience-focused approach for Western Balkan communities in the Drini and Drina river watersheds with the goal of safeguarding public health and the environment. The initial phases of this project give a contextualized example of how to advance resilience-driven environmental health goals in Western Balkan communities, and experience within the region has garnered several theme areas that require focus in order to promote a holistic watershed management program. In this paper, using CRESSIDA as a case study, we show (1) how watershed projects designed with resilience-driven environmental health goals can work in context, (2) provide data surrounding contextualized problems with resilience and suggest tools and strategies for the implementation of projects to address these problems, and (3) explore how cross-boundary foci are central to the success of these approaches in watersheds that comprise several countries. Published in the journal, Reviews on Environmental Health.

Numerical evaluation of single central jet for turbine disk cooling

NASA Astrophysics Data System (ADS)

Subbaraman, M. R.; Hadid, A. H.; McConnaughey, P. K.

The cooling arrangement of the Space Shuttle Main Engine High Pressure Oxidizer Turbopump (HPOTP) incorporates two jet rings, each of which produces 19 high-velocity coolant jets. At some operating conditions, the frequency of excitation associated with the 19 jets coincides with the natural frequency of the turbine blades, contributing to fatigue cracking of blade shanks. In this paper, an alternate turbine disk cooling arrangement, applicable to disk faces of zero hub radius, is evaluated, which consists of a single coolant jet impinging at the center of the turbine disk. Results of the CFD analysis show that replacing the jet ring with a single central coolant jet in the HPOTP leads to an acceptable thermal environment at the disk rim. Based on the predictions of flow and temperature fields for operating conditions, the single central jet cooling system was recommended for implementation into the development program of the Technology Test Bed Engine at NASA Marshall Space Flight Center.

Field Review of Fish Habitat Improvement Projects in Central Idaho.

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

Beschta, Robert L.; Griffith, Jack; Wesche, Thomas A.

1993-05-01

The goal of this field review was to provide information to the Bonneville Power Administration (BPA) regarding previous and ongoing fish habitat improvement projects in central Idaho. On July 14, 1992, the review team met at the Sawtooth National Recreation Area office near Ketchum, Idaho, for a slide presentation illustrating several habitat projects during their construction phases. Following the slide presentation, the review team inspected fish habitat projects that have been implemented in the last several years in the Stanley Basin and adjacent valleys. At each site the habitat project was described to the field team and a brief periodmore » for project inspection followed. The review team visited approximately a dozen sites on the Challis, Sawtooth, and Boise National Forests over a period of approximately two and a half days. There are two objectives of this review namely to summarize observations for specific field sites and to provide overview commentary regarding the BPA habitat improvement program in central Idaho.« less

Mapping and Analyzing Stakeholders in China's Essential Drug System by Using a Circular Model: Who We Should Deal with Next?

PubMed

Shao, Hui; Li, Shixue; Xu, Lingzhong; Yang, Shuang; Thomas, Nicholas J; Mir, Mohammed Umer; Guo, Zhen; Ning, Bo; Shi, Lizheng

2015-05-01

To predict the prospects of the essential drug system by using the Stakeholder Impact Index (SII) and evaluate the current performance of each main stakeholder and suggested dangerous stakeholders and dormant stakeholders. A Delphi method was used, involving 36 experts with experience in implementation and evaluation of the essential drug policy, to construct the circular model as well as evaluate the performance of each stakeholder. The central government was a dominant stakeholder of the whole essential drug system. The provincial governments were definitive stakeholders, whereas local governments and medical institutions were dependent stakeholders. Furthermore, media and drug stores were dormant stakeholders and pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders. Patients, community residents, and medical insurance programs were discretionary stakeholders. The SII for the essential drug system was positive (SII proj ⁎ = 2.72). The overall anticipation of the essential drug policy is optimistic. Letting definitive stakeholders (provincial governments) having more autonomy can efficiently accelerate the pace of implementation of the essential drug policy in the current situation. Central government, however, also needs to construct an experience exchange platform with the aim of building versatile methods for running the essential drug system in all provinces. Pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders for the essential drug policy. Because of their potential threat to the implementation of the policy, the central government should motivate them to support the construction of the essential drug system spontaneously. In that case, provincial governments need to construct a fair, balanced, and self-stabilized bidding platform. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Changes in Student Attributions Due to the Implementation of Central Exit Exams

ERIC Educational Resources Information Center

Oerke, Britta; Maag Merki, Katharina; Holmeier, Monika; Jager, Daniela J.

2011-01-01

The central aim of standardized exit exams is to motivate students and teachers to work harder on critical subject matters and thus increase student achievement. However, the effects of the implementation of central exams on student motivation have not been analyzed in a longitudinal section until now. In the present study, the consequences of…

75 FR 34311 - To Implement Certain Provisions of the Dominican Republic-Central America-United States Free...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... Implement Certain Provisions of the Dominican Republic-Central America-United States Free Trade Agreement With Respect to Costa Rica, and for Other Purposes By the President of the United States of America A Proclamation 1. On August 5, 2004, the United States entered into the Dominican Republic-Central America-United...

Integrating school-based and therapeutic conflict management models at schools.

PubMed

D'Oosterlinck, Franky; Broekaert, Eric

2003-08-01

Including children with emotional and behavioral needs in mainstream school systems leads to growing concern about the increasing number of violent and nonviolent conflicts. Schools must adapt to this evolution and adopt a more therapeutic dimension. This paper explores the possibility of integrating school-based and therapeutic conflict management models and compares two management models: a school-based conflict management program. Teaching Students To Be Peacemakers; and a therapeutic conflict management program, Life Space Crisis Intervention. The authors conclude that integration might be possible, but depends on establishing a positive school atmosphere, the central position of the teacher, and collaborative and social learning for pupils. Further implementation of integrated conflict management models can be considered but must be underpinned by appropriate scientific research.

AMIDE: a free software tool for multimodality medical image analysis.

PubMed

Loening, Andreas Markus; Gambhir, Sanjiv Sam

2003-07-01

Amide's a Medical Image Data Examiner (AMIDE) has been developed as a user-friendly, open-source software tool for displaying and analyzing multimodality volumetric medical images. Central to the package's abilities to simultaneously display multiple data sets (e.g., PET, CT, MRI) and regions of interest is the on-demand data reslicing implemented within the program. Data sets can be freely shifted, rotated, viewed, and analyzed with the program automatically handling interpolation as needed from the original data. Validation has been performed by comparing the output of AMIDE with that of several existing software packages. AMIDE runs on UNIX, Macintosh OS X, and Microsoft Windows platforms, and it is freely available with source code under the terms of the GNU General Public License.

Institutional blood glucose monitoring system for hospitalized patients: an integral component of the inpatient glucose control program.

PubMed

Boaz, Mona; Landau, Zohar; Matas, Zipora; Wainstein, Julio

2009-09-01

The ability to measure patient blood glucose levels at bedside in hospitalized patients and to transmit those values to a central database enables and facilitates glucose control and follow-up and is an integral component in the care of the hospitalized diabetic patient. The goal of this study was to evaluate the performance of an institutional glucometer employed in the framework of the Program for the Treatment of the Hospitalized Diabetic Patient (PTHDP) at E. Wolfson Medical Center, Holon, Israel. As part of the program to facilitate glucose control in hospitalized diabetic patients, an institutional glucometer was employed that permits uploading of data from stands located in each inpatient department and downloading of that data to a central hospital-wide database. Blood glucose values from hospitalized diabetic patients were collected from August 2007 to October 2008. The inpatient glucose control program was introduced gradually beginning January 2008. During the follow-up period, more than 150,000 blood glucose measures were taken. Mean glucose was 195.7 +/- 99.12 mg/dl during the follow-up period. Blood glucose values declined from 206 +/- 105 prior to PTHDP (August 2007-December 2007) to 186 +/- 92 after its inception (January 2008-October 2008). The decline was associated significantly with time (r = 0.11, p < 0.0001). The prevalence of blood glucose values lower than 60 mg/dl was 1.48% [95% confidence interval (CI) 0.36%] prior to vs 1.55% (95% CI 0.37%) following implementation of the PTHDP. Concomitantly, a significant increase in the proportion of blood glucose values between 80 and 200 mg/dl was observed, from 55.5% prior to program initiation vs 61.6% after program initiation (p < 0.0001). The present study was designed to observe changes in institution-wide glucose values following implementation of the PTHDP. Information was extracted from the glucometer system itself. Because the aforementioned study was not a clinical trial, we cannot rule out that factors other than introduction of the program could explain some of the variability observed. With these limitations in mind, it nevertheless appears that the PTHDP, of which the institutional glucometer is an integral, essential component, was associated with improved blood glucose values in the hospitalized diabetic patient. 2009 Diabetes Technology Society.

Conclusions drawn from actions implemented within the first stage of the Cracow program of energy conservation and clean fossil fuels

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

Bieda, J.; Bardel, J.; Pierce, B.

1995-12-31

Since 1992 Brookhaven National Laboratory (BNL) and Pacific Northwest Laboratory (PNL), acting on behalf of the U.S. Department of Energy, executed the first stage of the Cracow Program of Energy Conservation and Clean Fossil Fuels, called also American-Polish Program of Actions for Elimination of Low Emission Sources in Cracow. The main contractor for BNL and PNL was the Cracow Development Office (BRK). The interest in improving the condition of Cracow air results from the fact that the standard for permissible air pollution was exceeded several times in Cracow and especially within the central part of the town. Therefore, air pollutionmore » appeared one of the most important problems that faced the municipal authorities. It followed from monitoring investigations that the high level of air pollutant concentration is caused by in-home coal-fired tile stoves operated in winter seasons and by coal- and coke-fired boiler houses simulated mainly in the central part of the town. The results obtained in first stage are presented. This paper is an attempt to formulate conclusions drawn from these works and recommendations with regard to the future policy of the town authorities; selected results are presented to clarify or illustrate the conclusions.« less

Data management at Biosphere 2 center

NASA Technical Reports Server (NTRS)

McCreary, Leone F.

1997-01-01

Throughout the history of Biosphere 2, the collecting and recording of biological data has been sporadic. Currently no active effort to administer and record regular biological surveys is being made. Also, there is no central location, such as an on-site data library, where all records from various studies have been archived. As a research institute, good, complete data records are at the core of all Biosphere 2's scientific endeavors. It is therefore imperative that an effective data management system be implemented within the management and research departments as soon as possible. Establishing this system would require three general phases: (1) Design/implement a new archiving/management program (including storage, cataloging and retrieval systems); (2) Organize and input baseline and intermediate data from existing archives; and (3) Maintain records by inputting new data.

Atmospheric numerical modeling resource enhancement and model convective parameterization/scale interaction studies

NASA Technical Reports Server (NTRS)

Cushman, Paula P.

1993-01-01

Research will be undertaken in this contract in the area of Modeling Resource and Facilities Enhancement to include computer, technical and educational support to NASA investigators to facilitate model implementation, execution and analysis of output; to provide facilities linking USRA and the NASA/EADS Computer System as well as resident work stations in ESAD; and to provide a centralized location for documentation, archival and dissemination of modeling information pertaining to NASA's program. Additional research will be undertaken in the area of Numerical Model Scale Interaction/Convective Parameterization Studies to include implementation of the comparison of cloud and rain systems and convective-scale processes between the model simulations and what was observed; and to incorporate the findings of these and related research findings in at least two refereed journal articles.

Olfactory Cued Learning Paradigm.

PubMed

Liu, Gary; McClard, Cynthia K; Tepe, Burak; Swanson, Jessica; Pekarek, Brandon; Panneerselvam, Sugi; Arenkiel, Benjamin R

2017-05-05

Sensory stimulation leads to structural changes within the CNS (Central Nervous System), thus providing the fundamental mechanism for learning and memory. The olfactory circuit offers a unique model for studying experience-dependent plasticity, partly due to a continuous supply of integrating adult born neurons. Our lab has recently implemented an olfactory cued learning paradigm in which specific odor pairs are coupled to either a reward or punishment to study downstream circuit changes. The following protocol outlines the basic set up for our learning paradigm. Here, we describe the equipment setup, programming of software, and method of behavioral training.

Core curricula for postdoctoral dental students: recent problems, potential solutions, and a model for the future.

PubMed

Iacopino, Anthony M; Taft, Thomas B

2007-11-01

Development of common core curricula for the graduate advanced education/specialty programs in dental schools presents significant challenges. Similarities in graduate education accreditation standards justify such an approach, yet a core curriculum is difficult to achieve for a variety of reasons including scheduling constraints and the capacity of a common, single pathway curriculum to address the specific educational needs of postgraduate students in different disciplines. Additionally, many dental schools are experiencing severe shortages of qualified faculty to provide graduate program instruction. There are no previous reports regarding graduate core curricula and the definition/delivery of such core curricula in advanced education programs in dentistry although there are several reports in the medical literature that support the educational value of a unified core curriculum implemented in a modular format. Graduate curricula are typically designed to provide residents with advanced education/training beyond what is acquired during their predoctoral dental school experience. Advanced education programs must emphasize knowledge and skills that are discipline-specific; however, there is a large amount of common foundational material within the early phases of these programs. Dental schools have attempted to identify and present this common material within the context of an organized shared set of courses/seminars where residents from each advanced education program are scheduled simultaneously. However, there have been problems with the implementation of a shared core curricula including the following: 1) dissimilar educational backgrounds/abilities among residents; 2) relevance of material to all residents; 3) lack of central management; 4) scheduling conflicts; and 5) lack of adequate and consistent program evaluation. In an attempt to resolve these problems, a new comprehensive graduate core curriculum was implemented at the Marquette University School of Dentistry in 2000. This core curriculum was designed to 1) be user-friendly; 2) allow flexibility; 3) meet specific programmatic/accreditation needs for each advanced education program; and 4) provide assessment tools for continuous resident feedback and curriculum improvement. Assessment data obtained from residents, faculty, and program directors indicate that this approach has been successful and has transformed graduate education at Marquette. Thus, this model may prove useful for other institutions seeking to refine or develop graduate core curricula.

Evaluation of the childhood obesity prevention program Kids--'Go for your life'.

PubMed

de Silva-Sanigorski, Andrea; Prosser, Lauren; Carpenter, Lauren; Honisett, Suzy; Gibbs, Lisa; Moodie, Marj; Sheppard, Lauren; Swinburn, Boyd; Waters, Elizabeth

2010-05-28

Kids--'Go for your life' (K-GFYL) is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention) activities. Once the K-GFYL program 'criteria' are reached the school/service is assessed and 'awarded'. This paper describes the design of the evaluation of the statewide K-GFYL intervention program. The evaluation is mixed method and cross sectional and aims to: 1) Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only; 2) Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only; 3) Examine the barriers to implementing and achieving the K-GFYL award; and 4) Determine the economic cost of implementing K-GFYL in primary schools. Parent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis. The K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation design is constrained by the lack of a non-K-GFYL control group, short time frames and delayed funding of this large scale evaluation across all intervention settings. However, despite this, the evaluation will generate valuable evidence about the utility of a community-wide environmental approach to preventing childhood obesity which will inform future public health policies and health promotion programs internationally. ACTRN12609001075279.

Development of an adaptive harvest management program for Taiga bean geese

USGS Publications Warehouse

Johnson, Fred A.; Alhainen, Mikko; Fox, Anthony D.; Madsen, Jesper

2016-01-01

This report describes recent progress in specifying the elements of an adaptive harvest program for taiga bean goose. It describes harvest levels appropriate for first rebuilding the population of the Central Management Unit and then maintaining it near the goal specified in the AEWA International Single Species Action Plan (ISSAP). This report also provides estimates of the length of time it would take under ideal conditions (no density dependence and no harvest) to rebuild depleted populations in the Western and Eastern Management Units. We emphasize that our estimates are a first approximation because detailed demographic information is lacking for taiga bean geese. Using allometric relationships, we estimated parameters of a thetalogistic matrix population model. The mean intrinsic rate of growth was estimated as r = 0.150 (90% credible interval: 0.120 – 0.182). We estimated the mean form of density dependence as   2.361 (90% credible interval: 0.473 – 11.778), suggesting the strongest density dependence occurs when the population is near its carrying capacity. Based on expert opinion, carrying capacity (i.e., population size expected in the absence of hunting) for the Central Management Unit was estimated as K  87,900 (90% credible interval: 82,000 – 94,100). The ISSAP specifies a population goal for the Central Management Unit of 60,000 – 80,000 individuals in winter; thus, we specified a preliminary objective function as one which would minimize the difference between this goal and population size. Using the concept of stochastic dominance to explicitly account for uncertainty in demography, we determined that optimal harvest rates for 5, 10, 15, and 20-year time horizons were h = 0.00, 0.02, 0.05, and 0.06, respectively. These optima represent a tradeoff between the harvest rate and the time required to achieve and maintain a population size within desired bounds. We recognize, however, that regulation of absolute harvest rather than harvest rate is more practical, but our matrix model does not permit one to calculate an exact harvest associated with a specific harvest rate. Approximate harvests for current population size in the Central Management Unit are 0, 1,200, 2,300, and 3,500 for the 5, 10, 15, and 20-year time horizons, respectively. Populations of taiga bean geese in the Western and Eastern Units would require at least 10 and 13 years, respectively, to reach their minimum goals under the most optimistic of scenarios. The presence of harvest, density dependence, or environmental variation could extend these time frames considerably. Finally, we stress that development and implementation of internationally coordinated monitoring programs will be essential to further development and implementation of an adaptive harvest management program.

Implementing Problem-Solving Techniques in an Urban Central Office Department by Establishing Teams and Infusing TQM Concepts.

ERIC Educational Resources Information Center

Smith, Jewell R.

This practicum is designed to assist central office personnel in evaluating the work environment for better coordination to accomplish work, plan for a change effort, and implement a participatory change initiative. The work setting involved a K-12 urban school district (193 schools) containing 431 central-office administrators and more than…

Scalability and Validation of Big Data Bioinformatics Software.

PubMed

Yang, Andrian; Troup, Michael; Ho, Joshua W K

2017-01-01

This review examines two important aspects that are central to modern big data bioinformatics analysis - software scalability and validity. We argue that not only are the issues of scalability and validation common to all big data bioinformatics analyses, they can be tackled by conceptually related methodological approaches, namely divide-and-conquer (scalability) and multiple executions (validation). Scalability is defined as the ability for a program to scale based on workload. It has always been an important consideration when developing bioinformatics algorithms and programs. Nonetheless the surge of volume and variety of biological and biomedical data has posed new challenges. We discuss how modern cloud computing and big data programming frameworks such as MapReduce and Spark are being used to effectively implement divide-and-conquer in a distributed computing environment. Validation of software is another important issue in big data bioinformatics that is often ignored. Software validation is the process of determining whether the program under test fulfils the task for which it was designed. Determining the correctness of the computational output of big data bioinformatics software is especially difficult due to the large input space and complex algorithms involved. We discuss how state-of-the-art software testing techniques that are based on the idea of multiple executions, such as metamorphic testing, can be used to implement an effective bioinformatics quality assurance strategy. We hope this review will raise awareness of these critical issues in bioinformatics.

Using a Root Cause Analysis Curriculum for Practice-Based Learning and Improvement in General Surgery Residency.

PubMed

Ramanathan, Rajesh; Duane, Therese M; Kaplan, Brian J; Farquhar, Doris; Kasirajan, Vigneshwar; Ferrada, Paula

2015-01-01

To describe and evaluate a root cause analysis (RCA)-based educational curriculum for quality improvement (QI) practice-based learning and implementation in general surgery residency. A QI curriculum was designed using RCA and spaced-learning approaches to education. The program included a didactic session about the RCA methodology. Resident teams comprising multiple postgraduate years then selected a personal complication, completed an RCA, and presented the findings to the Department of Surgery. Mixed methods consisting of quantitative assessment of performance and qualitative feedback about the program were used to assess the value, strengths, and limitations of the program. Urban tertiary academic medical center. General surgery residents, faculty, and medical students. An RCA was completed by 4 resident teams for the following 4 adverse outcomes: postoperative neck hematoma, suboptimal massive transfusion for trauma, venous thromboembolism, and decubitus ulcer complications. Quantitative peer assessment of their performance revealed proficiency in selecting an appropriate case, defining the central problem, identifying root causes, and proposing solutions. During the qualitative feedback assessment, residents noted value of the course, with the greatest limitation being time constraints and equal participation. An RCA-based curriculum can provide general surgery residents with QI exposure and training that they value. Barriers to successful implementation include time restrictions and equal participation from all involved members. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Tick-borne encephalitis.

PubMed

Dumpis, U; Crook, D; Oksi, J

1999-04-01

Tick-borne encephalitis (TBE) is a zoonotic arbovirus infection endemic to Russia and Eastern and Central Europe. Despite being a common and serious life-threatening disease for which a mass vaccination program was implemented in Austria, there is only limited reference to this disease in the English-language literature. TBE is transmitted to humans usually by the bite of a tick (either Ixodes persulcatus or Ixodes ricinus); occasionally, cases occur following consumption of infected unpasteurized milk. Transmission is seasonal and occurs in spring and summer, particularly in rural areas favored by the vector. TBE is a serious cause of acute central nervous system disease, which may result in death or long-term neurological sequelae. Effective vaccines are available in a few countries. The risk for travelers of acquiring TBE is increasing with the recent rise in tourism to areas of endemicity during spring and summer.

Enhancing voluntary participation in community collaborative forest management: a case of Central Java, Indonesia.

PubMed

Lestari, Sri; Kotani, Koji; Kakinaka, Makoto

2015-03-01

This paper examines voluntary participation in community forest management, and characterizes how more participation may be induced. We implemented a survey of 571 respondents and conducted a case study in Central Java, Indonesia. The study's novelty lies in categorizing the degrees of participation into three levels and in identifying how socio-economic factors affect people's participation at each level. The analysis finds that voluntary participation responds to key determinants, such as education and income, in a different direction, depending on each of the three levels. However, the publicly organized programs, such as information provision of benefit sharing, are effective, irrespective of the levels of participation. Overall, the results suggest a possibility of further success and corrective measures to enhance the participation in community forest management. Copyright © 2014 Elsevier Ltd. All rights reserved.

Application driven interface generation for EASIE. M.S. Thesis

NASA Technical Reports Server (NTRS)

Kao, Ya-Chen

1992-01-01

The Environment for Application Software Integration and Execution (EASIE) provides a user interface and a set of utility programs which support the rapid integration and execution of analysis programs about a central relational database. EASIE provides users with two basic modes of execution. One of them is a menu-driven execution mode, called Application-Driven Execution (ADE), which provides sufficient guidance to review data, select a menu action item, and execute an application program. The other mode of execution, called Complete Control Execution (CCE), provides an extended executive interface which allows in-depth control of the design process. Currently, the EASIE system is based on alphanumeric techniques only. It is the purpose of this project to extend the flexibility of the EASIE system in the ADE mode by implementing it in a window system. Secondly, a set of utilities will be developed to assist the experienced engineer in the generation of an ADE application.

An Overview of NASA's Program of Future M&S VV&A Outreach and Training Activities

NASA Technical Reports Server (NTRS)

Caine, Lisa; Hale, Joseph P.

2006-01-01

NASA's Exploration Systems Mission Directorate (ESMD) is implementing a management approach for modeling and simulation (M&S) that will provide decision-makers information on the model s fidelity, credibility, and quality. The Integrated Modeling & Simulation Verification, Validation and Accreditation (IM&S W&A) process will allow the decision-maker to understand the risks involved in using a model s results for mission-critical decisions. The W&A Technical Working Group (W&A TWG) has been identified to communicate this process throughout the agency. As the W&A experts, the W&A NVG will be the central resource for support of W&A policy, procedures, training and templates for documentation. This presentation will discuss the W&A Technical Working Group s outreach approach aimed at educating M&S program managers, developers, users and proponents on the W&A process, beginning at MSFC with the CLV program.

AMTEC: a cooperative effort in medical technology education.

PubMed

Beiermann, M K; Coggeshall, M; Gavin, M L; Laughlin, P; Palermo, J; Torrey, J A; Weidner, J

1978-04-01

A committee in the St. Louis Metropolitan area has been established to promote communication and cooperation among the area's existing hospital-based programs in medical technology. Area Medical Technology Education Coordinators (AMTEC) was established three years ago primarily to facilitate the administrative functions of medical technology education and to serve as an instrument for the exchange of ideas. Its primary undertaking has been the central processing of applications to the area programs, as an aid in the admission process. In addition, a continuing education program sponsored by the committee has been established, and various "curriculum sharing" activities have been sponsored for the students enrolled in the schools. Future plans for the committee include sponsoring an on-going evaluation process of graduates by employers, and establishing a criterion-referenced question pool. The authors describe the experiences of the committee to date and plans for the implementation of future goals.

Implementation of Wireless and Intelligent Sensor Technologies in the Propulsion Test Environment

NASA Technical Reports Server (NTRS)

Solano, Wanda M.; Junell, Justin C.; Shumard, Kenneth

2003-01-01

From the first Saturn V rocket booster (S-II-T) testing in 1966 and the routine Space Shuttle Main Engine (SSME) testing beginning in 1975, to more recent test programs such as the X-33 Aerospike Engine, the Integrated Powerhead Development (IPD) program, and the Hybrid Sounding Rocket (HYSR), Stennis Space Center (SSC) continues to be a premier location for conducting large-scale propulsion testing. Central to each test program is the capability for sensor systems to deliver reliable measurements and high quality data, while also providing a means to monitor the test stand area to the highest degree of safety and sustainability. As part of an on-going effort to enhance the testing capabilities of Stennis Space Center, the Test Technology and Development group is developing and applying a number of wireless and intelligent sensor technologies in ways that are new to the test existing test environment.

Implementation of a pharmacist-led pharmacogenomics service for the Program of All-Inclusive Care for the Elderly (PHARM-GENOME-PACE).

PubMed

Bain, Kevin T; Schwartz, Emily J; Knowlton, Orsula V; Knowlton, Calvin H; Turgeon, Jacques

To determine the feasibility of implementing a pharmacist-led pharmacogenomics (PGx) service for the Program of All-Inclusive Care for the Elderly (PACE). A national centralized pharmacy providing PGx services to community-based PACE centers. Individuals 55 years of age and older enrolled in PACE who underwent PGx testing as part of their medical care (n = 296). Pharmacist-led PGx testing, interpreting, and consulting. Implementation processes and roles were ascertained by reviewing policies and procedures for the PGx service and documented observations made by pharmacists providing the service. Genetic variants and drug-gene interactions (DGIs) were determined by interpretations of PGx test results. Types of recommendations provided by pharmacists were ascertained from PGx consultations. Prescribers' acceptance of recommendations were ascertained by documented responses or drug changes made after PGx consultations. Challenges to implementation included lack of systems interoperability, limited access to medical electronic health records, determining prescribers' responses, and knowledge and competency gaps in PGx. Pharmacist roles most essential to overcoming challenges were interpreting and applying PGx data, determining how to disseminate those data to prescribers, advocating for appropriate PGx testing, and educating about the application of test results to clinical practice. Participants frequently used drugs posing DGI risks, with the majority (73.6%) reporting more than 1 interaction. The overwhelming majority (89.0%) of pharmacists' recommendations to mitigate risks were accepted by referring prescribers. Implementing a pharmacist-led PGx service for PACE is feasible. Implementation of this service highlights the leadership role of pharmacists in moving PGx from research to practice. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study

PubMed Central

2011-01-01

Background The present study examines the structure and operation of social networks of information and advice and their role in making decisions as to whether to adopt new evidence-based practices (EBPs) among agency directors and other program professionals in 12 California counties participating in a large randomized controlled trial. Methods Interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. Grounded-theory analytic methods were used to identify themes related to EBP adoption and network influences. A web-based survey collected additional quantitative information on members of information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176) for examination of associations between advice seeking and network structure. Results Systems leaders develop and maintain networks of information and advice based on roles, responsibility, geography, and friendship ties. Networks expose leaders to information about EBPs and opportunities to adopt EBPs; they also influence decisions to adopt EBPs. Individuals in counties at the same stage of implementation accounted for 83% of all network ties. Networks in counties that decided not to implement a specific EBP had no extra-county ties. Implementation of EBPs at the two-year follow-up was associated with the size of county, urban versus rural counties, and in-degree centrality. Collaboration was viewed as critical to implementing EBPs, especially in small, rural counties where agencies have limited resources on their own. Conclusions Successful implementation of EBPs requires consideration and utilization of existing social networks of high-status systems leaders that often cut across service organizations and their geographic jurisdictions. Trial Registration NCT00880126 PMID:21958674

Exploring the process of capacity-building among community-based health promotion workers in Alberta, Canada.

PubMed

Montemurro, Genevieve R; Raine, Kim D; Nykiforuk, Candace I J; Mayan, Maria

2014-09-01

Community capacity-building is a central element to health promotion. While capacity-building features, domains and relationships to program sustainability have been well examined, information on the process of capacity-building as experienced by practitioners is needed. This study examined this process as experienced by coordinators working within a community-based chronic disease prevention project implemented in four communities in Alberta (Canada) from 2005-2010 using a case study approach with a mixed-method design. Data collection involved semi-structured interviews, a focus group and program documents tracking coordinator activity. Qualitative analysis followed the constant comparative method using open, axial and selective coding. Quantitative data were analyzed for frequency of major activity distribution. Capacity-building process involves distinct stages of networking, information exchange, partnering, prioritizing, planning/implementing and supporting/ sustaining. Stages are incremental though not always linear. Contextual factors exert a great influence on the process. Implications for research, practice and policy are discussed. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Education of speech and language therapists/logopedists in selected Central and Southeastern European countries: challenges and new horizons.

PubMed

Georgieva, Dobrinka; Woźniak, Tomasz; Topbaş, Seyhun; Vitaskova, Katerina; Vukovic, Mile; Zemva, Nada; Duranovic, Mirela

2014-01-01

To provide an overview of student training in speech and language therapy/logopedics (SLT) in selected Central and Southeastern European countries (Poland, Slovenia, Bulgaria, Czech Republic, Serbia, Bosnia and Herzegovina and Turkey). Data were collected using a special questionnaire developed by Söderpalm and supplemented by Georgieva. Results from 23 SLT programs in the seven countries were collected and organized. In all these countries, SLT has roots in special education or health and is centralized in the university environment. The training programs have positive accreditation provided by the national agencies of accreditation and evaluation. Results were examined specifically for evidence of the new paradigm of evidence-based practice (EBP) according to the revised International Association of Logopedics and Phoniatrics (IALP) guidelines and the application of research-based teaching in SLT. The professional bodies that govern clinical practice in public health and/or educational fields are in the process of EBP implementation. Most speech and language therapists/logopedists in the selected countries work in an educational setting, clinical organization and/or hospital as well as in social day care centers. Except in Turkey, private practices are not regulated by the law. In the seven countries examined in this survey, SLT is progressing as a professional discipline but must be supported by government funding of SLT education and services to relevant populations. © 2015 S. Karger AG, Basel.

The Significance of Ongoing Teacher Support in Earth Science Education Programs: Evidence from the GLOBE Program

NASA Astrophysics Data System (ADS)

Penuel, B.; Korbak, C.; Shear, L.

2003-12-01

The GLOBE program provides a rich context for examining issues concerning implementation of inquiry-oriented, scientist-driven educational programs, because the program has both a history of collecting evaluation data on implementation and mechanisms for capturing program activity as it occurs. In this paper, researchers from SRI International's evaluation team explore the different roles that regional partners play in preparing and supporting teachers to implement the GLOBE Program, an international inquiry-based Earth science education initiative that has trained over 14,000 teachers worldwide. GLOBE program evaluation results show the program can be effective in increasing students' inquiry skills, but that the program is also hard for teachers to implement (Means et al., 2001; Penuel et al., 2002). An analysis of GLOBE's regional partner organizations, which are tasked with preparing teachers to implement its data collection and reporting protocols with students, shows that some partners are more successful than others. This paper reports findings from a quantitative analysis of the relationship between data reporting and partner support activities and from case studies of two such regional partners focused on analyzing what makes them successful. The first analysis examined associations between partner training and support activities and data reporting. For this analysis, we used data from the GLOBE Student Data Archive matched with survey data collected from a large sample of GLOBE teachers as part of SRI's Year 5 evaluation of GLOBE. Our analyses point to the central importance of mentoring and material support to teachers. We found that incentives, mentoring, and other on-site support to teachers have a statistically significant association with higher data reporting levels. We also found that at present, teachers access these supports less often than they access listservs and e-mail communication with teachers after GLOBE training. As a follow-up to this study, SRI researchers used the data on student data reporting activity from different partners to identify candidate sites for case studies, where we might investigate the nature of follow-up activities provided by successful partners more closely. We worked to select 2 regional partners that had evidence of high percentages of teachers trained that reported data and that also offered follow-up to teachers. Case study researchers conducted observations within 2-3 active GLOBE schools supported by each regional partner organization and interviewed teachers, principals, and partner staff. On the basis of our observation data and transcripts from interviews, we compiled profiles of schools' implementation and analyzed the core activities of each regional partner. Researchers found that keys to promoting successful implementation in one partnership were: one partnership were: close alignment with state mathematics and science initiatives; mentors that helped teachers by modeling inquiry in GLOBE and by assisting with equipment set-up and curriculum planning; and allowing room for schools to adopt diverse goals for GLOBE. In the second partnership, keys to success included a strategic approach to developing funding for the program; a focus on integration of culturally-relevant knowledge into teacher preparation; follow-up support for teachers; and use of GLOBE as an opportunity to investigate local evidence of climate change. Both partner organizations were challenged by funding limitations that prevented them from providing as much follow-up support as they believe is necessary.

The cold chain and the expanded program on immunization in Chile: an evaluation exercise.

PubMed

Carrasco, R; Dinstrans, R; Montaldo, I; Medina, E; Reyes, M; Vergara, I; Piwonka, A; Thomas, E R

1982-01-01

It was decided that a study of the cold chain should be conducted in Chile in an effort to identify situations that could be corrected and to improve the technical and administrative development of the program. Specifically, study objectives were as follows: to determine the degree to which the EPI standards for procurement, receipt, transfer, control, maintenance, and distribution of vaccines were being met; to assess the turnover, knowledge, and training of auxiliary vaccination personnel against the relevant standards established for vaccine and cold chain management; to determine the antigenic potency of measles vaccine samples available at the time visits were made to local clinics, regional health storage sites, and the central supply facility; and to test a written instrument designed for the express purpose of assessing achievement of the first 2 objectives cited. The study sought to provide a descriptive assessment of work being performed at the central, regional, and local levels in the Metropolitan Region. The operating units involved included the airport and main supply center at the central level; the 7 storage facilities of the Metropolitan Region's 78 local clinics providing maternal and child health care. 40 clinics, selected by lot, represented 51% of the region's 78 clinics and provided coverage for 49% of the population assigned to the region's health services. The units studied failed to satisfy half the investigated Expanded Program for Immunization (EPI) standards, i.e., the average achievement rating of the 3 levels combined (49.3%) fell short of half the desired 100%. The airport unit met very few of the EPI implementation standards, scoring only 20% in this area. Deficiencies were found in systems for shipping vaccine in cold boxes, for making cold rooms permanently available, and for providing adequate vaccine transportation. The central supply facility, responsible for the purchase, storage, distribution, and maintenance of an adequate vaccine stock, had an achievement score of only 41%. The regional level, represented by the 7 storage facilities studied, obtained a lower overall achievement score than the other 2 levels and appears to be a high-risk link in the cold chain. The local level, represented by the 40 clinics studied, attained the highest average achievement score of any level (57%). Yet, serious deficiencies also emerged at this level, particularly regarding implementation and control activities. These deficiencies were aggravated by the fact that vaccines undoubtedly encounter a larger number of potentially damaging contingencies at the local level than they do elsewhere. Suggestions are made for overcoming these difficulties.

Adaptation of a culturally relevant nutrition and physical activity program for low-income, Mexican-origin parents with young children.

PubMed

Kaiser, Lucia; Martinez, Judith; Horowitz, Marcel; Lamp, Catherine; Johns, Margaret; Espinoza, Dorina; Byrnes, Michele; Gomez, Mayra Muñoz; Aguilera, Alberto; de la Torre, Adela

2015-05-14

Latino children experience higher rates of obesity than do non-Latino white children. Family-centered nutrition interventions can slow the rate of weight gain in this population. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a 5-year, community-based, participatory research study that targets rural Mexican-origin farmworker families with children aged 2 to 8 years in California's Central Valley. Adaptation of a culturally relevant obesity prevention program involved qualitative research to tailor key obesity prevention messages, pilot testing and implementation of key messages and activities at family nights, and continual modification to incorporate culturally innovative elements. Of the 238 families enrolled, 53% (125) attended the recommended minimum of 5 (of 10 possible) classes during the first year. A university and community partnership can guide development of a culturally tailored obesity prevention program that is suitable for reaching a high-risk Mexican-origin audience through cooperative extension and other public health programs.

Weqaya: A Population-Wide Cardiovascular Screening Program in Abu Dhabi, United Arab Emirates

PubMed Central

Harrison, Oliver; Al Siksek, Zaid

2012-01-01

Objectives. We sought to determine cardiovascular risk factor prevalence rates among adults in Abu Dhabi, United Arab Emirates. Methods. We used self-reported indicators, anthropometric measures, and blood tests to screen 50 138 adults aged 18 years or older taking part in a population-wide cardiovascular screening program. Results. Participants’ mean age was 36.82 years (SD = 14.3); 43% were men. Risk factor prevalence rates were as follows: obesity, 35%; overweight, 32%; central obesity, 55%; diabetes, 18%; prediabetes, 27%; dyslipidemia, 44%; and hypertension, 23.1%. In addition, 26% of men were smokers, compared with 0.8% of women. Age-standardized diabetes and prediabetes rates were 25% and 30%, respectively, and age-standardized rates of obesity and overweight were 41% and 34%. Conclusions. This population-wide cardiovascular screening program demonstrated a high cardiovascular burden for our small sample in Abu Dhabi. The data form a baseline against which interventions can be implemented and progress monitored as part of the population-wide Abu Dhabi Cardiovascular Disease Program. PMID:21940918

EPA Facility Registry Service (FRS): CAMDBS

EPA Pesticide Factsheets

This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Clean Air Markets Division Business System (CAMDBS). Administered by the EPA Clean Air Markets Division, within the Office of Air and Radiation, CAMDBS supports the implementation of market-based air pollution control programs, including the Acid Rain Program and regional programs designed to reduce the transport of ozone. FRS identifies and geospatially locates facilities, sites or places subject to environmental regulations or of environmental interest. Using vigorous verification and data management procedures, FRS integrates facility data from EPA's national program systems, other federal agencies, and State and tribal master facility records and provides EPA with a centrally managed, single source of comprehensive and authoritative information on facilities. This data set contains the subset of FRS integrated facilities that link to CAMDBS facilities once the CAMDBS data has been integrated into the FRS database. Additional information on FRS is available at the EPA website https://www.epa.gov/enviro/facility-registry-service-frs.

Predictors of Acquisition of Competitive Employment for People Enrolled in Supported Employment Programs.

PubMed

Corbière, Marc; Lecomte, Tania; Reinharz, Daniel; Kirsh, Bonnie; Goering, Paula; Menear, Matthew; Berbiche, Djamal; Genest, Karine; Goldner, Elliot M

2017-04-01

This study aims at assessing the relative contribution of employment specialist competencies working in supported employment (SE) programs and client variables in determining the likelihood of obtaining competitive employment. A total of 489 persons with a severe mental illness and 97 employment specialists working in 24 SE programs across three Canadian provinces were included in the study. Overall, 43% of the sample obtained competitive work. Both client variables and employment specialist competencies, while controlling for the quality of SE programs implementation, predicted job acquisition. Multilevel analyses further indicated that younger client age, shorter duration of unemployment, and client use of job search strategies, as well as the working alliance perceived by the employment specialist, were the strongest predictors of competitive employment for people with severe mental illness, with 51% of variance explained. For people with severe mental illness seeking employment, active job search behaviors, relational abilities, and employment specialist competencies are central contributors to acquisition of competitive employment.

Adaptation of a Culturally Relevant Nutrition and Physical Activity Program for Low-Income, Mexican-Origin Parents With Young Children

PubMed Central

Martinez, Judith; Horowitz, Marcel; Lamp, Catherine; Johns, Margaret; Espinoza, Dorina; Byrnes, Michele; Gomez, Mayra Muñoz; Aguilera, Alberto; de la Torre, Adela

2015-01-01

Latino children experience higher rates of obesity than do non-Latino white children. Family-centered nutrition interventions can slow the rate of weight gain in this population. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a 5-year, community-based, participatory research study that targets rural Mexican-origin farmworker families with children aged 2 to 8 years in California’s Central Valley. Adaptation of a culturally relevant obesity prevention program involved qualitative research to tailor key obesity prevention messages, pilot testing and implementation of key messages and activities at family nights, and continual modification to incorporate culturally innovative elements. Of the 238 families enrolled, 53% (125) attended the recommended minimum of 5 (of 10 possible) classes during the first year. A university and community partnership can guide development of a culturally tailored obesity prevention program that is suitable for reaching a high-risk Mexican-origin audience through cooperative extension and other public health programs. PMID:25974142

Evolution of Diabetes Care in Hong Kong: From the Hong Kong Diabetes Register to JADE-PEARL Program to RAMP and PEP Program

PubMed Central

Cheung, Kitty K.T.; Yau, Tiffany T.L.; Chow, Elaine; Ozaki, Risa

2018-01-01

The rapid increase in diabetes prevalence globally has contributed to large increases in health care expenditure on diabetic complications, posing a major health burden to countries worldwide. Asians are commonly observed to have poorer β-cell function and greater insulin resistance compared to the Caucasian population, which is attributed by their lower lean body mass and central obesity. This “double phenotype” as well as the rising prevalence of young onset diabetes in Asia has placed Asians with diabetes at high risk of cardiovascular and renal complications, with cancer emerging as an important cause of morbidity and mortality. The experience from Hong Kong had demonstrated that a multifaceted approach, involving team-based integrated care, information technological advances, and patient empowerment programs were able to reduce the incidence of diabetic complications, hospitalizations, and mortality. System change and public policies to enhance implementation of such programs may provide solutions to combat the burgeoning health problem of diabetes at a societal level. PMID:29589385

Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

PubMed

Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

2018-03-01

Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have <12% of their patients utilizing central venous catheters for hemodialysis treatments. On the Eastern Shore of Maryland, the central venous catheter rates in the dialysis units averaged >45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

Policy and administrative issues for large-scale clinical interventions following disasters.

PubMed

Scheeringa, Michael S; Cobham, Vanessa E; McDermott, Brett

2014-02-01

Large, programmatic mental health intervention programs for children and adolescents following disasters have become increasingly common; however, little has been written about the key goals and challenges involved. Using available data and the authors' experiences, this article reviews the factors involved in planning and implementing large-scale treatment programs following disasters. These issues include funding, administration, choice of clinical targets, workforce selection, choice of treatment modalities, training, outcome monitoring, and consumer uptake. Ten factors are suggested for choosing among treatment modalities: 1) reach (providing access to the greatest number), 2) retention of patients, 3) privacy, 4) parental involvement, 5) familiarity of the modality to clinicians, 6) intensity (intervention type matches symptom acuity and impairment of patient), 7) burden to the clinician (in terms of time, travel, and inconvenience), 8) cost, 9) technology needs, and 10) effect size. Traditionally, after every new disaster, local leaders who have never done so before have had to be recruited to design, administer, and implement programs. As expertise in all of these areas represents a gap for most local professionals in disaster-affected areas, we propose that a central, nongovernmental agency with national or international scope be created that can consult flexibly with local leaders following disasters on both overarching and specific issues. We propose recommendations and point out areas in greatest need of innovation.

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.

AstroCom NYC: Expanding the Partnership

NASA Astrophysics Data System (ADS)

Paglione, Timothy; Ford, Saavik; Agueros, Marcel A.; Mac Low, Mordecai-Mark; Robbins, Dennis

2015-01-01

AstroCom NYC is an undergraduate mentoring program designed to improve urban minority student access to opportunities in astrophysical research by greatly enhancing partnerships between research astronomers in New York City (City University of New York - an MSI, American Museum of Natural History, and Columbia). AstroCom NYC provides centralized, personalized mentoring as well as financial and academic support, to CUNY undergraduates throughout their studies, plus the resources and opportunities to further CUNY faculty research with students. The goal is that students' residency at AMNH helps them build a sense of belonging in the field, and readies and inspires them for graduate study. AstroCom NYC provides a rigorous Methods of Scientific Research course developed specifically to this purpose, a laptop, research and career mentors, outreach activities, scholarships and stipends, Metrocards, and regular assessment for maximum effectiveness. Stipends in part alleviate the burdens at home typical for CUNY students so they may concentrate on their academic success. AMNH serves as the central hub for our faculty and students, who are otherwise dispersed among all five boroughs of the City. For our second cohort, we dramatically improved the application and screening process, implemented a number of tools to evaluate their potential for grad school, and began growing a network of potential hosts for summer internships around NY State and the US. We review these implementations and outcomes, as well as plans for Year 3, when we expect many of our current students to compete for external summer REUs, and after greatly expanding the program reach through a NASA community college initiative.

A central support system can facilitate implementation and sustainability of a Classroom-based Undergraduate Research Experience (CURE) in Genomics.

PubMed

Lopatto, David; Hauser, Charles; Jones, Christopher J; Paetkau, Don; Chandrasekaran, Vidya; Dunbar, David; MacKinnon, Christy; Stamm, Joyce; Alvarez, Consuelo; Barnard, Daron; Bedard, James E J; Bednarski, April E; Bhalla, Satish; Braverman, John M; Burg, Martin; Chung, Hui-Min; DeJong, Randall J; DiAngelo, Justin R; Du, Chunguang; Eckdahl, Todd T; Emerson, Julia; Frary, Amy; Frohlich, Donald; Goodman, Anya L; Gosser, Yuying; Govind, Shubha; Haberman, Adam; Hark, Amy T; Hoogewerf, Arlene; Johnson, Diana; Kadlec, Lisa; Kaehler, Marian; Key, S Catherine Silver; Kokan, Nighat P; Kopp, Olga R; Kuleck, Gary A; Lopilato, Jane; Martinez-Cruzado, Juan C; McNeil, Gerard; Mel, Stephanie; Nagengast, Alexis; Overvoorde, Paul J; Parrish, Susan; Preuss, Mary L; Reed, Laura D; Regisford, E Gloria; Revie, Dennis; Robic, Srebrenka; Roecklien-Canfield, Jennifer A; Rosenwald, Anne G; Rubin, Michael R; Saville, Kenneth; Schroeder, Stephanie; Sharif, Karim A; Shaw, Mary; Skuse, Gary; Smith, Christopher D; Smith, Mary; Smith, Sheryl T; Spana, Eric P; Spratt, Mary; Sreenivasan, Aparna; Thompson, Jeffrey S; Wawersik, Matthew; Wolyniak, Michael J; Youngblom, James; Zhou, Leming; Buhler, Jeremy; Mardis, Elaine; Leung, Wilson; Shaffer, Christopher D; Threlfall, Jennifer; Elgin, Sarah C R

2014-01-01

In their 2012 report, the President's Council of Advisors on Science and Technology advocated "replacing standard science laboratory courses with discovery-based research courses"-a challenging proposition that presents practical and pedagogical difficulties. In this paper, we describe our collective experiences working with the Genomics Education Partnership, a nationwide faculty consortium that aims to provide undergraduates with a research experience in genomics through a scheduled course (a classroom-based undergraduate research experience, or CURE). We examine the common barriers encountered in implementing a CURE, program elements of most value to faculty, ways in which a shared core support system can help, and the incentives for and rewards of establishing a CURE on our diverse campuses. While some of the barriers and rewards are specific to a research project utilizing a genomics approach, other lessons learned should be broadly applicable. We find that a central system that supports a shared investigation can mitigate some shortfalls in campus infrastructure (such as time for new curriculum development, availability of IT services) and provides collegial support for change. Our findings should be useful for designing similar supportive programs to facilitate change in the way we teach science for undergraduates. © 2014 D. Lopatto et al. CBE—Life Sciences Education © 2014 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).

The Parliamentarian, NGO and Youth Fora.

PubMed

1999-01-01

Three fora, namely, the Parliamentarian's Forum, the Nongovernmental Organization (NGO) Forum, and the Youth Forum, immediately preceded the Hague Forum. Each of the forums assessed achievements in implementing the International Conference on Population and Development Programme of Action (ICPD-PA) and formulated recommendations that provided valuable input to the International Forum. The Parliamentarian's Forum, attended by 210 parliamentarians from 103 countries, evaluated the progress in development of the parliamentarians' movement after the ICPD. The parliamentarians focused their discussions on the following priority areas: reproductive health and rights; gender and population; adolescents, youth, the elderly, and persons with disabilities; population, environment, and food security; resource mobilization; economic crises; and parliamentarian networks. The NGO Forum, on the other hand, emphasized the need to achieve consensus on policy formulation that includes NGOs as partners; establish permanent mechanisms for ICPD-PA implementation; and mobilize financial resources for sexual and reproductive health initiatives. Lastly, the Youth Forum highlighted the central role that youth can play in the development of policies and programs for ICPD-PA implementation.

Assessment of digital literacy and use of smart phones among Central Indian dental students.

PubMed

Saxena, Payal; Gupta, Saurabh Kumar; Mehrotra, Divya; Kamthan, Shivam; Sabir, Husain; Katiyar, Pratibha; Sai Prasad, S V

2018-01-01

Education has largely been digitalized. More so, for professional education, keeping updated in this fast paced world has become a necessary requisite and dentistry has not been left untouched. This cross sectional questionnaire based study aimed to assess the digital literacy and smartphone usage amongst the 260 Central Indian dental students including their perspicacity about smartphone/internet usage for learning purposes. The students' attitude for implementation of digital technology in study programs/education system was also evaluated. The questionnaire was distributed among total 260 dental students from different dental institutes of Central India. The data was collected and analyzed using SPSS software. Out of 260 students, 250 were internet users, out of which 56% had internet access all time. 94.23% students owned a smartphone. 46.53% (114/245) students had some app related to the dentistry in their smartphone device. The commonest site for surfing related to knowledge seeking was google scholar (72%) followed by Pubmed and others. Nearly 80% dental students believed that social media helps them in their professional course studies. Post graduate students showed statistitically significant difference from undergraduates and interns in terms of knowledge of keywords, dental apps and reading research journals. 89.23% students were keen for implementation of e-learning in their curriculum. This study reflects willingness of dental students to adopt digital revolution in dental education which in turn may present an opportunity for educators and policy makers to modify educational methods and thereby advance student's current learning approaches.

Integrating Engineering Data Systems for NASA Spaceflight Projects

NASA Technical Reports Server (NTRS)

Carvalho, Robert E.; Tollinger, Irene; Bell, David G.; Berrios, Daniel C.

2012-01-01

NASA has a large range of custom-built and commercial data systems to support spaceflight programs. Some of the systems are re-used by many programs and projects over time. Management and systems engineering processes require integration of data across many of these systems, a difficult problem given the widely diverse nature of system interfaces and data models. This paper describes an ongoing project to use a central data model with a web services architecture to support the integration and access of linked data across engineering functions for multiple NASA programs. The work involves the implementation of a web service-based middleware system called Data Aggregator to bring together data from a variety of systems to support space exploration. Data Aggregator includes a central data model registry for storing and managing links between the data in disparate systems. Initially developed for NASA's Constellation Program needs, Data Aggregator is currently being repurposed to support the International Space Station Program and new NASA projects with processes that involve significant aggregating and linking of data. This change in user needs led to development of a more streamlined data model registry for Data Aggregator in order to simplify adding new project application data as well as standardization of the Data Aggregator query syntax to facilitate cross-application querying by client applications. This paper documents the approach from a set of stand-alone engineering systems from which data are manually retrieved and integrated, to a web of engineering data systems from which the latest data are automatically retrieved and more quickly and accurately integrated. This paper includes the lessons learned through these efforts, including the design and development of a service-oriented architecture and the evolution of the data model registry approaches as the effort continues to evolve and adapt to support multiple NASA programs and priorities.

Building a visionary astrophysics program from the ground up

NASA Astrophysics Data System (ADS)

Mathews, Geoffrey S.; Barnes, Joshua Edward; Coleman, Paul; Gal, Roy R.; Meech, Karen J.; Mendez, Roberto Hugo; Nassir, Michael A.; Sanders, David B.

2015-08-01

The University of Hawaii’s Institute for Astronomy is in the process of implementing a new Bachelor of Science in Astrophysics at UH Manoa. This requires a significant adjustment in the role of the IfA, which has long been at the forefront of modern astronomy in Hawaii and is now broadening its educational mission. The IfA’s history of excellence in research and access to observational resources are expected to draw students from around the nation and the world. These factors have inspired our programmatic focus culminating in a senior year research experience. We expect that the program will produce many undergraduate astrophysics majors, making it an ideal testbed to apply modern theories of learning to the teaching of astrophysics. We have explicitly designed the major around three pillars: physical theory, the application of physics to astrophysical phenomena, and the development of core observational astronomy skills. We describe our cooperative approach to developing a program-level curriculum map of key concepts and skills, as well as descriptors of student success throughout the program. These are central tools for course design, program assessment, and professional development.

Updated operational protocols for the U.S. Geological Survey Precipitation Chemistry Quality Assurance Project in support of the National Atmospheric Deposition Program

USGS Publications Warehouse

Wetherbee, Gregory A.; Martin, RoseAnn

2017-02-06

The U.S. Geological Survey Branch of Quality Systems operates the Precipitation Chemistry Quality Assurance Project (PCQA) for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN) and National Atmospheric Deposition Program/Mercury Deposition Network (NADP/MDN). Since 1978, various programs have been implemented by the PCQA to estimate data variability and bias contributed by changing protocols, equipment, and sample submission schemes within NADP networks. These programs independently measure the field and laboratory components which contribute to the overall variability of NADP wet-deposition chemistry and precipitation depth measurements. The PCQA evaluates the quality of analyte-specific chemical analyses from the two, currently (2016) contracted NADP laboratories, Central Analytical Laboratory and Mercury Analytical Laboratory, by comparing laboratory performance among participating national and international laboratories. Sample contamination and stability are evaluated for NTN and MDN by using externally field-processed blank samples provided by the Branch of Quality Systems. A colocated sampler program evaluates the overall variability of NTN measurements and bias between dissimilar precipitation gages and sample collectors.This report documents historical PCQA operations and general procedures for each of the external quality-assurance programs from 2007 to 2016.

Detection and management of drug-resistant tuberculosis in HIV-infected patients from lower income countries

PubMed Central

Ballif, Marie; Nhandu, Venerandah; Wood, Robin; Dusingize, Jean Claude; Carter, E. Jane; Cortes, Claudia P.; McGowan, Catherine C.; Diero, Lameck; Graber, Claire; Renner, Lorna; Hawerlander, Denise; Kiertiburanakul, Sasisopin; Du, Quy Tuan; Sterling, Timothy R.; Egger, Matthias; Fenner, Lukas

2015-01-01

Setting Drug resistance threatens tuberculosis (TB) control, particularly among HIV-infected persons. Objective We surveyed antiretroviral therapy (ART) programs from lower-income countries on prevention and management of drug-resistant TB. Design We used online questionnaires to collect program-level data in 47 ART programs in Southern Africa (14), East Africa (8), West Africa (7), Central Africa (5), Latin America (7) and Asia-Pacific (6 programs) in 2012. Patient-level data were collected on 1,002 adult TB patients seen at 40 of the participating ART programs. Results Phenotypic drug susceptibility testing was available at 36 (77%) ART programs, but only used for 22% of all TB patients. Molecular drug resistance testing was available at 33 (70%) programs and used for 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the whole treatment, 16 (34%) during intensive phase only and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line TB regimens; 18 (38%) reported TB drug shortages. Conclusions Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower income countries. DOT was not always implemented and drug supply was regularly interrupted, which may contribute to the global emergence of drug resistance. PMID:25299866

Rationale and design of a randomized trial of automated hovering for post-myocardial infarction patients: The HeartStrong program.

PubMed

Troxel, Andrea B; Asch, David A; Mehta, Shivan J; Norton, Laurie; Taylor, Devon; Calderon, Tirza A; Lim, Raymond; Zhu, Jingsan; Kolansky, Daniel M; Drachman, Brian M; Volpp, Kevin G

2016-09-01

Coronary artery disease is the single leading cause of death in the United States, and medications can significantly reduce the rate of repeat cardiovascular events and treatment procedures. Adherence to these medications, however, is very low. HeartStrong is a national randomized trial offering 3 innovations. First, the intervention is built on concepts from behavioral economics that we expect to enhance its effectiveness. Second, the implementation of the trial takes advantage of new technology, including wireless pill bottles and remote feedback, to substantially automate procedures. Third, the trial's design includes an enhancement of the standard randomized clinical trial that allows rapid-cycle innovation and ongoing program enhancement. Using a system involving direct data feeds from 6 insurance partners followed by mail, telephone, and email contact, we enrolled 1,509 patients discharged from the hospital with acute myocardial infarction in a 2:1 ratio of intervention:usual care. The intervention period lasts 1 year; the primary outcome is time to first fatal or nonfatal acute vascular event or revascularization, including acute myocardial infarction, unstable angina, stroke, acute coronary syndrome admission, or death. Our randomized controlled trial of the HeartStrong program will provide an evaluation of a state-of-the-art behavioral economic intervention with a number of important pragmatic features. These include a tailored intervention responding to patient activity, streamlining of consent and implementation processes using new technologies, outcomes centrally important to patients, and the ability to implement rapid-cycle innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

Practitioner insights on obesity prevention: the voice of South Australian OPAL workers.

PubMed

2016-06-01

Knowledge based on science has been central to implementing community-based childhood obesity prevention interventions. The art of practitioner wisdom is equally critical to ensure locally relevant responses. In South Australia (SA), the OPAL (Obesity Prevention and Lifestyle) program has been implemented to reduce childhood obesity across 20 communities reaching nearly one quarter of the state's population. Staff from across the State come together at regular intervals to share practice challenges and insights and refine the model of practice. Over a 3-year period 12 reflective practice workshops were held with OPAL staff (n = 46). OPAL staff were guided by an external facilitator using inquiring questions to reflect on their health promotion practice within local government. Three themes were identified as central within the reflections. The first theme is shared clarity through the OPAL obesity prevention model highlighting the importance of working to a clearly articulated, holistic obesity prevention model. The second theme is practitioner skill and sensitivity required to implement the model and deal with the 'politics' of obesity prevention. The final theme is the power of relationships as intrinsic to effective community based health promotion. Insights into the daily practices and reflections from obesity prevention practitioners are shared to shed light on the skills required to contribute to individual and social change. OPAL staff co-authored this paper. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Country watch: Central African Republic (CAR).

PubMed

Aubel, J; Sobela, F; Voga, P

1997-01-01

This article describes the activities of the Community Peer AIDS Education Project, initiated in 1995 in the Central African Republic (CAR). The CAR project was created by the National AIDS Committee (NAC) and the US Peace Corps. A 4-day workshop was held at the onset for project staff and consultants. Staff developed a simple monitoring and evaluation (M&E) system that emphasizes "learning." M&E schemes measure project outputs, expenditures, and other measures of program implementation in order to help staff gradually improve implementation. M&E helps staff document activities, share information, and learn from the implementation process. Project activities are documented by maintaining community logbooks, taking photos of significant aspects of the educational activities, and leading informal discussion groups. The CAR project engaged in sharing and learning activities by holding meetings with peer leaders, team meetings, meetings with project managers, and meetings with the NAC. Once a month, peer field coordinators conducted a structured exercise with peer leaders. One aim was to gain their feedback on the successes and constraints of activities. Another was to make suggestions on how to improve activities. These structured exercises are recorded as lessons learned in a project book. Team meetings are held periodically. During meetings, staff review project books and photos and discuss successes and problems encountered. Project manager meetings provide time to share lessons learned and to suggest project strengthening options. NAC meetings between the project manager and field coordinators allow for a bottom-up learning process. CAR project staff were receptive to M&E efforts.

Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Idaho

USGS Publications Warehouse

Packard, F.A.

1996-01-01

To ensure continued confidence in its products, the Water Resources Division of the U.S. Geological Survey implemented a policy that all its scientific work be performed in accordance with a centrally managed quality-assurance program. This report establishes and documents a formal policy for current (1995) quality assurance within the Idaho District of the U.S. Geological Survey. Quality assurance is formalized by describing district organization and operational responsibilities, documenting the district quality-assurance policies, and describing district functions. The districts conducts its work through offices in Boise, Idaho Falls, Twin Falls, Sandpoint, and at the Idaho National Engineering Laboratory. Data-collection programs and interpretive studies are conducted by two operating units, and operational and technical assistance is provided by three support units: (1) Administrative Services advisors provide guidance on various personnel issues and budget functions, (2) computer and reports advisors provide guidance in their fields, and (3) discipline specialists provide technical advice and assistance to the district and to chiefs of various projects. The district's quality-assurance plan is based on an overall policy that provides a framework for defining the precision and accuracy of collected data. The plan is supported by a series of quality-assurance policy statements that describe responsibilities for specific operations in the district's program. The operations are program planning; project planning; project implementation; review and remediation; data collection; equipment calibration and maintenance; data processing and storage; data analysis, synthesis, and interpretation; report preparation and processing; and training. Activities of the district are systematically conducted under a hierarchy of supervision an management that is designed to ensure conformance with Water Resources Division goals quality assurance. The district quality-assurance plan does not describe detailed technical activities that are commonly termed "quality-control procedures." Instead, it focuses on current policies, operations, and responsibilities that are implemented at the management level. Contents of the plan will be reviewed annually and updated as programs and operations change.

A randomised controlled trial of a physical activity and nutrition program targeting middle-aged adults at risk of metabolic syndrome in a disadvantaged rural community.

PubMed

Blackford, Krysten; Jancey, Jonine; Lee, Andy H; James, Anthony P; Howat, Peter; Hills, Andrew P; Anderson, Annie

2015-03-25

Approximately 70% of Australian adults aged over 50 are overweight or obese, with the prevalence significantly higher in regional/remote areas compared to cities. This study aims to determine if a low-cost, accessible lifestyle program targeting insufficiently active adults aged 50-69 y can be successfully implemented in a rural location, and whether its implementation will contribute to the reduction/prevention of metabolic syndrome, or other risk factors for type 2 diabetes, and cardiovascular disease. This 6-month randomised controlled trial will consist of a nutrition, physical activity, and healthy weight intervention for 50-69 year-olds from a disadvantaged rural community. Five hundred participants with central obesity and at risk of metabolic syndrome will be recruited from Albany and surrounding areas in Western Australia (within a 50 kilometre radius of the town). They will be randomly assigned to either the intervention (n = 250) or wait-listed control group (n = 250). The theoretical concepts in the study utilise the Self-Determination Theory, complemented by Motivational Interviewing. The intervention will include a custom-designed booklet and interactive website that provides information, and encourages physical activity and nutrition goal setting, and healthy weight management. The booklet and website will be supplemented by an exercise chart, calendar, newsletters, resistance bands, accelerometers, and phone and email contact from program staff. Data will be collected at baseline and post-intervention. This study aims to contribute to the prevention of metabolic syndrome and inter- related chronic illnesses: type 2 diabetes mellitus, cardiovascular disease, and some cancers; which are associated with overweight/obesity, physical inactivity, and poor diet. This large rural community-based trial will provide guidelines for recruitment, program development, implementation, and evaluation, and has the potential to translate findings into practice by expanding the program to other regional areas in Australia. Australian and New Zealand Clinical Trials Registry [ ACTRN12614000512628 , registration date 14(th) May 2014].

Factors associated with implementation of a multicomponent responsible beverage service program – results from two surveys in 290 Swedish municipalities

PubMed Central

2013-01-01

Background The purpose of this study was to investigate which factors affected the implementation of a multicomponent Responsible Beverage Service (RBS) program in 290 Swedish municipalities and whether the amount of such factors influenced the level of implementation of the program. Methods This study used variation in the presence of implementation-promoting factors to predict the level of implementation of the RBS program in municipalities throughout Sweden. The presence of such factors and the level of implementation of the program were studied by means of two surveys in all Swedish municipalities (N=290). Logistic regression and Spearman’s correlation analyses were used to analyze the relationship between implementation-promoting factors and the level of implementation of the RBS program. Results The response rates of the two surveys were 96% and 98%, respectively. One main finding was that program fidelity was low. Only 13% of the municipalities surveyed had implemented the RBS program as a whole, as stated in the specification of requirements. In municipalities reporting a higher amount of implementation-promoting factors, a significantly higher level of implementation of the program was shown. Evaluation and feedback was the only factor that correlated significantly with the level of implementation of the RBS program as a whole. Conclusion Evaluation and feedback constitutes an important implementation-promoting factor also in complex programs like the RBS program. Program fidelity is significant for the outcome of an intervention and must be a major focus of the implementation processes. PMID:23497692

ALGORITHMS AND PROGRAMS FOR STRONG GRAVITATIONAL LENSING IN KERR SPACE-TIME INCLUDING POLARIZATION

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

Chen, Bin; Maddumage, Prasad; Kantowski, Ronald

2015-05-15

Active galactic nuclei (AGNs) and quasars are important astrophysical objects to understand. Recently, microlensing observations have constrained the size of the quasar X-ray emission region to be of the order of 10 gravitational radii of the central supermassive black hole. For distances within a few gravitational radii, light paths are strongly bent by the strong gravity field of the central black hole. If the central black hole has nonzero angular momentum (spin), then a photon’s polarization plane will be rotated by the gravitational Faraday effect. The observed X-ray flux and polarization will then be influenced significantly by the strong gravitymore » field near the source. Consequently, linear gravitational lensing theory is inadequate for such extreme circumstances. We present simple algorithms computing the strong lensing effects of Kerr black holes, including the effects on polarization. Our algorithms are realized in a program “KERTAP” in two versions: MATLAB and Python. The key ingredients of KERTAP are a graphic user interface, a backward ray-tracing algorithm, a polarization propagator dealing with gravitational Faraday rotation, and algorithms computing observables such as flux magnification and polarization angles. Our algorithms can be easily realized in other programming languages such as FORTRAN, C, and C++. The MATLAB version of KERTAP is parallelized using the MATLAB Parallel Computing Toolbox and the Distributed Computing Server. The Python code was sped up using Cython and supports full implementation of MPI using the “mpi4py” package. As an example, we investigate the inclination angle dependence of the observed polarization and the strong lensing magnification of AGN X-ray emission. We conclude that it is possible to perform complex numerical-relativity related computations using interpreted languages such as MATLAB and Python.« less

Algorithms and Programs for Strong Gravitational Lensing In Kerr Space-time Including Polarization

NASA Astrophysics Data System (ADS)

Chen, Bin; Kantowski, Ronald; Dai, Xinyu; Baron, Eddie; Maddumage, Prasad

2015-05-01

Active galactic nuclei (AGNs) and quasars are important astrophysical objects to understand. Recently, microlensing observations have constrained the size of the quasar X-ray emission region to be of the order of 10 gravitational radii of the central supermassive black hole. For distances within a few gravitational radii, light paths are strongly bent by the strong gravity field of the central black hole. If the central black hole has nonzero angular momentum (spin), then a photon’s polarization plane will be rotated by the gravitational Faraday effect. The observed X-ray flux and polarization will then be influenced significantly by the strong gravity field near the source. Consequently, linear gravitational lensing theory is inadequate for such extreme circumstances. We present simple algorithms computing the strong lensing effects of Kerr black holes, including the effects on polarization. Our algorithms are realized in a program “KERTAP” in two versions: MATLAB and Python. The key ingredients of KERTAP are a graphic user interface, a backward ray-tracing algorithm, a polarization propagator dealing with gravitational Faraday rotation, and algorithms computing observables such as flux magnification and polarization angles. Our algorithms can be easily realized in other programming languages such as FORTRAN, C, and C++. The MATLAB version of KERTAP is parallelized using the MATLAB Parallel Computing Toolbox and the Distributed Computing Server. The Python code was sped up using Cython and supports full implementation of MPI using the “mpi4py” package. As an example, we investigate the inclination angle dependence of the observed polarization and the strong lensing magnification of AGN X-ray emission. We conclude that it is possible to perform complex numerical-relativity related computations using interpreted languages such as MATLAB and Python.

Current trends of sugar consumption in developing societies.

PubMed

Ismail, A I; Tanzer, J M; Dingle, J L

1997-12-01

This paper reviews recent data on sugar consumption in developing countries that may lead to a potential increase in caries prevalence. A search of the business, dental and nutritional literature was conducted through May 1995. There is evidence that sugar (sucrose) use was increasing in China, India, and Southeast Asia. In South and Central America (except Haiti) sugar use was either equivalent to or higher than that in most developed societies. In the Middle East, average sugar use was higher than that of other developing areas. However, it was either lower than or equivalent to the levels reported by other developed countries. Many central African countries consumed less than 15 kg of sugar/ person/year. Of particular concern is a rise in the consumption of sugar-containing carbonated beverages in a number of developing societies: China, India, Vietnam, Thailand, and other Southeast Asian countries are currently major growth markets for the soft drink industry. Consumption of high-sugar desserts and snacks may also be increasing in urban centers in some developing countries. To counteract the potential increase in the prevalence of dental caries in some developing countries, preventive and oral health promotion programs should be planned and implemented. We contend that taxation of sugar-containing products as well as efforts to reduce the level of sugar consumption to "safe" levels may be impractical, and in most countries, cannot be supported for political, economic, or health reasons. Instead, we recommend that collaboration be established between public health authorities and manufacturers/distributors of soft drinks and sweets in developing countries to establish a dental health fund that could be used to support caries preventive programs. The fund could be supported through donations from manufacturers based on the principle of the "milli-cent" (1 cent for every 1000 cents of sales). This minimal contribution would provide enough financial support for planning and implementing dental preventive and restorative programs in developing countries.

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.

The MRI-Linear Accelerator Consortium: Evidence-Based Clinical Introduction of an Innovation in Radiation Oncology Connecting Researchers, Methodology, Data Collection, Quality Assurance, and Technical Development.

PubMed

Kerkmeijer, Linda G W; Fuller, Clifton D; Verkooijen, Helena M; Verheij, Marcel; Choudhury, Ananya; Harrington, Kevin J; Schultz, Chris; Sahgal, Arjun; Frank, Steven J; Goldwein, Joel; Brown, Kevin J; Minsky, Bruce D; van Vulpen, Marco

2016-01-01

An international research consortium has been formed to facilitate evidence-based introduction of MR-guided radiotherapy (MR-linac) and to address how the MR-linac could be used to achieve an optimized radiation treatment approach to improve patients' survival, local, and regional tumor control and quality of life. The present paper describes the organizational structure of the clinical part of the MR-linac consortium. Furthermore, it elucidates why collaboration on this large project is necessary, and how a central data registry program will be implemented.

Utilization of parallel processing in solving the inviscid form of the average-passage equation system for multistage turbomachinery

NASA Technical Reports Server (NTRS)

Mulac, Richard A.; Celestina, Mark L.; Adamczyk, John J.; Misegades, Kent P.; Dawson, Jef M.

1987-01-01

A procedure is outlined which utilizes parallel processing to solve the inviscid form of the average-passage equation system for multistage turbomachinery along with a description of its implementation in a FORTRAN computer code, MSTAGE. A scheme to reduce the central memory requirements of the program is also detailed. Both the multitasking and I/O routines referred to are specific to the Cray X-MP line of computers and its associated SSD (Solid-State Disk). Results are presented for a simulation of a two-stage rocket engine fuel pump turbine.

Statistical process control: a practical application for hospitals.

PubMed

VanderVeen, L M

1992-01-01

A six-step plan based on using statistics was designed to improve quality in the central processing and distribution department of a 223-bed hospital in Oakland, CA. This article describes how the plan was implemented sequentially, starting with the crucial first step of obtaining administrative support. The QI project succeeded in overcoming beginners' fear of statistics and in training both managers and staff to use inspection checklists, Pareto charts, cause-and-effect diagrams, and control charts. The best outcome of the program was the increased commitment to quality improvement by the members of the department.

Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program.

PubMed

Viljoen, Myra; Coetzee, Isabel; Heyns, Tanya

2016-12-01

Society demands competent and safe health care, which obligates professionals to deliver quality patient care using current knowledge and skills. Participation in continuous professional development programs is a way to ensure quality nursing care. Despite the importance of continuous professional development, however, critical care nurse practitioners' attendance rates at these programs is low. To explore critical care nurses' reasons for their unsatisfactory attendance at a continuous professional development program. A nominal group technique was used as a consensus method to involve the critical care nurses and provide them the opportunity to reflect on their experiences and challenges related to the current continuous professional development program for the critical care units. Participants were 14 critical care nurses from 3 critical care units in 1 private hospital. The consensus was that the central theme relating to the unsatisfactory attendance at the continuous professional development program was attitude. In order of importance, the 4 contributing priorities influencing attitude were communication, continuous professional development, time constraints, and financial implications. Attitude relating to attending a continuous professional development program can be changed if critical care nurses are aware of the program's importance and are involved in the planning and implementation of a program that focuses on the nurses' individual learning needs. ©2016 American Association of Critical-Care Nurses.

'Virtual' central business office: how UMMS improved revenue cycle performance.

PubMed

Henciak, Bill; Fontaine, Christine; Fields, Keith; Parks, Stacy

2010-06-01

Based on its experience with implementing a virtual central business office, UMMS recommends the following steps to ensure the success of such an initiative: Define the process flow for the organization's day-today revenue cycle operations prior to implementation. Then select best practices and milestones for managing accounts. Identify any possible technology issues that could arise during implementation prior to go live. Hold a midproject debriefing with staff. Develop an organizational chart that details who is responsible for handling issues that arise during implementation and afterward.

Quality-improvement analytics for intravenous infusion pumps.

PubMed

Skledar, Susan J; Niccolai, Cynthia S; Schilling, Dennis; Costello, Susan; Mininni, Nicolette; Ervin, Kelly; Urban, Alana

2013-04-15

The implementation of a smart-pump continuous quality-improvement (CQI) program across a large health system is described, with an emphasis on key metrics for outcomes analyses and program refinement. Three years ago, the University of Pittsburgh Medical Center health system launched a CQI initiative to help ensure the safe use of 6000 smart pumps in its 14 inpatient facilities. A centralized team led by pharmacists is responsible for the retrieval and interpretation of smart-pump data, which is continuously transmitted to a main server. CQI findings are regularly posted on the health system's interdisciplinary intranet. Monitored metrics include rates of compliance with preprogrammed infusion limits, the top 20 drugs involved in alerts, drugs associated with alert-override rates of ≥90%, numbers of alerts by infusion type, nurse responses to alerts, and alert rate per drug library update. Based on the collected CQI data and site-specific requests, four systemwide updates of the smart-pump drug library were performed during the first 18 months of the program, reducing "nuisance alerts" by about 10% per update cycle and enabling targeted interventions to reduce rapid-infusion errors, other adverse drug events (ADEs), and pump-programming workarounds. Over one 12-month period, bedside alerts prompted nurses to reprogram or cancel continuous infusions an average of 400 times per month, potentially averting i.v. medication ADEs. A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication administration. The ongoing refinement of the drug library through the development and implementation of key interventions promotes the growth and sustainability of the smart-pump initiative systemwide.

Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates

PubMed Central

Larson, Elaine L.; Quiros, Dave; Lin, Susan X.

2007-01-01

Background The diffusion of national evidence-based practice guidelines and their impact on patient outcomes often go unmeasured. Methods Our objectives were to (1) evaluate implementation and compliance with clinical practices recommended in the new Centers for Disease Control and Prevention (CDC) Hand Hygiene Guideline, (2) compare rates of health care-associated infections (HAI) before and after implementation of the Guideline recommendations, and (3) examine the patterns and correlates of changes in rates of HAI. We used pre- and post-Guideline implementation site visits and surveys in the setting of 40 US hospitals—members of the National Nosocomial Infections Surveillance System—and measured HAI rates 1 year before and after publication of the CDC Guideline and used direct observation of hand hygiene compliance and Guideline implementation scores. Results All study hospitals had changed their policies and procedures and provided products in compliance with Guideline recommendations; 89.8% of 1359 staff members surveyed anonymously reported that they were familiar with the Guideline. However, in 44.2% of the hospitals (19/40), there was no evidence of a multidisciplinary program to improve compliance. Hand hygiene rates remained low (mean, 56.6%). Rates of central line-associated bloodstream infections were significantly lower in hospitals with higher rates of hand hygiene (P < .001). No impact of Guideline implementation or hand hygiene compliance on other HAI rates was identified. Other factors occurring over time could affect rates of HAI. Observed hand hygiene compliance rates were likely to overestimate rates in actual practice. The study may have been of too short duration to detect the impact of a practice guideline. Conclusion Wide dissemination of this Guideline was not sufficient to change practice. Only some hospitals had initiated multidisciplinary programs; practice change is unlikely without such multidisciplinary efforts and explicit administrative support. PMID:18063132

Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates.

PubMed

Larson, Elaine L; Quiros, Dave; Lin, Susan X

2007-12-01

The diffusion of national evidence-based practice guidelines and their impact on patient outcomes often go unmeasured. Our objectives were to (1) evaluate implementation and compliance with clinical practices recommended in the new Centers for Disease Control and Prevention (CDC) Hand Hygiene Guideline, (2) compare rates of health care-associated infections (HAI) before and after implementation of the Guideline recommendations, and (3) examine the patterns and correlates of changes in rates of HAI. We used pre- and post-Guideline implementation site visits and surveys in the setting of 40 US hospitals--members of the National Nosocomial Infections Surveillance System--and measured HAI rates 1 year before and after publication of the CDC Guideline and used direct observation of hand hygiene compliance and Guideline implementation scores. All study hospitals had changed their policies and procedures and provided products in compliance with Guideline recommendations; 89.8% of 1359 staff members surveyed anonymously reported that they were familiar with the Guideline. However, in 44.2% of the hospitals (19/40), there was no evidence of a multidisciplinary program to improve compliance. Hand hygiene rates remained low (mean, 56.6%). Rates of central line-associated bloodstream infections were significantly lower in hospitals with higher rates of hand hygiene (P < .001). No impact of Guideline implementation or hand hygiene compliance on other HAI rates was identified. Other factors occurring over time could affect rates of HAI. Observed hand hygiene compliance rates were likely to overestimate rates in actual practice. The study may have been of too short duration to detect the impact of a practice guideline. Wide dissemination of this Guideline was not sufficient to change practice. Only some hospitals had initiated multidisciplinary programs; practice change is unlikely without such multidisciplinary efforts and explicit administrative support.

Phase III (final) evaluation report : national evaluation of the FY01 earmark, area transportation authority of North Central Pennsylvania--regional GIS/ITS initiative.

DOT National Transportation Integrated Search

2009-08-31

This report presents the results of the United States Department of Transportation evaluation of a federally funded earmark project implemented by the Area Transportation Authority of North Central Pennsylvania (ATA). The project implemented a suite ...

Timing and Trajectory in Rhythm Production

ERIC Educational Resources Information Center

Doumas, Michail; Wing, Alan M.

2007-01-01

The Wing-Kristofferson movement timing model (A. M. Wing & A. B. Kristofferson, 1973a, 1973b) distinguishes central timer and motor implementation processes. Previous studies have shown that increases in interresponse interval (IRI) variability with mean IRI are due to central timer processes, not motor implementation. The authors examine whether…

77 FR 8221 - Determination Under the Textile and Apparel Commercial Availability Provision of the Dominican...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... Commercial Availability Provision of the Dominican Republic-Central America-United States Free Trade...-Central America-United States Free Trade Agreement Implementation Act (``CAFTA-DR Implementation Act... FURTHER INFORMATION CONTACT: Maria Dybczak, Office of Textiles and Apparel, U.S. Department of Commerce...

Implementing a gender policy in ACORD: strategies, constraints, and challenges.

PubMed

Hadjipateras, A

1997-02-01

ACORD, a consortium of 11 nongovernmental organizations from Europe, Asia, and North America devoted to poverty alleviation in Africa, formally adopted a gender policy in 1990 aimed at reducing gender-based inequities in communities where ACORD works. A 1994-96 survey of field programs indicated that the greatest gains for women had been recorded in the areas of welfare, access to resources, conscientization (awareness of and will to alter gender inequalities), and, to a lesser extent, participation; minimal progress was noted in shifting the prevailing gender-based imbalance of power and control in public or private spheres. The research identified several programming and organizational strategies that have promoted positive outcomes for women: gender-awareness training for staff and community members, working with mixed groups, working with women-only groups, promotion of female leadership, gender-aware participatory planning and evaluation, spreading responsibility throughout the organization for implementing the gender policy, recruitment and promotion of women staff, networks for women staff, and direct field involvement in research. Also identified were internal and external factors that weakened policy implementation: a lack of clarity as to its aims, culture-based resistance, confusion regarding responsibilities and procedures, weak accountability mechanisms, lack of gender impact indicators, training inadequacies, underrepresentation of women staff, and inadequate resources. As a result of the review process, ACORD has given gender issues centrality in its current 5-year strategic plan.

Determinants of health insurance ownership among women in Kenya: evidence from the 2008–09 Kenya demographic and health survey

PubMed Central

2014-01-01

Background The Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. The objective of this study was to examine the determinants associated with health insurance ownership among women in Kenya. Methods Data came from the 2008–09 Kenya Demographic and Health Survey, a nationally representative survey. The sample comprised 8,435 women aged 15–49 years. Descriptive statistics and multivariable logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with health insurance ownership. Results Being employed in the formal sector, being married, exposure to the mass media, having secondary education or higher, residing in households in the middle or rich wealth index categories and residing in a female-headed household were associated with having health insurance. However, region of residence was associated with a lower likelihood of having insurance coverage. Women residing in Central (OR = 0.4; p < 0.01) and North Eastern (OR = 0.1; p < 0.5) provinces were less likely to be insured compared to their counterparts in Nairobi province. Conclusions As the Kenyan government transforms the NHIF into a universal health program, it is important to implement a program that will increase equity and access to health care services among the poor and vulnerable groups. PMID:24678655

Involvement of the US Department of Defense in Civilian Assistance, Part I: a quantitative description of the projects funded by the Overseas Humanitarian, Disaster, and Civic Aid Program.

PubMed

Bourdeaux, Margaret Ellis; Lawry, Lynn; Bonventre, Eugene V; Burkle, Frederick M

2010-03-01

To review the history and goals of the US Department of Defense's largest civilian assistance program, the Overseas Humanitarian, Disaster and Civic Aid Program and to describe the number, geographic regions, years, key words, countries, and types of projects carried out under this program since 2001. Using the program's central database, we reviewed all approved projects since 2001 and tabulated them by year, combatant command, country, and key word. We also reviewed the project descriptions of projects funded between January 1, 2006, and February 9, 2008, and examined how their activities varied by combatant command and year. Of the 5395 projects in the database, 2097 were funded. Projects took place in more than 90 countries, with Southern, Pacific, and Africa Command hosting the greatest number. The most common types of projects were school, health, disaster response, and water infrastructure construction, and disaster-response training. The "global war on terror" was the key word most frequently tagged to project descriptions. Project descriptions lacked stated goals as well as implementation and coordination strategies with potential partners, and did not report outcome or impact indicators. The geographic reach of the program is vast and projects take place in a wide variety of public sectors. Yet their security and civilian assistance value remains unclear given the lack of stated project goals, implementation strategies, or measures of effectiveness. To facilitate transparency and policy discussion, we recommend project proposals include hypotheses as to how they will enhance US security, their relevance to the public sector they address, and outcome and impact indicators that can assess their value and effectiveness.

Systematic review of the cost-effectiveness of sample size maintenance programs in studies involving postal questionnaires reveals insufficient economic information.

PubMed

David, Michael C; Bensink, Mark; Higashi, Hideki; Boyd, Roslyn; Williams, Lesley; Ware, Robert S

2012-10-01

To identify and assess the existing cost-effectiveness evidence for sample size maintenance programs. Articles were identified by searching Cochrane Central Register of Controlled Trials Embase, CINAHL, PubMed, and Web of Science from 1966 to July 2011. Randomized controlled trials in which investigators evaluated program cost-effectiveness in postal questionnaires were eligible for inclusion. Fourteen studies from 13 articles, with 11,165 participants met the inclusion criteria. Thirty-one distinct programs were identified; each incorporated at least one strategy (reminders, incentives, modified questionnaires, or types of postage) aimed at minimizing attrition. Reminders, in the form of replacement questionnaires and cards, were the most commonly used strategies, with 15 and 11 studies reporting their usage, respectively. All strategies improved response, with financial incentives being the most costly. Heterogeneity between studies was too great to allow for meta-analysis of the results. The implementation of strategies such as no-obligation incentives, modified questionnaires, and personalized reply paid postage improved program cost-effectiveness. Analyses of attrition minimization programs need to consider both cost and effect in their evaluation. Copyright © 2012 Elsevier Inc. All rights reserved.

Implementing large-scale food fortification in Ghana: lessons learned.

PubMed

Nyumuah, Richard Odum; Hoang, Thuy-Co Caroline; Amoaful, Esi Foriwa; Agble, Rosanna; Meyer, Marc; Wirth, James P; Locatelli-Rossi, Lorenzo; Panagides, Dora

2012-12-01

Food fortification began in Ghana in 1996 when legislation was passed to enforce the iodization of salt. This paper describes the development of the Ghanaian fortification program and identifies lessons learned in implementing fortification initiatives (universal salt iodization, fortification of vegetable oil and wheat flour) from 1996 to date. This paper identifies achievements, challenges, and lessons learned in implementing large scale food fortification in Ghana. Primary data was collected through interviews with key members of the National Food Fortification Alliance (NFFA), implementation staff of the Food Fortification Project, and staff of GAIN. Secondary data was collected through desk review of documentation from the project offices of the National Food Fortification Project and the National Secretariat for the Implementation of the National Salt Iodization in Ghana. Reduction of the prevalence of goiter has been observed, and coverage of households with adequately iodized salt increased between 1996 and 2006. Two models were designed to increase production of adequately iodized salt: one to procure and distribute potassium iodate (KIO3) locally, and the second, the salt bank cooperative (SBC) model, specifically designed for small-scale artisanal salt farmers. This resulted in the establishment of a centralized potassium iodate procurement and distribution system, tailored to local needs and ensuring competitive and stable prices. The SBC model allowed for nearly 157 MT of adequately iodized salt to be produced in 2011 in a region where adequately iodized salt was initially not available. For vegetable oil fortification, implementing quantitative analysis methods for accurate control of added fortificant proved challenging but was overcome with the use of a rapid test device, confirming that 95% of vegetable oil is adequately fortified in Ghana. However, appropriate compliance with national standards on wheat flour continues to pose challenges due to adverse sensory effects, which have led producers to reduce the dosage of premix in wheat flour. Challenges to access to premix experienced by small producers can be overcome with a central procurement model in which the distributor leverages the overall volume by tendering for a consolidated order. The SBC model has the potential to be expanded and to considerably increase the coverage of the population consuming iodized salt in Ghana. Successful implementation of the cost-effective iCheck CHROMA rapid test device should be replicated in other countries where quality control of fortified vegetable oil is a challenge, and extended to additional food vehicles, such as wheat flour and salt. Only a reduced impact on iron deficiency in Ghana can be expected, given the low level of fortificant added to the wheat flour. An integrated approach, with complementary programs including additional iron-fortified food vehicles, should be explored to maximize health impact.

Forest productivity: an integrated research and development program

Treesearch

Daniel C. Dey; Thomas R. Crow; Don E. Riemenschneider

2003-01-01

In 2000, the North Central Research Station initiated the Forest Productivity Integrated Research Program (North Central Research Station 2001). This program combines the efforts of scientists from across the Station's 13 research work units to examine the current condition of the forests in the North Central Region and their prospects for producing wood and fiber...

[Strive, plan and reach the "Summit": the Faculty Development Program at the Ruth & Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology].

PubMed

Castel, Orit Cohen; Nave, Rachel; Ganor, Margalit; Hasson-Gilad, Dalia R; Brika, Riva

2010-04-01

In recent years, faculty development has turned into a central component of medical education and a primary instrument in qualifying physicians to be teachers and educators. The faculty development program at the Ruth & Bruce Rappaport Faculty of Medicine ("Summit" program) was established in order to improve teaching of the clinical professions, to create a community of medical teachers and educators and to develop leadership in medical education within the Faculty of Medicine. This article aims to describe the design, implementation and evaluation of the faculty development program in the Technion's Faculty of Medicine. The program was designed for a group of 20 clinical teachers, of various clinical professions, who had gained at least one year of undergraduate teaching experience and wished to develop a career in medical education. The program included seven monthly, eight-hour meetings throughout the academic year. Learning was based on small group discussions, interactive exercises, role-plays and simulations, self-directed reading and reflective writing. At the end of the final meeting, participants completed an evaluation form. Seventeen of the 20 participants (85%) graduated and received certificates. Learners' overall satisfaction was high. Graduates expressed high motivation to practice medical education within the Faculty of Medicine and reported that they gained new knowledge in medical education and skills regarding various aspects of teaching and learning, such as formulation of learning objectives, designing role plays, and providing effective feedback. The "Summit" program is an innovative initiative in the field of medical education in Israel. The program had a significant impact on participants' knowledge, teaching skills and attitudes. In order to ensure implementation of the acquired tools and skills, its shortterm and long-term effects on teaching behavior and the learning climate have yet to be demonstrated. In addition, it is necessary to check if the program affected the faculty as an organization, promoted changes in curricula, teaching and evaluation methods.

Marketing to Develop the Premier Medical Brand in the Huaihai Economic Zone.

PubMed

Zhang, Peiying; Meng, Qingchao

2015-06-01

Based on the practices at Xuzhou Central Hospital, the authors analyzed the improvements in the healthcare quality and economic efficiency after implementing a brand marketing strategy. Using methods including questionnaires and business controlling means, we summarized that the improvements to the healthcare quality and economic efficiency after strategies were implemented in the areas of network, reputation, academic research, and public welfare. After the implementation of a brand marketing campaign, the medical service quality and brand reputation have been greatly improved. Meanwhile, a central hospital group was formed and gradually became the central healthcare provider in the Huaihai Economic Zone. The new marketing facilitated the drastic increase of medical service and brand reputation.

Measuring the Implementation Fidelity of Student Affairs Programs: A Critical Component of the Outcomes Assessment Cycle

ERIC Educational Resources Information Center

Gerstner, Jerusha J.; Finney, Sara J.

2013-01-01

Implementation fidelity assessment provides a means of measuring the alignment between the planned program and the implemented program. Unfortunately, the implemented program can differ from the planned program, resulting in ambiguous inferences about the planned program's effectiveness (i.e., it is uncertain if poor results are due to an…

Implementation Options For the Solar System Exploration Survey's "Jupiter Polar Orbiter with Probes" Mission

NASA Astrophysics Data System (ADS)

Spilker, T. R.

2002-09-01

In July of this year the National Academy of Science released a draft of its report, "New Frontiers in the Solar System: An Integrated Exploration Strategy," briefly describing the current state of solar system planetary science and the most important science objectives for the next decade (2003-2013). It includes a prioritized list of five mission concepts that might be flown as part of NASA's fledgling New Frontiers Program; each "concept" is more a list of science or measurement objectives than a full mission concept, since it does not specify implementation details in most cases. Number three on that list is the "Jupiter Polar Orbiter with Probes" ("JPOP") mission. This mission concept combines the strengths of previously described or proposed Jupiter missions into a single mission, and gains from the synergies of some of the newly-combined investigations. The primary science objectives are: 1. Determine if Jupiter has a central core 2. Determine the deep abundance of water (and other volatiles) 3. Measure Jupiter's deep winds 4. Determine the structure of Jupiter's dynamo magnetic field 5. Sample in situ Jupiter's polar magnetosphere This paper examines some of the implementation options for a JPOP mission, and gives relative advantages and disadvantages. Given the New Frontier Program's maximum cost to NASA of \\650M, plus an approx. \\120M cap on international contributions, implementing the full range of JPOP science objectives in a single New Frontiers mission may be challenging. This work was performed at the Jet Propulsion Laboratory / California Institute of Technology, under contract with the National Aeronautics and Space Administration.

Sustainability of teacher implementation of school-based mental health programs.

PubMed

Han, Susan S; Weiss, Bahr

2005-12-01

Evidence-based prevention and intervention programs are increasingly being implemented in schools and it therefore is becoming increasingly important to understand the complexities of program implementation under real-world conditions. Much research has focused on the contextual factors that influence program implementation but less work has attempted to provide an integrated understanding of mechanisms (e.g., teacher-training processes) that affect teachers' program implementation. In this paper, we review literature on factors related to teachers' implementation of school-based prevention and intervention programs, then from this review abstract what we believe are four basic ingredients that characterize potentially sustainable teacher-implemented classroom programs. Finally, we present a sequential model, based on these ingredients, of the naturalistic processes underlying sustainability of teachers' program implementation and describe how this sustainability can be enhanced through provision of teacher training and performance feedback from a classroom consultant.

Dissemination of an innovative mastery learning curriculum grounded in implementation science principles: a case study.

PubMed

McGaghie, William C; Barsuk, Jeffrey H; Cohen, Elaine R; Kristopaitis, Theresa; Wayne, Diane B

2015-11-01

Dissemination of a medical education innovation, such as mastery learning, from a setting where it has been used successfully to a new and different medical education environment is not easy. This article describes the uneven yet successful dissemination of a simulation-based mastery learning (SBML) curriculum on central venous catheter (CVC) insertion for internal medicine and emergency medicine residents across medical education settings. The dissemination program was grounded in implementation science principles. The article begins by describing implementation science which addresses the mechanisms of medical education and health care delivery. The authors then present a mastery learning case study in two phases: (1) the development, implementation, and evaluation of the SBML CVC curriculum at a tertiary care academic medical center; and (2) the dissemination of the SBML CVC curriculum to an academic community hospital setting. Contextual information about the drivers and barriers that affected the SBML CVC curriculum dissemination is presented. This work demonstrates that dissemination of mastery learning curricula, like all other medical education innovations, will fail without active educational leadership, personal contacts, dedication, hard work, rigorous measurement, and attention to implementation science principles. The article concludes by presenting a set of lessons learned about disseminating an SBML CVC curriculum across different medical education settings.

Dial-in flow cytometry data analysis.

PubMed

Battye, Francis L

2002-02-01

As listmode data files continue to grow larger, access via any kind of network connections becomes more and more trouble because of the enormous traffic generated. The limited speed of transmission via modem makes analysis almost impossible. This unit presents a solution to these problems, one that involves installation at the central storage facility of a small computer program called a Web servlet. Operating in concert with a Web server, the servlet assists the analysis by extracting the display array from the data file and organizing its transmission over the network to a remote client program that creates the data display. The author discusses a recent implementation of this solution and the results for model transmission of two typical data files. The system greatly speeds access to remotely stored data yet retains the flexibility of manipulation expected with local access.

Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

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

Hewes, Tom; Peeks, Brady

2013-11-01

The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in themore » manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50 percent over typical manufactured homes produced in the northwest.« less

Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

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

Hewes, Tom; Peeks, Brady

2013-11-01

The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in themore » manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50% over typical manufactured homes produced in the northwest.« less

Teachers' social representations on drug use in a secondary school.

PubMed

Martini, Jussara Gue; Furegato, Antonia Regina Ferreira

2008-01-01

Increased concern regarding drug abuse among adolescents contributes to the elaboration of prevention programs at schools. This investigation aims to know teachers' social representations, regarding drug abuse, in a secondary school in Florianopolis, SC, Brazil. A total of 16 teachers of the 5th to 8th grades participated in the study. Data were collected through associations elaborated by teachers in response to the expression: drugs use/abuse. The teacher's representations are organized around a central concept - the vulnerable other: a needy adolescent, who becomes drugs user, highlighting the family, everyday coping, and the school's (in)visibility in prevention actions, as factors related. The complexity of factors involving drugs production, distribution and its commercialization, demands the implementation of actions that go beyond the scopes of education and health. The elaboration of inter-sector prevention programs considering local characteristics is necessary.

Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment.

PubMed

Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R

2018-05-01

To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

Analysis of impact of general-purpose graphics processor units in supersonic flow modeling

NASA Astrophysics Data System (ADS)

Emelyanov, V. N.; Karpenko, A. G.; Kozelkov, A. S.; Teterina, I. V.; Volkov, K. N.; Yalozo, A. V.

2017-06-01

Computational methods are widely used in prediction of complex flowfields associated with off-normal situations in aerospace engineering. Modern graphics processing units (GPU) provide architectures and new programming models that enable to harness their large processing power and to design computational fluid dynamics (CFD) simulations at both high performance and low cost. Possibilities of the use of GPUs for the simulation of external and internal flows on unstructured meshes are discussed. The finite volume method is applied to solve three-dimensional unsteady compressible Euler and Navier-Stokes equations on unstructured meshes with high resolution numerical schemes. CUDA technology is used for programming implementation of parallel computational algorithms. Solutions of some benchmark test cases on GPUs are reported, and the results computed are compared with experimental and computational data. Approaches to optimization of the CFD code related to the use of different types of memory are considered. Speedup of solution on GPUs with respect to the solution on central processor unit (CPU) is compared. Performance measurements show that numerical schemes developed achieve 20-50 speedup on GPU hardware compared to CPU reference implementation. The results obtained provide promising perspective for designing a GPU-based software framework for applications in CFD.

Chinese Grain for Green Program led to highly increased soil organic carbon levels: A meta-analysis

PubMed Central

Song, Xinzhang; Peng, Changhui; Zhou, Guomo; Jiang, Hong; Wang, Weifeng

2014-01-01

The Grain for Green Program (GGP), initiated in 1999, is the largest ecological restoration project in central and western China. Here, for the first time, we performed a meta-analysis and found that the GGP largely increased the soil organic carbon (SOC). The SOC was increased by 48.1%, 25.4%, and 25.5% at soil depths of 0–20 cm, 20–40 cm, and 40–60 cm, respectively. Moreover, this carbon accumulation has significantly increased over time since GGP implementation. The carbon accumulation showed a significantly more active response to the GGP in the top 20 cm of soil than in the deeper soil layers. Conversion of cropland to forest could lead to significantly greater SOC accumulation than would the conversion of cropland to grassland. Conversion from cropland to woodland could lead to greater SOC accumulation than would the conversion to either shrubland or orchard. Our results suggest that the GGP implementation caused SOC to accumulate and that there remains a large potential for further accumulation of carbon in the soil, which will help to mitigate climate change in the near future. PMID:24675818

When good practices by water committees are not relevant: Sustainability of small water infrastructures in semi-arid mozambique

NASA Astrophysics Data System (ADS)

Ducrot, Raphaëlle

2017-12-01

This paper explores the contradiction between the need for large scale interventions in rural water supplies and the need for flexibility when providing support for community institutions, by investigating the implementation of the Mozambique - National Rural Water Supply and Sanitation Program in a semi-arid district of the Limpopo Basin. Our results showed that coordinated leadership by key committee members, and the level of village governance was more important for borehole sustainability than the normative functioning of the committee. In a context in which the centrality of leadership prevails over collective action the sustainability of rural water infrastructure derives from the ability of leaders to motivate the community to provide supplementary funding. This, in turn, depends on the added value to the community of the water points and on village politics. Any interventions that increased community conflicts, for example because of lack of transparency or unequitable access to the benefit of the intervention, weakened the coordination and the collective action capacity of the community and hence the sustainability of the infrastructures even if the intervention was not directly related to water access. These results stress the importance of the project/program implementation pathway.

A Sketch of the Taiwan Zebrafish Core Facility.

PubMed

You, May-Su; Jiang, Yun-Jin; Yuh, Chiou-Hwa; Wang, Chien-Ming; Tang, Chih-Hao; Chuang, Yung-Jen; Lin, Bo-Hung; Wu, Jen-Leih; Hwang, Sheng-Ping L

2016-07-01

In the past three decades, the number of zebrafish laboratories has significantly increased in Taiwan. The Taiwan Zebrafish Core Facility (TZCF), a government-funded core facility, was launched to serve this growing community. The Core Facility was built on two sites, one located at the National Health Research Institutes (NHRI, called Taiwan Zebrafish Core Facility at NHRI or TZeNH) and the other is located at the Academia Sinica (Taiwan Zebrafish Core Facility at AS a.k.a. TZCAS). The total surface area of the TZCF is about 180 m(2) encompassing 2880 fish tanks. Each site has a separate quarantine room and centralized water recirculating systems, monitoring key water parameters. To prevent diseases, three main strategies have been implemented: (1) imported fish must be quarantined; (2) only bleached embryos are introduced into the main facilities; and (3) working practices were implemented to minimize pathogen transfer between stocks and facilities. Currently, there is no health program in place; however, a fourth measure for the health program, specific regular pathogen tests, is being planned. In March 2015, the TZCF at NHRI has been AAALAC accredited. It is our goal to ensure that we provide "disease-free" fish and embryos to the Taiwanese research community.

Cross-Training Laboratory Animal Care Personnel in Physically Separate Animal Facilities at a Land-Grant Institution.

PubMed

Henze, Tonja M; Allison, Sarah O; Criley, Jennifer M; Myers, Sara J; Goodly, Lyndon J

2016-01-01

The University of Illinois at Urbana-Champaign maintains physically separated animal care facilities under centralized management by the Division of Animal Resources. As part of a land-grant institution, the animal care and use program operates several animal units in key locations for specific disciplines within the campus, all of which have the core mission to teach, conduct research, and engage in public service. Populations of research animals vary with the levels of research funding, the number of research investigators on staff, research direction, and animal availability. Accordingly, the requirement for animal care staffing in each unit may vary widely also. To best use the existing animal care staff and remain fiscally responsible, cross-training of staff was implemented to allow staff to travel from units with small animal populations to units with larger populations or short-term staffing shortages. Here we detail and describe the system we used to assess the needs for cross-training, identify the staff to train, and implement the training plan. We believe this information will assist other programs, particularly those with large or complex organization (for example, land-grant institutions) that experience similar fluctuations in animal use.

A combined MOIP-MCDA approach to building and screening atmospheric pollution control strategies in urban regions.

PubMed

Mavrotas, George; Ziomas, Ioannis C; Diakouaki, Danae

2006-07-01

This article presents a methodological approach for the formulation of control strategies capable of reducing atmospheric pollution at the standards set by European legislation. The approach was implemented in the greater area of Thessaloniki and was part of a project aiming at the compliance with air quality standards in five major cities in Greece. The methodological approach comprises two stages: in the first stage, the availability of several measures contributing to a certain extent to reducing atmospheric pollution indicates a combinatorial problem and favors the use of Integer Programming. More specifically, Multiple Objective Integer Programming is used in order to generate alternative efficient combinations of the available policy measures on the basis of two conflicting objectives: public expenditure minimization and social acceptance maximization. In the second stage, these combinations of control measures (i.e., the control strategies) are then comparatively evaluated with respect to a wider set of criteria, using tools from Multiple Criteria Decision Analysis, namely, the well-known PROMETHEE method. The whole procedure is based on the active involvement of local and central authorities in order to incorporate their concerns and preferences, as well as to secure the adoption and implementation of the resulting solution.

Monitoring the tobacco use epidemic V: The environment: factors that influence tobacco use.

PubMed

Farrelly, Matthew C

2009-01-01

This environment paper (V of V) summarizes important surveillance and evaluation systems that monitor influences on tobacco use such as smoke-free laws and other legislation, excise taxes, mass media, and a broad range of tobacco control activities, discusses their strengths and weaknesses, and makes recommendations for enhancement. We summarize and expand on the recommendations from the Environment Working Group of the National Tobacco Monitoring, Research, and Evaluation Workshop prioritized surveillance needs. This group rank-ordered surveillance needs various environmental influences, considering both the perceived importance of each environmental influence and the adequacy of the current surveillance systems. Based on this ranking and subsequent discussion, the group identified key priorities for enhancement. The group arrived at two key priorities: (1) develop and implement a national system for local tobacco control ordinance surveillance, and (2) develop and implement a comprehensive program monitoring system that is used by all states and supported by all funding agencies. Other environmental influences recommended for priority monitoring include cigarette prices and tobacco countermarketing. Systematic surveillance and monitoring of key program inputs and outputs and environmental influences is central to understand the effectiveness and cost-effectiveness of tobacco control efforts.

A Combined MOIP-MCDA Approach to Building and Screening Atmospheric Pollution Control Strategies in Urban Regions

NASA Astrophysics Data System (ADS)

Mavrotas, George; Ziomas, Ioannis C.; Diakouaki, Danae

2006-07-01

This article presents a methodological approach for the formulation of control strategies capable of reducing atmospheric pollution at the standards set by European legislation. The approach was implemented in the greater area of Thessaloniki and was part of a project aiming at the compliance with air quality standards in five major cities in Greece. The methodological approach comprises two stages: in the first stage, the availability of several measures contributing to a certain extent to reducing atmospheric pollution indicates a combinatorial problem and favors the use of Integer Programming. More specifically, Multiple Objective Integer Programming is used in order to generate alternative efficient combinations of the available policy measures on the basis of two conflicting objectives: public expenditure minimization and social acceptance maximization. In the second stage, these combinations of control measures (i.e., the control strategies) are then comparatively evaluated with respect to a wider set of criteria, using tools from Multiple Criteria Decision Analysis, namely, the well-known PROMETHEE method. The whole procedure is based on the active involvement of local and central authorities in order to incorporate their concerns and preferences, as well as to secure the adoption and implementation of the resulting solution.

A Collaborative Knowledge Plane for Autonomic Networks

NASA Astrophysics Data System (ADS)

Mbaye, Maïssa; Krief, Francine

Autonomic networking aims to give network components self-managing capabilities. Several autonomic architectures have been proposed. Each of these architectures includes sort of a knowledge plane which is very important to mimic an autonomic behavior. Knowledge plane has a central role for self-functions by providing suitable knowledge to equipment and needs to learn new strategies for more accuracy.However, defining knowledge plane's architecture is still a challenge for researchers. Specially, defining the way cognitive supports interact each other in knowledge plane and implementing them. Decision making process depends on these interactions between reasoning and learning parts of knowledge plane. In this paper we propose a knowledge plane's architecture based on machine learning (inductive logic programming) paradigm and situated view to deal with distributed environment. This architecture is focused on two self-functions that include all other self-functions: self-adaptation and self-organization. Study cases are given and implemented.

QMCPACK: an open source ab initio quantum Monte Carlo package for the electronic structure of atoms, molecules and solids.

PubMed

Kim, Jeongnim; Baczewski, Andrew T; Beaudet, Todd D; Benali, Anouar; Bennett, M Chandler; Berrill, Mark A; Blunt, Nick S; Borda, Edgar Josué Landinez; Casula, Michele; Ceperley, David M; Chiesa, Simone; Clark, Bryan K; Clay, Raymond C; Delaney, Kris T; Dewing, Mark; Esler, Kenneth P; Hao, Hongxia; Heinonen, Olle; Kent, Paul R C; Krogel, Jaron T; Kylänpää, Ilkka; Li, Ying Wai; Lopez, M Graham; Luo, Ye; Malone, Fionn D; Martin, Richard M; Mathuriya, Amrita; McMinis, Jeremy; Melton, Cody A; Mitas, Lubos; Morales, Miguel A; Neuscamman, Eric; Parker, William D; Pineda Flores, Sergio D; Romero, Nichols A; Rubenstein, Brenda M; Shea, Jacqueline A R; Shin, Hyeondeok; Shulenburger, Luke; Tillack, Andreas F; Townsend, Joshua P; Tubman, Norm M; Van Der Goetz, Brett; Vincent, Jordan E; Yang, D ChangMo; Yang, Yubo; Zhang, Shuai; Zhao, Luning

2018-05-16

QMCPACK is an open source quantum Monte Carlo package for ab initio electronic structure calculations. It supports calculations of metallic and insulating solids, molecules, atoms, and some model Hamiltonians. Implemented real space quantum Monte Carlo algorithms include variational, diffusion, and reptation Monte Carlo. QMCPACK uses Slater-Jastrow type trial wavefunctions in conjunction with a sophisticated optimizer capable of optimizing tens of thousands of parameters. The orbital space auxiliary-field quantum Monte Carlo method is also implemented, enabling cross validation between different highly accurate methods. The code is specifically optimized for calculations with large numbers of electrons on the latest high performance computing architectures, including multicore central processing unit and graphical processing unit systems. We detail the program's capabilities, outline its structure, and give examples of its use in current research calculations. The package is available at http://qmcpack.org.

Partitioning of centralized integrated flight/propulsion control design for decentralized implementation

NASA Technical Reports Server (NTRS)

Garg, Sanjay

1993-01-01

The notion of partitioning a centralized controller into a decentralized, hierarchical structure suitable for integrated flight/propulsion control (IFPC) implementation is discussed. A systematic procedure is developed for determining partitioned airframe and engine subsystem controllers (subcontrollers), with the desired interconnection structure, that approximate the closed-loop performance and robustness characteristics of a given centralized controller. The procedure is demonstrated by application to IFPC design for a short take-off and vertical landing (STOVL) aircraft in the landing-approach-to-hover-transition flight phase.

Policy and Administrative Issues for Large-Scale Clinical Interventions Following Disasters

PubMed Central

Cobham, Vanessa E.; McDermott, Brett

2014-01-01

Abstract Objective: Large, programmatic mental health intervention programs for children and adolescents following disasters have become increasingly common; however, little has been written about the key goals and challenges involved. Methods: Using available data and the authors' experiences, this article reviews the factors involved in planning and implementing large-scale treatment programs following disasters. Results: These issues include funding, administration, choice of clinical targets, workforce selection, choice of treatment modalities, training, outcome monitoring, and consumer uptake. Ten factors are suggested for choosing among treatment modalities: 1) reach (providing access to the greatest number), 2) retention of patients, 3) privacy, 4) parental involvement, 5) familiarity of the modality to clinicians, 6) intensity (intervention type matches symptom acuity and impairment of patient), 7) burden to the clinician (in terms of time, travel, and inconvenience), 8) cost, 9) technology needs, and 10) effect size. Traditionally, after every new disaster, local leaders who have never done so before have had to be recruited to design, administer, and implement programs. Conclusion: As expertise in all of these areas represents a gap for most local professionals in disaster-affected areas, we propose that a central, nongovernmental agency with national or international scope be created that can consult flexibly with local leaders following disasters on both overarching and specific issues. We propose recommendations and point out areas in greatest need of innovation. PMID:24521227

PROGRAMMED LEARNING IN CENTRAL AFRICAN CONTEXTS.

ERIC Educational Resources Information Center

HAWKRIDGE, D.G.

SINCE 1964, THE PROGRAMMED LEARNING CENTRE AT THE UNIVERSITY COLLEGE OF RHODESIA HAS BEEN INVESTIGATING THE POTENTIALITIES OF PROGRAMED LEARNING FOR CENTRAL AFRICA THROUGH A SERIES OF CONTROLLED EXPERIMENTS USING LOCALLY-WRITTEN AND PUBLISHED PROGRAMS. ASSESSMENT OF THE DESIRABILITY AND USEFULNESS OF PROGRAMS IN TEACHING, AND ASSESSMENT OF THEIR…

Creating an infrastructure for training in the responsible conduct of research: the University of Pittsburgh's experience.

PubMed

Barnes, Barbara E; Friedman, Charles P; Rosenberg, Jerome L; Russell, Joanne; Beedle, Ari; Levine, Arthur S

2006-02-01

In response to public concerns about the consequences of research misconduct, academic institutions have become increasingly cognizant of the need to implement comprehensive, effective training in the responsible conduct of research (RCR) for faculty, staff, students, and external collaborators. The ability to meet this imperative is challenging as universities confront declining financial resources and increasing complexity of the research enterprise. The authors describe the University of Pittsburgh's design, implementation, and evaluation of a Web-based, institution-wide RCR training program called Research and Practice Fundamentals (RPF). This project, established in 2000, was embedded in the philosophy, organizational structure, and technology developed through the Integrated Advanced Information Management Systems grant from the National Library of Medicine. Utilizing a centralized, comprehensive approach, the RPF system provides an efficient mechanism for deploying content to a large, diverse cohort of learners and supports the needs of research administrators by providing access to information about who has successfully completed the training. During its first 3 years of operation, the RPF served over 17,000 users and issued more than 38,000 training certificates. The 18 modules that are currently available address issues required by regulatory mandates and other content areas important to the research community. RPF users report high levels of satisfaction with content and ease of using the system. Future efforts must explore methods to integrate non-RCR education and training into a centralized, cohesive structure. The University of Pittsburgh's experience with the RPF demonstrates the importance of developing an infrastructure for training that is comprehensive, scalable, reliable, centralized, affordable, and sustainable.

A New Campus Built on Efficiency

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

Harding, Ari; Mercado, Andrea; Regnier, Cindy

2015-08-01

The University of California (UC), Merced partnered with the U.S. Department of Energy (DOE) to develop and implement solutions to reduce energy consumption by as part of DOE’s Commercial Buildings Partnerships (CBP) Program. Lawrence Berkeley National Laboratory (LBNL) provided technical expertise in support of this DOE program. This case study reports on the process and outcome of this project including the achieved savings from design improvements for the campus. The intent of the project was to retrofit the Science & Engineering (S&E) building and the central plant at UC Merced to achieve up to 30% energy reduction. The anticipated savingsmore » from these retrofits represented about 17% of whole-campus energy use. If achieved, the savings contribution from the CBP project would have brought overall campus performance to 56% of the 1999 UC/CSU benchmark performance for their portfolio of buildings. However, the final design that moved forward as part of the CBP program only included the retrofit measures for the S&E building.« less

Clinical performance improvement series. Classic CQI integrated with comprehensive disease management as a model for performance improvement.

PubMed

Joshi, M S; Bernard, D B

1999-08-01

In recent years, health and disease management has emerged as an effective means of delivering, integrating, and improving care through a population-based approach. Since 1997 the University of Pennsylvania Health System (UPHS) has utilized the key principles and components of continuous quality improvement (CQI) and disease management to form a model for health care improvement that focuses on designing best practices, using best practices to influence clinical decision making, changing processes and systems to deploy and deliver best practices, and measuring outcomes to improve the process. Experience with 28 programs and more than 14,000 patients indicates significant improvement in outcomes, including high physician satisfaction, increased patient satisfaction, reduced costs, and improved clinical process and outcome measures across multiple diseases. DIABETES DISEASE MANAGEMENT: In three months a UPHS multidisciplinary diabetes disease management team developed a best practice approach for the treatment of all patients with diabetes in the UPHS. After the program was pilot tested in three primary care physician sites, it was then introduced progressively to additional practice sites throughout the health system. The establishment of the role of the diabetes nurse care managers (certified diabetes educators) was central to successful program deployment. Office-based coordinators ensure incorporation of the best practice protocols into routine flow processes. A disease management intranet disseminates programs electronically. Outcomes of the UPHS health and disease management programs so far demonstrate success across multiple dimensions of performance-service, clinical quality, access, and value. The task of health care leadership today is to remove barriers and enable effective implementation of key strategies, such as health and disease management. Substantial effort and resources must be dedicated to gain physician buy-in and achieve compliance. The challenge is to provide leadership support, to reward and recognize best practice performers, and to emphasize the use of data for feedback and improvement. As these processes are implemented successfully, and evidence of improved outcomes is documented, it is likely that this approach will be more widely embraced and that organizationwide performance improvement will increase significantly. Health care has traditionally invested extraordinary resources in developing best practice approaches, including guidelines, education programs, or other tangible products and services. Comparatively little time, effort, and resources have been targeted to implementation and use, the stage at which most efforts fail. CQI's emphasis on data, rapid diffusion of innovative programs, and rapid cycle improvements enhance the implementation and effectiveness of disease management.

Innovation in survivor care: group visits.

PubMed

Trotter, Kathryn; Frazier, Alana; Hendricks, Colleen K; Scarsella, Heidi

2011-04-01

The Centering Cancer Survivorship (CCS) follow-up care program is an innovation in healthcare delivery that meets the needs of cancer survivors and cancer centers. Piloted in a breast cancer clinic, the program provides an avenue for provision of psychological support and health-promotion activities, as well as surveillance for recurrence or late effects. The program empowers each survivor by enlisting her to produce a written breast cancer survivorship care plan for personal use and to share with her primary care provider. Concurrently, this innovation should enhance the viability of the primary cancer center by freeing appointment slots for oncologists who provide expensive therapies to newly diagnosed patients. The CCS program's central feature is the implementation of a multidisciplinary clinic designated specifically for breast cancer survivors in which follow-up care is provided through a group visit medical model. This model of care provides opportunities for health assessment, patient empowerment, and patient education within a framework of social support from peers with similar issues. The group visit model may be well suited to addressing the unique chronic healthcare needs of breast cancer survivors. Further evaluation is needed to verify cost-benefit analysis.

Evolution of Diabetes Care in Hong Kong: From the Hong Kong Diabetes Register to JADE-PEARL Program to RAMP and PEP Program.

PubMed

Ng, Ivy H Y; Cheung, Kitty K T; Yau, Tiffany T L; Chow, Elaine; Ozaki, Risa; Chan, Juliana C N

2018-03-01

The rapid increase in diabetes prevalence globally has contributed to large increases in health care expenditure on diabetic complications, posing a major health burden to countries worldwide. Asians are commonly observed to have poorer β-cell function and greater insulin resistance compared to the Caucasian population, which is attributed by their lower lean body mass and central obesity. This "double phenotype" as well as the rising prevalence of young onset diabetes in Asia has placed Asians with diabetes at high risk of cardiovascular and renal complications, with cancer emerging as an important cause of morbidity and mortality. The experience from Hong Kong had demonstrated that a multifaceted approach, involving team-based integrated care, information technological advances, and patient empowerment programs were able to reduce the incidence of diabetic complications, hospitalizations, and mortality. System change and public policies to enhance implementation of such programs may provide solutions to combat the burgeoning health problem of diabetes at a societal level. Copyright © 2018 Korean Endocrine Society.

The Mark 3 data base handler

NASA Technical Reports Server (NTRS)

Ryan, J. W.; Ma, C.; Schupler, B. R.

1980-01-01

A data base handler which would act to tie Mark 3 system programs together is discussed. The data base handler is written in FORTRAN and is implemented on the Hewlett-Packard 21MX and the IBM 360/91. The system design objectives were to (1) provide for an easily specified method of data interchange among programs, (2) provide for a high level of data integrity, (3) accommodate changing requirments, (4) promote program accountability, (5) provide a single source of program constants, and (6) provide a central point for data archiving. The system consists of two distinct parts: a set of files existing on disk packs and tapes; and a set of utility subroutines which allow users to access the information in these files. Users never directly read or write the files and need not know the details of how the data are formatted in the files. To the users, the storage medium is format free. A user does need to know something about the sequencing of his data in the files but nothing about data in which he has no interest.

Interdisciplinary collaboration to maintain a culture of safety in a labor and delivery setting.

PubMed

Burke, Carol; Grobman, William; Miller, Deborah

2013-01-01

A culture of safety is a growing movement in obstetrical healthcare quality and management. Patient-centered and safe care is a primary priority for all healthcare workers, with communication and teamwork central to achieving optimal maternal health outcomes. A mandatory educational program was developed and implemented by physicians and nurses to sustain awareness and compliance to current protocols within a large university-based hospital. A didactic portion reviewing shoulder dystocia, operative vaginal delivery, obstetric hemorrhage, and fetal monitoring escalation was combined with a simulation session. The simulation was a fetal bradycardia activating the decision to perform an operative vaginal delivery complicated by a shoulder dystocia. More than 370 members of the healthcare team participated including obstetricians, midwives, the anesthesia team, and nurses. Success of the program was measured by an evaluation tool and comparing results from a prior safety questionnaire. Ninety-seven percent rated the program as excellent, and the response to a question on perception of overall grade on patient safety measured by the Agency for Healthcare Research and Quality safety survey demonstrated a significant improvement in the score (P = .003) following the program.

Methicillin-resistant Staphylococcus aureus prevention practices in hospitals throughout a rural state.

PubMed

McDanel, Jennifer S; Ward, Melissa A; Leder, Laurie; Schweizer, Marin L; Dawson, Jeffrey D; Diekema, Daniel J; Smith, Tara C; Chrischilles, Elizabeth A; Perencevich, Eli N; Herwaldt, Loreen A

2014-08-01

The Institute for Healthcare Improvement (IHI) created an evidence-based bundle to help reduce methicillin-resistant Staphylococcus aureus (MRSA) health care-associated infections. The study aim was to identify which components of the IHI's MRSA bundle that rural hospitals have implemented and to identify barriers that hindered implementation of bundle components. Four surveys about the IHI's MRSA bundle were administered at the Iowa Statewide Infection Prevention Seminar between 2007 and 2011. Surveys were mailed to infection preventionists (IPs) who did not attend the meetings. The percentage of IPs reporting that their hospital implemented a hand hygiene program (range by year, 87%-94%) and used contact precautions for patients infected (range by year, 97%-100%) or colonized (range by year, 77%-92%) with MRSA did not change significantly. The number of hospitals that monitored the effectiveness of environmental cleaning significantly increased from 23%-71% (P < .01). Few hospitals assessed daily if central lines were necessary (range by year, 22%-26%). IPs perceived lack of support to be a major barrier to implementing bundle components. Most IPs reported that their hospitals had implemented most components of the MRSA bundle. Support within the health care system is essential for implementing each component of an evidence-based bundle. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Program Implementers' Evaluation of the Project P.A.T.H.S.: Findings Based on Different Datasets over Time

PubMed Central

Shek, Daniel T. L.; Ma, Cecilia M. S.

2012-01-01

This paper integrates the evaluation findings based on program implementers in nine datasets collected from 2005 to 2009 (244 schools and 7,926 implementers). Using consolidated data with schools as the unit of analysis, results showed that program implementers generally had positive perceptions of the program, themselves, and benefits of the program, with more than four-fifths of the implementers regarding the program as beneficial to the program participants. The subjective outcome evaluation instrument was found to be internally consistent. Multiple regression analyses revealed that perceived qualities of the program and program implementers predicted perceived effectiveness of the program. In conjunction with evaluation findings based on other sources, the present study provides support for the effectiveness of the Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in Hong Kong. PMID:22629224

Communications, Immunization, and Polio Vaccines: Lessons From a Global Perspective on Generating Political Will, Informing Decision-Making and Planning, and Engaging Local Support.

PubMed

Menning, Lisa; Garg, Gaurav; Pokharel, Deepa; Thrush, Elizabeth; Farrell, Margaret; Kodio, Frederic Kunjbe; Veira, Chantal Laroche; Wanyoike, Sarah; Malik, Suleman; Patel, Manish; Rosenbauer, Oliver

2017-07-01

The requirements under objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018-to introduce at least 1 dose of inactivated poliomyelitis vaccine (IPV); withdraw oral poliomyelitis vaccine (OPV), starting with the type 2 component; and strengthen routine immunization programs-set an ambitious series of targets for countries. Effective implementation of IPV introduction and the switch from trivalent OPV (containing types 1, 2, and 3 poliovirus) to bivalent OPV (containing types 1 and 3 poliovirus) called for intense global communications and coordination on an unprecedented scale from 2014 to 2016, involving global public health technical agencies and donors, vaccine manufacturers, World Health Organization and United Nations Children's Fund regional offices, and national governments. At the outset, the new program requirements were perceived as challenging to communicate, difficult to understand, unrealistic in terms of timelines, and potentially infeasible for logistical implementation. In this context, a number of core areas of work for communications were established: (1) generating awareness and political commitment via global communications and advocacy; (2) informing national decision-making, planning, and implementation; and (3) in-country program communications and capacity building, to ensure acceptance of IPV and continued uptake of OPV. Central to the communications function in driving progress for objective 2 was its ability to generate a meaningful policy dialogue about polio vaccines and routine immunization at multiple levels. This included efforts to facilitate stakeholder engagement and ownership, strengthen coordination at all levels, and ensure an iterative process of feedback and learning. This article provides an overview of the global efforts and challenges in successfully implementing the communications activities to support objective 2. Lessons from the achievements by countries and partners will likely be drawn upon when all OPVs are completely withdrawn after polio eradication, but also may offer a useful model for other global health initiatives. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries.

PubMed

Ballif, M; Nhandu, V; Wood, R; Dusingize, J C; Carter, E J; Cortes, C P; McGowan, C C; Diero, L; Graber, C; Renner, L; Hawerlander, D; Kiertiburanakul, S; Du, Q T; Sterling, T R; Egger, M; Fenner, L

2014-11-01

Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons. To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries. We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs. Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages. Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.

Advances and Challenges in Genomic Selection for Disease Resistance.

PubMed

Poland, Jesse; Rutkoski, Jessica

2016-08-04

Breeding for disease resistance is a central focus of plant breeding programs, as any successful variety must have the complete package of high yield, disease resistance, agronomic performance, and end-use quality. With the need to accelerate the development of improved varieties, genomics-assisted breeding is becoming an important tool in breeding programs. With marker-assisted selection, there has been success in breeding for disease resistance; however, much of this work and research has focused on identifying, mapping, and selecting for major resistance genes that tend to be highly effective but vulnerable to breakdown with rapid changes in pathogen races. In contrast, breeding for minor-gene quantitative resistance tends to produce more durable varieties but is a more challenging breeding objective. As the genetic architecture of resistance shifts from single major R genes to a diffused architecture of many minor genes, the best approach for molecular breeding will shift from marker-assisted selection to genomic selection. Genomics-assisted breeding for quantitative resistance will therefore necessitate whole-genome prediction models and selection methodology as implemented for classical complex traits such as yield. Here, we examine multiple case studies testing whole-genome prediction models and genomic selection for disease resistance. In general, whole-genome models for disease resistance can produce prediction accuracy suitable for application in breeding. These models also largely outperform multiple linear regression as would be applied in marker-assisted selection. With the implementation of genomic selection for yield and other agronomic traits, whole-genome marker profiles will be available for the entire set of breeding lines, enabling genomic selection for disease at no additional direct cost. In this context, the scope of implementing genomics selection for disease resistance, and specifically for quantitative resistance and quarantined pathogens, becomes a tractable and powerful approach in breeding programs.

Preparation for practice in family medicine: before and after duty hours.

PubMed

Carek, Peter J; Diaz, Vanessa; Dickerson, Lori M; Peterson, Lars; Johnson, Sharleen

2012-09-01

In July of 2003, the Accreditation Council for Graduate Medical Education (ACGME) adopted requirements limiting the duty hours of resident physicians. The impact of these restrictions on education and patient care activities is not clear. The purpose of this study is to examine the perception of graduates of family medicine residency programs immediately prior to and following implementation of duty hours regarding preparedness to practice and board certification status, as well as current patient care activities. Surveys of graduates of family medicine residency programs in South Carolina were conducted. Preparation for practice and professional activities of program graduates prior to (1999--2003) and following (2005--2009) implementation of duty hours were compared. Response rates were 54.4% and 53.1%, respectively. No significant differences by survey years in the average age, gender, or race was noted. Recent graduates felt as well prepared for practice in most curricular areas except surgery (OR=0.50 [0.27, 0.91]) and performed similar procedures with the following exceptions: central line placement (OR=0.32 [0.11, 0.95]), flexible sigmoidoscopy (OR=0.12 [0.02, 0.80]), ICU care (OR=0.39 [0.22, 0.70]), and ventilator management (OR=0.54 [0.29, 0.99]). Higher proportion of recent graduates do not take after hours call (22.3% versus 8.6%). Similarly, fewer recent graduates care for patients in nursing homes (22.0% versus 44.9%) and hospitals (46.2% versus 68.0%). Implementation of resident duty hours appears to have little overall association with self-reported preparedness for practice. An association was noted in the patient care services and procedures performed.

A FAST POLYNOMIAL TRANSFORM PROGRAM WITH A MODULARIZED STRUCTURE

NASA Technical Reports Server (NTRS)

Truong, T. K.

1994-01-01

This program utilizes a fast polynomial transformation (FPT) algorithm applicable to two-dimensional mathematical convolutions. Two-dimensional convolution has many applications, particularly in image processing. Two-dimensional cyclic convolutions can be converted to a one-dimensional convolution in a polynomial ring. Traditional FPT methods decompose the one-dimensional cyclic polynomial into polynomial convolutions of different lengths. This program will decompose a cyclic polynomial into polynomial convolutions of the same length. Thus, only FPTs and Fast Fourier Transforms of the same length are required. This modular approach can save computational resources. To further enhance its appeal, the program is written in the transportable 'C' language. The steps in the algorithm are: 1) formulate the modulus reduction equations, 2) calculate the polynomial transforms, 3) multiply the transforms using a generalized fast Fourier transformation, 4) compute the inverse polynomial transforms, and 5) reconstruct the final matrices using the Chinese remainder theorem. Input to this program is comprised of the row and column dimensions and the initial two matrices. The matrices are printed out at all steps, ending with the final reconstruction. This program is written in 'C' for batch execution and has been implemented on the IBM PC series of computers under DOS with a central memory requirement of approximately 18K of 8 bit bytes. This program was developed in 1986.

Centralization and Experimentation in the Implementation of a National Monitoring and Evaluation System: The Experience of Malawi.

ERIC Educational Resources Information Center

Useem, Michael; Chipande, Graham

1991-01-01

To identify general principles of implementing a system of evaluation, the experience of Malawi in building a national system for agriculture is described. Applying principles of both centralization and decentralization and principles of trial and error has helped translate theories of evaluation into practice in Malawi. (SLD)

Lessons from the Field: Developing and Implementing the Qatar Student Assessment System, 2002-2006. Technical Report

ERIC Educational Resources Information Center

Gonzalez, Gabriella; Le, Vi-Nhuan; Broer, Markus; Mariano, Louis T.; Froemel, J. Enrique; Goldman, Charles A.; DaVanzo, Julie

2009-01-01

Qatar has recently positioned itself to be a leader in education. Central to the country's efforts is the implementation of reforms to its K-12 education system. Central to the reform initiatives was the development of internationally benchmarked curriculum standards in four subjects: Arabic, English as a foreign language, mathematics, and…

How Do Implementation Efforts Relate to Program Adherence? Examining the Role of Organizational, Implementer, and Program Factors

ERIC Educational Resources Information Center

Dariotis, Jacinda K.; Bumbarger, Brian K.; Duncan, Larissa G.; Greenberg, Mark T.

2008-01-01

Widespread replications of evidence-based prevention programs (EBPPs) prompt prevention scientists to examine program implementation adherence in real world settings. Based on Chen's model (1990), we identified five key factors of the implementation system and assessed which characteristics related to program adherence. The sample included 32…

Reducing hospital-acquired heel ulcer rates in an acute care facility: an evaluation of a nurse-driven performance improvement project.

PubMed

McElhinny, Mary Louise; Hooper, Christine

2008-01-01

A nurse-driven performance improvement project designed to reduce the incidence of hospital-acquired ulcers of the heel in an acute care setting was evaluated. This was a descriptive evaluative study using secondary data analysis. Data were collected in 2004, prior to implementation of the prevention project and compared to results obtained in 2006, after the project was implemented. Data were collected in a 172-bed, not-for-profit inpatient acute care facility in North Central California. All medical-surgical inpatients aged 18 years and older were included in the samples. Data were collected on 113 inpatients prior to implementation of the project in 2004. Data were also collected on a sample of 124 inpatients in 2006. The prevalence and incidence of heel pressure ulcers were obtained through skin surveys prior to implementation of the prevention program and following its implementation. Results from 2004 were compared to data collected in 2006 after introduction of the Braden Scale for Predicting Pressure Sore Risk. Heel pressure ulcers were staged using the National Pressure Ulcer Advisory Panel (NPUAP) staging system and recommendations provided by the Agency for Health Care Quality Research (AHRQ) clinical practice guidelines. The incidence of hospital-acquired heel pressure ulcers in 2004 was 13.5% (4 of 37 patients). After implementation of the program in 2006, the incidence of hospital-acquired heel pressure ulcers was 13.8% (5 of 36 patients). The intervention did not appear to receive adequate staff nurse support needed to make the project successful. Factors that influenced the lack of support may have included: (1) educational method used, (2) lack of organization approved, evidenced-based standardized protocols for prevention and treatment of heel ulcers, and (3) failure of facility management to convey the importance as well as their support for the project.

Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature.

PubMed

Wu, C-H; Kao, I-J; Hung, W-C; Lin, S-C; Liu, H-C; Hsieh, M-H; Bagga, S; Achra, M; Cheng, T-T; Yang, R-S

2018-06-01

Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023-$28,800 US dollars (USD) in Japan to $14,513-$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards.

Protecting breastfeeding in West and Central Africa: over 25 years of implementation of the International Code of Marketing of Breastmilk Substitutes.

PubMed

Sokol, Ellen; Clark, David; Aguayo, Victor M

2008-09-01

In 1981 the World Health Assembly (WHA) adopted the International Code of Marketing of Breastmilk Substitutes out of concern that inappropriate marketing of breastmilk substitutes was contributing to the alarming decline in breastfeeding worldwide and the increase in child malnutrition and mortality, particularly in developing countries. To document progress, challenges, and lessons learned in the implementation of the International Code in West and Central Africa. Data were obtained by literature review and interviews with key informants. Twelve of the 24 countries have laws, decrees, or regulations that implement all or most of the provisions of the Code, 6 countries have a draft law or decree that is awaiting government approval or have a government committee that is studying how best to implement the Code, 3 countries have a legal instrument that enacts a few provisions of the Code, and 3 countries have not taken any action to implement the Code. International declarations and initiatives for child nutrition and survival have provided impetus for national implementation of the Code. National action to regulate the marketing of breastmilk substitutes needs to be linked to national priorities for nutrition and child survival. A clearly defined scope is essential for effective implementation of national legislation. Leadership and support by health professionals is essential to endorse and enforce national legislation. Training on Code implementation is instrumental for national action; national implementation of the Code requires provisions and capacity to monitor and enforce the legislative framework and needs to be part of a multipronged strategy to advance national child nutrition and survival goals. Nations in West and Central Africa have made important progress in implementing the International Code. More than 25 years after its adoption by the WHA, the Code remains as important as ever for child survival and development in West and Central Africa.

Crew resource management training within the automotive industry: does it work?

PubMed

Marquardt, Nicki; Robelski, Swantje; Hoeger, Rainer

2010-04-01

This article presents the development, implementation, and evaluation of a crew resource management (CRM) training program specifically designed for employees within the automotive industry. The central objective of this training program was to improve communication, teamwork, and stress management skills as well to increase the workers' situational awareness of potential errors that can occur during the production process. Participants in the training program of this study were 80 employees, all of whom were working in a production unit for gearbox manufacturing. Effectiveness of the CRM training course was evaluated two times (1 month and 6 months after the training program). The results showed a significant improvement in a wide range of CRM-relevant categories, especially in teamwork-related attitudes, in addition to an increase in the workers' situational awareness after the training program. On the basis of the results, it can be stated that CRM training, which was originally developed for the aviation industry, can be transferred to the automotive industry. However, because of the lack of behavioral observations, these effects are limited to CRM attitudes and knowledge changes. Several recommendations for future research and training development in the field of human factors training are made.

GRAM-86 - FOUR DIMENSIONAL GLOBAL REFERENCE ATMOSPHERE MODEL

NASA Technical Reports Server (NTRS)

Johnson, D.

1994-01-01

The Four-D Global Reference Atmosphere program was developed from an empirical atmospheric model which generates values for pressure, density, temperature, and winds from surface level to orbital altitudes. This program can be used to generate altitude profiles of atmospheric parameters along any simulated trajectory through the atmosphere. The program was developed for design applications in the Space Shuttle program, such as the simulation of external tank re-entry trajectories. Other potential applications would be global circulation and diffusion studies, and generating profiles for comparison with other atmospheric measurement techniques, such as satellite measured temperature profiles and infrasonic measurement of wind profiles. The program is an amalgamation of two empirical atmospheric models for the low (25km) and the high (90km) atmosphere, with a newly developed latitude-longitude dependent model for the middle atmosphere. The high atmospheric region above 115km is simulated entirely by the Jacchia (1970) model. The Jacchia program sections are in separate subroutines so that other thermosphericexospheric models could easily be adapted if required for special applications. The atmospheric region between 30km and 90km is simulated by a latitude-longitude dependent empirical model modification of the latitude dependent empirical model of Groves (1971). Between 90km and 115km a smooth transition between the modified Groves values and the Jacchia values is accomplished by a fairing technique. Below 25km the atmospheric parameters are computed by the 4-D worldwide atmospheric model of Spiegler and Fowler (1972). This data set is not included. Between 25km and 30km an interpolation scheme is used between the 4-D results and the modified Groves values. The output parameters consist of components for: (1) latitude, longitude, and altitude dependent monthly and annual means, (2) quasi-biennial oscillations (QBO), and (3) random perturbations to partially simulate the variability due to synoptic, diurnal, planetary wave, and gravity wave variations. Quasi-biennial and random variation perturbations are computed from parameters determined by various empirical studies and are added to the monthly mean values. The UNIVAC version of GRAM is written in UNIVAC FORTRAN and has been implemented on a UNIVAC 1110 under control of EXEC 8 with a central memory requirement of approximately 30K of 36 bit words. The GRAM program was developed in 1976 and GRAM-86 was released in 1986. The monthly data files were last updated in 1986. The DEC VAX version of GRAM is written in FORTRAN 77 and has been implemented on a DEC VAX 11/780 under control of VMS 4.X with a central memory requirement of approximately 100K of 8 bit bytes. The GRAM program was originally developed in 1976 and later converted to the VAX in 1986 (GRAM-86). The monthly data files were last updated in 1986.

The utilization of parallel processing in solving the inviscid form of the average-passage equation system for multistage turbomachinery

NASA Technical Reports Server (NTRS)

Mulac, Richard A.; Celestina, Mark L.; Adamczyk, John J.; Misegades, Kent P.; Dawson, Jef M.

1987-01-01

A procedure is outlined which utilizes parallel processing to solve the inviscid form of the average-passage equation system for multistage turbomachinery along with a description of its implementation in a FORTRAN computer code, MSTAGE. A scheme to reduce the central memory requirements of the program is also detailed. Both the multitasking and I/O routines referred to in this paper are specific to the Cray X-MP line of computers and its associated SSD (Solid-state Storage Device). Results are presented for a simulation of a two-stage rocket engine fuel pump turbine.

Implementing Immediate Postpartum Long-Acting Reversible Contraception Programs.

PubMed

Hofler, Lisa G; Cordes, Sarah; Cwiak, Carrie A; Goedken, Peggy; Jamieson, Denise J; Kottke, Melissa

2017-01-01

To understand the most important steps required to implement immediate postpartum long-acting reversible contraception (LARC) programs in different Georgia hospitals and the barriers to implementing such a program. This was a qualitative study. We interviewed 32 key personnel from 10 Georgia hospitals working to establish immediate postpartum LARC programs. Data were analyzed using directed qualitative content analysis principles. We used the Stages of Implementation to organize participant-identified key steps for immediate postpartum LARC into an implementation guide. We compared this guide to hospitals' implementation experiences. At the completion of the study, LARC was available for immediate postpartum placement at 7 of 10 study hospitals. Participants identified common themes for the implementation experience: team member identification and ongoing communication, payer preparedness challenges, interdependent department-specific tasks, and piloting with continuing improvements. Participants expressed a need for anticipatory guidance throughout the process. Key first steps to immediate postpartum LARC program implementation were identifying project champions, creating an implementation team that included all relevant departments, obtaining financial reassurance, and ensuring hospital administration awareness of the project. Potential barriers included lack of knowledge about immediate postpartum LARC, financial concerns, and competing clinical and administrative priorities. Hospitals that were successful at implementing immediate postpartum LARC programs did so by prioritizing clear communication and multidisciplinary teamwork. Although the implementation guide reflects a comprehensive assessment of the steps to implementing immediate postpartum LARC programs, not all hospitals required every step to succeed. Hospital teams report that implementing immediate postpartum LARC programs involves multiple departments and a number of important steps to consider. A stage-based approach to implementation, and a standardized guide detailing these steps, may provide the necessary structure for the complex process of implementing immediate postpartum LARC programs in the hospital setting.

Design of CIAO, a research program to support the development of an integrated approach to prevent overweight and obesity in the Netherlands.

PubMed

van Koperen, Marije Tm; van der Kleij, Rianne Mjj; Renders, Carry Cm; Crone, Matty Mr; Hendriks, Anna-Marie Am; Jansen, Maria M; van de Gaar, Vivian Vm; Raat, Hein Jh; Ruiter, Emilie Elm; Molleman, Gerard Grm; Schuit, Jantine Aj; Seidell, Jacob Jc

2014-01-01

The aim of this paper is to describe the research aims, concepts and methods of the research Consortium Integrated Approach of Overweight (CIAO). CIAO is a concerted action of five Academic Collaborative Centres, local collaborations between academic institutions, regional public health services, local authorities and other relevant sectors in the Netherlands. Prior research revealed lacunas in knowledge of and skills related to five elements of the integrated approach of overweight prevention in children (based upon the French EPODE approach), namely political support, parental education, implementation, social marketing and evaluation. CIAO aims to gain theoretical and practical insight of these elements through five sub-studies and to develop, based on these data, a framework for monitoring and evaluation. For this research program, mixed methods are used in all the five sub-studies. First, problem specification through literature research and consultation of stakeholders, experts, health promotion specialists, parents and policy makers will be carried out. Based on this information, models, theoretical frameworks and practical instruments will be developed, tested and evaluated in the communities that implement the integrated approach to prevent overweight in children. Knowledge obtained from these studies and insights from experts and stakeholders will be combined to create an evaluation framework to evaluate the integrated approach at central, local and individual levels that will be applicable to daily practice. This innovative research program stimulates sub-studies to collaborate with local stakeholders and to share and integrate their knowledge, methodology and results. Therefore, the output of this program (both knowledge and practical tools) will be matched and form building blocks of a blueprint for a local evidence- and practice-based integrated approach towards prevention of overweight in children. The output will then support various communities to further optimize the implementation and subsequently the effects of this approach.

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

Dear, Jody

DOE grant DE-SC0005904 was allocated to fund the faculty development, curriculum development and travel to support the four institutions of the Connecticut State University System’s (CSUS) Initiative for Nanotechnology-related Equipment, Faculty Development and Curriculum Development. DOE grant DE-SC0005072 was also awarded for this program. In 2010, CSUS had identified the establishment of nanotechnology programs and infrastructure as a priority. At that time, the system set the goal of establishing an academic initiative in nanotechnology for the CSUS, beginning with the development of a series of courses at the graduate level. Implementation was planned via a collaborative effort including faculty frommore » all four of the CSUS campuses. The CSUS Nanotechnology Working Group [CSUS NWG] was established to accomplish this goal. A faculty member from the Physics Department at Southern Connecticut State University [SCSU] was assigned the task of organizing and coordinating the work of the CSUS NWG. Representatives from each of the four CSUS campuses were appointed to join the CSUS NWG with the following initial representation: SCSU [Physics and Biology], Western Connecticut State University (WCSU) [Chemistry], Eastern Connecticut State University (ECSU) [Chemistry] and Central Connecticut State University (CCSU) [Chemistry. As a further outcome it was determined that this collaborative effort would lead to the establishment of a formal nanotechnology center, serving as the nucleus of CSUS student and faculty learning and research. This CSUS Nanotechnology Center [CSUS-NC] was to be located at Southern Connecticut State University (SCSU). The goal of this grant was to provide funding for curriculum and faculty development necessary to facilitate the development and implementation of a collaborative Graduate Certificate in Nanotechnology for the Connecticut State University System. This outcome has been successfully achieved. The courses and structure of the Graduate Certificate program have been developed and approved and the program will be completely implemented in the fall of 2013. The Nanotechnology Center will be recognized as the CSCU Center for Nanotechnology and will thus impact both the CSUS and Connecticut Community College Systems.« less

Food Safety Programs Based on HACCP Principles in School Nutrition Programs: Implementation Status and Factors Related to Implementation

ERIC Educational Resources Information Center

Stinson, Wendy Bounds; Carr, Deborah; Nettles, Mary Frances; Johnson, James T.

2011-01-01

Purpose/Objectives: The objectives of this study were to assess the extent to which school nutrition (SN) programs have implemented food safety programs based on Hazard Analysis and Critical Control Point (HACCP) principles, as well as factors, barriers, and practices related to implementation of these programs. Methods: An online survey was…

Population perspective is widening. Interview: Louise Lassonde.

PubMed

1992-01-01

Commentary is provided on the link between poverty and population growth, the link between population growth and the environment, solutions in general and at the village level, integrated programs, urban growth, and critical policies. Developing countries do recognize that rural poverty is part of the cycle of urban migration and population dynamics. Poverty also must be treated separately from population growth issues. An important issue is the reproductive health of women, their economic opportunities, and empowerment in decision making and access to information. Another important issue is the link between human species survival and the biosphere. Both issues need to be addressed and there is no contradiction between the issues; each is reinforcing of the other in policy. At the village level improving the personal, social, and environmental gains for women in villages with high fertility and soil erosion, deforestation, and water shortages serves both concerns. Programmatically, this means more information for women, better reproductive health services for women, improved social services, tree planting programs, water use programs, and environmental protection programs. Central planning is needed, but also decentralization in implementation and decision making. Urban population growth does not lend itself to ready-made solutions. The positive is that it offers modernization and the possibility of improved social services; the negative is how to provide the services. Both population dynamics and underlying infrastructure and urban management must work together. Recommendations are 3-fold. 1) Technology, the production/consumption process, and population dynamics are the major driving forces of environmental change. 2) The planning approach needs to be reconsidered: population dynamics and implications must be integrated at every level of planning. 3) Policies that recognize the aforementioned points will induce political will to implement activities and programs.

Results-Based Financing in Mozambique’s Central Medical Store: A Review After 1 Year

PubMed Central

Spisak, Cary; Morgan, Lindsay; Eichler, Rena; Rosen, James; Serumaga, Brian; Wang, Angela

2016-01-01

ABSTRACT Background: Public health commodity supply chains are typically weak in low-income countries, partly because they have many disparate yet interdependent functions and components. Approaches to strengthening supply chains in such settings have often fallen short—they address technical weaknesses, but not the incentives that motivate staff to perform better. Methods: We reviewed the first year of a results-based financing (RBF) program in Mozambique, which began in January 2013. The program aimed to improve the performance of the central medical store—Central de Medicamentos e Artigos Medicos (CMAM)—by realigning incentives. We completed in-depth interviews and focus group discussions with 33 key informants, including representatives from CMAM and donor agencies, and collected quantitative data on performance measures and use of funds. Implementation: The RBF agreement linked CMAM performance payments to quarterly results on 5 performance indicators related to supply planning, distribution planning, and warehouse management. RBF is predicated on the theory that a combination of carrot and stick—i.e., shared financial incentives, plus increased accountability for results—will spur changes in behavior. Important design elements: (1) indicators were measured against quarterly targets, and payments were made only for indicators that met those targets; (2) targets were set based on documented performance, at levels that could be reasonably attained, yet pushed for improvement; (3) payment was shared with and dependent on all staff, encouraging teamwork and collaboration; (4) results were validated by verifiable data sources; and (5) CMAM had discretion over how to use the funds. Findings: We found that CMAM’s performance continually improved over baseline and that CMAM achieved many of its performance targets, for example, timely submission of quarterly supply and distribution planning reports. Warehouse indicators, such as inventory management and order fulfillment, proved more challenging but were nonetheless positive. By linking payments to periodic verified results, and giving CMAM discretion over how to spend the funds, the RBF agreement motivated the workforce; focused attention on results; strengthened data collection; encouraged teamwork and innovation; and ultimately strengthened the central supply chain. Conclusion: Policy makers and program managers can use performance incentives to catalyze and leverage existing investments. To further strengthen the approach, such incentive programs can shift attention from quantity to quality indicators, improve verification processes, and aim to institutionalize the approach. PMID:27016552

Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.

PubMed

Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth

2018-05-10

Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by implementers and recipients alike can inform future dissemination and implementation efforts of CBIM. Further, by pinpointing where and how coaches were successful in implementing the program and what resonated with athletes, can help better understand how CBIM is effective in promoting athletes to stop violence against women and girls. Coach and athlete reflections on CBIM implementation provide insights for optimizing future program delivery and dissemination.

Implementation of evidence-informed practice through central network actors; a case study of three public health units in Canada.

PubMed

Yousefi Nooraie, Reza; Marin, Alexandra; Hanneman, Robert; Lohfeld, Lynne; Dobbins, Maureen

2017-03-15

Workforce development is an important aspect of evidence-informed decision making (EIDM) interventions. The social position of individuals in formal and informal social networks, and the relevance of formal roles in relation to EIDM are important factors identifying key EIDM players in public health organizations. We assessed the role of central actors in information sharing networks in promoting the adoption of EIDM by the staff of three public health units in Canada, over a two-year period during which an organization-wide intervention was implemented. A multi-faceted and tailored intervention to train select staff applying research evidence in practice was implemented in three public health units in Canada from 2011 to 2013. Staff (n = 572) were asked to identify those in the health unit whom they turned to get help using research in practice, whom they considered as experts in EIDM, and friends. We developed multi-level linear regression models to predict the change in EIDM behavior scores predicted by being connected to peers who were central in networks and were engaged in the intervention. Only the group of highly engaged central actors who were connected to each other, and the staff who were not engaged in the intervention but were connected to highly engaged central actors significantly improved their EIDM behavior scores. Among the latter group, the staff who were also friends with their information sources showed a larger improvement in EIDM behavior. If engaged, central network actors use their formal and informal connections to promote EIDM. Central actors themselves are more likely to adopt EIDM if they communicate with each other. These social communications should be reinforced and supported through the implementation of training interventions as a means to promoting EIDM.

Genetic diversity and association mapping in the Colombian Central Collection of Solanum tuberosum L. Andigenum group using SNPs markers.

PubMed

Berdugo-Cely, Jhon; Valbuena, Raúl Iván; Sánchez-Betancourt, Erika; Barrero, Luz Stella; Yockteng, Roxana

2017-01-01

The potato (Solanum tuberosum L.) is the fourth most important crop food in the world and Colombia has one of the most important collections of potato germplasm in the world (the Colombian Central Collection-CCC). Little is known about its potential as a source of genetic diversity for molecular breeding programs. In this study, we analyzed 809 Andigenum group accessions from the CCC using 5968 SNPs to determine: 1) the genetic diversity and population structure of the Andigenum germplasm and 2) the usefulness of this collection to map qualitative traits across the potato genome. The genetic structure analysis based on principal components, cluster analyses, and Bayesian inference revealed that the CCC can be subdivided into two main groups associated with their ploidy level: Phureja (diploid) and Andigena (tetraploid). The Andigena population was more genetically diverse but less genetically substructured than the Phureja population (three vs. five subpopulations, respectively). The association mapping analysis of qualitative morphological data using 4666 SNPs showed 23 markers significantly associated with nine morphological traits. The present study showed that the CCC is a highly diverse germplasm collection genetically and phenotypically, useful to implement association mapping in order to identify genes related to traits of interest and to assist future potato genetic breeding programs.

Genetic diversity and association mapping in the Colombian Central Collection of Solanum tuberosum L. Andigenum group using SNPs markers

PubMed Central

Berdugo-Cely, Jhon; Valbuena, Raúl Iván; Sánchez-Betancourt, Erika; Barrero, Luz Stella

2017-01-01

The potato (Solanum tuberosum L.) is the fourth most important crop food in the world and Colombia has one of the most important collections of potato germplasm in the world (the Colombian Central Collection-CCC). Little is known about its potential as a source of genetic diversity for molecular breeding programs. In this study, we analyzed 809 Andigenum group accessions from the CCC using 5968 SNPs to determine: 1) the genetic diversity and population structure of the Andigenum germplasm and 2) the usefulness of this collection to map qualitative traits across the potato genome. The genetic structure analysis based on principal components, cluster analyses, and Bayesian inference revealed that the CCC can be subdivided into two main groups associated with their ploidy level: Phureja (diploid) and Andigena (tetraploid). The Andigena population was more genetically diverse but less genetically substructured than the Phureja population (three vs. five subpopulations, respectively). The association mapping analysis of qualitative morphological data using 4666 SNPs showed 23 markers significantly associated with nine morphological traits. The present study showed that the CCC is a highly diverse germplasm collection genetically and phenotypically, useful to implement association mapping in order to identify genes related to traits of interest and to assist future potato genetic breeding programs. PMID:28257509

Toward the Development of a Sustainable Scientific Research Culture in Azerbaijan (2011-2015).

PubMed

Aliyeva, Saida; Flanagan, Peter; Johnson, April; Strelow, Lisa

2016-01-01

This review especially describes the dangerous pathogens research program in Azerbaijan (AJ) funded by the US Defense Threat Reduction Agency under the Cooperative Biological Engagement Program (CBEP) from 2011 through 2015. The objectives of the CBEP are to prevent the proliferation of biological weapons; to consolidate and secure collections of dangerous pathogens in central repositories; to strengthen biosafety and biosecurity of laboratory facilities; and to improve partner nations' ability to detect, diagnose, report, and respond to outbreaks of disease caused by especially dangerous pathogens. One of the missions of the CBEP is therefore to increase the research skills and proficiency of partner country scientists. The program aims to fulfill this mission by sponsoring scientific research projects that exercise the modern diagnostic techniques available in the CBEP-engaged laboratories and the enhanced disease surveillance/control programs. To strengthen the local scientists' ability to develop research ideas, write grant proposals, and conduct research independently, in-country CBEP integrating contractor personnel have mentored scientists across AJ and conducted workshops to address technical gaps. As a result of CBEP engagement, seven research projects developed and led by AJ scientists have been funded, and five projects are currently in various stages of implementation. The Defense Threat Reduction Agency has also sponsored AJ scientist participation at international scientific conferences to introduce and integrate them into the global scientific community. The efforts summarized in this review represent the first steps in an ongoing process that will ultimately provide AJ scientists with the skills and resources to plan and implement research projects of local and regional relevance.

A Strategic Approach for Developing an Advanced Practice Workforce: From Postgraduate Transition-to-Practice Fellowship Programs and Beyond.

PubMed

Taylor, Dennis A; Broyhill, Britney S; Burris, Allison M; Wilcox, Mary Ann

The healthcare provider landscape is rapidly changing. Given the imminent retirement of baby boomer physicians, implementation of the Affordable Care Act, and the increased utilization of health care services by an ever-aging population, the supply of providers cannot keep pace with the demand for services. This has led to an increased utilization of advanced clinical practitioners (ACPs). This article shows how one large highly-matrixed health care system approached identifying this workforce, and how thought leaders worked collaboratively with physicians, administrators, and ACPs to meet a growing demand for providers. Carolinas HealthCare System developed a 3-pronged approach to this opportunity. The development of a Center for Advanced Practice was explored and implemented. This Center serves as a 2-way conduit of information and ideas between system administrators and providers. It also serves as a central source of regulatory and practice information for administrators and providers. The growing number of open ACP positions, along with the reluctance to employ novice and new graduate ACPs, led to the development of a postgraduate transition to practice fellowship program. This program's clinical tracks and curriculum are described. Finally, a collaborative effort between the health care system and a local university resulted in the local offering of an acute care nurse practitioner program, which allowed system nurses to continue their education without the need for relocation. Higher satisfaction and engagement, lower turnover, better career opportunities, more satisfied administrators, and physicians all contributed to the overwhelming success of this initiative.

Development and implementation of a comprehensive strategic plan for medical education at an academic medical center.

PubMed

Schwartzstein, Richard M; Huang, Grace C; Coughlin, Christine M

2008-06-01

Despite their vital contributions to the training of future physicians, many academic teaching hospitals have grown operationally and financially distinct from affiliated medical schools because of divergent missions, contributing to the erosion of clinical training. Some institutions have responded by building hybrid organizations; others by creating large health care networks with variable relationships with the affiliated medical school. In this case, the authors wished to establish the future educational mission of their medical center as a core element of the institution by creating data-driven recommendations for reorganization, programs, and financing. They conducted a self-study of all constituents, the results of which confirmed the importance of education at their institution but also revealed the insufficiency of incentives for teaching. They underwent an external review by a committee of prominent educators, and they involved administrators at the hospital and the medical school. Together, these inputs composed an informed assessment of medical education at their teaching hospital, from which they developed and actualized an institution-wide strategic plan for education. Over the course of three years, they centralized the administrative structure for education, implemented programs that cross departments and reinforce the UME-GME continuum, and created transparency in the financing of medical education. The plan was purposefully aligned with the clinical and research strategic plans by supporting patient safety in programs and the professional development of faculty. The application of a rigorous strategic planning process to medical education at an academic teaching hospital can focus the mission, invigorate faculty, and lead to innovative programs.

A Faster Parallel Algorithm and Efficient Multithreaded Implementations for Evaluating Betweenness Centrality on Massive Datasets

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

Madduri, Kamesh; Ediger, David; Jiang, Karl

2009-05-29

We present a new lock-free parallel algorithm for computing betweenness centrality of massive small-world networks. With minor changes to the data structures, our algorithm also achieves better spatial cache locality compared to previous approaches. Betweenness centrality is a key algorithm kernel in the HPCS SSCA#2 Graph Analysis benchmark, which has been extensively used to evaluate the performance of emerging high-performance computing architectures for graph-theoretic computations. We design optimized implementations of betweenness centrality and the SSCA#2 benchmark for two hardware multithreaded systems: a Cray XMT system with the ThreadStorm processor, and a single-socket Sun multicore server with the UltraSparc T2 processor.more » For a small-world network of 134 million vertices and 1.073 billion edges, the 16-processor XMT system and the 8-core Sun Fire T5120 server achieve TEPS scores (an algorithmic performance count for the SSCA#2 benchmark) of 160 million and 90 million respectively, which corresponds to more than a 2X performance improvement over the previous parallel implementations. To better characterize the performance of these multithreaded systems, we correlate the SSCA#2 performance results with data from the memory-intensive STREAM and RandomAccess benchmarks. Finally, we demonstrate the applicability of our implementation to analyze massive real-world datasets by computing approximate betweenness centrality for a large-scale IMDb movie-actor network.« less

Optimal management of on-farm resources in small-scale dairy systems of Central Mexico: model development and evaluation.

PubMed

Castelán-Ortega, Octavio Alonso; Martínez-García, Carlos Galdino; Mould, Fergus L; Dorward, Peter; Rehman, Tahir; Rayas-Amor, Adolfo Armando

2016-06-01

This study evaluates the available on-farm resources of five case studies typified as small-scale dairy systems in central Mexico. A comprehensive mixed-integer linear programming model was developed and applied to two case studies. The optimal plan suggested the following: (1) instruction and utilization of maize silage, (2) alfalfa hay making that added US$140/ha/cut to the total net income, (3) allocation of land to cultivated pastures in a ratio of 27:41(cultivated pastures/maize crop) rather than at the current 14:69, and dairy cattle should graze 12 h/day, (4) to avoid grazing of communal pastures because this activity represented an opportunity cost of family labor that reduced the farm net income, and (5) that the highest farm net income was obtained when liquid milk and yogurt sales were included in the optimal plan. In the context of small-scale dairy systems of central Mexico, the optimal plan would need to be implemented gradually to enable farmers to develop required skills and to change management strategies from reliance on forage and purchased concentrate to pasture-based and conserved forage systems.

External quality-assurance programs managed by the U.S. Geological Survey in support of the National Atmospheric Deposition Program/National Trends Network

USGS Publications Warehouse

Latysh, Natalie E.; Wetherbee, Gregory A.

2005-01-01

The U.S. Geological Survey, Branch of Quality Systems, operates the external quality-assurance programs for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN). Beginning in 1978, six different programs have been implemented?the intersite-comparison program, the blind-audit program, the sample-handling evaluation program, the field-audit program, the interlaboratory-comparison program, and the collocated-sampler program. Each program was designed to measure error contributed by specific components in the data-collection process. The intersite-comparison program, which was discontinued in 2004, was designed to assess the accuracy and reliability of field pH and specific-conductance measurements made by site operators. The blind-audit and sample-handling evaluation programs, which also were discontinued in 2002 and 2004, respectively, assessed contamination that may result from sampling equipment and routine handling and processing of the wet-deposition samples. The field-audit program assesses the effects of sample handling, processing, and field exposure. The interlaboratory-comparison program evaluates bias and precision of analytical results produced by the contract laboratory for NADP, the Illinois State Water Survey, Central Analytical Laboratory, and compares its performance with the performance of international laboratories. The collocated-sampler program assesses the overall precision of wet-deposition data collected by NADP/NTN. This report documents historical operations and the operating procedures for each of these external quality-assurance programs. USGS quality-assurance information allows NADP/NTN data users to discern between actual environmental trends and inherent measurement variability.

Implementation of a central line maintenance care bundle in hospitalized pediatric oncology patients.

PubMed

Rinke, Michael L; Chen, Allen R; Bundy, David G; Colantuoni, Elizabeth; Fratino, Lisa; Drucis, Kim M; Panton, Stephanie Y; Kokoszka, Michelle; Budd, Alicia P; Milstone, Aaron M; Miller, Marlene R

2012-10-01

To investigate whether a multidisciplinary, best-practice central line maintenance care bundle reduces central line-associated blood stream infection (CLABSI) rates in hospitalized pediatric oncology patients and to further delineate the epidemiology of CLABSIs in this population. We performed a prospective, interrupted time series study of a best-practice bundle addressing all areas of central line care: reduction of entries, aseptic entries, and aseptic procedures when changing components. Based on a continuous quality improvement model, targeted interventions were instituted to improve compliance with each of the bundle elements. CLABSI rates and epidemiological data were collected for 10 months before and 24 months after implementation of the bundle and compared in a Poisson regression model. CLABSI rates decreased from 2.25 CLABSIs per 1000 central line days at baseline to 1.79 CLABSIs per 1000 central line days during the intervention period (incidence rate ratio [IRR]: 0.80, P = .58). Secondary analyses indicated CLABSI rates were reduced to 0.81 CLABSIs per 1000 central line days in the second 12 months of the intervention (IRR: 0.36, P = .091). Fifty-nine percent of infections resulted from Gram-positive pathogens, 37% of patients with a CLABSI required central line removal, and patients with Hickman catheters were more likely to have a CLABSI than patients with Infusaports (IRR: 4.62, P = .02). A best-practice central line maintenance care bundle can be implemented in hospitalized pediatric oncology patients, although long ramp-up times may be necessary to reap maximal benefits. Further research is needed to determine if this CLABSI rate reduction can be sustained and spread.

Performance and scalability evaluation of "Big Memory" on Blue Gene Linux.

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

Yoshii, K.; Iskra, K.; Naik, H.

2011-05-01

We address memory performance issues observed in Blue Gene Linux and discuss the design and implementation of 'Big Memory' - an alternative, transparent memory space introduced to eliminate the memory performance issues. We evaluate the performance of Big Memory using custom memory benchmarks, NAS Parallel Benchmarks, and the Parallel Ocean Program, at a scale of up to 4,096 nodes. We find that Big Memory successfully resolves the performance issues normally encountered in Blue Gene Linux. For the ocean simulation program, we even find that Linux with Big Memory provides better scalability than does the lightweight compute node kernel designed solelymore » for high-performance applications. Originally intended exclusively for compute node tasks, our new memory subsystem dramatically improves the performance of certain I/O node applications as well. We demonstrate this performance using the central processor of the LOw Frequency ARray radio telescope as an example.« less

Demonstration of the use of ADAPT to derive predictive maintenance algorithms for the KSC central heat plant

NASA Technical Reports Server (NTRS)

Hunter, H. E.

1972-01-01

The Avco Data Analysis and Prediction Techniques (ADAPT) were employed to determine laws capable of detecting failures in a heat plant up to three days in advance of the occurrence of the failure. The projected performance of algorithms yielded a detection probability of 90% with false alarm rates of the order of 1 per year for a sample rate of 1 per day with each detection, followed by 3 hourly samplings. This performance was verified on 173 independent test cases. The program also demonstrated diagnostic algorithms and the ability to predict the time of failure to approximately plus or minus 8 hours up to three days in advance of the failure. The ADAPT programs produce simple algorithms which have a unique possibility of a relatively low cost updating procedure. The algorithms were implemented on general purpose computers at Kennedy Space Flight Center and tested against current data.

Logistics support economy and efficiency through consolidation and automation

NASA Technical Reports Server (NTRS)

Savage, G. R.; Fontana, C. J.; Custer, J. D.

1985-01-01

An integrated logistics support system, which would provide routine access to space and be cost-competitive as an operational space transportation system, was planned and implemented to support the NSTS program launch-on-time goal of 95 percent. A decision was made to centralize the Shuttle logistics functions in a modern facility that would provide office and training space and an efficient warehouse area. In this warehouse, the emphasis is on automation of the storage and retrieval function, while utilizing state-of-the-art warehousing and inventory management technology. This consolidation, together with the automation capabilities being provided, will allow for more effective utilization of personnel and improved responsiveness. In addition, this facility will be the prime support for the fully integrated logistics support of the operations era NSTS and reduce the program's management, procurement, transportation, and supply costs in the operations era.

Religious Beliefs and Cancer Screening Behaviors among Catholic Latinos: Implications for Faith-based Interventions

PubMed Central

Allen, Jennifer D.; Leyva, Bryan; Torres, María Idalí; Ospino, Hosffman; Tom, Laura; Rustan, Sarah; Bartholomew, Amanda

2014-01-01

Although most U.S. Latinos identify as Catholic, few studies have focused on the influence of this religious tradition on health beliefs among this population. This study explores the role of Catholic religious teachings, practices, and ministry on cancer screening knowledge, attitudes and behaviors among Latinos. Eight focus groups were conducted with 67 Catholic Latino parishioners in Massachusetts. Qualitative analysis provided evidence of strong reliance on faith, God, and parish leaders for health concerns. Parishes were described as vital sources of health and social support, playing a central role in the community's health. Participants emphasized that their religious beliefs promote positive health behaviors and health care utilization, including the use of cancer screening services. In addition, they expressed willingness to participate in cancer education programs located at their parishes and provided practical recommendations for implementing health programs in parishes. Implications for culturally appropriate health communication and faith-based interventions are discussed. PMID:24858865

The ambiguities of performance-based governance reforms in Italy: Reviving the fortunes of evaluation and performance measurement.

PubMed

Marra, Mita

2018-08-01

Over the past two decades, Italy's administrative reforms have institutionalized evaluation to improve program effectiveness, staff productivity, and results-driven accountability against waste and corruption. Across ministries, regional governments, universities, schools and environmental protection agencies, seemingly unexpected consequences have emerged out of the implementation of performance measurement and evaluation regimes within public organizations. Formal compliance to legally binding evaluation procedures, judicially-sanctioned managerial accountability and lack of cross-agency coordination coupled with long-standing cultural separations among evaluators are some of the ambiguities associated with a performance-based governance system within Italian public administration. Building upon the 'new governane theory,' and qualitative fieldwork, I explore the political consequences of evaluation and performance measurement for possible improvements. From a normative perspective, greater integration between program evaluation and performance measurement can support organizational learning and democratic accountability both at the central and local level. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding direct neuronal reprogramming-from pioneer factors to 3D chromatin.

PubMed

Ninkovic, Jovica; Götz, Magdalena

2018-06-14

Cell replacement therapies aim at reestablishment of neuronal circuits after brain injury, stroke or neurodegeneration. Recently, direct reprogramming of resident glial cells into the affected neuronal subtypes has become a feasible and promising option for central nervous system regeneration. Direct reprogramming relies on the implementation of a new transcriptional program defining the desired neuronal identity in fully differentiated glial cells implying the more or less complete down-regulation of the program for the former identity of the glial cell. Despite the enormous progress achieved in this regard with highly efficient in vivo reprogramming after injury, a number of hurdles still need to be resolved. One way to further improve direct neuronal reprogramming is to understand the molecular hurdles which we discuss with the focus on chromatin states of the starting versus the reprogrammed cells. Copyright © 2018 Elsevier Ltd. All rights reserved.

Enzyme-free nucleic acid dynamical systems.

PubMed

Srinivas, Niranjan; Parkin, James; Seelig, Georg; Winfree, Erik; Soloveichik, David

2017-12-15

Chemistries exhibiting complex dynamics-from inorganic oscillators to gene regulatory networks-have been long known but either cannot be reprogrammed at will or rely on the sophisticated enzyme chemistry underlying the central dogma. Can simpler molecular mechanisms, designed from scratch, exhibit the same range of behaviors? Abstract chemical reaction networks have been proposed as a programming language for complex dynamics, along with their systematic implementation using short synthetic DNA molecules. We developed this technology for dynamical systems by identifying critical design principles and codifying them into a compiler automating the design process. Using this approach, we built an oscillator containing only DNA components, establishing that Watson-Crick base-pairing interactions alone suffice for complex chemical dynamics and that autonomous molecular systems can be designed via molecular programming languages. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Lay Navigator Model for Impacting Cancer Health Disparities

PubMed Central

Meade, Cathy D.; Wells, Kristen J.; Arevalo, Mariana; Calcano, Ercilia R.; Rivera, Marlene; Sarmiento, Yolanda; Freeman, Harold P; Roetzheim, Richard G.

2014-01-01

This paper recounts experiences, challenges, and lessons learned when implementing a lay patient navigator program to improve cancer care among medically underserved patients who presented in a primary care clinic with a breast or colorectal cancer abnormality. The program employed five lay navigators to navigate 588 patients. Central programmatic elements were: 1) use of bilingual lay navigators with familiarity of communities they served; 2) provision of training, education and supportive activities; 3) multidisciplinary clinical oversight that factored in caseload intensity; and 4) well-developed partnerships with community clinics and social service entities. Deconstruction of health care system information was fundamental to navigation processes. We conclude that a lay model of navigation is well suited to assist patients through complex health care systems; however, a stepped care model that includes both lay and professional navigation may be optimal to help patients across the entire continuum. PMID:24683043

Lay navigator model for impacting cancer health disparities.

PubMed

Meade, Cathy D; Wells, Kristen J; Arevalo, Mariana; Calcano, Ercilia R; Rivera, Marlene; Sarmiento, Yolanda; Freeman, Harold P; Roetzheim, Richard G

2014-09-01

This paper recounts experiences, challenges, and lessons learned when implementing a lay patient navigator program to improve cancer care among medically underserved patients who presented in a primary care clinic with a breast or colorectal cancer abnormality. The program employed five lay navigators to navigate 588 patients. Central programmatic elements were the following: (1) use of bilingual lay navigators with familiarity of communities they served; (2) provision of training, education, and supportive activities; (3) multidisciplinary clinical oversight that factored in caseload intensity; and (4) well-developed partnerships with community clinics and social service entities. Deconstruction of healthcare system information was fundamental to navigation processes. We conclude that a lay model of navigation is well suited to assist patients through complex healthcare systems; however, a stepped care model that includes both lay and professional navigation may be optimal to help patients across the entire continuum.

Characterizing implementation strategies using a systems engineering survey and interview tool: a comparison across 10 prevention programs for drug abuse and HIV sexual risk behavior.

PubMed

Czaja, Sara J; Valente, Thomas W; Nair, Sankaran N; Villamar, Juan A; Brown, C Hendricks

2016-05-17

Although many behavioral interventions have proven to be efficacious, new methodologies are required beyond efficacy trials to understand how to adopt, implement with fidelity, and sustain behavioral interventions in community settings. In this paper, we present a new approach, based on systems engineering concepts and methods, for characterizing implementation strategies that are used to deliver evidence-based behavioral interventions in health and social service settings. We demonstrate the use of this approach with implementation strategies, used or being used for broader dissemination of 10 evidence-based prevention program projects focused on the prevention of drug or HIV sex risk behaviors. The results indicate that there are wide variations in intervention approaches and that there are challenges in program implementation including maintaining program fidelity, serving community needs, and adequate resources. The results also indicate that implementation requires a committed partnership between the program developers, implementation researchers, and community partners. In addition, there is a need for adaptability within programs to meet community needs, resources, and priorities while maintaining program fidelity. Our methodological approach enabled us to highlight challenges associated with the community implementation of health risk prevention interventions. We also demonstrate how comprehensive descriptions of interventions facilitate understanding of the requirements of program implementation and decisions about the feasibility of implementing a program in community settings.

Using organization theory to understand the determinants of effective implementation of worksite health promotion programs.

PubMed

Weiner, Bryan J; Lewis, Megan A; Linnan, Laura A

2009-04-01

The field of worksite health promotion has moved toward the development and testing of comprehensive programs that target health behaviors with interventions operating at multiple levels of influence. Yet, observational and process evaluation studies indicate that such programs are challenging for worksites to implement effectively. Research has identified several organizational factors that promote or inhibit effective implementation of comprehensive worksite health promotion programs. However, no integrated theory of implementation has emerged from this research. This article describes a theory of the organizational determinants of effective implementation of comprehensive worksite health promotion programs. The model is adapted from theory and research on the implementation of complex innovations in manufacturing, education and health care settings. The article uses the Working Well Trial to illustrate the model's theoretical constructs. Although the article focuses on comprehensive worksite health promotion programs, the conceptual model may also apply to other types of complex health promotion programs. An organization-level theory of the determinants of effective implementation of worksite health promotion programs.

Sporting programs for inactive population groups: factors influencing implementation in the organized sports setting.

PubMed

Ooms, Linda; Veenhof, Cindy; Schipper-van Veldhoven, Nicolette; de Bakker, Dinny H

2015-01-01

The organized sports sector has received increased attention as a setting to promote health-enhancing physical activity (HEPA) to the general population. For significant public health impact, it is important that successful HEPA programs are widely adopted, implemented and continued as ongoing practice. The importance of evaluating the context in which programs are implemented has been identified as critical. However, little research has focused on understanding the organized sports implementation context, including factors facilitating and impeding implementation. In this study, the main factors influencing implementation of HEPA programs in the organized sports setting were studied. Fourteen sporting programs in the Netherlands aimed at increasing participation in sports by inactive population groups and funded within the National Action Plan for Sport and Exercise (NAPSE) were investigated. The programs were developed by ten Dutch National Sports Federations (NSFs) and implemented by different sports clubs in the Netherlands over a 3-year implementation period (June 2008-June 2011). The qualitative research component involved yearly face-to-face interviews (i.e. fourteen interviews each year, n = 12 program coordinators) and a group meeting with the program coordinators of the NSFs (n = 8). Cross-case comparisons and thematic analyses were performed to identify and categorize important facilitating and impeding factors respectively. The quantitative research component, used to identify the most important facilitating and impeding factors across all sporting programs, consisted of ranking of factors according to importance by the program coordinators (n = 12). Different factors act during six identified (implementation) phases. When comparing factors across phases, several key learnings were evident. Successful implementation relied, for example, on program design and enthusiastic individuals within sporting organizations. On the other hand, inactive people were hard to reach and participation of sports clubs was not self-evident. The findings were discussed in a broader context. This study adds to the knowledge base concerning the implementation of sporting programs, aimed at inactive people, in the organized sports setting. The main factors facilitating and impeding implementation were identified. The results of this study can be used by sports practitioners and policy makers when developing and implementing HEPA programs in this setting.

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.

A computer program for anisotropic shallow-shell finite elements using symbolic integration

NASA Technical Reports Server (NTRS)

Andersen, C. M.; Bowen, J. T.

1976-01-01

A FORTRAN computer program for anisotropic shallow-shell finite elements with variable curvature is described. A listing of the program is presented together with printed output for a sample case. Computation times and central memory requirements are given for several different elements. The program is based on a stiffness (displacement) finite-element model in which the fundamental unknowns consist of both the displacement and the rotation components of the reference surface of the shell. Two triangular and four quadrilateral elements are implemented in the program. The triangular elements have 6 or 10 nodes, and the quadrilateral elements have 4 or 8 nodes. Two of the quadrilateral elements have internal degrees of freedom associated with displacement modes which vanish along the edges of the elements (bubble modes). The triangular elements and the remaining two quadrilateral elements do not have bubble modes. The output from the program consists of arrays corresponding to the stiffness, the geometric stiffness, the consistent mass, and the consistent load matrices for individual elements. The integrals required for the generation of these arrays are evaluated by using symbolic (or analytic) integration in conjunction with certain group-theoretic techniques. The analytic expressions for the integrals are exact and were developed using the symbolic and algebraic manipulation language.

Identifying Strategies Programs Adopt to Meet Healthy Eating and Physical Activity Standards in Afterschool Programs.

PubMed

Weaver, Robert G; Moore, Justin B; Turner-McGrievy, Brie; Saunders, Ruth; Beighle, Aaron; Khan, M Mahmud; Chandler, Jessica; Brazendale, Keith; Randell, Allison; Webster, Collin; Beets, Michael W

2017-08-01

The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies' effectiveness. (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between strategy implementation and meeting Standards. HEPA was measured via accelerometer (moderate-to-vigorous-physical-activity [MVPA]) and direct observation (snacks served) in 20 ASPs. Strategies were identified and mapped onto a capacity building framework ( Strategies To Enhance Practice [STEPs]). Mixed-effects regression estimated increases in HEPA outcomes as implementation increased. Model-implied estimates were calculated for high (i.e., highest implementation score achieved), moderate (median implementation score across programs), and low (lowest implementation score achieved) implementation for both HEPA separately. Programs implemented a variety of strategies identified in STEPs. For every 1-point increase in implementation score 1.45% (95% confidence interval = 0.33% to 2.55%, p ≤ .001) more girls accumulated 30 min/day of MVPA and fruits and/or vegetables were served on 0.11 more days (95% confidence interval = 0.11-0.45, p ≤ .01). Relationships between implementation and other HEPA outcomes did not reach statistical significance. Still regression estimates indicated that desserts are served on 1.94 fewer days (i.e., 0.40 vs. 2.34) in the highest implementing program than the lowest implementing program and water is served 0.73 more days (i.e., 2.37 vs. 1.64). Adopting HEPA Standards at the national level does not lead to changes in routine practice in all programs. Practical strategies that programs could adopt to more fully comply with the HEPA Standards are identified.

Dissemination and Implementation Strategies of Lower Extremity Preventive Training Programs in Youth: A Clinical Review.

PubMed

DiStefano, Lindsay J; Frank, Barnett S; Root, Hayley J; Padua, Darin A

Neuromuscular preventive training programs effectively reduce injury and improve performance in youth athletes. However, program effectiveness is directly linked to program compliance, fidelity, and dosage. Preventive training programs are not widely adopted by youth sport coaches. One way to promote widespread dissemination and compliance is to identify implementation strategies that influence program adoption and maintenance. It is unknown how previously published programs have followed the elements of an implementation framework. The objective of this review was to evaluate how elements of the 7 steps of implementation, developed by Padua et al, have been performed in the evidence of lower extremity preventive training programs. A systematic review of the literature from 1996 through September 2016 was conducted using electronic databases. Investigations that documented implementation of a sport team-based neuromuscular preventive training program in youth athletes and measured lower extremity injury rates were included. Clinical review. Level 4. A total of 12 studies met the inclusion criteria and were reviewed. Information regarding the completion of any of the 7 steps within the implementation framework developed by Padua et al was extracted. None of the 12 articles documented completion of all 7 steps. While each study addressed some of the 7 steps, no study addressed maintenance or an exit strategy for youth athletes. Program implementation appears limited in obtaining administrative support, utilizing an interdisciplinary implementation team, and monitoring or promoting fidelity of the intervention. Despite strong evidence supporting the effectiveness of preventive training programs in youth athletes, there is a gap between short-term improvements and long-term implementation strategies. Future interventions should include all 7 steps of the implementation framework to promote transparent dissemination of preventive training programs.

Prevalence and Implementation Fidelity of Research-Based Prevention Programs in Public Schools. Final Report

ERIC Educational Resources Information Center

Crosse, Scott; Williams, Barbara; Hagen, Carol A.; Harmon, Michele; Ristow, Liam; DiGaetano, Ralph; Broene, Pamela; Alexander, Debbie; Tseng, Margaret; Derzon, James H.

2011-01-01

This report presents descriptive information about the prevalence and quality of implementation of research-based programs from the Study of the Implementation of Research-Based Programs to Prevent Youth Substance Abuse and School Crime. The study found that, while schools reported implementing a large number of prevention programs during the…

Meeting the Challenge: The National Cancer Institute's Central Institutional Review Board for Multi-Site Research.

PubMed

Massett, Holly A; Hampp, Sharon L; Goldberg, Jacquelyn L; Mooney, Margaret; Parreco, Linda K; Minasian, Lori; Montello, Mike; Mishkin, Grace E; Davis, Catasha; Abrams, Jeffrey S

2018-03-10

The National Institutes of Health (NIH) issued a new policy that requires a single institutional review board (IRB) of record be used for all protocols funded by the NIH that are carried out at more than one site in the United States, effective January 2018. This policy affects several hundred clinical trials opened annually across the NIH. Limited data exist to compare the use of a single IRB to that of multiple local IRBs, so some institutions are resistant to or distrustful of single IRBs. Since 2001, the National Cancer Institute (NCI) has funded a central IRB (CIRB) that provides human patient reviews for its extensive national cancer clinical trials program. This paper presents data to show the adoption, efficiencies gained, and satisfaction of the CIRB among NCI trial networks and reviews key lessons gleaned from 16 years of experience that may be informative for others charged with implementation of the new NIH single-IRB policy.

12 CFR 725.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ADMINISTRATION CENTRAL LIQUIDITY FACILITY § 725.1 Scope. This part contains the regulations implementing the National Credit Union Central Liquidity Facility Act, subchapter III of the Federal Credit Union Act. The National Credit Union Administration Central Liquidity Facility is a mixed-ownership Government corporation...

Do Program Implementation Factors or Fidelity Affect Chronic Disease Self-Management Education Programs' Outcomes?

PubMed

Brady, Teresa J; Murphy, Louise B; O'Colmain, Benita J; Hobson, Reeti Desai

2017-09-01

To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. Community. N = 10 792. Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. Meta-analysis using pooled effect sizes. Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing.... (4) A part 145 certificate holder who has your own drug testing program Obtain an Antidrug and...

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing... 145 certificate holder who has your own drug testing program Obtain an Antidrug and Alcohol Misuse...

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing... 145 certificate holder who has your own drug testing program Obtain an Antidrug and Alcohol Misuse...

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing... Specification, Letter of Authorization, or Drug and Alcohol Testing Program Registration from the FAA: If you...

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing... 145 certificate holder who has your own drug testing program Obtain an Antidrug and Alcohol Misuse...

Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda.

PubMed

Baker, Ulrika; Okuga, Monica; Waiswa, Peter; Manzi, Fatuma; Peterson, Stefan; Hanson, Claudia

2015-06-01

To identify and compare implementation bottlenecks for effective coverage of screening for syphilis, HIV, and anemia in antenatal care in rural Tanzania and Uganda; and explore the underlying determinants and perceived solutions to overcome these bottlenecks. In this multiple case study, we analyzed data collected as part of the Expanded Quality Management Using Information Power (EQUIP) project between November 2011 and April 2014. Indicators from household interviews (n=4415 mothers) and health facility surveys (n=122) were linked to estimate coverage in stages of implementation between which bottlenecks can be identified. Key informant interviews (n=15) were conducted to explore underlying determinants and analyzed using a framework approach. Large differences in implementation were found within and between countries. Availability and effective coverage was significantly lower for all tests in Uganda compared with Tanzania. Syphilis screening had the lowest availability and effective coverage in both countries. The main implementation bottleneck was poor availability of tests and equipment. Key informant interviews validated these findings and perceived solutions included the need for improved procurement at the central level. Our findings reinforce essential screening as a missed opportunity, caused by a lack of integration of funding and support for comprehensive antenatal care programs. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Telephone Counseling to Implement Best Parenting Practices to Prevent Adolescent Problem Behaviors

PubMed Central

Pierce, John P.; James, Lisa E.; Messer, Karen; Myers, Mark G.; Williams, Rebecca E.; Trinidad, Dennis R.

2008-01-01

There is considerable suggestive evidence that parents can protect their adolescents from developing problem behaviors if they implement recommended best parenting practices. These include providing appropriate limits on adolescent free time, maintaining a close personal relationship with the adolescent, and negotiating and providing incentives for positive behavior patterns. However, retention of the study samples has limited conclusions that can be drawn from published studies. This randomized controlled trial recruited and randomized a national population sample of 1036 families to an intensive parenting intervention using telephone counseling or to a no-contact control group. At enrollment, eligible families had an eldest child between the ages of 10–13 years. The intervention included an initial training program using a self-help manual with telephone counselor support. Implementation of best parenting practices was encouraged using quarterly telephone contacts and a family management check-up questionnaire. A computer-assisted structured counseling protocol was used to aid parents who needed additional assistance to implement best practices. This, along with a centralized service, enabled implementation of quality control procedures. Assessment of problem behavior is undertaken with repeated telephone interviews of the target adolescents. The study is powered to test whether the intervention encouraging parents to maintain best parenting practices is associated with a reduction of 25% in the incidence of problem behaviors prior to age 18 years and will be tested through a maximum likelihood framework. PMID:17964223

Good Ideas and Engagement Aren't Enough: School District Central Offices and the Micro-Politics of Implementing Comprehensive Human Resource Reform

ERIC Educational Resources Information Center

DeArmond, Michael

2013-01-01

This dissertation is about how organizational politics--or what some scholars call micro-politics--shapes the implementation of comprehensive human resource (HR) reform in school district central offices. Over the last decade, education reformers and advocates have promoted comprehensive HR reform as a way to improve teaching and learning in K-12…

An economic assessment of implementing streamside management zones in central Appalachian hardwood forests

Treesearch

Yaoxiang Li; Chris B. LeDoux; Jingxin Wang

2006-01-01

The effects of variable width of streamside management zones (25, 50, 75, and 100 ft) (SMZs) and removal level of trees (10%, 30%, and 50% of basal area) on production and cost of implementing SMZs in central Appalachian hardwood forests were simulated by using a computer model. Harvesting operations were performed on an 80-year-old generated natural hardwood stand...

Increasing Retention and Graduation Rates through a STEM Learning Community

ERIC Educational Resources Information Center

Dagley, Melissa; Georgiopoulos, Michael; Reece, Amber; Young, Cynthia

2016-01-01

The EXCEL Program began as a National Science Foundation-sponsored STEM Talent Expansion Program in 2006 and, because of its significant impact on retention of STEM majors, has since become an institutionalized program at the University of Central Florida. The University of Central Florida EXCEL Program annually recruits approximately 200…

Critical care procedure logging using handheld computers

PubMed Central

Carlos Martinez-Motta, J; Walker, Robin; Stewart, Thomas E; Granton, John; Abrahamson, Simon; Lapinsky, Stephen E

2004-01-01

Introduction We conducted this study to evaluate the feasibility of implementing an internet-linked handheld computer procedure logging system in a critical care training program. Methods Subspecialty trainees in the Interdepartmental Division of Critical Care at the University of Toronto received and were trained in the use of Palm handheld computers loaded with a customized program for logging critical care procedures. The procedures were entered into the handheld device using checkboxes and drop-down lists, and data were uploaded to a central database via the internet. To evaluate the feasibility of this system, we tracked the utilization of this data collection system. Benefits and disadvantages were assessed through surveys. Results All 11 trainees successfully uploaded data to the central database, but only six (55%) continued to upload data on a regular basis. The most common reason cited for not using the system pertained to initial technical problems with data uploading. From 1 July 2002 to 30 June 2003, a total of 914 procedures were logged. Significant variability was noted in the number of procedures logged by individual trainees (range 13–242). The database generated by regular users provided potentially useful information to the training program director regarding the scope and location of procedural training among the different rotations and hospitals. Conclusion A handheld computer procedure logging system can be effectively used in a critical care training program. However, user acceptance was not uniform, and continued training and support are required to increase user acceptance. Such a procedure database may provide valuable information that may be used to optimize trainees' educational experience and to document clinical training experience for licensing and accreditation. PMID:15469577

Inclusive blue swimming crab fishery management initiative in Betahwalang Demak, Indonesia

NASA Astrophysics Data System (ADS)

Ghofar, A.; Redjeki, S.; Madduppa, H.; Abbey, M.; Tasunar, N.

2018-02-01

There has been a growing interest in the sustainability of the blue swimming crab (Portunus pelagicus, BSC) fisheries in Indonesia. The fishery is operated on a small-scale basis and yet it significantly contributes to the Indonesia’s fisheries as the third biggest export commodities following tuna and shrimp. The project inclusively (i) brings together coastal and fishing communities, university, the private sector, government at various levels and international agencies, (ii) bottom up approach is integrated with top-down (government policy) approach and (iii) integration o f conservation into fisheries management. This approach resulted in better understanding and participation among the coastal fishing communities on sustainable fisheries and the necessity to perform fisheries management. This led to the establishment of BSC fishery management body (legally support by Village Regulation - No.06/2013 on BSC fishery management in 2013, followed by a District Regulation No.523/0166/2014 on BSC fishery management in 2014. More recently, the Governor of Central Java issued a Governor Regulation No. 33/2017 on Crab and Lobster fisheries management and a Governor Decree No. 523/93/2017 on the establishment of the BSC fisheries management committee in Central Java. Further impacts have been raised awareness in sustainable BSC fishery management in surrounding districts in other provinces, namely East Java and Southeast Sulawesi. There remains, further needs to strengthen fishery governance by means of integrating national and local government effort in sustaining the fisheries, including the Issuance and effective implementation of the provincial decree on BSC fishery management for Central Java, that will enable the use of province’s resource to implement fisheries management and strengthen law enforcement. To help improve the stock, a plan for stock enhancement should also be developed with proper monitoring program and community commitment to avoid “put and take” practices.

The impact of middle manager affective commitment on perceived improvement program implementation success.

PubMed

Fryer, Ashley-Kay; Tucker, Anita L; Singer, Sara J

Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success. We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment. We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units' falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success. Middle manager affective commitment to their unit's falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers' affective commitment to their unit's falls program mediates the relationship between perceived organizational support for the program and perceived implementation success. We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program. Increasing levels of middle manager affective commitment to an improvement program could strengthen program implementation success by facilitating frontline worker support for the program. Furthermore, providing the organizational support items in our survey construct may bolster middle manager affective commitment.

Culturally relevant inquiry-based laboratory module implementations in upper-division genetics and cell biology teaching laboratories.

PubMed

Siritunga, Dimuth; Montero-Rojas, María; Carrero, Katherine; Toro, Gladys; Vélez, Ana; Carrero-Martínez, Franklin A

2011-01-01

Today, more minority students are entering undergraduate programs than ever before, but they earn only 6% of all science or engineering PhDs awarded in the United States. Many studies suggest that hands-on research activities enhance students' interest in pursuing a research career. In this paper, we present a model for the implementation of laboratory research in the undergraduate teaching laboratory using a culturally relevant approach to engage students. Laboratory modules were implemented in upper-division genetics and cell biology courses using cassava as the central theme. Students were asked to bring cassava samples from their respective towns, which allowed them to compare their field-collected samples against known lineages from agricultural stations at the end of the implementation. Assessment of content and learning perceptions revealed that our novel approach allowed students to learn while engaged in characterizing Puerto Rican cassava. In two semesters, based on the percentage of students who answered correctly in the premodule assessment for content knowledge, there was an overall improvement of 66% and 55% at the end in the genetics course and 24% and 15% in the cell biology course. Our proposed pedagogical model enhances students' professional competitiveness by providing students with valuable research skills as they work on a problem to which they can relate.

Weight gain prevention in the school worksite setting: Results of a multi-level cluster randomized trial

PubMed Central

Lemon, Stephenie C.; Wang, Monica L.; Wedick, Nicole M.; Estabrook, Barbara; Druker, Susan; Schneider, Kristin L.; Li, Wenjun; Pbert, Lori

2014-01-01

Objective To describe the effectiveness, reach and implementation of a weight gain prevention intervention among public school employees. Method A multi-level intervention was tested in a cluster randomized trial among 782 employees in 12 central Massachusetts public high schools from 2009 to 2012. The intervention targeted the nutrition and physical activity environment and policies, the social environment and individual knowledge, attitudes and skills. The intervention was compared to a materials only condition. The primary outcome measures were change in weight and body mass index (BMI) at 24-month follow-up. Implementation of physical environment, policy and social environment strategies at the school and interpersonal levels, and intervention participation at the individual level were assessed. Results At 24-month follow-up, there was a net change (difference of the difference) of −3.03 pounds (p=.04) and of −.48 BMI units (p=.05) between intervention and comparison conditions. The majority of intervention strategies were successfully implemented by all intervention schools, although establishing formal policies was challenging. Employee participation in programs targeting the physical and social environment was maintained over time. Conclusion This study supports that a multi-level intervention integrated within the organizational culture can be successfully implemented and prevent weight gain in public high school employees. PMID:24345602

Accelerating Fibre Orientation Estimation from Diffusion Weighted Magnetic Resonance Imaging Using GPUs

PubMed Central

Hernández, Moisés; Guerrero, Ginés D.; Cecilia, José M.; García, José M.; Inuggi, Alberto; Jbabdi, Saad; Behrens, Timothy E. J.; Sotiropoulos, Stamatios N.

2013-01-01

With the performance of central processing units (CPUs) having effectively reached a limit, parallel processing offers an alternative for applications with high computational demands. Modern graphics processing units (GPUs) are massively parallel processors that can execute simultaneously thousands of light-weight processes. In this study, we propose and implement a parallel GPU-based design of a popular method that is used for the analysis of brain magnetic resonance imaging (MRI). More specifically, we are concerned with a model-based approach for extracting tissue structural information from diffusion-weighted (DW) MRI data. DW-MRI offers, through tractography approaches, the only way to study brain structural connectivity, non-invasively and in-vivo. We parallelise the Bayesian inference framework for the ball & stick model, as it is implemented in the tractography toolbox of the popular FSL software package (University of Oxford). For our implementation, we utilise the Compute Unified Device Architecture (CUDA) programming model. We show that the parameter estimation, performed through Markov Chain Monte Carlo (MCMC), is accelerated by at least two orders of magnitude, when comparing a single GPU with the respective sequential single-core CPU version. We also illustrate similar speed-up factors (up to 120x) when comparing a multi-GPU with a multi-CPU implementation. PMID:23658616

Culturally Relevant Inquiry-Based Laboratory Module Implementations in Upper-Division Genetics and Cell Biology Teaching Laboratories

PubMed Central

Siritunga, Dimuth; Montero-Rojas, María; Carrero, Katherine; Toro, Gladys; Vélez, Ana; Carrero-Martínez, Franklin A.

2011-01-01

Today, more minority students are entering undergraduate programs than ever before, but they earn only 6% of all science or engineering PhDs awarded in the United States. Many studies suggest that hands-on research activities enhance students’ interest in pursuing a research career. In this paper, we present a model for the implementation of laboratory research in the undergraduate teaching laboratory using a culturally relevant approach to engage students. Laboratory modules were implemented in upper-division genetics and cell biology courses using cassava as the central theme. Students were asked to bring cassava samples from their respective towns, which allowed them to compare their field-collected samples against known lineages from agricultural stations at the end of the implementation. Assessment of content and learning perceptions revealed that our novel approach allowed students to learn while engaged in characterizing Puerto Rican cassava. In two semesters, based on the percentage of students who answered correctly in the premodule assessment for content knowledge, there was an overall improvement of 66% and 55% at the end in the genetics course and 24% and 15% in the cell biology course. Our proposed pedagogical model enhances students’ professional competitiveness by providing students with valuable research skills as they work on a problem to which they can relate. PMID:21885825

An implementation of the programming structural synthesis system (PROSSS)

NASA Technical Reports Server (NTRS)

Rogers, J. L., Jr.; Sobieszczanski-Sobieski, J.; Bhat, R. B.

1981-01-01

A particular implementation of the programming structural synthesis system (PROSSS) is described. This software system combines a state of the art optimization program, a production level structural analysis program, and user supplied, problem dependent interface programs. These programs are combined using standard command language features existing in modern computer operating systems. PROSSS is explained in general with respect to this implementation along with the steps for the preparation of the programs and input data. Each component of the system is described in detail with annotated listings for clarification. The components include options, procedures, programs and subroutines, and data files as they pertain to this implementation. An example exercising each option in this implementation to allow the user to anticipate the type of results that might be expected is presented.

Microsatellite analyses of San Franciscuito Creek rainbow trout

USGS Publications Warehouse

Nielsen, Jennifer L.

2000-01-01

Microsatellite genetic diversity found in San Francisquito Creek rainbow trout support a close genetic relationship with rainbow trout (Oncorhynchus mykiss) from another tributary of San Francisco Bay, Alameda Creek, and coastal trout found in Lagunitas Creek, Marin County, California. Fish collected for this study from San Francisquito Creek showed a closer genetic relationship to fish from the north-central California steelhead ESU than for any other listed group of O. mykiss. No significant genotypic or allelic frequency associations could be drawn between San Francisquito Creek trout and fish collected from the four primary rainbow trout hatchery strains in use in California, i.e. Whitney, Mount Shasta, Coleman, and Hot Creek hatchery fish. Indeed, genetic distance analyses (δµ2) supported separation between San Francisquito Creek trout and all hatchery trout with 68% bootstrap values in 1000 replicate neighbor-joining trees. Not surprisingly, California hatchery rainbow trout showed their closest evolutionary relationships with contemporary stocks derived from the Sacramento River. Wild collections of rainbow trout from the Sacramento-San Joaquin basin in the Central Valley were also clearly separable from San Francisquito Creek fish supporting separate, independent ESUs for two groups of O. mykiss (one coastal and one Central Valley) with potentially overlapping life histories in San Francisco Bay. These data support the implementation of management and conservation programs for rainbow trout in the San Francisquito Creek drainage as part of the central California coastal steelhead ESU.

Implementation of ADI: Schemes on MIMD parallel computers

NASA Technical Reports Server (NTRS)

Vanderwijngaart, Rob F.

1993-01-01

In order to simulate the effects of the impingement of hot exhaust jets of High Performance Aircraft on landing surfaces a multi-disciplinary computation coupling flow dynamics to heat conduction in the runway needs to be carried out. Such simulations, which are essentially unsteady, require very large computational power in order to be completed within a reasonable time frame of the order of an hour. Such power can be furnished by the latest generation of massively parallel computers. These remove the bottleneck of ever more congested data paths to one or a few highly specialized central processing units (CPU's) by having many off-the-shelf CPU's work independently on their own data, and exchange information only when needed. During the past year the first phase of this project was completed, in which the optimal strategy for mapping an ADI-algorithm for the three dimensional unsteady heat equation to a MIMD parallel computer was identified. This was done by implementing and comparing three different domain decomposition techniques that define the tasks for the CPU's in the parallel machine. These implementations were done for a Cartesian grid and Dirichlet boundary conditions. The most promising technique was then used to implement the heat equation solver on a general curvilinear grid with a suite of nontrivial boundary conditions. Finally, this technique was also used to implement the Scalar Penta-diagonal (SP) benchmark, which was taken from the NAS Parallel Benchmarks report. All implementations were done in the programming language C on the Intel iPSC/860 computer.

Building a cloud based distributed active archive data center

NASA Astrophysics Data System (ADS)

Ramachandran, Rahul; Baynes, Katie; Murphy, Kevin

2017-04-01

NASA's Earth Science Data System (ESDS) Program serves as a central cog in facilitating the implementation of NASA's Earth Science strategic plan. Since 1994, the ESDS Program has committed to the full and open sharing of Earth science data obtained from NASA instruments to all users. One of the key responsibilities of the ESDS Program is to continuously evolve the entire data and information system to maximize returns on the collected NASA data. An independent review was conducted in 2015 to holistically review the EOSDIS in order to identify gaps. The review recommendations were to investigate two areas: one, whether commercial cloud providers offer potential for storage, processing, and operational efficiencies, and two, the potential development of new data access and analysis paradigms. In response, ESDS has initiated several prototypes investigating the advantages and risks of leveraging cloud computing. This poster will provide an overview of one such prototyping activity, "Cumulus". Cumulus is being designed and developed as a "native" cloud-based data ingest, archive and management system that can be used for all future NASA Earth science data streams. The long term vision for Cumulus, its requirements, overall architecture, and implementation details, as well as lessons learned from the completion of the first phase of this prototype will be covered. We envision Cumulus will foster design of new analysis/visualization tools to leverage collocated data from all of the distributed DAACs as well as elastic cloud computing resources to open new research opportunities.

Implementation of a hepatitis A/B vaccination program using an accelerated schedule among high-risk inmates, Los Angeles County Jail, 2007-2010.

PubMed

Costumbrado, John; Stirland, Ali; Cox, Garrett; El-Amin, Alvin Nelson; Miranda, Armidia; Carter, Ann; Malek, Mark

2012-11-06

The Centers for Disease Control and Prevention recommend vaccination for men who have sex with men (MSM) and injection drug users against hepatitis A and B. This study is the first report of a hepatitis vaccination program in a United States jail with a combined vaccine using an accelerated schedule. Los Angeles County has the largest jail system in the nation and Men's Central Jail (MCJ) is the largest facility within that system. MCJ includes a unit for self-identified MSM, where approximately 2700 inmates are housed per year. Starting in August 2007, a combined hepatitis A and B vaccine was offered to all inmates housed in this special unit. Using an accelerated schedule (0-, 7-, 21-30 days, 12-month booster), a total of 3931 doses were administered to 1633 inmates as of June 2010. Of those, 77% received 2 doses, 58% received 3 doses, and 11% received the booster dose. Inmates who screened positive for a sexually transmitted infection in this unit were 1.3 times more likely to be vaccinated (95% CI 1.2-1.4) compared to others in the same housing unit who screened negative. Hepatitis vaccination initiatives can be successfully implemented in an urban jail among an extremely high-risk population using the accelerated, combined hepatitis A/B vaccine. Ours may be a useful model for other programs to vaccinate incarcerated populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Integrating Health Education in Core Curriculum Classrooms: Successes, Challenges, and Implications for Urban Middle Schools.

PubMed

Rajan, Sonali; Roberts, Katherine J; Guerra, Laura; Pirsch, Moira; Morrell, Ernest

2017-12-01

School-based health education efforts can positively affect health behaviors and learning outcomes; however, there is limited available time during the school day for separate health education classes. The purpose of this study was to assess the feasibility and sustainability of implementing a classroom-based health education program that integrates skill development with health learning. A wait-list control study design was conducted among 168 6th graders in 2 urban schools. Data on program implementation, feasibility, and health outcomes were collected from students at 3 time points and from 5 teachers across the implementation of the 10-week program. There were barriers to implementation, including time limitations, unexpected school-wide disruptions, and variations in student reading ability and teacher preparedness. However, analyses revealed there were significant increases in self-efficacy regarding fruit and vegetable consumption and outcome expectations following program implementation, which were also sustained post-program implementation. Despite inconsistent implementation in the wait-list control school, small gains were also noted following the completion of the program. Integrating health education efforts within core curricula classes can lead to favorable outcomes. However, implementation barriers must be actively addressed by schools and program developers to improve program fidelity and maximize the sustainability of program gains. © 2017, American School Health Association.

32 CFR 322.1 - Purpose and applicability.

Code of Federal Regulations, 2012 CFR

2012-07-01

... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICES PRIVACY ACT PROGRAM § 322.1 Purpose and... of Defense Privacy Program (32 CFR part 310) within the National Security Agency/Central Security...

32 CFR 322.1 - Purpose and applicability.

Code of Federal Regulations, 2014 CFR

2014-07-01

... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICES PRIVACY ACT PROGRAM § 322.1 Purpose and... of Defense Privacy Program (32 CFR part 310) within the National Security Agency/Central Security...

32 CFR 322.1 - Purpose and applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICES PRIVACY ACT PROGRAM § 322.1 Purpose and... of Defense Privacy Program (32 CFR part 310) within the National Security Agency/Central Security...

32 CFR 322.1 - Purpose and applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICES PRIVACY ACT PROGRAM § 322.1 Purpose and... of Defense Privacy Program (32 CFR part 310) within the National Security Agency/Central Security...

32 CFR 322.1 - Purpose and applicability.

Code of Federal Regulations, 2013 CFR

2013-07-01

... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICES PRIVACY ACT PROGRAM § 322.1 Purpose and... of Defense Privacy Program (32 CFR part 310) within the National Security Agency/Central Security...

The Woodlands, Texas.

ERIC Educational Resources Information Center

McHaney, Larry J.; Bernhardt, Jerry

1988-01-01

The authors describe the "central project" concept for implementing technology education while addressing education reform. The central project is a topic around which students, teachers, administrators, and the community focus their energies as a team. At McCullough High School (Texas), the central project involved design and…

An informatics model for tissue banks--lessons learned from the Cooperative Prostate Cancer Tissue Resource.

PubMed

Patel, Ashokkumar A; Gilbertson, John R; Parwani, Anil V; Dhir, Rajiv; Datta, Milton W; Gupta, Rajnish; Berman, Jules J; Melamed, Jonathan; Kajdacsy-Balla, Andre; Orenstein, Jan; Becich, Michael J

2006-05-05

Advances in molecular biology and growing requirements from biomarker validation studies have generated a need for tissue banks to provide quality-controlled tissue samples with standardized clinical annotation. The NCI Cooperative Prostate Cancer Tissue Resource (CPCTR) is a distributed tissue bank that comprises four academic centers and provides thousands of clinically annotated prostate cancer specimens to researchers. Here we describe the CPCTR information management system architecture, common data element (CDE) development, query interfaces, data curation, and quality control. Data managers review the medical records to collect and continuously update information for the 145 clinical, pathological and inventorial CDEs that the Resource maintains for each case. An Access-based data entry tool provides de-identification and a standard communication mechanism between each group and a central CPCTR database. Standardized automated quality control audits have been implemented. Centrally, an Oracle database has web interfaces allowing multiple user-types, including the general public, to mine de-identified information from all of the sites with three levels of specificity and granularity as well as to request tissues through a formal letter of intent. Since July 2003, CPCTR has offered over 6,000 cases (38,000 blocks) of highly characterized prostate cancer biospecimens, including several tissue microarrays (TMA). The Resource developed a website with interfaces for the general public as well as researchers and internal members. These user groups have utilized the web-tools for public query of summary data on the cases that were available, to prepare requests, and to receive tissues. As of December 2005, the Resource received over 130 tissue requests, of which 45 have been reviewed, approved and filled. Additionally, the Resource implemented the TMA Data Exchange Specification in its TMA program and created a computer program for calculating PSA recurrence. Building a biorepository infrastructure that meets today's research needs involves time and input of many individuals from diverse disciplines. The CPCTR can provide large volumes of carefully annotated prostate tissue for research initiatives such as Specialized Programs of Research Excellence (SPOREs) and for biomarker validation studies and its experience can help development of collaborative, large scale, virtual tissue banks in other organ systems.

Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis.

PubMed

Breland, Jessica Y; Asch, Steven M; Slightam, Cindie; Wong, Ava; Zulman, Donna M

2016-03-01

Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH. Interviewees included facility leadership and clinical staff who were involved in a pilot Intensive Management Patient Aligned Care Team (ImPACT) intervention for high-need, high-cost VA PCMH patents. We classified implementation factors in the literature review and qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). The literature review (n=9 studies) and analyses of interviews (n=15) revealed key implementation factors in three CFIR domains. First, the Inner Setting (i.e., the organizational and PCMH environment), mostly enabled implementation through a culture of innovation, good networks and communication, and positive tension for change. Second, Characteristics of Individuals, including creativity, flexibility, and interpersonal skills, allowed program staff to augment existing PCMH services. Finally, certain Intervention Characteristics (e.g., adaptability) enabled implementation, while others (e.g., complexity) generated implementation barriers. Resources and structural features common to PCMHs can facilitate implementation of intensive outpatient programs, but program success is also dependent on staff creativity and flexibility, and intervention adaptations to meet patient and organizational needs. Established PCMHs likely provide resources and environments that permit accelerated implementation of intensive outpatient programs. V. Published by Elsevier Inc.

A Framework for Identifying Implementation Issues Affecting Extension Human Sciences Programming

ERIC Educational Resources Information Center

Abell, Ellen; Cummings, Rebekah; Duke, Adrienne M.; Marshall, Jennifer Wells

2015-01-01

Extension programs based on identified needs, relevant theory, and solid research too often fail to realize their objectives. Program implementation is acknowledged to contribute to program effectiveness, yet systematic attention has not been paid to the array of implementation issues that can complicate achieving program goals. We developed the…

Fixing extensions to general relativity in the nonlinear regime

NASA Astrophysics Data System (ADS)

Cayuso, Juan; Ortiz, Néstor; Lehner, Luis

2017-10-01

The question of what gravitational theory could supersede General Relativity has been central in theoretical physics for decades. Many disparate alternatives have been proposed motivated by cosmology, quantum gravity and phenomenological angles, and have been subjected to tests derived from cosmological, solar system and pulsar observations typically restricted to linearized regimes. Gravitational waves from compact binaries provide new opportunities to probe these theories in the strongly gravitating/highly dynamical regimes. To this end however, a reliable understanding of the dynamics in such a regime is required. Unfortunately, most of these theories fail to define well posed initial value problems, which prevents at face value from meeting such challenge. In this work, we introduce a consistent program able to remedy this situation. This program is inspired in the approach to "fixing" viscous relativistic hydrodynamics introduced by Israel and Stewart in the late 70's. We illustrate how to implement this approach to control undesirable effects of higher order derivatives in gravity theories and argue how the modified system still captures the true dynamics of the putative underlying theories in 3 +1 dimensions. We sketch the implementation of this idea in a couple of effective theories of gravity, one in the context of Noncommutative Geometry, and one in the context of Chern-Simons modified General Relativity.

Object-oriented Technology for Compressor Simulation

NASA Technical Reports Server (NTRS)

Drummond, C. K.; Follen, G. J.; Cannon, M. R.

1994-01-01

An object-oriented basis for interdisciplinary compressor simulation can, in principle, overcome several barriers associated with the traditional structured (procedural) development approach. This paper presents the results of a research effort with the objective to explore the repercussions on design, analysis, and implementation of a compressor model in an object oriented (OO) language, and to examine the ability of the OO system design to accommodate computational fluid dynamics (CFD) code for compressor performance prediction. Three fundamental results are that: (1) the selection of the object oriented language is not the central issue; enhanced (interdisciplinary) analysis capability derives from a broader focus on object-oriented technology; (2) object-oriented designs will produce more effective and reusable computer programs when the technology is applied to issues involving complex system inter-relationships (more so than when addressing the complex physics of an isolated discipline); and (3) the concept of disposable prototypes is effective for exploratory research programs, but this requires organizations to have a commensurate long-term perspective. This work also suggests that interdisciplinary simulation can be effectively accomplished (over several levels of fidelity) with a mixed language treatment (i.e., FORTRAN-C++), reinforcing the notion the OO technology implementation into simulations is a 'journey' in which the syntax can, by design, continuously evolve.

Applying Best Practices to Florida Local Government Retrofit Programs

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

McIlvaine, J.; Sutherland, K.

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the 'current best practices.' A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Applying Best Practices to Florida Local Government Retrofit Programs

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

McIlvaine, J.; Sutherland, K.

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

PubMed

Kelsey, Meredith; Layzer, Jean

2014-03-01

This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

PubMed

Dennis, Sarah; Hetherington, Sharon A; Borodzicz, Jerrad A; Hermiz, Oshana; Zwar, Nicholas A

2015-04-01

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.

A Qualitative Exploration of Implementation Factors in a School-Based Mindfulness and Yoga Program: Lessons Learned from Students and Teachers

PubMed Central

Dariotis, Jacinda K.; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T.; Mendelson, Tamar

2016-01-01

Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings. PMID:28670007

A Qualitative Exploration of Implementation Factors in a School-Based Mindfulness and Yoga Program: Lessons Learned from Students and Teachers.

PubMed

Dariotis, Jacinda K; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T; Mendelson, Tamar

2017-01-01

Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators - students and their classroom teachers - merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings.

Centralized and distributed control architectures under Foundation Fieldbus network.

PubMed

Persechini, Maria Auxiliadora Muanis; Jota, Fábio Gonçalves

2013-01-01

This paper aims at discussing possible automation and control system architectures based on fieldbus networks in which the controllers can be implemented either in a centralized or in a distributed form. An experimental setup is used to demonstrate some of the addressed issues. The control and automation architecture is composed of a supervisory system, a programmable logic controller and various other devices connected to a Foundation Fieldbus H1 network. The procedures used in the network configuration, in the process modelling and in the design and implementation of controllers are described. The specificities of each one of the considered logical organizations are also discussed. Finally, experimental results are analysed using an algorithm for the assessment of control loops to compare the performances between the centralized and the distributed implementations. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

Decentralizing Education in Transition Societies: Case Studies from Central and Eastern Europe. WBI Learning Resources Series.

ERIC Educational Resources Information Center

Fiszbein, Ariel, Ed.

This book is about education system reform in Central and Eastern Europe, with emphasis on decentralization and management. In the past, local authorities served as implementation arms of the central ministry, while finance and decision-making were controlled by the central government, leaving local communities with little influence. New education…

Developmental milestones across the programmatic life cycle: implementing the CDC's Colorectal Cancer Screening Demonstration Program.

PubMed

Glover-Kudon, Rebecca; DeGroff, Amy; Rohan, Elizabeth A; Preissle, Judith; Boehm, Jennifer E

2013-08-01

In 2005 through 2009, the Centers for Disease Control and Prevention (CDC) funded 5 sites to implement a colorectal cancer screening program for uninsured, low-income populations. These 5 sites composed a demonstration project intended to explore the feasibility of establishing a national colorectal cancer screening program through various service delivery models. A longitudinal, multiple case study was conducted to understand and document program implementation processes. Using metaphor as a qualitative analytic technique, evaluators identified stages of maturation across the programmatic life cycle. Analysis rendered a working theory of program development during screening implementation. In early stages, program staff built relationships with CDC and local partners around screening readiness, faced real-world challenges putting program policies into practice, revised initial program designs, and developed new professional skills. Midterm implementation was defined by establishing program cohesiveness and expanding programmatic reach. In later stages of implementation, staff focused on sustainability and formal program closeout, which prompted reflection about personal and programmatic accomplishments. Demonstration sites evolved through common developmental stages during screening implementation. Findings elucidate ways to target technical assistance to more efficiently move programs along their maturation trajectory. In practical terms, the time and cost associated with guiding a program to maturity may be potentially shortened to maximize return on investment for both organizations and clients receiving service benefits. © 2013 American Cancer Society.

Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

PubMed

Mangone, Emily R; Agarwal, Smisha; L'Engle, Kelly; Lasway, Christine; Zan, Trinity; van Beijma, Hajo; Orkis, Jennifer; Karam, Robert

2016-01-01

There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this strategy was sustainable for the implementer, a central concern is that health information may not reach those who are too poor to pay, limiting the program's reach and impact. Incorporating strategies presented here may make mHealth programs more appealing to funders and investors but need further consideration to balance sustainability, scale, and impact.

Cost-effectiveness of a quality improvement programme to reduce central line-associated bloodstream infections in intensive care units in the USA

PubMed Central

Herzer, Kurt R; Niessen, Louis; Constenla, Dagna O; Ward, William J; Pronovost, Peter J

2014-01-01

Objective To assess the cost-effectiveness of a multifaceted quality improvement programme focused on reducing central line-associated bloodstream infections in intensive care units. Design Cost-effectiveness analysis using a decision tree model to compare programme to non-programme intensive care units. Setting USA. Population Adult patients in the intensive care unit. Costs Economic costs of the programme and of central line-associated bloodstream infections were estimated from the perspective of the hospital and presented in 2013 US dollars. Main outcome measures Central line-associated bloodstream infections prevented, deaths averted due to central line-associated bloodstream infections prevented, and incremental cost-effectiveness ratios. Probabilistic sensitivity analysis was performed. Results Compared with current practice, the programme is strongly dominant and reduces bloodstream infections and deaths at no additional cost. The probabilistic sensitivity analysis showed that there was an almost 80% probability that the programme reduces bloodstream infections and the infections’ economic costs to hospitals. The opportunity cost of a bloodstream infection to a hospital was the most important model parameter in these analyses. Conclusions This multifaceted quality improvement programme, as it is currently implemented by hospitals on an increasingly large scale in the USA, likely reduces the economic costs of central line-associated bloodstream infections for US hospitals. Awareness among hospitals about the programme's benefits should enhance implementation. The programme's implementation has the potential to substantially reduce morbidity, mortality and economic costs associated with central line-associated bloodstream infections. PMID:25256190

IPM: Integrated Pest Management Kit for Building Managers. How To Implement an Integrated Pest Management Program in Your Building(s).

ERIC Educational Resources Information Center

Mitchell, Brad

This management kit introduces building managers to the concept of Integrated Pest Management (IPM), and provides the knowledge and tools needed to implement an IPM program in their buildings. It discusses the barriers to implementing an IPM program, why such a program should be used, and the general guidelines for its implementation. Managerial…