Science.gov

Sample records for development adoption implementation

  1. Energy standards and model codes development, adoption, implementation, and enforcement

    SciTech Connect

    Conover, D.R.

    1994-08-01

    This report provides an overview of the energy standards and model codes process for the voluntary sector within the United States. The report was prepared by Pacific Northwest Laboratory (PNL) for the Building Energy Standards Program and is intended to be used as a primer or reference on this process. Building standards and model codes that address energy have been developed by organizations in the voluntary sector since the early 1970s. These standards and model codes provide minimum energy-efficient design and construction requirements for new buildings and, in some instances, existing buildings. The first step in the process is developing new or revising existing standards or codes. There are two overall differences between standards and codes. Energy standards are developed by a consensus process and are revised as needed. Model codes are revised on a regular annual cycle through a public hearing process. In addition to these overall differences, the specific steps in developing/revising energy standards differ from model codes. These energy standards or model codes are then available for adoption by states and local governments. Typically, energy standards are adopted by or adopted into model codes. Model codes are in turn adopted by states through either legislation or regulation. Enforcement is essential to the implementation of energy standards and model codes. Low-rise residential construction is generally evaluated for compliance at the local level, whereas state agencies tend to be more involved with other types of buildings. Low-rise residential buildings also may be more easily evaluated for compliance because the governing requirements tend to be less complex than for commercial buildings.

  2. Development and Implementation of a Telecommuting Evaluation Framework, and Modeling the Executive Telecommuting Adoption Process

    NASA Astrophysics Data System (ADS)

    Vora, V. P.; Mahmassani, H. S.

    2002-02-01

    This work proposes and implements a comprehensive evaluation framework to document the telecommuter, organizational, and societal impacts of telecommuting through telecommuting programs. Evaluation processes and materials within the outlined framework are also proposed and implemented. As the first component of the evaluation process, the executive survey is administered within a public sector agency. The survey data is examined through exploratory analysis and is compared to a previous survey of private sector executives. The ordinal probit, dynamic probit, and dynamic generalized ordinal probit (DGOP) models of telecommuting adoption are calibrated to identify factors which significantly influence executive adoption preferences and to test the robustness of such factors. The public sector DGOP model of executive willingness to support telecommuting under different program scenarios is compared with an equivalent private sector DGOP model. Through the telecommuting program, a case study of telecommuting travel impacts is performed to further substantiate research.

  3. Developing and implementing new safe practices: voluntary adoption through statewide collaboratives

    PubMed Central

    Leape, L L; Rogers, G; Hanna, D; Griswold, P; Federico, F; Fenn, C A; Bates, D W; Kirle, L; Clarridge, B R

    2006-01-01

    Background Disseminating new safe practices has proved challenging. In a statewide initiative we developed a framework for (1) selecting two safe practices, (2) developing operational details of implementation, (3) enlisting hospitals to participate, and (4) facilitating implementation. Methods Potential topics were selected by a multistep process to identify candidate practices, review the evidence for efficacy and feasibility, and then select them on the basis of importance, efficacy, feasibility, and impact. A multi‐stakeholder advisory group representing all constituencies selected two practices: reconciling medications (RM) and communicating critical test results (CTR). Operational details and strategies for implementation were then developed for each practice using a consensus process of discipline stakeholders led by content experts. Hospital CEOs were solicited to participate by the Massachusetts Hospital Association which made the project a “flagship” initiative. A collaborative model was used to facilitate implementation, following the IHI Model for Improvement. In addition to providing exposure to content and method experts, we gave teams a “toolkit” containing recommendations, a change package, and implementation strategies. Each collaborative met four times over an 18 month period. Results were assessed using the IHI team assessment scale and surveys of teams and hospital leaders. Results Hospital participation rate was high with 88% of hospitals participating in one or both collaboratives. Partial implementation of the practices was achieved by 50% of RM teams and 65% of CTR teams. Full implementation was achieved by 20% of teams for each. Conclusions Major factors leading to hospital participation included the intrinsic appeal of the practices, access to experts, and the availability of implementation strategies. Team success was correlated with active engagement of a senior administrator, engagement of physicians, increased use of PDSA

  4. Adopter's Guide for Planning, Developing and Implementing a Model Construction Cluster Program.

    ERIC Educational Resources Information Center

    Beaverton School District 48, OR.

    This guide contains processes for planning, developing, and implementing an industry-based construction cluster program in Oregon secondary schools. Each process was pilot tested and revised by Beaverton School District during the development of a model program at Beaverton High School. The guide is intended to help other school districts…

  5. 49 CFR 1544.101 - Adoption and implementation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 9 2014-10-01 2014-10-01 false Adoption and implementation. 1544.101 Section 1544... AND COMMERCIAL OPERATORS Security Program § 1544.101 Adoption and implementation. (a) Full program... deplaned into a sterile area. (b) Partial program—adoption. Each aircraft operator must carry out the...

  6. 49 CFR 1544.101 - Adoption and implementation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 9 2012-10-01 2012-10-01 false Adoption and implementation. 1544.101 Section 1544... AND COMMERCIAL OPERATORS Security Program § 1544.101 Adoption and implementation. (a) Full program... deplaned into a sterile area. (b) Partial program—adoption. Each aircraft operator must carry out the...

  7. 49 CFR 1544.101 - Adoption and implementation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 9 2013-10-01 2013-10-01 false Adoption and implementation. 1544.101 Section 1544... AND COMMERCIAL OPERATORS Security Program § 1544.101 Adoption and implementation. (a) Full program... deplaned into a sterile area. (b) Partial program—adoption. Each aircraft operator must carry out the...

  8. 49 CFR 1544.101 - Adoption and implementation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Adoption and implementation. 1544.101 Section 1544... AND COMMERCIAL OPERATORS Security Program § 1544.101 Adoption and implementation. (a) Full program... deplaned into a sterile area. (b) Partial program—adoption. Each aircraft operator must carry out the...

  9. 49 CFR 1544.101 - Adoption and implementation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 9 2011-10-01 2011-10-01 false Adoption and implementation. 1544.101 Section 1544... AND COMMERCIAL OPERATORS Security Program § 1544.101 Adoption and implementation. (a) Full program... deplaned into a sterile area. (b) Partial program—adoption. Each aircraft operator must carry out the...

  10. Cognitively Guided Instruction, a Professional Development Approach to Teaching Elementary Mathematics: A Case Study of Adoption and Implementation in Three Rural Elementary Schools

    ERIC Educational Resources Information Center

    Guerrero, Jessie Elizabeth

    2014-01-01

    This study examined teacher and administrator perspectives in regards to the adoption and implementation of an elementary mathematics teaching approach called Cognitively Guided Instruction (CGI), at three elementary school sites of a rural elementary school district, located in the Central Valley of California. A holistic exploratory case study…

  11. Cognitively Guided Instruction, a Professional Development Approach to Teaching Elementary Mathematics: A Case Study of Adoption and Implementation in Three Rural Elementary Schools

    ERIC Educational Resources Information Center

    Guerrero, Jessie Elizabeth

    2014-01-01

    This study examined teacher and administrator perspectives in regards to the adoption and implementation of an elementary mathematics teaching approach called Cognitively Guided Instruction (CGI), at three elementary school sites of a rural elementary school district, located in the Central Valley of California. A holistic exploratory case study…

  12. 49 CFR 1546.101 - Adoption and implementation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 9 2012-10-01 2012-10-01 false Adoption and implementation. 1546.101 Section 1546.101 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY... Program § 1546.101 Adoption and implementation. Each foreign air carrier landing or taking off in the...

  13. 49 CFR 1546.101 - Adoption and implementation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 9 2013-10-01 2013-10-01 false Adoption and implementation. 1546.101 Section 1546.101 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY... Program § 1546.101 Adoption and implementation. Each foreign air carrier landing or taking off in the...

  14. 49 CFR 1546.101 - Adoption and implementation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 9 2014-10-01 2014-10-01 false Adoption and implementation. 1546.101 Section 1546.101 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY... Program § 1546.101 Adoption and implementation. Each foreign air carrier landing or taking off in the...

  15. 49 CFR 1546.101 - Adoption and implementation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 9 2011-10-01 2011-10-01 false Adoption and implementation. 1546.101 Section 1546.101 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY... Program § 1546.101 Adoption and implementation. Each foreign air carrier landing or taking off in the...

  16. 49 CFR 1546.101 - Adoption and implementation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Adoption and implementation. 1546.101 Section 1546.101 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY... Program § 1546.101 Adoption and implementation. Each foreign air carrier landing or taking off in the...

  17. Developing and Implementing a New Online Bachelor Program: Formal Adoption of Videoconferencing and Social Networking as a Step towards M-Learning

    ERIC Educational Resources Information Center

    van Oostveen, Roland; Desjardins, François

    2013-01-01

    The political will to move educational opportunities online is growing for numerous reasons and new mobile technologies are being adopted at unprecedented rates. Such a context presents opportunities to develop online programs and experiments in universities, with new affordances to solve old problems such as access and isolation. This paper…

  18. 75 FR 59086 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption... INFORMATION: On April 23, 2010, MDE submitted to EPA a SIP revision concerning the adoption of the EPA CTG for...) concerning the adoption of the EPA CTG for flexible packaging printing. EPA develops CTGs as guidance on...

  19. Nutrition educator adoption and implementation of an experiential foods curriculum.

    PubMed

    Diker, Ann; Cunningham-Sabo, Leslie; Bachman, Kari; Stacey, Jane E; Walters, Lynn M; Wells, Linda

    2013-01-01

    Describe changes in Nutrition Educator (NE) and Extension Agent (EA) motivation, self-efficacy, and behavioral capability over time after experiential food tasting curriculum training. Identify promoters of curriculum adoption, implementation, and future use. Mixed methods design including surveys, lesson implementation reports, and interviews. New Mexico limited-resource schools. Convenience sample of New Mexico Extension NE (n = 42) and their EA supervisors (n = 21). Three-hour curriculum training employing Social Cognitive Theory and Diffusion of Innovations. Perceived change in motivation, self-efficacy, and behavioral capability from post-training through 8-month post-training; promoters and challenges to curriculum adoption, implementation, and future use. Repeated-measures ANOVA analyzed perceived behavior change over time. Significance was set at P ≤ .05. Qualitative responses were categorized by theme. Gains in NE motivation, self-efficacy, and behavioral capability were sustained at 8 months post-training. High adoption/implementation rates (79%) were attributed to strong implementation expectations, observational learning, experiential training elements, and perceived curriculum compatibility. Environmental factors including time constraints, personnel turnover, and scheduling conflicts proved challenging. Maximizing curriculum simplicity and compatibility and incorporating behavioral capability, observational learning, and expectations into training support adoption and use. Adaptations and techniques to problem-solve challenges should be provided to new curricula implementers. Published by Elsevier Inc.

  20. A Statewide Scale up of Positive Behavioral Interventions and Supports: A Description of the Development of Systems of Support and Analysis of Adoption and Implementation

    ERIC Educational Resources Information Center

    Bradshaw, Catherine P.; Pas, Elise T.

    2011-01-01

    This study describes the process by which a statewide support system was developed in Maryland to promote high-quality implementation of a school-wide prevention model called Positive Behavioral Interventions and Supports (PBIS). PBIS (Sugai & Horner, 2006) aims to prevent disruptive behavior problems and promote a positive school climate…

  1. Limitations of a Research, Development and Diffusion (RD and D) Strategy in Diffusion: A Case Study of Nine Local Implementations of a State-Adopted Curriculum.

    ERIC Educational Resources Information Center

    Schumacher, Sally

    This study of the first year of an inter-organizational diffusion effort by a national educational laboratory, a state department of education, and nine local school districts focuses on the implementation phase within the Research, Development and Diffusion (RD and D) strategy of an aesthetic education program which uses the arts as the…

  2. Nurturing Development of Foster and Adopted Children

    ERIC Educational Resources Information Center

    Nowak-Fabrykowski, Krystyna Teresa

    2015-01-01

    The goal of this study is to investigate early childhood teachers' perspective of teaching foster and adopted children. The main purpose is to seek suggestions how teachers can nurture the development of foster and adopted children. A 6 question survey was sent to 44 teachers pursuing graduate studies in early childhood education. Of this 50%…

  3. Nurturing Development of Foster and Adopted Children

    ERIC Educational Resources Information Center

    Nowak-Fabrykowski, Krystyna Teresa

    2015-01-01

    The goal of this study is to investigate early childhood teachers' perspective of teaching foster and adopted children. The main purpose is to seek suggestions how teachers can nurture the development of foster and adopted children. A 6 question survey was sent to 44 teachers pursuing graduate studies in early childhood education. Of this 50%…

  4. 75 FR 59179 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption... same title, ``Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of...

  5. [Adoption].

    ERIC Educational Resources Information Center

    Pawl, Jeree, Ed.; And Others

    1990-01-01

    This newsletter theme issue addresses adoption and the young child's life. Contributors suggest ways in which practitioners in many professions and settings can better understand and support adoptive families. The first article, "Adoption, 1990" by Barbara F. Nordhaus and Albert J. Solnit, reviews the history of adoption and notes obstacles to…

  6. Structural equation modeling for implementation intentions, cancer worry, and stages of mammography adoption.

    PubMed

    Hirai, Kei; Harada, Kazuhiro; Seki, Aiko; Nagatsuka, Miwa; Arai, Hirokazu; Hazama, Ayako; Ishikawa, Yoshiki; Hamashima, Chisato; Saito, Hiroshi; Shibuya, Daisuke

    2013-10-01

    This study aimed to develop a structural model for mammography adoption in Japanese middle-aged women by using constructs from the transtheoretical model (TTM), the theory of planned behavior (TPB), implementation intentions, and cancer worry. Questionnaires based on items including TTM, TPB, implementation intentions, cancer worry-related variables, and demographic variables were distributed to 1000 adult women aged 40 to 59 years, with 641 subjects being used in the final analysis (response rate = 64.1%). Regarding the stage of adoption, 79 participants (12.3%) were at the precontemplation stage, 30 (4.7%) were at the relapse stage, 142 (22.2%) were at the contemplation stage, 88 (13.7%) were at the action stage, and 302 (47.1%) were at the maintenance stage. Our model, derived from structural equation modeling, revealed that the stage of mammography adoption was significantly affected by goal intentions, implementation intentions, perceived barriers, history of breast cancer screening, and relative risk. A logistic regression analysis revealed that goal intentions and implementation intentions significantly predicted mammography uptake within 1 year. This study developed an integrated model constructed from TTM, TPB, implementation intentions, and cancer worry to account for mammography adoption in Japan, and also confirmed the predictive validity of the model. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Adoption

    MedlinePlus

    ... of Adoption It's natural for any adopted person, child or adult, to have complex feelings about being adopted. It's also natural to feel that "my parents are my parents" and not feel a desire to seek out more information about the identity of the birth family. Most of us (whether ...

  8. Adoption

    MedlinePlus

    ... biological families) and where they came from. This curiosity often becomes more intense as part of the ... adoptive family or feel close to them. This curiosity, which can feel quite intense, is a normal ...

  9. Communication Development in Infants and Toddlers Adopted from Abroad

    ERIC Educational Resources Information Center

    Hwa-Froelich, Deborah A.

    2009-01-01

    Approximately 20,000 children are adopted from foreign countries each year. Of these children, approximately 46% are adopted before they are 12 months old and 43% are adopted between 1 and 4 years of age. The development of children adopted from abroad before or by 2 years of age is the focus of this article. Given the impoverished language input…

  10. Implementation and the Process of Adopting Managerial Technology

    ERIC Educational Resources Information Center

    Wolek, Francis W.

    1975-01-01

    An innovation adoption process paradigm is presented in four stages. Users (1) are aware of a specific need, (2) relate to the logical continuity between previous approaches and the innovation, (3) assess evidence of positive value, and (4) integrate the innovation with their personal and social lives. (Author/MLF)

  11. 76 FR 27335 - Laboratory Animal Welfare: Proposed Adoption and Implementation of the Eighth Edition of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... HUMAN SERVICES National Institutes of Health Laboratory Animal Welfare: Proposed Adoption and... extending the period for public comments on (1) NIH's adoption of the eighth edition of the Guide for the... comments on (1) The adoption of the Guide and (2) the implementation plan. The notice on the proposed...

  12. 76 FR 17423 - Laboratory Animal Welfare: Proposed Adoption and Implementation of the Eighth Edition of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... HUMAN SERVICES National Institutes of Health Laboratory Animal Welfare: Proposed Adoption and... Institutes of Health (NIH) is extending the period for public comments on (1) NIH's adoption of the eighth... consider comments on (1) the adoption of the Guide and (2) the implementation plan. The notice on the...

  13. Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation.

    PubMed

    Novak, Laurie L; Anders, Shilo; Gadd, Cynthia S; Lorenzi, Nancy M

    2012-01-01

    Without careful attention to the work of users, implementation of health IT can produce new risks and inefficiencies in care. This paper uses the technology use mediation framework to examine the work of a group of nurses who serve as mediators of the adoption and use of a barcode medication administration (BCMA) system in an inpatient setting. The study uses ethnographic methods to explore the mediators' work. Data included field notes from observations, documents, and email communications. This variety of sources enabled triangulation of findings between activities observed, discussed in meetings, and reported in emails. Mediation work integrated the BCMA tool with nursing practice, anticipating and solving implementation problems. Three themes of mediation work include: resolving challenges related to coordination, integrating the physical aspects of BCMA into everyday practice, and advocacy work. Previous work suggests the following factors impact mediation effectiveness: proximity to the context of use, understanding of users' practices and norms, credibility with users, and knowledge of the technology and users' technical abilities. We describe three additional factors observed in this case: 'influence on system developers,' 'influence on institutional authorities,' and 'understanding the network of organizational relationships that shape the users' work.' Institutionally supported clinicians who facilitate adoption and use of health IT systems can improve the safety and effectiveness of implementation through the management of unintended consequences. Additional research on technology use mediation can advance the science of implementation by providing decision-makers with theoretically durable, empirically grounded evidence for designing implementations.

  14. 49 CFR 1522.105 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Adoption and implementation of the security program. 1522.105 Section 1522.105 Transportation Other Regulations Relating to Transportation (Continued... Certified Cargo Screening Program § 1522.105 Adoption and implementation of the security program. (a...

  15. 76 FR 36471 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption... Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised Nitrogen Dioxide Standards...

  16. 49 CFR 1548.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 9 2011-10-01 2011-10-01 false Adoption and implementation of the security program. 1548.5 Section 1548.5 Transportation Other Regulations Relating to Transportation (Continued... CARRIER SECURITY § 1548.5 Adoption and implementation of the security program. (a) Security program...

  17. 49 CFR 1548.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Adoption and implementation of the security program. 1548.5 Section 1548.5 Transportation Other Regulations Relating to Transportation (Continued... CARRIER SECURITY § 1548.5 Adoption and implementation of the security program. (a) Security program...

  18. 49 CFR 1549.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Adoption and implementation of the security program. 1549.5 Section 1549.5 Transportation Other Regulations Relating to Transportation (Continued... SCREENING PROGRAM General § 1549.5 Adoption and implementation of the security program. (a) Security program...

  19. 49 CFR 1549.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 9 2011-10-01 2011-10-01 false Adoption and implementation of the security program. 1549.5 Section 1549.5 Transportation Other Regulations Relating to Transportation (Continued... SCREENING PROGRAM General § 1549.5 Adoption and implementation of the security program. (a) Security program...

  20. Sustainable Implementation of Interprofessional Education Using an Adoption Model Framework

    ERIC Educational Resources Information Center

    Grymonpre, Ruby E.; Ateah, Christine A.; Dean, Heather J.; Heinonen, Tuula I.; Holmqvist, Maxine E.; MacDonald, Laura L.; Ready, A. Elizabeth; Wener, Pamela F.

    2016-01-01

    Interprofessional education (IPE) is a growing focus for educators in health professional academic programs. Recommendations to successfully implement IPE are emerging in the literature, but there remains a dearth of evidence informing the bigger challenges of sustainability and scalability. Transformation to interprofessional education for…

  1. Meausures of organizational characteristics associated with adoption and/or implementation of innovations: A systematic review.

    PubMed

    Allen, Jennifer D; Towne, Samuel D; Maxwell, Annette E; DiMartino, Lisa; Leyva, Bryan; Bowen, Deborah J; Linnan, Laura; Weiner, Bryan J

    2017-08-23

    This paper identifies and describes measures of constructs relevant to the adoption or implementation of innovations (i.e., new policies, programs or practices) at the organizational-level. This work is intended to advance the field of dissemination and implementation research by aiding scientists in the identification of existing measures and highlighting methodological issues that require additional attention. We searched for published studies (1973-2013) in 11 bibliographic databases for quantitative, empirical studies that presented outcome data related to adoption and/or implementation of an innovation. Included studies had to assess latent constructs related to the "inner setting" of the organization, as defined by the Consolidated Framework for Implementation Research. Of the 76 studies included, most (86%) were cross sectional and nearly half (49%) were conducted in health care settings. Nearly half (46%) involved implementation of evidence-based or "best practice" strategies; roughly a quarter (26%) examined use of new technologies. Primary outcomes most often assessed were innovation implementation (57%) and adoption (34%); while 4% of included studies assessed both outcomes. There was wide variability in conceptual and operational definitions of organizational constructs. The two most frequently assessed constructs included "organizational climate" and "readiness for implementation." More than half (55%) of the studies did not articulate an organizational theory or conceptual framework guiding the inquiry; about a third (34%) referenced Diffusion of Innovations theory. Overall, only 46% of articles reported psychometric properties of measures assessing latent organizational characteristics. Of these, 94% (33/35) described reliability and 71% (25/35) reported on validity. The lack of clarity associated with construct definitions, inconsistent use of theory, absence of standardized reporting criteria for implementation research, and the fact that few

  2. Adoption of Requirements Engineering Practices in Malaysian Software Development Companies

    NASA Astrophysics Data System (ADS)

    Solemon, Badariah; Sahibuddin, Shamsul; Ghani, Abdul Azim Abd

    This paper presents exploratory survey results on Requirements Engineering (RE) practices of some software development companies in Malaysia. The survey attempted to identify patterns of RE practices the companies are implementing. Information required for the survey was obtained through a survey, mailed self-administered questionnaires distributed to project managers and software developers who are working at software development companies operated across the country. The results showed that the overall adoption of the RE practices in these companies is strong. However, the results also indicated that fewer companies in the survey have use appropriate CASE tools or software to support their RE process and practices, define traceability policies and maintain traceability manual in their projects.

  3. Adoption, implementation and enforcement of commercial building energy codes in New Mexico and Arizona

    SciTech Connect

    Callaway, J W; Thurman, A G; Shankle, D L

    1991-07-01

    The US Department of Energy (DOE) is considering ways to encourage states to adopt energy efficiency standards for residential and commercial buildings in the private sector. Such standards are now mandatory for federal buildings, and for private buildings in 34 states; in the remaining 16 states, the standards serve as guidelines for voluntary compliance. In this study for DOE, Pacific Northwest Laboratory (PNL) assessed the process by which energy codes for commercial buildings were adopted and implemented in Arizona and New Mexico. Information was gathered primarily through a series of interviews with state officials, city building officials, architects and engineers, builders, and staff from utilities in the two states. Until other state processes are studied, the extent of the similarities and dissimilarities to the situation in New Mexico and Arizona are unknown. A more extensive study may show that at least some elements of the two state's experience have been paralleled in other parts of the country. General strategies to encourage the adoption of energy codes, assist implementation, and support enforcement were developed based on the research from Arizona and New Mexico and are presented in this report. 6 refs., 4 figs.

  4. Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.

    PubMed

    Shoemaker, Sarah J; Staub-DeLong, Leah; Wasserman, Melanie; Spranca, Mark

    2013-01-01

    Pharmacies are key sources of medication information for patients, yet few effectively serve patients with low health literacy. The Agency for Healthcare Research and Quality (AHRQ) supported the development of four health literacy tools for pharmacists to address this problem, and to help assess and improve pharmacies' health literacy practices. This study aimed to understand the facilitators and barriers to the adoption and implementation of AHRQ's health literacy tools, particularly a tool to assess a pharmacy's health literacy practices. We conducted a comparative, multiple-case study of eight pharmacies, guided by an adaptation of Rogers's Diffusion of Innovations model. Data were collected and triangulated through interviews, site visit observations, and the review of documents, and analyzed on the factors affecting pharmacies' adoption decisions and implementation of the tools. Factors important to pharmacies' decision to adopt the health literacy tools included awareness of health literacy; a culture of innovation; a change champion; the relative advantage and compatibility of the tools; and an invitation to utilize and receive support to use the tools. The barriers included a lack of leadership support, limited staff time, and a perception of the tools as complex with limited value. For implementation, the primary facilitators were buy-in from leadership, qualified staff, college-affiliated change champions, the adaptability and organization of the tool, and support. Barriers to implementation were limited leadership buy-in, prioritization of other activities, lack of qualified staff, and tool complexity. If pharmacists are provided tools that could ultimately improve their health literacy practices and patient-centered services; and the tools have a clear relative advantage, are simple as well adaptable, and the pharmacists are supported in their efforts - either by colleagues or by collaborating with colleges of pharmacy-then there could be important

  5. Dissemination, Adoption, and Implementation of Acamprosate for Treating Alcohol Use Disorders

    PubMed Central

    Knudsen, Hannah K; Roman, Paul M

    2014-01-01

    Objective: Acamprosate has been available in the United States for treating alcohol use disorders (AUDs) for nearly a decade, yet few studies have examined its use within AUD treatment organizations. In addition to describing dissemination and adoption of acamprosate, this study provides novel data regarding organizational processes that underlie its implementation within adopting programs. Method: Data were drawn from interviews with leaders of a nationally representative sample of 307 organizations delivering AUD treatment. Quantitative indicators of organizational characteristics, dissemination, adoption, and implementation of acamprosate, as well as qualitative measures of implementation processes, were measured during face-to-face interviews. Results: Only 18.0% (n = 55) of sampled organizations had adopted acamprosate for treating AUDs, and adoption was positively associated with accreditation, having a physician on staff, receiving information about acamprosate via pharmaceutical representatives, and learning about this medication from other treatment providers. Within adopting programs, an average of 6.0% of AUD patients were currently receiving acamprosate. Numerous implementation challenges were identified, including appropriate patient selection, patient reluctance to be prescribed acamprosate, suboptimal adherence, its costs, and limited counselor training. Conclusions: The limited adoption and implementation of acamprosate likely limits the potential public health impact of this adjunct to AUD treatment. Research integrating the perspectives of organizational leaders, medical professionals, and patients is needed to determine whether specific strategies can address the implementation challenges identified in the current study and increase use of acamprosate in specialty AUD treatment settings. PMID:24766759

  6. Implementing Health Outcomes for Better Information and Care (HOBIC): Lessons from an Early Adopter Site.

    PubMed

    Tregunno, Deborah; Gordon, Sandra; Gardiner-Harding, Peter

    2010-09-01

    Measuring patient outcomes to assess quality and to support evidence-based decision-making has gained momentum over the last two decades. In Ontario, the Health Outcomes for Better Information and Care (HOBIC) initiative has become a part of the province's Information Management Strategy as a way to demonstrate the impact of nursing care on health outcomes. In fall 2006, HOBIC implementation began in early adopter sites with the goal of sharing lessons learned with other healthcare providers and organizations. This action learning study was undertaken in one of the early adopter sites to gain a greater understanding of the factors that support, or fail to support, the integration of HOBIC into professional practice. Participants reported a lack of confidence using HOBIC that they attributed to scarce resources for ongoing education and support. Together, we developed a simulation workshop aimed at enhancing communication skills to achieve more meaningful nurse-patient interaction during the HOBIC assessment. This paper focuses Canadian nurse leaders' attention on the reality that implementing HOBIC is far from straightforward. The real challenge in HOBIC implementation is not mastery of the technology per se, but support for nurses and their ability to adapt daily practice in order to maximize its functionality.

  7. A case study of one school system's adoption and implementation of an elementary science program

    NASA Astrophysics Data System (ADS)

    Kelly, Michael Patrick

    2000-10-01

    The researcher's purpose in this study was to examine the process used by the Minot Public Schools to adopt and implement a new elementary science program from Silver Burdett Ginn called Discovery Works. Using case study methods within a naturalistic design, the researcher investigated teachers' concerns as they adopted and implemented Discovery Works in their classrooms. Data were gathered using the Concerns Based Adoption Model (CBAM) instrument, interviews with adoption committee members, classroom teachers, grade level meetings, and document analysis of field notes related to each phase of the study. Content analysis methods were used to analyze the data. Emergent themes were presented and substantiated in the data, in terms of six research questions that guided this research. The data were analyzed both quantitatively and qualitatively to provide a rich, thick description that and enabled the researcher to confirm and triangulate the concerns of teachers in this study. The quantitative data revealed a general nonuser profile by teachers as they implemented Discovery Works. Three major themes of concerns emerged from a qualitative analysis of the data. The first theme was implementation, including issues related to teacher attitudes and inservice needs. The second theme, management issues, had five concerns subsumed within it. These included concerns related to time, materials, storage, reorder, and cooperative groups. The third theme, effects on students, included issues concerning hands-on methods of teaching science, vocabulary, especially at the upper elementary, and assessment issues. Possible solutions to resolve each of the concerns were presented. Major conclusions are that teacher concerns about Discovery Works were normal for any group experiencing a new innovation. Teachers and students enjoyed using the hands-on materials, and that Minot Public Schools has taken a small, but important step forward on the road to science education reform. Although

  8. Next Generation Science Standards: Adoption and Implementation Workbook

    ERIC Educational Resources Information Center

    Peltzman, Alissa; Rodriguez, Nick

    2013-01-01

    The Next Generation Science Standards (NGSS) represent the culmination of years of collaboration and effort by states, science educators and experts from across the United States. Based on the National Research Council's "A Framework for K-12 Science Education" and developed in partnership with 26 lead states, the NGSS, when…

  9. Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation

    PubMed Central

    Anders, Shilo; Gadd, Cynthia S; Lorenzi, Nancy M

    2012-01-01

    Objective Without careful attention to the work of users, implementation of health IT can produce new risks and inefficiencies in care. This paper uses the technology use mediation framework to examine the work of a group of nurses who serve as mediators of the adoption and use of a barcode medication administration (BCMA) system in an inpatient setting. Materials and methods The study uses ethnographic methods to explore the mediators' work. Data included field notes from observations, documents, and email communications. This variety of sources enabled triangulation of findings between activities observed, discussed in meetings, and reported in emails. Results Mediation work integrated the BCMA tool with nursing practice, anticipating and solving implementation problems. Three themes of mediation work include: resolving challenges related to coordination, integrating the physical aspects of BCMA into everyday practice, and advocacy work. Discussion Previous work suggests the following factors impact mediation effectiveness: proximity to the context of use, understanding of users' practices and norms, credibility with users, and knowledge of the technology and users' technical abilities. We describe three additional factors observed in this case: ‘influence on system developers,’ ‘influence on institutional authorities,’ and ‘understanding the network of organizational relationships that shape the users' work.’ Conclusion Institutionally supported clinicians who facilitate adoption and use of health IT systems can improve the safety and effectiveness of implementation through the management of unintended consequences. Additional research on technology use mediation can advance the science of implementation by providing decision-makers with theoretically durable, empirically grounded evidence for designing implementations. PMID:22634157

  10. 76 FR 27622 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-12

    ... of Control Techniques Guidelines for Large Appliance Coatings AGENCY: Environmental Protection Agency... Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG... Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for...

  11. Measuring Cognitive Characteristics Associated with Adoption and Implementation of Health Innovations in Schools.

    ERIC Educational Resources Information Center

    Gingiss, Phyllis Levenson; And Others

    1994-01-01

    The study described here attempted to operationalize adopter characteristics identified by research and assess their relationship to the adoption and implementation of health innovations in schools. Surveys of second-grade teachers after the introduction of a new health promotion program identified three components of teacher views that measured…

  12. 76 FR 36326 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption... in the proposed rulemaking. This action ] pertaining to the Commonwealth of Virginia's adoption of...

  13. Implementing solutions to improve and expand telehealth adoption: participatory action research in four community healthcare settings.

    PubMed

    Taylor, Johanna; Coates, Elizabeth; Wessels, Bridgette; Mountain, Gail; Hawley, Mark S

    2015-12-01

    Adoption of telehealth has been slower than anticipated, and little is known about the service improvements that help to embed telehealth into routine practice or the role of frontline staff in improving adoption. This paper reports on participatory action research carried out in four community health settings using telehealth for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure. To inform the action research, in-depth case studies of each telehealth service were conducted (May 2012-June 2013). Each service was then supported by researchers through two cycles of action research to implement changes to increase adoption of telehealth, completed over a seven month period (July 2013-April 2014). The action research was studied via observation of multi-stakeholder workshops, analysis of implementation plans, and focus groups. Action research participants included 57 staff and one patient, with between eight and 20 participants per site. The case study findings were identified as a key source of information for planning change, with sites addressing common challenges identified through this work. For example, refining referral criteria; standardizing how and when patients are monitored; improving data sharing; and establishing evaluation processes. Sites also focused on raising awareness of telehealth to increase adoption in other clinical teams and to help secure future financial investment for telehealth, which was required because of short-term funding arrangements. Specific solutions varied due to local infrastructures, resources, and opinion, as well as previous service developments. Local telehealth champions played an important role in engaging multiple stakeholders in the study. Action research enabled services to make planned changes to telehealth and share learning across multiple stakeholders about how and when to use telehealth. However, adoption was impeded by continual changes affecting telehealth and wider service provision

  14. Oral and Written Language Development of Children Adopted from China

    ERIC Educational Resources Information Center

    Scott, Kathleen A.; Roberts, Jenny A.; Krakow, Rena

    2008-01-01

    Purpose: The sharp increase in the number of international adoptions in the United States has prompted a heightened interest in the language development of internationally adopted children. Although recent studies have investigated the early language development of adoptees, little is known about the school-age language and literacy skills of…

  15. Implementing sustainable development

    SciTech Connect

    Loran, B.

    1997-08-01

    Criteria for the implementation of sustainable development are presented. These criteria are derived systematically from a definition of desirable goals, a comparison with the present situation, and an identification of available means to achieve the desired results. A revision of the standards used to measure a country status level (national standards) is found to be a key element. The present situation involves a largely unchecked population expansion in locations least suited to accommodate it, lack of energy and resource use plans, and national standards based on development, or growth. A sustainable development, on the other hand, requires stabilized population and energy and resource use, and national standards moving away from growth and accepting quality of life in its place. Examples of specific applications to different cultural environments and references to pertinent studies are provided, showing that sustainable development is a concrete possibility, once the basic criteria identified are recognized as desirable goals and receive gradual acceptance.

  16. Increasing Psychotherapists’ Adoption and Implementation of the Evidence-based Practice of Progress Monitoring

    PubMed Central

    Persons, Jacqueline B.; Koerner, Kelly; Eidelman, Polina; Thomas, Cannon; Liu, Howard

    2015-01-01

    Evidence-based practices (EBPs) reach consumers slowly because practitioners are slow to adopt and implement them. We hypothesized that giving psychotherapists a tool + training intervention that was designed to help the therapist integrate the EBP of progress monitoring into his or her usual way of working would be associated with adoption and sustained implementation of the particular progress monitoring tool we trained them to use (the Depression Anxiety Stress Scales on our Online Progress Tracking tool) and would generalize to all types of progress monitoring measures. To test these hypotheses, we developed an online progress monitoring tool and a course that trained psychotherapists to use it, and we assessed progress monitoring behavior in 26 psychotherapists before, during, immediately after, and 12 months after they received the tool and training. Immediately after receiving the tool + training intervention, participants showed statistically significant increases in use of the online tool and of all types of progress monitoring measures. Twelve months later, participants showed sustained use of any type of progress monitoring measure but not the online tool. PMID:26618237

  17. Factors influencing the adoption and implementation of teledentistry in the UK, with a focus on orthodontics.

    PubMed

    Patel, Reena N; Antonarakis, Gregory S

    2013-10-01

    Utilizing Rogers' diffusion of innovation theory, this study aims to develop a better understanding of the challenges faced in teledental projects, and outline the factors that impact upon the adoption and implementation of teledental projects, with a focus on orthodontics, thus attempting to provide an explanation for the low uptake in the UK, as well as to suggest factors to encourage success. A literature search was carried out to obtain information concerning teledentistry (and telemedicine) from both primary and secondary research sources. Using the relevant information obtained, Rogers' diffusion of innovation theory was used as a framework, which was subsequently applied to the key stakeholder groups of a healthcare organization. The model describes five characteristics of an innovation: relative advantage, compatibility, complexity, trialability and observability. These attributes are discussed in the context of key stakeholder groups within a healthcare organization: clinicians, patients, hospital managers, and healthcare decision-makers and funders. Each stakeholder group is motivated by different values and experiences, which in turn influence their decision to adopt a new technology. Implementing teledental applications necessitates full comprehension and consideration of the healthcare environment and also a commitment to completely integrate teledentistry within that environment. This is a process that demands strategic alignment with clinical and organizational goals, clinical engagement and strong political support. The challenges within each stakeholder group must be specifically targeted. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. District Adoption and Implementation of Interim and Benchmark Assessments. CRESST Report 806

    ERIC Educational Resources Information Center

    Davidson, Kristen L.; Frohbieter, Greta

    2011-01-01

    As an outgrowth of the accountability requirements of the No Child Left Behind Act, districts are increasingly implementing "interim" or "benchmark" assessments. This report investigates various stakeholders' original purposes in adopting interim or benchmark assessments, ensuing implementation efforts, and actual assessment…

  19. Alternative Student Growth Measures for Teacher Evaluation: Implementation Experiences of Early-Adopting Districts. REL 2015-093

    ERIC Educational Resources Information Center

    McCullough, Moira; English, Brittany; Angus, Megan Hague; Gill, Brian

    2015-01-01

    Alternative student growth measures for teacher evaluation: Implementation experiences of early-adopting districts: State requirements to include student achievement growth in teacher evaluations are prompting the development of alternative ways to measure growth in grades and subjects not covered by state assessments. These alternative growth…

  20. Closing the Research-Practice Gap: Factors Affecting Adoption and Implementation of a Children's Mental Health Program

    ERIC Educational Resources Information Center

    Henderson, Joanna L.; MacKay, Sherri; Peterson-Badali, Michele

    2006-01-01

    Despite the availability of effective interventions, they are not widely used in community mental health centers. This study examined the adoption and implementation of The Arson Prevention Program for Children (TAPP-C), a program for juvenile firesetters developed at a teaching hospital and disseminated to community settings. Questionnaire data…

  1. Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff.

    PubMed

    Langhan, Melissa L; Riera, Antonio; Kurtz, Jordan C; Schaeffer, Paula; Asnes, Andrea G

    2015-01-01

    Technologies are not always successfully implemented into practice. This study elicited experiences of acute care providers with the introduction of technology and identified barriers and facilitators in the implementation process. A qualitative study using one-on-one interviews among a purposeful sample of 19 physicians and nurses within 10 emergency departments and intensive care units was performed. Grounded theory, iterative data analysis and the constant comparative method were used to inductively generate ideas and build theories. Five major categories emerged: decision-making factors, the impact on practice, technology's perceived value, facilitators and barriers to implementation. Barriers included negative experiences, age, infrequent use and access difficulties. A positive outlook, sufficient training, support staff and user friendliness were facilitators. This study describes strategies implicated in the successful implementation of newly adopted technology in acute care settings. Improved implementation methods and evaluation of implementation processes are necessary for successful adoption of new technology.

  2. Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff

    PubMed Central

    Langhan, Melissa L.; Riera, Antonio; Kurtz, Jordan C.; Schaeffer, Paula; Asnes, Andrea G.

    2015-01-01

    Objective Technologies are not always successfully implemented into practise. We elicited experiences of acute care providers with the introduction of technology and identified barriers and facilitators in the implementation process. Methods A qualitative study using one-on-one interviews among a purposeful sample of 19 physicians and nurses within ten emergency departments and intensive care units was performed. Grounded theory, iterative data analysis and the constant comparative method were used to inductively generate ideas and build theories. Results Five major categories emerged: decision-making factors, the impact on practise, technology's perceived value, facilitators and barriers to implementation. Barriers included negative experiences, age, infrequent use, and access difficulties. A positive outlook, sufficient training, support staff, and user friendliness were facilitators. Conclusions This study describes strategies implicated in the successful implementation of newly adopted technology in acute care settings. Improved implementation methods and evaluation of implementation processes are necessary for successful adoption of new technology. PMID:25367721

  3. Factors Influencing Cloud-Computing Technology Adoption in Developing Countries

    ERIC Educational Resources Information Center

    Hailu, Alemayehu

    2012-01-01

    Adoption of new technology has complicating components both from the selection, as well as decision-making criteria and process. Although new technology such as cloud computing provides great benefits especially to the developing countries, it has challenges that may complicate the selection decision and subsequent adoption process. This study…

  4. The Role of Perceptions in Instructional Development and Adoption.

    ERIC Educational Resources Information Center

    Surry, Daniel W.; Gustafson, Kent L.

    The roles of perceptions in instructional development and adoption processes were studied with regard to the attributes of three computer-based learning modules designed for use in weather-forecasting agencies as on-site training for forecasters. Twenty-nine forecasters were the potential adoption group studied as intended end-users. Seven…

  5. Factors Influencing Cloud-Computing Technology Adoption in Developing Countries

    ERIC Educational Resources Information Center

    Hailu, Alemayehu

    2012-01-01

    Adoption of new technology has complicating components both from the selection, as well as decision-making criteria and process. Although new technology such as cloud computing provides great benefits especially to the developing countries, it has challenges that may complicate the selection decision and subsequent adoption process. This study…

  6. Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

    PubMed Central

    2013-01-01

    for sustainable e-Health adoption. Conclusions Rural e-Health implementation is an emerging, rapidly developing, field. Too often, e-Health adoption fails due to underestimating implementation factors and their interactions. We argue that rural e-Health implementation only leads to sustainable adoption (i.e. it “sticks”) when the implementation carefully considers and aligns the e-Health content (the “clicks”), the pre-existing structures in the context (the “bricks”), and the interventions in the implementation process (the “tricks”). PMID:23311452

  7. Developing and Implementing an Online Doctoral Programme

    ERIC Educational Resources Information Center

    Combe, Colin

    2005-01-01

    Purpose: This article is a critical reflection of the development and implementation of one of the first online doctoral programs in the UK set up at the University of Northumbria, Newcastle in 2000. Design/methodology/approach: The method adopted for analysis takes the form of a case study. Findings: Effective market research has to be undertaken…

  8. Developing and Implementing an Online Doctoral Programme

    ERIC Educational Resources Information Center

    Combe, Colin

    2005-01-01

    Purpose: This article is a critical reflection of the development and implementation of one of the first online doctoral programs in the UK set up at the University of Northumbria, Newcastle in 2000. Design/methodology/approach: The method adopted for analysis takes the form of a case study. Findings: Effective market research has to be undertaken…

  9. Challenges in identifying barriers to adoption in a theory-based implementation study: lessons for future implementation studies

    PubMed Central

    2012-01-01

    Background Exploring barriers to the uptake of research based recommendations into practice is an important part of the development of implementation programmes. Techniques to identify barriers can include use of theory-informed questionnaires and qualitative interviews. Conceptualising and measuring theory-informed factors, and engaging health professionals’ to uncover all potential barriers, can be a difficult task. This paper presents a case study of the process of trying to identify, systematically, the key factors influencing health professionals’ referrals for women diagnosed with mild to moderate postnatal depression for psychological treatment. The paper illustrates how the factors were conceptualised and measured and explores the real world challenges experienced, with implications for future implementation studies. Methods Theory-informed factors were conceptualised and measured using a questionnaire and interviews. The questionnaire was piloted, before being administered to general practitioners, practice nurses and health visitors working in general practices in one area of the UK NHS. The interviews were conducted with a small sample of general practitioners who had not completed the questionnaire, further exploring factors influencing their referral decisions in the local context. Results The response rate to the questionnaire was low (19%), despite selecting the recommendation to target through engagement with local stakeholders and surveying local health professionals, and despite using two reminders, an incentive prize, and phone calls to practice managers to bolster response rates. Conclusions Two significant challenges to achieving higher response rates and successfully exploring local context were identified: the difficulties of developing a robust- but feasible- questionnaire to explore theory-informed factors, and targeting recommendations that are important to policy makers, but which health professionals view as unimportant. This case

  10. Private primary care physicians' perspectives on factors affecting the adoption of electronic medical records: a qualitative pre-implementation study.

    PubMed

    Or, Calvin; Wong, Katie; Tong, Ellen; Sek, Antonio

    2014-01-01

    Use of electronic medical records (EMR) has the potential to offer quality and safety benefits, but without the adoption of the technology, the benefits will not be realized. This study aimed to identify the factors perceived as relevant by private physicians when considering EMR adoption. A qualitative pre-implementation study was conducted using semi-structured, face to face interviews to explore the perspectives of physicians (n=16) operating in private clinics on the factors affecting their adoption of EMR. A multilevel, work system approach and the immersion/crystallization data analysis technique guided the researchers in examining the data, identifying patterns and key themes, and extracting representative quotes to illustrate these themes. The major factors associated with EMR adoption, which relate to the five categories of a work system, were system usefulness; user interface design; technical support; cost; system reliability; the privacy, confidentiality, and security of patient information; physical space in the clinic; data migration process; adverse work-related factors; and the computer and systems skills of physicians. Pre-implementation identification of factors important to adoption can allow system developers to focus proactively on these factors when developing the system and its implementation strategies, to maximize the likelihood of successful introduction.

  11. Adopting and implementing nutrition guidelines in recreational facilities: tensions between public health and corporate profitability.

    PubMed

    Olstad, Dana Lee; Raine, Kim D; McCargar, Linda J

    2013-05-01

    Little is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities. In-depth semi-structured interviews were conducted. Data were analysed using directed content analysis. Food services in recreational facilities. Seven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters). Industry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete. Public-private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted.

  12. Media Competition Implementation for the Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD): Adoption and Reach

    PubMed Central

    Criss, Shaniece; Cheung, Lilian; Giles, Catherine; Gortmaker, Steven; Viswanath, Kasisomayajula; Kwass, Jo-Ann; Davison, Kirsten

    2016-01-01

    The Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD) was a multi-level, multi-sector community intervention with a media competition component to provide an overarching synergy and promote awareness of target behaviors to reduce childhood obesity. Students participating in the media competition were tasked with developing videos, song/rap lyrics, and artwork that reflected the goals. The aim of this study is to document the process used to develop and implement the media competition along with its reach and adoption. An adapted version of Neta and colleagues’ 2015 framework on dissemination and implementation was used to summarize the process by which the media competition was developed and implemented. Adoption was defined by whether eligible schools or afterschool programs decided to implement the media competition. Reach was defined by student participation rates within schools/programs and the number of votes cast for the finalists on the coalition website and students’ paper ballots. A total of 595 students participated in the media competition from 18 school and afterschool programs in two communities. Adoption of the media competitions ranged from 22% to 100% in programs and reach ranged from 3% to 33% of the student population. The documentation of the implementation should contribute to the replication of the media competition. PMID:27058549

  13. Media Competition Implementation for the Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD): Adoption and Reach.

    PubMed

    Criss, Shaniece; Cheung, Lilian; Giles, Catherine; Gortmaker, Steven; Viswanath, Kasisomayajula; Kwass, Jo-Ann; Davison, Kirsten

    2016-04-05

    The Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD) was a multi-level, multi-sector community intervention with a media competition component to provide an overarching synergy and promote awareness of target behaviors to reduce childhood obesity. Students participating in the media competition were tasked with developing videos, song/rap lyrics, and artwork that reflected the goals. The aim of this study is to document the process used to develop and implement the media competition along with its reach and adoption. An adapted version of Neta and colleagues' 2015 framework on dissemination and implementation was used to summarize the process by which the media competition was developed and implemented. Adoption was defined by whether eligible schools or afterschool programs decided to implement the media competition. Reach was defined by student participation rates within schools/programs and the number of votes cast for the finalists on the coalition website and students' paper ballots. A total of 595 students participated in the media competition from 18 school and afterschool programs in two communities. Adoption of the media competitions ranged from 22% to 100% in programs and reach ranged from 3% to 33% of the student population. The documentation of the implementation should contribute to the replication of the media competition.

  14. Developing a Broadband Adoption Model in the UK Context

    NASA Astrophysics Data System (ADS)

    Dwivedi, Yogesh K.; Mustafee, Navonil; Williams, Michael D.; Lal, Banita

    This research examines the factors affecting the consumer adoption of broadband in the United Kingdom. A conceptual model of broadband adoption was developed by selecting and justifying a number of relevant constructs from the technology adoption literature. The model was then empirically tested by employing survey data that was randomly collected from 358 UK broadband consumers. The findings suggest that, with the exception of one construct that was included in the conceptual model (namely, knowledge), all of the con structs significantly influence consumers when adopting broadband in a UK household. The significant constructs include relative advantage, utilitarian outcomes, hedonic outcomes, primary influence, facilitating conditions resources, and self-efficacy. Furthermore, when considering the behavioral intention and facilitating conditions resources constructs together, they significantly explain UK broad band adoption behavior. The theoretical contri bution of this research is that it determines and integrates the appropriate constructs from the technology adoption literature in order to enhance the knowledge of technology adoption from the consumer's perspective. This research has implications for policy makers and broadband providers since the results of this study can be exploited by the aforementioned stakeholders in order to encourage and promote the adoption and usage of broadband among the general population.

  15. Statewide dissemination of a rural, non-chain restaurant intervention: adoption, implementation and maintenance

    PubMed Central

    Nothwehr, F.; Haines, H.; Chrisman, M.; Schultz, U.

    2014-01-01

    The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States, the study targeted randomly selected, non-chain, family-style restaurants. Owners were recruited through mail, then telephone follow-up. Data were collected through telephone at baseline, and 3, 6, 12 and 18 months post-adoption. Using mixed methods, measures captured the program adoption rate, characteristics of adopters and non-adopters, program implementation and maintenance issues, and owner and customer satisfaction. Analyses involved descriptive statistics and summaries of qualitative data. The program adoption rate was 28%. Adopters were similar to responding non-adopters demographically, but varied in attitudes. The majority of restaurants maintained the program for at least 12 months. Adopters and their customers expressed satisfaction with the program. With some adjustments, the RE-AIM model was helpful in guiding evaluation of this process. Results provide implications for future dissemination of this and other programs with regard to research procedures and potential barriers that may be encountered. Research on alternative strategies for widespread dissemination of such programs is needed in this and other settings. PMID:24650944

  16. Statewide dissemination of a rural, non-chain restaurant intervention: adoption, implementation and maintenance.

    PubMed

    Nothwehr, F; Haines, H; Chrisman, M; Schultz, U

    2014-06-01

    The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States, the study targeted randomly selected, non-chain, family-style restaurants. Owners were recruited through mail, then telephone follow-up. Data were collected through telephone at baseline, and 3, 6, 12 and 18 months post-adoption. Using mixed methods, measures captured the program adoption rate, characteristics of adopters and non-adopters, program implementation and maintenance issues, and owner and customer satisfaction. Analyses involved descriptive statistics and summaries of qualitative data. The program adoption rate was 28%. Adopters were similar to responding non-adopters demographically, but varied in attitudes. The majority of restaurants maintained the program for at least 12 months. Adopters and their customers expressed satisfaction with the program. With some adjustments, the RE-AIM model was helpful in guiding evaluation of this process. Results provide implications for future dissemination of this and other programs with regard to research procedures and potential barriers that may be encountered. Research on alternative strategies for widespread dissemination of such programs is needed in this and other settings.

  17. Adoption of information technology enabled innovations by primary care physicians: model and questionnaire development.

    PubMed Central

    Dixon, D. R.; Dixon, B. J.

    1994-01-01

    A survey instrument was developed based on a model of the substantive factors influencing the adoption of Information Technology (IT) enabled innovations by physicians. The survey was given to all faculty and residents in a Primary Care teaching institution. Computerized literature searching was the IT innovation studied. The results support the role of the perceived ease of use and the perceived usefulness of an innovation as well as the intent to use an innovation as factors important for implementation. The model and survey instruments developed show significant potential to enhance our understanding of the process of implementing IT innovations such that Physicians will adopt them. PMID:7950004

  18. The early growth and development study: a prospective adoption design.

    PubMed

    Leve, Leslie D; Neiderhiser, Jenae M; Ge, Xiaojia; Scaramella, Laura V; Conger, Rand D; Reid, John B; Shaw, Daniel S; Reiss, David

    2007-02-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N=359 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study are recruited through adoption agencies located throughout the United States, following the birth of a child. Assessments occur at 6-month intervals until the child reaches 3 years of age. Data collection includes the following primary constructs: infant and toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described.

  19. The Early Growth and Development Study: A Prospective Adoption Design

    PubMed Central

    Leve, Leslie D.; Neiderhiser, Jenae M.; Ge, Xiaojia; Scaramella, Laura V.; Conger, Rand D.; Reid, John B.; Shaw, Daniel S.; Reiss, David

    2014-01-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N = 350 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study were recruited following the birth of the child through adoption agencies located throughout the United States. Assessments occur at 6-month intervals until child age 3 years. Data collection includes the following primary constructs: infant/toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described. PMID:17539368

  20. Identification of attributes that promote the adoption and implementation of 2005 Dietary Guidelines for Americans

    USDA-ARS?s Scientific Manuscript database

    As part of a larger study, this research was to identify attributes of the Dietary Guidelines for Americans (DGAs) that would promote their adoption and implementation by participants in a nutrition intervention. Project procedures were guided by the Diffusion of Innovations (DOI) theory. To identif...

  1. Assessing multilevel determinants of adoption and implementation of genomic medicine: an organizational mixed-methods approach.

    PubMed

    Oishi, Sabine M; Marshall, Nell; Hamilton, Alison B; Yano, Elizabeth M; Lerner, Barbara; Scheuner, Maren T

    2015-11-01

    Adoption and implementation of evidence-based genetic and genomic medicine have been slow. We describe a methodology for identifying the influence of organizational factors on adoption and implementation of these services in health-care organizations. We illustrate a three-component, mixed-methods health services research approach, including expert panels, qualitative interviews with key informants, and quantitative surveys completed by key informants. This research approach yielded a baseline assessment of existing genetic health-care models in the Veterans Health Administration and identified organizational barriers to and facilitators of adoption. In aggregate, the panel and key informant strategies created a communication network of relevant organizational stakeholders and a detailed foundation of organizational knowledge from which to design tools and models for implementation-level genetic/genomic translation. Expert panel and key informant strategies can be used to create a backdrop of stakeholder involvement and baseline organizational knowledge within which to plan translation research and to inform strategic planning and policies for adoption and implementation of genetic services in health-care organizations.

  2. 76 FR 4578 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised Lead Standards and Related Reference Conditions, and Update of Appendices AGENCY... conditions, and update the list of appendices under ``Documents Incorporated by Reference.'' In the Final...

  3. 76 FR 14805 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised Lead Standards and Related Reference Conditions and Update of Appendices; Withdrawal... lead standards of 0.15 micrograms per cubic meter ( g/m3), related reference conditions, and update the...

  4. 49 CFR 1548.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 9 2014-10-01 2014-10-01 false Adoption and implementation of the security program. 1548.5 Section 1548.5 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY INDIRECT...

  5. 49 CFR 1548.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 9 2012-10-01 2012-10-01 false Adoption and implementation of the security program. 1548.5 Section 1548.5 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY INDIRECT...

  6. 49 CFR 1548.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 9 2013-10-01 2013-10-01 false Adoption and implementation of the security program. 1548.5 Section 1548.5 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY INDIRECT...

  7. 49 CFR 1549.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SCREENING PROGRAM General § 1549.5 Adoption and implementation of the security program. (a) Security program... approved security program under this part. (b) Content. Each security program under this part must— (1... certified cargo screening facility's security program; (2) Be designed to prevent or deter the introduction...

  8. 49 CFR 1549.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SCREENING PROGRAM General § 1549.5 Adoption and implementation of the security program. (a) Security program... approved security program under this part. (b) Content. Each security program under this part must— (1... certified cargo screening facility's security program; (2) Be designed to prevent or deter the introduction...

  9. 49 CFR 1549.5 - Adoption and implementation of the security program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SCREENING PROGRAM General § 1549.5 Adoption and implementation of the security program. (a) Security program... approved security program under this part. (b) Content. Each security program under this part must— (1... certified cargo screening facility's security program; (2) Be designed to prevent or deter the introduction...

  10. A Framework for Institutional Adoption and Implementation of Blended Learning in Higher Education

    ERIC Educational Resources Information Center

    Graham, Charles R.; Woodfield, Wendy; Harrison, J. Buckley

    2013-01-01

    There has been rapid growth in blended learning implementation and research focused on course-level issues such as improved learning outcomes, but very limited research focused on institutional policy and adoption issues. More institutional-level blended learning research is needed to guide institutions of higher education in strategically…

  11. A Framework for Institutional Adoption and Implementation of Blended Learning in Higher Education

    ERIC Educational Resources Information Center

    Graham, Charles R.; Woodfield, Wendy; Harrison, J. Buckley

    2013-01-01

    There has been rapid growth in blended learning implementation and research focused on course-level issues such as improved learning outcomes, but very limited research focused on institutional policy and adoption issues. More institutional-level blended learning research is needed to guide institutions of higher education in strategically…

  12. Statewide Adoption and Initial Implementation of Contingency Management for Substance-Abusing Adolescents

    ERIC Educational Resources Information Center

    Henggeler, Scott W.; Chapman, Jason E.; Rowland, Melisa D.; Halliday-Boykins, Colleen A.; Randall, Jeff; Shackelford, Jennifer; Schoenwald, Sonja K.

    2008-01-01

    Four hundred thirty-two public sector therapists attended a workshop in contingency management (CM) and were interviewed monthly for the following 6 months to assess their adoption and initial implementation of CM to treat substance-abusing adolescent clients. Results showed that 58% (n = 131) of the practitioners with at least one…

  13. 76 FR 18870 - Requirements for Preparation, Adoption, and Submittal of Implementation Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... From the Federal Register Online via the Government Publishing Office ] ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 51 Requirements for Preparation, Adoption, and Submittal of Implementation Plans CFR Correction In Title 40 of the Code of Federal Regulations, Parts 50 to 51, revised as of July 1, 2010, on...

  14. Improving children's nutrition environments: A survey of adoption and implementation of nutrition guidelines in recreational facilities

    PubMed Central

    2011-01-01

    Background Although the mandate of recreational facilities is to enhance well-being, many offer foods inconsistent with recommendations for healthy eating. Little is known regarding recreational facility food environments and how they might be improved, as few studies exist. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are intended to ensure access to healthy food choices in schools, childcare and recreational facilities. This study investigated awareness, adoption and implementation of the ANGCY among recreational facilities in Alberta, Canada, one year following their release. Methods A cross-sectional telephone survey was conducted from June - December, 2009 (n = 151) with managers of publicly funded recreational facilities that served food. The questionnaire included 10 closed and 7 open ended questions to assess the organizational priority for healthy eating, awareness, adoption and implementation of the ANGCY. Chi-squared tests examined quantitative variables, while qualitative data were analysed using directed content analysis. Greenhalgh's model of diffusion of complex innovations within health service organizations constituted the theoretical framework for the study. Results One half of respondents had heard of the ANGCY, however their knowledge of them was limited. Although 51% of facilities had made changes to improve the nutritional quality of foods offered in the past year, only a small fraction (11%) of these changes were motivated by the ANGCY. At the time of the survey, 14% of facilities had adopted the ANGCY and 6% had implemented them. Barriers to adoption and implementation were primarily related to perceived negative attributes of the ANGCY, the inner (organizational) context, and negative feedback received during the implementation process. Managers strongly perceived that implementing nutrition guidelines would limit their profit-making ability. Conclusions If fully adopted and implemented, the ANGCY have the potential to

  15. Adoption and implementation of strategies for diabetes management in primary care practices.

    PubMed

    Weiner, Bryan J; Helfrich, Christian D; Savitz, Lucy A; Swiger, Kathleen D

    2007-07-01

    Secondary and tertiary prevention of chronic illness is a major challenge for the United States healthcare system. Controlled studies show that interventions can enhance secondary prevention in primary care practices, but they shed little light on implementation of secondary prevention outside the experimental context. This study examines the adoption and implementation of an important set of secondary and tertiary prevention efforts--diabetes management strategies--for type 2 diabetes in the everyday clinical practice of primary care. It explores whether adoption and implementation processes differ by type of strategy or prevalence of diabetes among patients in the practice. Holistic case studies (those used to assess a single analytic unit, in this case, the physician group practice, as opposed to multiple embedded subunits) were conducted in 2001-2002 on six primary care practices in North Carolina identified from a statewide physician survey on strategies for diabetes management. Practices were selected by prevalence of diabetes and type of strategy for diabetes management--patient oriented (focused on self-management) versus biomedical (focused on secondary prevention practices). Results were derived from thematic analysis of interviews and secondary documents. Adoption and implementation did not differ by diabetes prevalence or type of diabetes strategy. All practices had a routine forum for vetting new strategies, and most used traditional channels for identifying them. Implementation often required adaptation of the strategy and the organization. Sustained use of a diabetes strategy depended on favorable organizational policies and procedures (e.g., training, job redesign) and ongoing commitment of resources. Diabetes management strategies are often complex and require adoption and implementation processes different from those described by classic innovation diffusion models. Alternative conceptual models that consider organizational process, structure, and

  16. Adoption and Implementation of Physical Activity and Dietary Counseling by Community Health Center Providers and Nurses

    PubMed Central

    Wilcox, Sara; Parra-Medina, Deborah; Felton, Gwen M.; Poston, Mary Elizabeth; McClain, Amanda

    2011-01-01

    Background Primary care providers are expected to provide lifestyle counseling, yet many barriers exist. Few studies report on adoption and implementation in routine practice. This study reports training, adoption, and implementation of an intervention to promote physical activity (PA) and dietary counseling in community health centers. Methods Providers (n = 30) and nurses (n = 28) from 9 clinics were invited to participate. Adopters completed CD-ROM training in stage-matched, patient-centered counseling and goal setting. Encounters were audio recorded. A subsample was coded for fidelity. Results Fifty-seven percent of providers and nurses adopted the program. Provider counseling was seen in 66% and nurse goal setting in 58% of participant (N = 266) encounters, although audio recordings were lower. Duration of provider counseling and nurse goal setting was 4.9 ± 4.5 and 7.3 ± 3.8 minutes, respectively. Most PA (80%) and diet (94%) goals were stage-appropriate. Although most providers discussed at least 1 behavioral topic, some topics (eg, self-efficacy, social support) were rarely covered. Conclusions A sizeable percentage of providers and nurses completed training, rated it favorably, and delivered lifestyle counseling, although with variable fidelity. With low implementation cost and limited office time required, this model has the potential to be disseminated to improve counseling rates in primary care. PMID:20864755

  17. A Reach, Effectiveness, Adoption, Implementation, Maintenance Evaluation of Weekend Backpack Food Assistance Programs.

    PubMed

    Shanks, Carmen Byker; Harden, Samantha

    2016-09-01

    The purpose of this study was to evaluate an ongoing statewide weekend backpack program through the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Mixed-methods inquiry was used to explore the reach, effectiveness, adoption, implementation, and maintenance of backpack programs within Montana. Study participants completed audio-recorded one-on-one phone interviews. Key informants (e.g., managers at food banks, staff at participating schools, policy makers) were purposively sampled (N = 20). Semistructured interviews were conducted to gather data to describe each RE-AIM dimension. Interviews were transcribed verbatim and deductively (i.e., using RE-AIM as themes) coded for meaning units, placed into higher-order categories, and summarized in narrative. Supporting quantitative data (e.g., the proportion of eligible students that joined the program, rate of school-level adoption) were calculated using descriptive statistics. Backpack programs with a broad reach and evidenced effect may be appealing to adopt. Weekend food bags cost an average $3.87 (SD ± .94) and there were some positive (i.e., ease, protecting participants' privacy) and very few negative (logistical) components of implementation. Collaborators and community partners are necessary for long-term sustainability. Backpack programs are widespread and have potential to relieve weekend hunger; however, more efforts need to be made to end childhood hunger. © 2016 by American Journal of Health Promotion, Inc.

  18. Adoption, implementation and prioritization of specialist outreach policy in Australia: a national perspective.

    PubMed

    O'Sullivan, Belinda G; Joyce, Catherine M; McGrail, Matthew R

    2014-07-01

    The World Health Organization has endorsed the use of outreach to promote: efficient redeployment of the health-care workforce; continuity of care at the local level; and professional support for local, rural, health-care workers. Australia is the only country that has had, since 2000, a sustained national policy on outreach for subsidizing medical specialist outreach to rural areas. This paper describes the adoption, implementation and prioritization of a national specialist outreach policy in Australia. Adoption of the national policy followed a long history of successful outreach, largely driven by the professional interest and personal commitment of the workforce. Initially the policy supported only new outreach services but concerns about the sustainability of existing services resulted in eligibility for funding being extended to all specialist services. The costs of travel, travel time, accommodation, professional support, staff relief at specialists' primary practices and equipment hire were subsidized. Over time, a national political commitment to the equitable treatment of indigenous people resulted in more targeted support for outreach in remote areas. Current priorities are: (i) establishing team-based outreach services; (ii) improving local staff's skills; (iii) achieving local coordination; and (iv) conducting a nationally consistent needs assessment. The absence of subsidies for specialists' clinical work can discourage private specialists from providing services in remote areas where clinical throughput is low. To be successful, outreach policy must harmonize with the interests of the workforce and support professional autonomy. Internationally, the development of outreach policy must take account of the local pay and practice conditions of health workers.

  19. Adoption, implementation and prioritization of specialist outreach policy in Australia: a national perspective

    PubMed Central

    Joyce, Catherine M; McGrail, Matthew R

    2014-01-01

    Abstract The World Health Organization has endorsed the use of outreach to promote: efficient redeployment of the health-care workforce; continuity of care at the local level; and professional support for local, rural, health-care workers. Australia is the only country that has had, since 2000, a sustained national policy on outreach for subsidizing medical specialist outreach to rural areas. This paper describes the adoption, implementation and prioritization of a national specialist outreach policy in Australia. Adoption of the national policy followed a long history of successful outreach, largely driven by the professional interest and personal commitment of the workforce. Initially the policy supported only new outreach services but concerns about the sustainability of existing services resulted in eligibility for funding being extended to all specialist services. The costs of travel, travel time, accommodation, professional support, staff relief at specialists’ primary practices and equipment hire were subsidized. Over time, a national political commitment to the equitable treatment of indigenous people resulted in more targeted support for outreach in remote areas. Current priorities are: (i) establishing team-based outreach services; (ii) improving local staff’s skills; (iii) achieving local coordination; and (iv) conducting a nationally consistent needs assessment. The absence of subsidies for specialists’ clinical work can discourage private specialists from providing services in remote areas where clinical throughput is low. To be successful, outreach policy must harmonize with the interests of the workforce and support professional autonomy. Internationally, the development of outreach policy must take account of the local pay and practice conditions of health workers. PMID:25110376

  20. Language development in preschool-age children adopted from China.

    PubMed

    Roberts, Jenny A; Pollock, Karen E; Krakow, Rena; Price, Johanna; Fulmer, Kathleen C; Wang, Paul P

    2005-02-01

    This study examined the language development of 55 preschool-age children adopted from China who had resided in their permanent homes for approximately 2 years or longer. Slightly over 5% of the children scored below average on 2 or more measures from a battery of standardized speech-language tests normed on monolingual English speakers. However, the vast majority scored within or well above the average range on 2 or more measures. Contrary to other reports on the language development of internationally adopted children, the results suggest that "second first language" acquisition proceeds rapidly in the majority of preschool-age children adopted as infants and toddlers. For the children in the sample who scored below average, results indicated that they were among the children who had been exposed to English for the least amount of time. The results of this study demonstrate both the robustness of the language system in the majority of adopted children from China as well as slower growth in a small subset of lower performers in the 1st years after adoption.

  1. Implementation of fluorescence confocal mosaicing microscopy by "early adopter" Mohs surgeons: a review of recent progress

    NASA Astrophysics Data System (ADS)

    Jain, Manu; Rajadhyaksha, Milind; Nehal, Kishwer

    2016-03-01

    Confocal mosaicing microscopy (CMM) enables rapid imaging of large areas of fresh tissue ex vivo without the processing that is necessary for conventional histology. When performed with fluorescence mode using acridine orange (nuclear specific dye) it enhances nuclei-to-dermis contrast that enables detection of all types of BCCs including thin strands of infiltrative basal cell carcinomas (BCCs). Thus far, this technique has been mostly validated in research setting for the analysis of BCC tumor margins. Recently, CMM has been adopted and implemented in real clinical settings by some surgeons as an alternative tool to frozen section (FS) during Mohs surgery. In this review article we summarize the development of CMM guided imaging of ex vivo tissues from bench to bedside. We also present its current state of application in routine clinical workflow not only for the assessment of BCC margin but also for other skin cancers such as melanoma, SCC, and some infectious diseases where FS is not routinely performed. Lastly, we also discuss the potential limitations of this technology as well as future developments. As this technology advances further, it may serve as an adjunct to standard histology and enable rapid surgical pathology of skin cancers at the bedside.

  2. Implementation of fluorescence confocal mosaicking microscopy by ``early adopter'' Mohs surgeons and dermatologists: recent progress

    NASA Astrophysics Data System (ADS)

    Jain, Manu; Rajadhyaksha, Milind; Nehal, Kishwer

    2017-02-01

    Confocal mosaicking microscopy (CMM) enables rapid imaging of large areas of fresh tissue ex vivo without the processing that is necessary for conventional histology. When performed in fluorescence mode using acridine orange (nuclear specific dye), it enhances nuclei-to-dermis contrast that enables detection of all types of basal cell carcinomas (BCCs), including micronodular and thin strands of infiltrative types. So far, this technique has been mostly validated in research settings for the detection of residual BCC tumor margins with high sensitivity of 89% to 96% and specificity of 99% to 89%. Recently, CMM has advanced to implementation and testing in clinical settings by "early adopter" Mohs surgeons, as an adjunct to frozen section during Mohs surgery. We summarize the development of CMM guided imaging of ex vivo skin tissues from bench to bedside. We also present its current state of application in routine clinical workflow not only for the assessment of residual BCC margins in the Mohs surgical setting but also for some melanocytic lesions and other skin conditions in clinical dermatology settings. Last, we also discuss the potential limitations of this technology as well as future developments. As this technology advances further, it may serve as an adjunct to standard histology and enable rapid surgical pathology of skin cancers at the bedside.

  3. Obstacles to integrated pest management adoption in developing countries.

    PubMed

    Parsa, Soroush; Morse, Stephen; Bonifacio, Alejandro; Chancellor, Timothy C B; Condori, Bruno; Crespo-Pérez, Verónica; Hobbs, Shaun L A; Kroschel, Jürgen; Ba, Malick N; Rebaudo, François; Sherwood, Stephen G; Vanek, Steven J; Faye, Emile; Herrera, Mario A; Dangles, Olivier

    2014-03-11

    Despite its theoretical prominence and sound principles, integrated pest management (IPM) continues to suffer from anemic adoption rates in developing countries. To shed light on the reasons, we surveyed the opinions of a large and diverse pool of IPM professionals and practitioners from 96 countries by using structured concept mapping. The first phase of this method elicited 413 open-ended responses on perceived obstacles to IPM. Analysis of responses revealed 51 unique statements on obstacles, the most frequent of which was "insufficient training and technical support to farmers." Cluster analyses, based on participant opinions, grouped these unique statements into six themes: research weaknesses, outreach weaknesses, IPM weaknesses, farmer weaknesses, pesticide industry interference, and weak adoption incentives. Subsequently, 163 participants rated the obstacles expressed in the 51 unique statements according to importance and remediation difficulty. Respondents from developing countries and high-income countries rated the obstacles differently. As a group, developing-country respondents rated "IPM requires collective action within a farming community" as their top obstacle to IPM adoption. Respondents from high-income countries prioritized instead the "shortage of well-qualified IPM experts and extensionists." Differential prioritization was also evident among developing-country regions, and when obstacle statements were grouped into themes. Results highlighted the need to improve the participation of stakeholders from developing countries in the IPM adoption debate, and also to situate the debate within specific regional contexts.

  4. Obstacles to integrated pest management adoption in developing countries

    PubMed Central

    Parsa, Soroush; Morse, Stephen; Bonifacio, Alejandro; Chancellor, Timothy C. B.; Condori, Bruno; Crespo-Pérez, Verónica; Hobbs, Shaun L. A.; Kroschel, Jürgen; Ba, Malick N.; Rebaudo, François; Sherwood, Stephen G.; Vanek, Steven J.; Faye, Emile; Herrera, Mario A.; Dangles, Olivier

    2014-01-01

    Despite its theoretical prominence and sound principles, integrated pest management (IPM) continues to suffer from anemic adoption rates in developing countries. To shed light on the reasons, we surveyed the opinions of a large and diverse pool of IPM professionals and practitioners from 96 countries by using structured concept mapping. The first phase of this method elicited 413 open-ended responses on perceived obstacles to IPM. Analysis of responses revealed 51 unique statements on obstacles, the most frequent of which was “insufficient training and technical support to farmers.” Cluster analyses, based on participant opinions, grouped these unique statements into six themes: research weaknesses, outreach weaknesses, IPM weaknesses, farmer weaknesses, pesticide industry interference, and weak adoption incentives. Subsequently, 163 participants rated the obstacles expressed in the 51 unique statements according to importance and remediation difficulty. Respondents from developing countries and high-income countries rated the obstacles differently. As a group, developing-country respondents rated “IPM requires collective action within a farming community” as their top obstacle to IPM adoption. Respondents from high-income countries prioritized instead the “shortage of well-qualified IPM experts and extensionists.” Differential prioritization was also evident among developing-country regions, and when obstacle statements were grouped into themes. Results highlighted the need to improve the participation of stakeholders from developing countries in the IPM adoption debate, and also to situate the debate within specific regional contexts. PMID:24567400

  5. Language Development in Preschool-Age Children Adopted from China.

    ERIC Educational Resources Information Center

    Roberts, Jenny A.; Pollock, Karen E.; Krakow, Rena; Price, Johanna; Fulmer, Kathleen C.; Wang, Paul P.

    2005-01-01

    This study examined the language development of 55 preschool-age children adopted from China who had resided in their permanent homes for approximately 2 years or longer. Slightly over 5% of the children scored below average on 2 or more measures from a battery of standardized speech-language tests normed on monolingual English speakers. However,…

  6. The timing and sources of information for the adoption and implementation of production innovations

    NASA Technical Reports Server (NTRS)

    Ettlie, J. E.

    1976-01-01

    Two dimensions (personal-impersonal and internal-external) are used to characterize information sources as they become important during the interorganizational transfer of production innovations. The results of three studies are reviewed for the purpose of deriving a model of the timing and importance of different information sources and the utilization of new technology. Based on the findings of two retrospective studies, it was concluded that the pattern of information seeking behavior in user organizations during the awareness stage of adoption is not a reliable predictor of the eventual utilization rate. Using the additional findings of a real-time study, an empirical model of the relative importance of information sources for successful user organizations is presented. These results are extended and integrated into a theoretical model consisting of a time-profile of successful implementations and the relative importance of four types of information sources during seven stages of the adoption-implementation process.

  7. The timing and sources of information for the adoption and implementation of production innovations

    NASA Technical Reports Server (NTRS)

    Ettlie, J. E.

    1976-01-01

    Two dimensions (personal-impersonal and internal-external) are used to characterize information sources as they become important during the interorganizational transfer of production innovations. The results of three studies are reviewed for the purpose of deriving a model of the timing and importance of different information sources and the utilization of new technology. Based on the findings of two retrospective studies, it was concluded that the pattern of information seeking behavior in user organizations during the awareness stage of adoption is not a reliable predictor of the eventual utilization rate. Using the additional findings of a real-time study, an empirical model of the relative importance of information sources for successful user organizations is presented. These results are extended and integrated into a theoretical model consisting of a time-profile of successful implementations and the relative importance of four types of information sources during seven stages of the adoption-implementation process.

  8. Barriers to adopting and implementing local-level tobacco control policies.

    PubMed

    Satterlund, Travis D; Cassady, Diana; Treiber, Jeanette; Lemp, Cathy

    2011-08-01

    Although California communities have been relatively successful in adopting and implementing a wide range of local tobacco control policies, the process has not been without its setbacks and barriers. Little is known about local policy adoption, and this paper examines these processes related to adopting and implementing outdoor smoke-free policies, focusing on the major barriers faced by local-level tobacco control organizations in this process. Ninety-six projects funded by the California Tobacco Control Program submitted final evaluation reports pertaining to an outdoor smoking objective, and the reports from these projects were analyzed. The barriers were grouped in three primary areas: politically polarizing barriers, organizational barriers, and local political orientation. The barriers identified in this study underscore the need for an organized action plan in adopting local tobacco policy. The authors also suggest potential strategies to offset the barriers, including: (1) having a "champion" who helps to carry an objective forward; (2) tapping into a pool of youth volunteers; (3) collecting and using local data as a persuasive tool; (4) educating the community in smoke-free policy efforts; (5) working strategically within the local political climate; and (6) demonstrating to policymakers the constituent support for proposed policy.

  9. Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study.

    PubMed

    Wu, R Ryanne; Myers, Rachel A; McCarty, Catherine A; Dimmock, David; Farrell, Michael; Cross, Deanna; Chinevere, Troy D; Ginsburg, Geoffrey S; Orlando, Lori A

    2015-11-24

    Risk assessment with a thorough family health history is recommended by numerous organizations and is now a required component of the annual physical for Medicare beneficiaries under the Affordable Care Act. However, there are several barriers to incorporating robust risk assessments into routine care. MeTree, a web-based patient-facing health risk assessment tool, was developed with the aim of overcoming these barriers. In order to better understand what factors will be instrumental for broader adoption of risk assessment programs like MeTree in clinical settings, we obtained funding to perform a type III hybrid implementation-effectiveness study in primary care clinics at five diverse healthcare systems. Here, we describe the study's protocol. MeTree collects personal medical information and a three-generation family health history from patients on 98 conditions. Using algorithms built entirely from current clinical guidelines, it provides clinical decision support to providers and patients on 30 conditions. All adult patients with an upcoming well-visit appointment at one of the 20 intervention clinics are eligible to participate. Patient-oriented risk reports are provided in real time. Provider-oriented risk reports are uploaded to the electronic medical record for review at the time of the appointment. Implementation outcomes are enrollment rate of clinics, providers, and patients (enrolled vs approached) and their representativeness compared to the underlying population. Primary effectiveness outcomes are the percent of participants newly identified as being at increased risk for one of the clinical decision support conditions and the percent with appropriate risk-based screening. Secondary outcomes include percent change in those meeting goals for a healthy lifestyle (diet, exercise, and smoking). Outcomes are measured through electronic medical record data abstraction, patient surveys, and surveys/qualitative interviews of clinical staff. This study

  10. Internationally Adopted Children from Non-European Countries: General Development during the First Two Years in the Adoptive Family

    PubMed Central

    Dalen, Monica; Theie, Steinar

    2012-01-01

    Internationally adopted children are often delayed in their development and demonstrate more behaviour problems than nonadopted children due to adverse preadoption circumstances. This is especially true for children adopted from Eastern European countries. Few studies have focused on children adopted from non-European countries. This paper presents results from an ongoing longitudinal study of 119 internationally adopted children from non-European countries during their first two years in Norway. Several scales measuring different aspects of the children's development are included in the study: communication and gross motor development, temperamental characteristics, and behaviour problems. The results show that internationally adopted children are delayed in their general development when they first arrive in their adoptive families. After two years the children have made significant progress in development. However, they still lag behind in communication and motor skills compared to non-adopted children. The temperamental characteristics seem very stable from time of adoption until two years after adoption. The children demonstrate a low frequency of behaviour problems. However, the behaviour problems have changed during the two years. At time of adoption they show more nonphysically challenging behaviour while after two years their physically challenging behaviour has increased. PMID:22919309

  11. Implementing Nursing Professional Development.

    PubMed

    Bruce, Sandra L

    2016-01-01

    Sandra Bruce is the Nurse Education Program Manager, Air Force Personnel Center, Joint Base San Antonio-Randolph in Texas, and is responsible for the Air Force Continuing Nursing Education program and facilitation of selection boards for graduate education and fellowship programs. She served as editor for the third and fourth editions of the Association for Nursing Professional Development (ANPD) Core Curriculums for Nursing Professional Development. Sandy previously served as the Education Consultant to the Air Force Surgeon General for Nursing Education programs for over 3,000 Air Force Nurse Corps members. She received her BSN from Mercy College of Detroit in 1976 and entered the Air Force in 1982. The Air Force sponsored her Master's Degree in Nursing as a Clinical Nurse Specialist.

  12. Factors Influencing Adoption and Implementation of Cooking with Kids, an Experiential School-Based Nutrition Education Curriculum

    ERIC Educational Resources Information Center

    Diker, Ann; Walters, Lynn M.; Cunningham-Sabo, Leslie; Baker, Susan S.

    2011-01-01

    Little research has been conducted to examine factors leading to adoption and implementation of nutrition education curricula. Data from two Web-based surveys (n = 313) and 27 interviews were used to explore how Diffusion of Innovations' perceived attributes contributed to adoption and implementation of Cooking with Kids (CWK) food and nutrition…

  13. Factors Influencing Adoption and Implementation of Cooking with Kids, an Experiential School-Based Nutrition Education Curriculum

    ERIC Educational Resources Information Center

    Diker, Ann; Walters, Lynn M.; Cunningham-Sabo, Leslie; Baker, Susan S.

    2011-01-01

    Little research has been conducted to examine factors leading to adoption and implementation of nutrition education curricula. Data from two Web-based surveys (n = 313) and 27 interviews were used to explore how Diffusion of Innovations' perceived attributes contributed to adoption and implementation of Cooking with Kids (CWK) food and nutrition…

  14. .Adoption and further development of the CIRA -2008 -Introduction

    NASA Astrophysics Data System (ADS)

    Rees, David; Bowman, Bruce R.; Vaughan, William

    This is an introduction to the series of Solicited Review Talks to be presented within this Meeting on the Adoption and further development of CIRA -2008. This will include additional activities demonstratingthe validation of the new Models, the limits of the currently-available Models, and the likely further stages stages of developments through which future improvements may be possible. A new activity to update Models of the Minor and Trace species of the Middle and Upper Atmosphere will also be started during this Meeting.

  15. Growth & development of Indian children adopted in Sweden.

    PubMed

    Proos, Lemm A

    2009-11-01

    More than 6800 children from India have been adopted in Sweden over the last four decades. At arrival many were undernourished and suffered from infectious diseases. Catch-up growth was common. Unexpectedly, cases of early pubertal development were subsequently reported. In order to investigate the growth and development of adopted children more in detail we studied 114 children adopted from India prospectively during two years. The majority were stunted at arrival and caught up in height and weight after two years. Psychomotor retardation and common infections diminished fairly soon. Those that were stunted did not attain the higher catch-up levels of those not stunted at arrival. Low birthweight also limited the degree of catch-up growth. 107 girls were analysed retrospectively in another study. The median menarcheal age was 11.6 yr (range 7.3-14.6 yr) which is significantly earlier than the mean in Swedish and privileged Indian girls (13.0 and 12.4-12.9 yr, respectively). The pubertal linear growth component was normal in duration and magnitude but likewise started 1.5 yr earlier. The final height/age was 154 cm (-1.4 SDS) and the weight/age 46.9 kg (-1.1 SDS) 8 per cent were 145 cm or shorter. Stunting limited catch-up growth and final height. Those that were most stunted at arrival, and had the fastest catch-up growth, had the earliest menarche. Good maternal and child nutrition is necessary for full expression of a child's growth potential. What is lost in growth early in life can only partially be recovered by catch-up growth. Such growth is associated with risk for early pubertal development which abbreviates the childhood growth period and limits final height. The mechanism underlying the early pubertal development, and the optimal management of nutrition rehabilitation after chronic malnutrition, need to be clarified by further studies.

  16. Desktop Publishing: Organizational Considerations for Adoption and Implementation. TDC Research Report No. 6.

    ERIC Educational Resources Information Center

    Lee, Paul

    This report explores the implementation of desktop publishing in the Minnesota Extension Service (MES) and provides a framework for its implementation in other organizations. The document begins with historical background on the development of desktop publishing. Criteria for deciding whether to purchase a desktop publishing system, advantages and…

  17. Adopting a Resilience Practice Framework: A Case Study in What to Select and How to Implement

    ERIC Educational Resources Information Center

    Antcliff, Greg; Mildon, Robyn; Baldwin, Laura; Michaux, Annette; Nay, Cherie

    2014-01-01

    This paper describes the collaborative application of three theoretical models for supporting service planning (Hunter, 2006), programme planning (Chorpita et al, 2005a), and implementation (Meyers et al, 2012) to develop and implement a Resilience Practice Framework (RPF). Specifically, we (1) describe a theory of change framework (Hunter, 2006)…

  18. The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model

    PubMed Central

    Grouchy, Michelle; Graham, Ian D.; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E.

    2016-01-01

    Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites. Lessons learned include the following: assess readiness, develop tailored implementation materials, consider characteristics of implementation supports, protect champion time and consider evaluation feasibility. PMID:27232234

  19. Implementation of Job Development Practices

    ERIC Educational Resources Information Center

    Migliore, Alberto; Butterworth, John; Nord, Derek; Cox, Monica; Gelb, Amy

    2012-01-01

    We investigated the extent to which employment consultants implemented job development practices recommended in the literature when assisting job seekers with intellectual or developmental disabilities. We contacted 83 employment consultants from 25 employment programs in Minnesota and Connecticut. Fifty-nine participants were eligible and…

  20. Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory.

    PubMed

    Carlfjord, Siw; Lindberg, Malou; Bendtsen, Preben; Nilsen, Per; Andersson, Agneta

    2010-08-23

    Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process, and the factors that play a role in the change process are not yet fully understood. There is a number of theories concerned with factors predicting successful implementation in various settings, however, this issue is insufficiently studied in primary health care (PHC). The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in PHC in Sweden. A qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption. The theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process. When implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the perceived need for the innovation to be implemented, and of its

  1. Adopting and implementing nutrition guidelines in recreational facilities: public and private sector roles. A multiple case study.

    PubMed

    Olstad, Dana Lee; Raine, Kim D; McCargar, Linda J

    2012-05-25

    Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children's access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them. We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools. The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers' nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY. ANGCY uptake may continue to falter under the current voluntary approach, as the environmental supports for

  2. Designing for sustained adoption: A model of developing educational innovations for successful propagation

    NASA Astrophysics Data System (ADS)

    Khatri, Raina; Henderson, Charles; Cole, Renée; Froyd, Jeffrey E.; Friedrichsen, Debra; Stanford, Courtney

    2016-06-01

    [This paper is part of the Focused Collection on Preparing and Supporting University Physics Educators.] The physics education research community has produced a wealth of knowledge about effective teaching and learning of college level physics. Based on this knowledge, many research-proven instructional strategies and teaching materials have been developed and are currently available to instructors. Unfortunately, these intensive research and development activities have failed to influence the teaching practices of many physics instructors. This paper describes interim results of a larger study to develop a model of designing materials for successful propagation. The larger study includes three phases, the first two of which are reported here. The goal of the first phase was to characterize typical propagation practices of education developers, using data from a survey of 1284 National Science Foundation (NSF) principal investigators and focus group data from eight disciplinary groups of NSF program directors. The goal of the second phase was to develop an understanding of successful practice by studying three instructional strategies that have been well propagated. The result of the first two phases is a tentative model of designing for successful propagation, which will be further validated in the third phase through purposeful sampling of additional well-propagated instructional strategies along with typical education development projects. We found that interaction with potential adopters was one of the key missing ingredients in typical education development activities. Education developers often develop a polished product before getting feedback, rely on mass-market communication channels for dissemination, and do not plan for supporting adopters during implementation. The tentative model resulting from this study identifies three key propagation activities: interactive development, interactive dissemination, and support of adopters. Interactive development

  3. Adoption of Test Driven Development and Continuous Integration for the Development of the Trick Simulation Toolkit

    NASA Technical Reports Server (NTRS)

    Penn, John M.

    2013-01-01

    This paper describes the adoption of a Test Driven Development approach and a Continuous Integration System in the development of the Trick Simulation Toolkit, a generic simulation development environment for creating high fidelity training and engineering simulations at the NASA/Johnson Space Center and many other NASA facilities. It describes what was learned and the significant benefits seen, such as fast, thorough, and clear test feedback every time code is checked-in to the code repository. It also describes a system that encourages development of code that is much more flexible, maintainable, and reliable. The Trick Simulation Toolkit development environment provides a common architecture for user-defined simulations. Trick builds executable simulations using user-supplied simulation-definition files (S_define) and user supplied "model code". For each Trick-based simulation, Trick automatically provides job scheduling, checkpoint / restore, data-recording, interactive variable manipulation (variable server), and an input-processor. Also included are tools for plotting recorded data and various other supporting tools and libraries. Trick is written in C/C++ and Java and supports both Linux and MacOSX. Prior to adopting this new development approach, Trick testing consisted primarily of running a few large simulations, with the hope that their complexity and scale would exercise most of Trick's code and expose any recently introduced bugs. Unsurprising, this approach yielded inconsistent results. It was obvious that a more systematic, thorough approach was required. After seeing examples of some Java-based projects that used the JUnit test framework, similar test frameworks for C and C++ were sought. Several were found, all clearly inspired by JUnit. Googletest, a freely available Open source testing framework, was selected as the most appropriate and capable. The new approach was implemented while rewriting the Trick memory management component, to eliminate a

  4. Implementation and adoption of mechanical patient lift equipment in the hospital setting: The importance of organizational and cultural factors.

    PubMed

    Schoenfisch, Ashley L; Myers, Douglas J; Pompeii, Lisa A; Lipscomb, Hester J

    2011-12-01

    Work focused on understanding implementation and adoption of interventions designed to prevent patient-handling injuries in the hospital setting is lacking in the injury literature and may be more insightful than more traditional evaluation measures. Data from focus groups with health care workers were used to describe barriers and promoters of the adoption of patient lift equipment and a shift to a "minimal-manual lift environment" at two affiliated hospitals. Several factors influencing the adoption of the lift equipment and patient-handling policy were noted: time, knowledge/ability, staffing, patient characteristics, and organizational and cultural aspects of work. The adoption process was complex, and considerable variability by hospital and across units was observed. The use of qualitative data can enhance the understanding of factors that influence implementation and adoption of interventions designed to prevent patient-handling injuries among health care workers. Copyright © 2011 Wiley Periodicals, Inc.

  5. Development, Adoption, and Implementation of Military Sentencing Guidelines

    DTIC Science & Technology

    2000-04-01

    Sentencing Guidelines, 101 HARV. L. REv. 1938, 1940-41. (1988). 140 See Herbert J. Hoelter et. al., Practicing Law in the Americas: The New Hemispheric Reality...1251-53. 141 See Hoelter et. al., supra note 140, at 1078. 142 See Stith, supra note 136, at 1251-53. 30 Sentencing in the 20th Century was the...restitution came under 143 Id. 144 Id. 145 See Ogletree, supra note 139, at 1941-1942. 146 Id. 147 See Hoelter et. al., supra note 140, at 1075. 148 Exodus

  6. [Maternal mortality in developing countries: what strategies to adopt?].

    PubMed

    de Bernis, L

    2003-01-01

    Despite an international consensus on the strategies necessary to achieve a massive reduction of maternal mortality and related neonatal mortality, many countries have made no progress in these areas. The main reason for this failure is that this aspect of public health and the basic human right to bear children under acceptably safe and respectable conditions have received neither sufficient attention from governments in developing countries nor long-term technical and financial support from rich countries. Yet a sound health care system that is accessible to the poorest classes is prerequisite for durable socio-economic development. Implementation of the UN Millennium Development Goals (MDG) provides an excellent opportunity to reaffirm the need for massive support of programs undertaken in this domain by developing countries and for implementation of an effective strategy to enhance access to quality care for the poorest classes. The purpose of this article is to review the main points in a strategy to reduce maternal mortality, i.e., use of practices with documented effectiveness; access to qualified personal during pregnancy and delivery; availability of health services and underlying facilities; the role of individuals, families, and communities; and the political and legal framework. This article also stresses the fact that programs designed to enhance maternal and newborn health can significantly strengthen the health care system for the community as a whole: maternal health offers a gateway for strengthening health care services in general.

  7. Design and Implementation of a Cloud Computing Adoption Decision Tool: Generating a Cloud Road

    PubMed Central

    Bildosola, Iñaki; Río-Belver, Rosa; Cilleruelo, Ernesto; Garechana, Gaizka

    2015-01-01

    Migrating to cloud computing is one of the current enterprise challenges. This technology provides a new paradigm based on “on-demand payment” for information and communication technologies. In this sense, the small and medium enterprise is supposed to be the most interested, since initial investments are avoided and the technology allows gradual implementation. However, even if the characteristics and capacities have been widely discussed, entry into the cloud is still lacking in terms of practical, real frameworks. This paper aims at filling this gap, presenting a real tool already implemented and tested, which can be used as a cloud computing adoption decision tool. This tool uses diagnosis based on specific questions to gather the required information and subsequently provide the user with valuable information to deploy the business within the cloud, specifically in the form of Software as a Service (SaaS) solutions. This information allows the decision makers to generate their particular Cloud Road. A pilot study has been carried out with enterprises at a local level with a two-fold objective: to ascertain the degree of knowledge on cloud computing and to identify the most interesting business areas and their related tools for this technology. As expected, the results show high interest and low knowledge on this subject and the tool presented aims to readdress this mismatch, insofar as possible. PMID:26230400

  8. Design and Implementation of a Cloud Computing Adoption Decision Tool: Generating a Cloud Road.

    PubMed

    Bildosola, Iñaki; Río-Belver, Rosa; Cilleruelo, Ernesto; Garechana, Gaizka

    2015-01-01

    Migrating to cloud computing is one of the current enterprise challenges. This technology provides a new paradigm based on "on-demand payment" for information and communication technologies. In this sense, the small and medium enterprise is supposed to be the most interested, since initial investments are avoided and the technology allows gradual implementation. However, even if the characteristics and capacities have been widely discussed, entry into the cloud is still lacking in terms of practical, real frameworks. This paper aims at filling this gap, presenting a real tool already implemented and tested, which can be used as a cloud computing adoption decision tool. This tool uses diagnosis based on specific questions to gather the required information and subsequently provide the user with valuable information to deploy the business within the cloud, specifically in the form of Software as a Service (SaaS) solutions. This information allows the decision makers to generate their particular Cloud Road. A pilot study has been carried out with enterprises at a local level with a two-fold objective: to ascertain the degree of knowledge on cloud computing and to identify the most interesting business areas and their related tools for this technology. As expected, the results show high interest and low knowledge on this subject and the tool presented aims to readdress this mismatch, insofar as possible.

  9. Barriers to implementing evidence-based clinical guidelines: A survey of early adopters

    PubMed Central

    Spallek, Heiko; Song, Mei; Polk, Deborah E; Bekhuis, Tanja; Frantsve-Hawley, Julie; Aravamudhan, Krishna

    2010-01-01

    Objective The purpose of this study is to identify barriers that early-adopting dentists perceive as common and challenging when implementing recommendations from evidence-based (EB) clinical guidelines. Method This is a cross-sectional study. Dentists who attended the 2008 Evidence-based Dentistry Champion Conference were eligible for inclusion. Forty-three dentists (34%) responded to a 22-item questionnaire administered online. Two investigators independently coded and categorized responses to open-ended items. Descriptive statistics were computed to assess the frequency of barriers and perceived challenges. Results The most common barriers to implementation are difficulty in changing current practice model, resistance and criticism from colleagues, and lack of trust in evidence or research. Barriers perceived as serious problems have to do with lack of up-to-date evidence, lack of clear answers to clinical questions, and contradictory information in the scientific literature. Conclusions Knowledge of barriers will help improve translation of biomedical research for dentists. Information in guidelines needs to be current, clear, and simplified for use at chairside; dentists’ fears need to be addressed. PMID:21093800

  10. Case Study of Implementation of Flexible Grouping in One School Framed within the Change Based Adoption Model

    ERIC Educational Resources Information Center

    Slaydon, Donda

    2013-01-01

    This case study was designed to investigate the implementation of flexible grouping at one elementary school framed within the Change Based Adoption Model. Using interviews and observations, data were compiled to answer research questions related to the steps taken to implement flexible grouping, challenges faced, overall effects of flexible…

  11. Forging Ahead! Teachers Reflect on the Early Adopter Program to Implement the Common Core State Standards

    ERIC Educational Resources Information Center

    Koning, Erin; Houghtby, Beth; Izard, Patrice; Schuler, Jennifer

    2014-01-01

    This "water cooler" column features e-mail conversations between Erin Koning and three teachers--Beth, Jenna, and Patrice--and is a reflection of their participation in a Chicago Public School (CPS), professional development series designed to support the implementation of the Common Core State Standards (CCSS) in grades K-12. At the…

  12. Forging Ahead! Teachers Reflect on the Early Adopter Program to Implement the Common Core State Standards

    ERIC Educational Resources Information Center

    Koning, Erin; Houghtby, Beth; Izard, Patrice; Schuler, Jennifer

    2014-01-01

    This "water cooler" column features e-mail conversations between Erin Koning and three teachers--Beth, Jenna, and Patrice--and is a reflection of their participation in a Chicago Public School (CPS), professional development series designed to support the implementation of the Common Core State Standards (CCSS) in grades K-12. At the…

  13. A University--School Partnership to Examine the Adoption and Implementation of the Ohio Community Collaboration Model in One Urban School District: A Mixed-Method Case Study

    ERIC Educational Resources Information Center

    Anderson-Butcher, Dawn; Iachini, Aidyn L.; Ball, Annahita; Barke, Susan; Martin, Lloyd D.

    2016-01-01

    School improvement models are expanding to incorporate priorities around positive youth development, safe and supportive school climates, school mental health, and school-family community partnerships. A partnership was formed between researchers and district/school leaders to examine the 3-year adoption and implementation of 1 such exemplary…

  14. A University--School Partnership to Examine the Adoption and Implementation of the Ohio Community Collaboration Model in One Urban School District: A Mixed-Method Case Study

    ERIC Educational Resources Information Center

    Anderson-Butcher, Dawn; Iachini, Aidyn L.; Ball, Annahita; Barke, Susan; Martin, Lloyd D.

    2016-01-01

    School improvement models are expanding to incorporate priorities around positive youth development, safe and supportive school climates, school mental health, and school-family community partnerships. A partnership was formed between researchers and district/school leaders to examine the 3-year adoption and implementation of 1 such exemplary…

  15. Low Rates of Adoption and Implementation of Rapid HIV Testing in Substance Use Disorder Treatment Programs.

    PubMed

    Frimpong, Jemima A; D'Aunno, Thomas; Helleringer, Stéphane; Metsch, Lisa R

    2016-04-01

    Rapid HIV testing (RHT) greatly increases the proportion of clients who learn their test results. However, existing studies have not examined the adoption and implementation of RHT in programs treating persons with substance use disorders, one of the population groups at higher risk for HIV infection. We examined 196 opioid treatment programs (OTPs) using data from the 2011 National Drug Abuse Treatment System Survey (NDATSS). We used logistic regressions to identify client and organizational characteristics of OTPs associated with availability of on-site RHT. We then used zero-inflated negative binomial regressions to measure the association between the availability of RHT on-site and the number of clients tested for HIV. Only 31.6% of OTPs offered on-site rapid HIV testing to their clients. Rapid HIV testing was more commonly available on-site in larger, publicly owned and better-staffed OTPs. On the other hand, on-site rapid HIV testing was less common in OTPs that prescribed only buprenorphine as a method of opioid dependence treatment. The availability of rapid HIV testing on-site reduced the likelihood that an OTP did not test any of its clients during the prior year. But on-site availability rapid HIV testing was not otherwise associated with an increased number of clients tested for HIV at an OTP. New strategies are needed to a) promote the adoption of rapid HIV testing on-site in substance use disorder treatment programs and b) encourage substance use disorder treatment providers to offer rapid HIV testing to their clients when it is available. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Diffusion of innovations in schools: a study of adoption and implementation of school-based tobacco prevention curricula.

    PubMed

    McCormick, L K; Steckler, A B; McLeroy, K R

    1995-01-01

    The purpose of this study was to determine the extent of implementation of school health education curricula, to identify factors which enhanced or impeded implementation, and to examine the link between the adoption and implementation phases of the diffusion process. The study used an experimental design; 22 school districts were randomly assigned to intervention and control conditions. The study was conducted in North Carolina. All teachers in the study districts identified by their schools as "eligible to teach health" were included in the sample. An in-depth training was conducted on the use of the middle school tobacco prevention curriculum that had been adopted. Three measures were used to assess implementation of the curricula. Independent variables of interest included organizational size and climate, teacher training, how long it took to make the adoption decision, and attitudes toward tobacco use prevention curricula. Response rates for these measures ranged from 44% to 78%. Nonparametric correlations and regression modeling indicated that larger organizational size and teacher training were the strongest predictors of curricula implementation. A favorable organizational climate within school districts also improved implementation. While interventions to increase adoption of school health education curricula should focus on larger school districts, the majority of efforts to improve implementation should focus on smaller districts.

  17. 76 FR 31856 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ...; Adoption of Control Techniques Guidelines for Flat Wood Paneling Surface Coating Processes AGENCY... Pennsylvania Code. Pennsylvania's SIP revision meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) standards for flat...

  18. 76 FR 52917 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ...; Adoption of Control Techniques Guidelines for Large Appliance and Metal Furniture Coatings AGENCY... sources) and meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) standards for large appliance and metal...

  19. Communication Development and Differences in Children Adopted from China and Eastern Europe

    ERIC Educational Resources Information Center

    Hwa-Froelich, Deborah A.; Matsuo, Hisako

    2010-01-01

    Purpose: The communication development of children adopted from China and Eastern Europe was compared by region of origin at 6 and 12 months after adoption. Method: Twenty children, recruited before or immediately following their adoption, participated in the study. Measures were collected between 2 and 6 months after adoption (Time 1) and between…

  20. 76 FR 10379 - Laboratory Animal Welfare: Proposed Adoption and Implementation of the Eighth Edition of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-24

    ... HUMAN SERVICES National Institutes of Health Laboratory Animal Welfare: Proposed Adoption and... comments on (1) NIH's adoption of the eighth edition of the Guide for the Care and Use of Laboratory... the basis for evaluation by March 31, 2012. NIH will consider comments on (1) the adoption of the...

  1. Factors influencing the implementation, adoption, use, sustainability and scalability of eLearning for family medicine specialty training: a systematic review protocol.

    PubMed

    Cotič, Živa; Rees, Rebecca; Wark, Petra A; Car, Josip

    2016-10-19

    In 2013, there was a shortage of approximately 7.2 million health workers worldwide, which is larger among family physicians than among specialists. eLearning could provide a potential solution to some of these global workforce challenges. However, there is little evidence on factors facilitating or hindering implementation, adoption, use, scalability and sustainability of eLearning. This review aims to synthesise results from qualitative and mixed methods studies to provide insight on factors influencing implementation of eLearning for family medicine specialty education and training. Additionally, this review aims to identify the actions needed to increase effectiveness of eLearning and identify the strategies required to improve eLearning implementation, adoption, use, sustainability and scalability for family medicine speciality education and training. A systematic search will be conducted across a range of databases for qualitative studies focusing on experiences, barriers, facilitators, and other factors related to the implementation, adoption, use, sustainability and scalability of eLearning for family medicine specialty education and training. Studies will be synthesised by using the framework analysis approach. This study will contribute to the evaluation of eLearning implementation, adoption, use, sustainability and scalability for family medicine specialty training and education and the development of eLearning guidelines for postgraduate medical education. PROSPERO http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016036449.

  2. Adoption and Implementation of Tobacco Control Policies in Schools in India: Results of the Bihar School Teachers Study.

    PubMed

    Mathur, N; Pednekar, Ms; Sorensen, Gs; Nagler, Em; Stoddard, Am; Lando, Ha; Aghi, Mb; Sinha, Dn; Gupta, Pc

    2016-01-01

    Implementation of no tobacco policies in schools is associated with lower tobacco use among teachers and students. In this study we assessed the extent that a school-based intervention for teachers resulted in adoption and implementation of tobacco control policies. From a random sample of government schools (8th-10th), 72 were randomized into intervention and control conditions. Intervention included health education programs for teachers and support for tobacco control policy implementation. Adoption and implementation of policies were assessed at baseline and immediately after intervention. All 36 intervention and one control school adopted a tobacco-control policy. Higher enforcement of tobacco-control policy was at post intervention (OR=3.26; CI: 2.35, 4.54) compared to baseline in intervention schools. Some 64% of intervention and 28% control schools showed "improvement" in policy implementation. Adoption and implementation of no tobacco policies was positively impacted by intervention. This study provides support for scaling up of school-based tobacco control interventions to promote school tobacco control policies.

  3. Adoption of Geospatial Systems towards evolving Sustainable Himalayan Mountain Development

    NASA Astrophysics Data System (ADS)

    Murthy, M. S. R.; Bajracharya, B.; Pradhan, S.; Shestra, B.; Bajracharya, R.; Shakya, K.; Wesselmann, S.; Ali, M.; Bajracharya, S.; Pradhan, S.

    2014-11-01

    Natural resources dependence of mountain communities, rapid social and developmental changes, disaster proneness and climate change are conceived as the critical factors regulating sustainable Himalayan mountain development. The Himalayan region posed by typical geographic settings, diverse physical and cultural diversity present a formidable challenge to collect and manage data, information and understands varied socio-ecological settings. Recent advances in earth observation, near real-time data, in-situ measurements and in combination of information and communication technology have transformed the way we collect, process, and generate information and how we use such information for societal benefits. Glacier dynamics, land cover changes, disaster risk reduction systems, food security and ecosystem conservation are a few thematic areas where geospatial information and knowledge have significantly contributed to informed decision making systems over the region. The emergence and adoption of near-real time systems, unmanned aerial vehicles (UAV), board-scale citizen science (crowd-sourcing), mobile services and mapping, and cloud computing have paved the way towards developing automated environmental monitoring systems, enhanced scientific understanding of geophysical and biophysical processes, coupled management of socio-ecological systems and community based adaptation models tailored to mountain specific environment. There are differentiated capacities among the ICIMOD regional member countries with regard to utilization of earth observation and geospatial technologies. The region can greatly benefit from a coordinated and collaborative approach to capture the opportunities offered by earth observation and geospatial technologies. The regional level data sharing, knowledge exchange, and Himalayan GEO supporting geospatial platforms, spatial data infrastructure, unique region specific satellite systems to address trans-boundary challenges would go a long way in

  4. Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory

    PubMed Central

    2010-01-01

    Background Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process, and the factors that play a role in the change process are not yet fully understood. There is a number of theories concerned with factors predicting successful implementation in various settings, however, this issue is insufficiently studied in primary health care (PHC). The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in PHC in Sweden. Methods A qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption. Results The theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process. Conclusion When implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the perceived need for the

  5. Adopting and implementing nutrition guidelines in recreational facilities: Public and private sector roles. A multiple case study

    PubMed Central

    2012-01-01

    Background Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children’s access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them. Methods We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools. Results The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers’ nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY. Conclusions ANGCY uptake may continue to falter under the current voluntary

  6. Pre-placement risk and longitudinal cognitive development for children adopted from foster care.

    PubMed

    Waterman, Jill M; Nadeem, Erum; Paczkowski, Emilie; Foster, Jared Cory; Lavner, Justin A; Belin, Thomas; Miranda, Jeanne

    2013-01-01

    This study examined the trajectory of cognitive development over the first five years of adoptive placement among children adopted from foster care and how pre-adoption risk factors relate to this development. Overall, children's cognitive scores increased significantly, with the most rapid improvement occurring in the first year post-placement. By five years post-placement, children's mean cognitive and achievement scores were in the average range. Adoption is a positive intervention for children's cognitive development.

  7. Processes of Change in Professional Development Schools as Viewed through the Lens of the Concerns-Based Adoption Model

    ERIC Educational Resources Information Center

    Kapustka, Katherine M.; Damore, Sharon J.

    2009-01-01

    This research focuses on change processes. It considers how components of a change framework--namely, the concerns-based adoption model--can be used as diagnostic evaluation tools to examine how participants' attitudes and levels of participation affect the implementation of the professional development school model. This article demonstrates how…

  8. Applying Organization Theory to Understanding the Adoption and Implementation of Accountable Care Organizations: Commentary.

    PubMed

    Shortell, Stephen M

    2016-12-01

    This commentary highights the key arguments and contributions of institutional thoery, transaction cost economics (TCE) theory, high reliability theory, and organizational learning theory to understanding the development and evolution of Accountable Care Organizations (ACOs). Institutional theory and TCE theory primarily emphasize the external influences shaping ACOs while high reliability theory and organizational learning theory underscore the internal fctors influencing ACO perfromance. A framework based on Implementation Science is proposed to conside the multiple perspectives on ACOs and, in particular, their abiity to innovate to achieve desired cost, quality, and population health goals.

  9. Implementing Patient-Oriented Discharge Summaries (PODS): A Multisite Pilot Across Early Adopter Hospitals.

    PubMed

    Hahn-Goldberg, Shoshana; Okrainec, Karen; Damba, Cynthia; Huynh, Tai; Lau, Davina; Maxwell, Joanne; McGuire, Ryan; Yang, Lily; Abrams, Howard B

    2016-01-01

    Communication gaps when patients transition from hospital to either home or community can be problematic. Partnership between Toronto Central Local Health Integration Network (TC LHIN) and OpenLab addressed this through the Patient-Oriented Discharge Summaries (PODS) project. From January through March 2015, eight hospital departments across Toronto came together to implement the PODS, a tool previously developed through a co-design process involving patients, caregivers and providers. This paper presents data on how the hospitals came together and the impact of PODS on the patient and provider experience across these hospitals and discusses it implications.

  10. 76 FR 29649 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-23

    ...; Adoption of Control Techniques Guidelines for Paper, Film, and Foil Surface Coating Processes AGENCY... Pennsylvania Code. Pennsylvania's SIP revision meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources covered by the Control Techniques Guidelines (CTG) standards for paper,...

  11. 76 FR 2829 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of 8-hour Ozone...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... which includes the revised ambient air quality standard for ozone, and related reference conditions... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of 8-hour Ozone Standard and Related Reference Conditions, and Update of Appendices AGENCY...

  12. 76 FR 2859 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of 8-hour Ozone...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of 8-hour Ozone Standard and Related Reference Conditions, and Update of Appendices AGENCY...-hour ozone National Ambient Air Quality Standard (NAAQS) of 0.075 parts per million (ppm), related...

  13. Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments.

    PubMed

    Ben-Assuli, Ofir

    2015-03-01

    Recently, the healthcare sector has shown a growing interest in information technologies. Two popular health IT (HIT) products are the electronic health record (EHR) and health information exchange (HIE) networks. The introduction of these tools is believed to improve care, but has also raised some important questions and legal and privacy issues. The implementation of these systems has not gone smoothly, and still faces some considerable barriers. This article reviews EHR and HIE to address these obstacles, and analyzes the current state of development and adoption in various countries around the world. Moreover, legal and ethical concerns that may be encountered by EHR users and purchasers are reviewed. Finally, links and interrelations between EHR and HIE and several quality of care issues in today's healthcare domain are examined with a focus on EHR and HIE in the emergency department (ED), whose unique characteristics makes it an environment in which the implementation of such technology may be a major contributor to health, but also faces substantial challenges. The paper ends with a discussion of specific policy implications and recommendations based on an examination of the current limitations of these systems.

  14. The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs.

    PubMed

    Korndorffer, James R; Arora, Sonal; Sevdalis, Nick; Paige, John; McClusky, David A; Stefanidis, Dimitris

    2013-07-01

    The American College of Surgeons/Association of Program Directors in Surgery (ACS/APDS) National Skills Curriculum is a 3-phase program targeting technical and nontechnical skills development. Few data exist regarding the adoption of this curriculum by surgical residencies. This study attempted to determine the rate of uptake and identify implementation enablers/barriers. A web-based survey was developed by an international expert panel of surgical educators (5 surgeons and 1 psychologist). After piloting, the survey was sent to all general surgery program directors via email link. Descriptive statistics were used to determine the residency program characteristics and perceptions of the curriculum. Implementation rates for each phase and module were calculated. Adoption barriers were identified quantitatively and qualitatively using free text responses. Standardized qualitative methodology of emergent theme analysis was used to identify strategies for success and details of support required for implementation. Of the 238 program directors approached, 117 (49%) responded to the survey. Twenty-one percent (25/117) were unaware of the ACS/APDS curriculum. Implementation rates for were 36% for phase I, 19% for phase II, and 16% for phase III. The most common modules adopted were the suturing, knot-tying, and chest tube modules of phase I. Over 50% of respondents identified lack of faculty protected time, limited personnel, significant costs, and resident work-hour restrictions as major obstacles to implementation. Strategies for effective uptake included faculty incentives, adequate funding, administrative support, and dedicated time and resources. Despite the availability of a comprehensive curriculum, its diffusion into general surgery residency programs remains low. Obstacles related to successful implementation include personnel, learner, and administrative issues. Addressing these issues may improve the adoption rate of the curriculum. Copyright © 2013 Mosby, Inc

  15. Adoption and Implementation of Policies to Support Preventive Dentistry Initiatives for Physicians: A National Survey of Medicaid Programs

    PubMed Central

    Rozier, R. Gary; Wilder, Rebecca S.; Quinonez, Rocio B.

    2013-01-01

    Objectives. We determined the number of state Medicaid programs adopting initiatives to support preventive dental services provision by nondental health care professionals, their perceived attributes, and implementation barriers. Methods. We used Qualtrics to conduct a cross-sectional survey in 2008 of Medicaid dental program managers to determine organizational stage of adoption classified according to the Transtheoretical Model of Behavior Change with 3-year follow-up. We assessed perceptions of the influence of 18 initiative attributes on the decision to adopt, drawn from Roger’s diffusion of innovations theory. Stage and date of adoption are presented descriptively. Attributes and barriers were analyzed by stage of adoption by using analyses of variance or χ2 statistics. Results. By 2011, 42 states had adopted a policy. Only 9 states included a comprehensive set of preventive services, the most common being fluoride varnish. Adoption was affected by perceived initiative simplicity and its compatibility with other Medicaid programs. Administrative barriers were the most common among the 15 studied. Conclusions. State Medicaid policies to reimburse nondental providers for preventive dental services are becoming widespread. Interventions are needed to ensure oral health services delivery at the practice level. PMID:23763420

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

    PubMed

    Mather, Carey; Cummings, Elizabeth

    2017-01-01

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

  17. The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model.

    PubMed

    Moore, Julia E; Grouchy, Michelle; Graham, Ian D; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E

    2016-05-01

    Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites. Lessons learned include the following: assess readiness, develop tailored implementation materials, consider characteristics of implementation supports, protect champion time and consider evaluation feasibility. Copyright © 2016 Longwoods Publishing.

  18. 76 FR 27610 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-12

    ... of Control Techniques Guidelines for Large Appliance Coatings AGENCY: Environmental Protection Agency... Processes and meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) standards for large appliance coatings....

  19. The adoption and implementation of RFID technologies in healthcare: a literature review.

    PubMed

    Yao, Wen; Chu, Chao-Hsien; Li, Zang

    2012-12-01

    Radio Frequency Identification (RFID) technology not only offers tracking capability to locate equipment, supplies and people in real time, but also provides efficient and accurate access to medical data for health professionals. However, the reality of RFID adoption in healthcare is far behind earlier expectation. This study reviews literature on the use of RFID in healthcare/hospitals following a formal innovation-decision framework. We aim to identify the common applications, potential benefits, barriers, and critical success factors. Our study facilitates quick assessment and provides guidance for researchers and practitioners in adopting RFID in medical arenas. Many earlier adopters in healthcare found RFID to be functional and useful in such areas as asset tracking and patient identification. Major barriers to adoption include technological limitations, interference concerns, prohibitive costs, lack of global standards and privacy concerns. Better designed RFID systems with low cost and privacy issues addressed are needed to increase acceptance of RFID in healthcare.

  20. Training Opioid Addiction Treatment Providers to Adopt Contingency Management: A Prospective Pilot Trial of a Comprehensive Implementation Science Approach

    PubMed Central

    Becker, Sara J.; Squires, Daniel D.; Strong, David R.; Barnett, Nancy P.; Monti, Peter M.; Petry, Nancy M.

    2016-01-01

    Background Few prospective studies have evaluated theory-driven approaches to the implementation of evidence-based opioid treatment. This study compared the effectiveness of an implementation model (Science to Service Laboratory; SSL) to training as usual (TAU) in promoting the adoption of contingency management across a multi-site opiate addiction treatment program. We also examined whether the SSL affected putative mediators of contingency management adoption (perceived innovation characteristics and organizational readiness to change). Methods Sixty treatment providers (39 SSL, 21 TAU) from 15 geographically diverse satellite clinics (7 SSL, 8 TAU) participated in the 12-month study. Both conditions received didactic contingency management training and those in the pre-determined experimental region received 9 months of SSL-enhanced training. Contingency management adoption was monitored biweekly, while putative mediators were measured at baseline, 3-, and 12-months. Results Relative to providers in the TAU region, treatment providers in the SSL region had comparable likelihood of contingency management adoption in the first 20 weeks of the study, and then significantly higher likelihood of adoption (odds ratios = 2.4-13.5) for the remainder of the study. SSL providers also reported higher levels of one perceived innovation characteristic (Observability) and one aspect of organizational readiness to change (Adequacy of Training Resources), although there was no evidence that the SSL affected these putative mediators over time. Conclusions Results of this study indicate that a fully powered randomized trial of the SSL is warranted. Considerations for a future evaluation are discussed. PMID:26682582

  1. Adopting Employees' Ideas: Moderators of the Idea Generation-Idea Implementation Link

    ERIC Educational Resources Information Center

    Da Silva, Nancy; Oldham, Greg R.

    2012-01-01

    This study examined the possibility that the relationship between the number of ideas an employee generated and the number of those ideas that were adopted by the organization was moderated by the general radicalness of the employee's ideas (i.e., the extent to which the ideas were breakthrough or groundbreaking), the employee's intention to stay,…

  2. Initiation, Adoption, and Implementation of Administrative Innovation in the Air Force: A Case Study

    DTIC Science & Technology

    1988-09-01

    Instrument Design ..................45 Data Collection.............................46 Data Analysis...............................46 IV. Findings...research results is the lack of an integrative theory of innovation. In other words, future research designs and past research results need to be properly...no evident relationship between size and the rate of adoption of innovations (Mohr, 1969; Utterback : 1974), most empirical studies have revealed that

  3. 76 FR 51922 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Plastic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-19

    ... of Plastic Parts and Business Machines Coating Standards AGENCY: Environmental Protection Agency (EPA... Coating, and adds new COMAR 26.11.19.07-2, Plastic Parts and Business Machines Coating. Maryland's SIP... revision concerning the adoption of the plastic parts and business machines coating standards found in the...

  4. 76 FR 52867 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ...; Adoption of Control Techniques Guidelines for Large Appliance and Metal Furniture Coatings AGENCY... Reasonably Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines... Department of Environmental Protection, Bureau of Air Quality Control, P.O. Box 8468, 400 Market...

  5. 76 FR 64015 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... of Control Techniques Guidelines for Drum and Pail Coatings AGENCY: Environmental Protection Agency... revision meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) standards for drum and pail coatings and will...

  6. 78 FR 59240 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... of Control Techniques Guidelines for Miscellaneous Metal and Plastic Parts Which Includes Pleasure... revision consists of a new regulation pertaining to control of volatile organic compound (VOC) emissions... submitted the formal SIP revision ( 12-08) adopting the requirements as recommended by EPA's control...

  7. 76 FR 51314 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Drum and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-18

    ... revision meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources covered... viruses. Docket: All documents in the electronic docket are listed in the http://www.regulations.gov index... from this industry, available control technologies for addressing such emissions, the costs of...

  8. Implementation of a Technological Innovation: Factors Influencing the Adoption of a New Student Information System

    ERIC Educational Resources Information Center

    Johnston, Katrina M.

    2013-01-01

    School information systems (SIS) have the potential to cause a change in a school's technical, structural, psycho-social, and managerial systems. Implementation of a technological innovation such as an SIS is not a one-step occurrence; it is a process that occurs over time. Implementing any technological innovation involves active learning…

  9. Implementing Motivational Interviewing (MI) in a Non-MI World: A MI Knowledge Adoption Study

    ERIC Educational Resources Information Center

    D'Ambrosio, Ryan; Laws, Katherine E.; Gabriel, Roy M.; Hromco, Joe; Kelly, Pamela

    2006-01-01

    The Oregon Practice Improvement Collaborative (OPIC) facilitated the implementation of motivational interviewing (MI) in two community-based substance abuse treatment agencies. "The Change Book: A Blueprint for Technology Transfer" was used to structure and support the implementation of motivational interviewing. As part of the…

  10. Implementation of a Technological Innovation: Factors Influencing the Adoption of a New Student Information System

    ERIC Educational Resources Information Center

    Johnston, Katrina M.

    2013-01-01

    School information systems (SIS) have the potential to cause a change in a school's technical, structural, psycho-social, and managerial systems. Implementation of a technological innovation such as an SIS is not a one-step occurrence; it is a process that occurs over time. Implementing any technological innovation involves active learning…

  11. Critical Elements for Successful Implementation and Adoption of Authentic Scientific Research Programs: Lessons Learned from NASA's Mars Student Imaging Project

    NASA Astrophysics Data System (ADS)

    Klug Boonstra, S.; Swann, J.; Boonstra, D.; Manfredi, L.; Christensen, P. R.

    2016-12-01

    Recent research identifies the most effective learning as active, engaged learning in which students interact with phenomena, other students, and the teacher/leader to derive meaning and construct understanding of their surroundings. "Similarly, an engaging and effective science education goes well beyond the low-level factual recall that is emphasized in many science classes. It must develop the skills that students need to solve complex problems, work in teams, make and recognize evidence-based arguments, and interpret and communicate complex information" (emphasis added). Authentic science research projects provide active, engaged learning in which students interact with authentic science data in an authentic problem-solving context to derive meaning and construct understanding of the world. In formal (and many informal) settings, the teacher/leader is effectively the gatekeeper who determines the learning experiences in which the students will participate. From our experience of nearly a decade and a half of authentic science programming for 5thgrade through early college students working with NASA Mars data, supporting and enabling the teacher is perhaps the most critical and foundational element for designing a successful authentic research experience. Yet, a major barrier to this type of learning are teacher/leaders who are too often not equipped or who lack confidence to succeed in facilitating authentic research projects. The Mars Student Imaging Project has implemented an iterative process of design, testing, and redesign that has identified and implemented critical teacher/leader-enabling elements that have led to increasingly successful adoptions within formal and informal educational settings - allowing more students to gain the benefits of immersive research experience.

  12. Adoption, adaptation, and abandonment: Appropriation of science education professional development learning

    NASA Astrophysics Data System (ADS)

    Longhurst, Max L.

    Understanding factors that impact teacher utilization of learning from professional development is critical in order maximize the educational and financial investment in teacher professional learning. This study used a multicase mixed quantitative and qualitative methodology to investigate the factors that influence teacher adoption, adaption, or abandonment of learning from science teacher professional development. The theoretical framework of activity theory was identified as a useful way to investigate the phenomenon of teacher appropriation of pedagogical practices from professional development. This framework has the capacity to account for a multitude of elements in the context of a learning experience. In this study educational appropriation is understood through a continuum of how an educator acquires and implements both practical and conceptual aspects of learning from professional development within localized context. The variability associated with instructional changes made from professional development drives this inquiry to search for better understandings of the appropriation of pedagogical practices. Purposeful sampling was used to identify two participants from a group of eighth-grade science teachers engaged in professional development designed to investigate how cyber-enabled technologies might enhance instruction and learning in integrated science classrooms. The data from this investigation add to the literature of appropriation of instructional practices by connecting eight factors that influence conceptual and practical tools with the development of ownership of pedagogical practices in the appropriation hierarchy. Recommendations are shared with professional development developers, providers, and participants in anticipation that future science teaching experiences might be informed by findings from this study.

  13. [Attachment and Cognitive and Motor Development in the First Years after Adoption: A Review of Studies on Internationally Adopted Children from China].

    PubMed

    Juffer, Femmie; Finet, Chloe; Vermeer, Harriet; van den Dries, Linda

    2015-01-01

    Due to early-childhood adversity, adopted children often display delays in their cognitive and motor development and have problems developing secure attachment relationships with their adoptive parents. In this review we present the results of all available studies on the attachment and the cognitive and motor development of internationally adopted children from China in the first years after arriving in the adoptive family. Seven pertinent studies were found, based on five samples examined in the USA, Canada, and the Netherlands. Regarding cognitive and motor development (five studies) the adoptees showed a delayed development at arrival in the adoptive family. As soon as six months after arrival the adoptees were, on average, functioning within normal ranges, although their catch-up to non-adopted children was not yet complete. Two years after arrival the catch-up to non-adopted peers appeared to be complete. Regarding attachment (two studies) observations of attachment six and twelve months after adoption showed less secure and more disorganized attachment for the adopted children compared to the normative distribution of non-adopted children. Two years after adoption, observations of attachment confirmed a catch-up in secure attachment, but the adoptees still displayed more insecure disorganized attachment than children in the norm group.

  14. How can environmental regulations promote clean coal technology adoption in APEC developing economies?

    SciTech Connect

    2007-11-15

    The study examines both existing and emerging regulatory frameworks in order to determine which type of regulations that would be most effective at promoting clean coal technology adoption in development Asia Pacific Economic Co-operation (APEC) economies and would be practical to implement. regulations targeting air emissions; regulations targeting water use; and regulations concerning coal combustion by-products. When considering the potential effect of existing and new environmental regulations on the adoption of clean coal the analysis of technologies was organised into three categories: environmental control technologies; high efficiency coal combustion technologies; and carbon dioxide capture and storage (CCS). To target the recommendations towards APEC economies that would benefit the most from this analysis, the study focused on developing and transition APEC economies that are expected to rely on coal for a large part of their future generating capacity. These economies include China, Indonesia, the Philippines, the Russian Federation, Thailand, and Vietnam. ACARP provided funding to this study, under Project C15078. 10 figs., 14 tabs., 10 apps.

  15. Pre-Placement Risk and Longitudinal Cognitive Development for Children Adopted from Foster Care

    PubMed Central

    Waterman, Jill M.; Nadeem, Erum; Paczkowski, Emilie; Foster, Jared Cory; Lavner, Justin A.; Belin, Thomas; Miranda, Jeanne

    2016-01-01

    This study examined the trajectory of cognitive development over the first five years of adoptive placement among children adopted from foster care and how pre-adoption risk factors relate to this development. Overall, children’s cognitive scores increased significantly, with the most rapid improvement occurring in the first year post-placement. By five years post-placement, children’s mean cognitive and achievement scores were in the average range. Adoption is a positive intervention for children’s cognitive development. PMID:24851473

  16. Advances in plant biotechnology and its adoption in developing countries.

    PubMed

    Toenniessen, Gary H; O'Toole, John C; DeVries, Joseph

    2003-04-01

    Developing countries are already benefiting and should continue to benefit significantly from advances in plant biotechnology. Insect-protected cotton containing a natural insecticide protein from Bacillus thuringiensis (Bt cotton) is providing millions of farmers with increased yields, reduced insecticide costs and fewer health risks. Many other useful plant biotechnology products that can benefit poor farmers and consumers are in the research and development pipelines of institutions in developing countries, and should soon reach farmers' fields.

  17. Differences in Readiness between Rural Hospitals and Primary Care Providers for Telemedicine Adoption and Implementation: Findings from a Statewide Telemedicine Survey

    ERIC Educational Resources Information Center

    Martin, Amy Brock; Probst, Janice C.; Shah, Kyle; Chen, Zhimin; Garr, David

    2012-01-01

    Purpose: Published advantages of and challenges with telemedicine led us to examine the scope of telemedicine adoption, implementation readiness, and barriers in a southern state where adoption has been historically low. We hypothesized that rural hospitals and primary care providers (RPCPs) differ on adoption, readiness, and implementation…

  18. Differences in Readiness between Rural Hospitals and Primary Care Providers for Telemedicine Adoption and Implementation: Findings from a Statewide Telemedicine Survey

    ERIC Educational Resources Information Center

    Martin, Amy Brock; Probst, Janice C.; Shah, Kyle; Chen, Zhimin; Garr, David

    2012-01-01

    Purpose: Published advantages of and challenges with telemedicine led us to examine the scope of telemedicine adoption, implementation readiness, and barriers in a southern state where adoption has been historically low. We hypothesized that rural hospitals and primary care providers (RPCPs) differ on adoption, readiness, and implementation…

  19. 7 CFR 18.3 - Development and adoption of equal employment opportunity programs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 1 2014-01-01 2014-01-01 false Development and adoption of equal employment opportunity programs. 18.3 Section 18.3 Agriculture Office of the Secretary of Agriculture EQUAL EMPLOYMENT OPPORTUNITY IN THE STATE COOPERATIVE EXTENSION SERVICES § 18.3 Development and adoption of equal employment...

  20. 7 CFR 18.3 - Development and adoption of equal employment opportunity programs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Development and adoption of equal employment opportunity programs. 18.3 Section 18.3 Agriculture Office of the Secretary of Agriculture EQUAL EMPLOYMENT OPPORTUNITY IN THE STATE COOPERATIVE EXTENSION SERVICES § 18.3 Development and adoption of equal...

  1. To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England

    PubMed Central

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2012-01-01

    Purpose: The success of the International Classifcation of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Method: Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and refective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, feld notes and a refective diary. Results: Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. Conclusions: The empirical fndings demonstrate how to make the ICF classifcation a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians. PMID:22372376

  2. To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England.

    PubMed

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2012-01-01

    The success of the International Classification of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and reflective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, field notes and a reflective diary. Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. The empirical findings demonstrate how to make the ICF classification a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians.

  3. Development of a remote sensing protocol for inventorying cover crop adoptions

    NASA Astrophysics Data System (ADS)

    Bermudez, Carolina

    The use of cover crops has been recognized as an agricultural management practice that can enhance soil quality, contribute to suppressing weeds, promote the recycling of nutrients, and provide many other benefits when incorporated in farming systems. Because cover crops can mitigate or prevent soil erosion and nutrient leaching, the positive impact of this conservation practice also has an effect beyond farm boundaries, by reducing the contamination of water bodies caused by agriculture. As a consequence, state and federal agencies have been trying to assess farmer's motivations and barriers for cover crop use, and have also intended to track their adoption as a means of assessing conservation practice implementation. Because remote sensing techniques can provide information over large areas, periodically, it can be useful for estimating cover cropped fields. A decision tree model approach was used in this study to develop sets of criteria for the identification of fields with cover crops, pastures and grasses, and stover, based on monthly NDVI values. The model had an overall accuracy of 82%, while the level of precision for cover crop detection was 76.9%. The results of this study demonstrate that remote sensing can be used successfully to identify the adoption of cover crops in agricultural fields based on monthly average NDVI values.

  4. A Program for Reading and Language Development. An Adopter's Guide.

    ERIC Educational Resources Information Center

    Carter, Nancy Hay

    "Project SAILS" (Symbolic and Innovative Language Systems) is a special program developed by the Portland, Oregon, public schools for training teachers to work with children who have learning and reading difficulties. Teachers are instructed in the use of the Monterey Reading and Language Programs, highly structured and highly…

  5. M-Learning Adoption: A Perspective from a Developing Country

    ERIC Educational Resources Information Center

    Iqbal, Shakeel; Qureshi, Ijaz A.

    2012-01-01

    M-learning is the style of learning for the new millennium. Decreases in cost and increases in capabilities of mobile devices have made this medium attractive for the dissemination of knowledge. Mobile engineers, software developers, and educationists represent the supply side of this technology, whereas students represent the demand side. In…

  6. Ten key considerations for the successful implementation and adoption of large-scale health information technology

    PubMed Central

    Cresswell, Kathrin M; Bates, David W; Sheikh, Aziz

    2013-01-01

    The implementation of health information technology interventions is at the forefront of most policy agendas internationally. However, such undertakings are often far from straightforward as they require complex strategic planning accompanying the systemic organizational changes associated with such programs. Building on our experiences of designing and evaluating the implementation of large-scale health information technology interventions in the USA and the UK, we highlight key lessons learned in the hope of informing the on-going international efforts of policymakers, health directorates, healthcare management, and senior clinicians. PMID:23599226

  7. Ten key considerations for the successful implementation and adoption of large-scale health information technology.

    PubMed

    Cresswell, Kathrin M; Bates, David W; Sheikh, Aziz

    2013-06-01

    The implementation of health information technology interventions is at the forefront of most policy agendas internationally. However, such undertakings are often far from straightforward as they require complex strategic planning accompanying the systemic organizational changes associated with such programs. Building on our experiences of designing and evaluating the implementation of large-scale health information technology interventions in the USA and the UK, we highlight key lessons learned in the hope of informing the on-going international efforts of policymakers, health directorates, healthcare management, and senior clinicians.

  8. Pre-implementation investigation of the readiness of allied health professionals to adopt electronic health records.

    PubMed

    Hailey, David; Yu, Ping; Munyisia, Esther

    2014-01-01

    There has been limited uptake of electronic health records (EHR) by allied health professionals. Yet, not much attention has been given to their information needs. For EHR to work for these health professionals, it is essential to understand their current practice of information management and their perceptions towards EHR. A qualitative interview study was thus conducted with four managers in four allied health practices in Sydney to understand their perceptions for the adoption and use of a new Australian e-health standards compliant EHR system. We found that these allied health professionals were highly confident with the use of electronic information system and were enthusiastically expecting the introduction of the EHR system to support their information management and practice. A number of issues related to the use of EHR in practice for small, independent allied health practices were also discussed. It appears that allied health professionals today are information technology (IT) savvy and ready to adopt EHR. EHR for allied health practices in Australia are long overdue. The health informatics community can no longer ignore the need and want of allied health professionals for EHR that are tailored and built to support their information and practice management.

  9. Three Decades of Implementation Research in Higher Education: Limitations and Prospects of Theory Development

    ERIC Educational Resources Information Center

    Kohoutek, Jan

    2013-01-01

    The article adopts a comparative approach to review three periods of theory development in research into higher education policy implementation. Given the conceptual affinity between Cerych and Sabatier's 1986 seminal study into higher education policy implementation and public policy implementation theory, the field of public policy is chosen for…

  10. Three Decades of Implementation Research in Higher Education: Limitations and Prospects of Theory Development

    ERIC Educational Resources Information Center

    Kohoutek, Jan

    2013-01-01

    The article adopts a comparative approach to review three periods of theory development in research into higher education policy implementation. Given the conceptual affinity between Cerych and Sabatier's 1986 seminal study into higher education policy implementation and public policy implementation theory, the field of public policy is chosen for…

  11. Development and Implementation Costs of Student Learning Objectives: Considerations for TIF Grantees

    ERIC Educational Resources Information Center

    Fermanich, Mark; Carl, Brad; Finster, Matthew

    2015-01-01

    This brief explores the costs of developing and implementing Student Learning Objectives (SLOs) in order to help Teacher Incentive Fund (TIF) grantees interested in adopting SLOs anticipate and understand the costs of implementing them in a district or school. The brief focuses on the costs involved with the initial design and implementation of an…

  12. Candidate Teachers? Views on Implementation and Adoption of Democracy: Istanbul University Sample

    ERIC Educational Resources Information Center

    Serin, Hüseyin

    2017-01-01

    The aim of this study is to determine the candidate teachers' views, who have pedagogical proficiency at Hasan Ali Yucel education faculty, on implementation of organizational democracy according to gender and education variable. 370 of the candidate teachers who have graduate degree and continue undergraduate study at Istanbul University…

  13. The Factors Affecting the Adoption and Implementation of Innovations in Rural Schools.

    ERIC Educational Resources Information Center

    Edington, Everett D.

    Change in rural schools is difficult to achieve because the diversity of these schools does not allow for one set implementation program. Small rural schools are an integral part of the rural community, and as such are as different as the part of the country where they are located. Change in rural areas is unsuccessful due to: the amount of…

  14. Full-Day Kindergarten: A Story of Successful Adoption and Initial Implementation

    ERIC Educational Resources Information Center

    Winters, Dixie; Saylor, Carol; Phillips, Carol

    2003-01-01

    Do the learning benefits of full-day (versus half-day) kindergarten outweigh the expense of hiring more teachers and adding classroom space? The authors describe planning and implementing a pilot program. The positive outcomes for children-including earlier emergent literacy skills, a more relaxed pace, and easier transition to first grade-lead…

  15. Implementation of Out-of-Office Blood Pressure Monitoring in the Netherlands: From Clinical Guidelines to Patients' Adoption of Innovation.

    PubMed

    Carrera, Pricivel M; Lambooij, Mattijs S

    2015-10-01

    Out-of-office blood pressure monitoring is promoted by various clinical guidelines toward properly diagnosing and effectively managing hypertension and engaging the patient in their care process. In the Netherlands, however, the Dutch cardiovascular risk management (CVRM) guidelines do not explicitly prescribe 24-hour ambulatory blood pressure measurement (ABPM) and home BP measurement (HBPM). The aim of this descriptive study was to develop an understanding of patients' and physicians' acceptance and use of out-of-office BP monitoring in the Netherlands given the CVRM recommendations.Three small focus group discussions (FGDs) with patients and 1 FGD with physicians were conducted to explore the mechanisms behind the acceptance and use of out-of-office BP monitoring and reveal real-world challenges that limit the implementation of out-of-office BP monitoring methods. To facilitate the FGDs, an analytical framework based on the technology acceptance model (TAM), the theory of planned behavior and the model of personal computing utilization was developed to guide the FGDs and analysis of the transcriptions of each FGD.ABPM was the out-of-office BP monitoring method prescribed by physicians and used by patients. HBPM was not offered to patients even with patients' feedback of poor tolerance of ABPM. Even as there was little awareness about HBPM among patients, there were a few patients who owned and used sphygmomanometers. Patients professed and seemed to exhibit self-efficacy, whereas physicians had reservations about (all of their) patients' self-efficacy in properly using ABPM. Since negative experience with ABPM impacted patients' acceptance of ABPM, the interaction of factors that determined acceptance and use was found to be dynamic among patients but not for physicians.In reference to the CVRM guidelines, physicians implemented out-of-office BP monitoring but showed a strong preference for ABPM even where there is poor tolerance of the method. We found that

  16. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region

    PubMed Central

    Kalolo, Albino; Radermacher, Ralf; Stoermer, Manfred; Meshack, Menoris; De Allegri, Manuela

    2015-01-01

    Background Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective In this paper, we describe a process evaluation protocol aimed at opening the ‘black box’ to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania. Design The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes. PMID:26679408

  17. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region.

    PubMed

    Kalolo, Albino; Radermacher, Ralf; Stoermer, Manfred; Meshack, Menoris; De Allegri, Manuela

    2015-01-01

    Background Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective In this paper, we describe a process evaluation protocol aimed at opening the 'black box' to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania. Design The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes.

  18. A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.

    PubMed

    Ser, Gloria; Robertson, Ann; Sheikh, Aziz

    2014-01-01

    To investigate the perceptions and reported practices of mental health hospital staff using national hospital electronic health records (EHRs) in order to inform future implementations, particularly in acute mental health settings. Thematic analysis of interviews with a wide range of clinical, information technology (IT), managerial and other staff at two early adopter mental health National Health Service (NHS) hospitals in London, UK, implementing national EHRs. We analysed 33 interviews. We first sought out examples of workarounds, such as delayed data entry, entering data in wrong places and individuals using the EHR while logged in as a colleague, then identified possible reasons for the reported workarounds. Our analysis identified four main categories of factors contributing to workarounds (i.e., operational, cultural, organisational and technical). Operational factors included poor system integration with existing workflows and the system not meeting users' perceived needs. Cultural factors involved users' competence with IT and resistance to change. Organisational factors referred to insufficient organisational resources and training, while technical factors included inadequate local technical infrastructure. Many of these factors, such as integrating the EHR system with day-to-day operational processes, staff training and adequate local IT infrastructure, were likely to apply to system implementations in various settings, but we also identified factors that related particularly to implementing EHRs in mental health hospitals, for example: EHR system incompatibility with IT systems used by mental health-related sectors, notably social services; the EHR system lacking specific, mental health functionalities and options; and clinicians feeling unable to use computers while attending to distressed psychiatric patients. A better conceptual model of reasons for workarounds should help with designing, and supporting the implementation and adoption of, EHRs for

  19. Thai Hospitals' Adoption of Information Technology: A Theory Development and Nationwide Survey

    ERIC Educational Resources Information Center

    Theera-Ampornpunt, Nawanan

    2011-01-01

    Background: With documented benefits and recent public policies, health information technology (IT) has received increasing attention in recent years. However, knowledge about Thailand's state of hospital IT adoption is lacking. The literature also identifies organizational management practices that are important to health IT implementation, but…

  20. Thai Hospitals' Adoption of Information Technology: A Theory Development and Nationwide Survey

    ERIC Educational Resources Information Center

    Theera-Ampornpunt, Nawanan

    2011-01-01

    Background: With documented benefits and recent public policies, health information technology (IT) has received increasing attention in recent years. However, knowledge about Thailand's state of hospital IT adoption is lacking. The literature also identifies organizational management practices that are important to health IT implementation, but…

  1. Elementary Engineering Education (EEE) Adoption and Expertise Development Framework: An Inductive and Deductive Study

    ERIC Educational Resources Information Center

    Sun, Yan; Strobel, Johannes

    2013-01-01

    Elementary engineering education (EEE) is an educational innovation. Using Rogers's innovation diffusion model, the Concerns-Based Adoption Model (CBAM), and Dreyfus's skill acquisition model as its theoretical frameworks, this study investigated elementary teachers' EEE adoption and EEE expertise development. Data of this study were collected…

  2. Anticipation of the sexual and gender development of children adopted by same-sex couples.

    PubMed

    Gato, Jorge; Fontaine, Anne Marie

    2013-01-01

    The present study aimed to characterize beliefs surrounding the sexual and gender development of children adopted by lesbian and gay couples. Participants were 768 Portuguese university students. Using a quasiexperimental design, participants were presented with identical descriptions of a couple interested in adopting a child, manipulating couple sexual orientation and child gender. Participants were then asked to anticipate three aspects of the sexual and gender development of the adopted child: sexual orientation, gender role behavior, and gender identity. MANOVAs and follow-up ANOVAs were conducted in order to analyze the data. Results indicated that participants, particularly males, considered children adopted by either lesbian or gay couples to have a lower probability of developing a normative sexual and gender identity than children adopted by heterosexual couples. Both men and women considered that children would emulate the sexual orientation of their same-sex parents, and that a boy's gender role behavior was more at risk if he was adopted by a lesbian couple. Moreover, men were apprehensive about the gender role behavior of a boy adopted by a gay male couple. Overall, these results indicate persistence of biased evaluations of the sexual and gender development of children adopted by lesbian and gay parents. Furthermore, both gender of the participant and gender of the child play an important role in these evaluations. Results are discussed and interpreted as a way of "doing gender" in the context of hegemonic masculinity.

  3. Elementary Engineering Education (EEE) Adoption and Expertise Development Framework: An Inductive and Deductive Study

    ERIC Educational Resources Information Center

    Sun, Yan; Strobel, Johannes

    2013-01-01

    Elementary engineering education (EEE) is an educational innovation. Using Rogers's innovation diffusion model, the Concerns-Based Adoption Model (CBAM), and Dreyfus's skill acquisition model as its theoretical frameworks, this study investigated elementary teachers' EEE adoption and EEE expertise development. Data of this study were collected…

  4. Implementation and adoption of nationwide electronic health records in secondary care in England: final qualitative results from prospective national evaluation in “early adopter” hospitals

    PubMed Central

    Cornford, Tony; Barber, Nicholas; Avery, Anthony; Takian, Amirhossein; Lichtner, Valentina; Petrakaki, Dimitra; Crowe, Sarah; Marsden, Kate; Robertson, Ann; Morrison, Zoe; Klecun, Ela; Prescott, Robin; Quinn, Casey; Jani, Yogini; Ficociello, Maryam; Voutsina, Katerina; Paton, James; Fernando, Bernard; Jacklin, Ann; Cresswell, Kathrin

    2011-01-01

    Objectives To evaluate the implementation and adoption of the NHS detailed care records service in “early adopter” hospitals in England. Design Theoretically informed, longitudinal qualitative evaluation based on case studies. Setting 12 “early adopter” NHS acute hospitals and specialist care settings studied over two and a half years. Data sources Data were collected through in depth interviews, observations, and relevant documents relating directly to case study sites and to wider national developments that were perceived to impact on the implementation strategy. Data were thematically analysed, initially within and then across cases. The dataset consisted of 431 semistructured interviews with key stakeholders, including hospital staff, developers, and governmental stakeholders; 590 hours of observations of strategic meetings and use of the software in context; 334 sets of notes from observations, researchers’ field notes, and notes from national conferences; 809 NHS documents; and 58 regional and national documents. Results Implementation has proceeded more slowly, with a narrower scope and substantially less clinical functionality than was originally planned. The national strategy had considerable local consequences (summarised under five key themes), and wider national developments impacted heavily on implementation and adoption. More specifically, delays related to unrealistic expectations about the capabilities of systems; the time needed to build, configure, and customise the software; the work needed to ensure that systems were supporting provision of care; and the needs of end users for training and support. Other factors hampering progress included the changing milieu of NHS policy and priorities; repeatedly renegotiated national contracts; different stages of development of diverse NHS care records service systems; and a complex communication process between different stakeholders, along with contractual arrangements that largely excluded NHS

  5. Huddle up!: The adoption and use of structured team communication for VA medical home implementation.

    PubMed

    Rodriguez, Hector P; Meredith, Lisa S; Hamilton, Alison B; Yano, Elizabeth M; Rubenstein, Lisa V

    2015-01-01

    Daily clinical team meetings (i.e., "huddles") may be helpful in implementing new roles and responsibilities for patient care because they provide a regular opportunity for member learning and feedback. We examined how huddles were implemented in the context of the VA patient-centered medical home (PCMH) transformation, including assessing barriers and facilitators to regular huddling among small teams ("teamlets"). We assessed the extent to which teamlet members that huddled had higher self-efficacy for PCMH changes, reported better teamwork experiences, and perceived more supportive practice environments. We used a convergent mixed-methods approach to analyze 79 teamlet member interviews from six VA primary care practices and 418 clinician and staff PCMH survey responses from the six interviewed practices and 13 additional practices in the same region. Most members reported participating in teamlet huddles when asked in surveys (85%). A minority of interview participants, however, described routine huddling focused on previsit planning that included all members. When members reported routine teamlet huddling, activities included (a) previsit planning, (b) strategizing treatment plans for patients with special or complex needs, (c) addressing daily workflow and communication issues through collective problem solving, and (d) ensuring awareness of what team members do and what actions are happening on the teamlet and in the practice. Primary care providers (PCPs) were least likely to report routine huddling. PCP huddlers reported greater self-efficacy for implementing PCMH changes. All huddlers, irrespective of role, reported better teamwork and more supportive practice climates. The most common barriers to teamlet huddling were limited time and operational constraints. In order to improve the impact of huddles on patient care, practice leaders should clearly communicate the goals, requirements, and benefits of huddling and provide adequate time and resources to

  6. Wormgear geometry adopted for implementing hydrostatic lubrication and formulation of the lubrication problem

    NASA Technical Reports Server (NTRS)

    Sun, D. C.; Yuan, Qin

    1995-01-01

    The geometrical parameters for a wormgear intended to be used as the transmission in advanced helicopters are finalized. The resulting contact pattern of the meshing tooth surfaces is suitable for the implementation of hydrostatic lubrication Fluid film lubrication of the contact is formulated considering external pressurization as well as hydrodynamic wedge and squeeze actions. The lubrication analysis is aimed at obtaining the oil supply pressure needed to separate the worm and gear surfaces by a prescribed minimum film thickness. The procedure of solving the mathematical problem is outlined.

  7. Language development of internationally adopted children: Adverse early experiences outweigh the age of acquisition effect.

    PubMed

    Rakhlin, Natalia; Hein, Sascha; Doyle, Niamh; Hart, Lesley; Macomber, Donna; Ruchkin, Vladislav; Tan, Mei; Grigorenko, Elena L

    2015-01-01

    We compared English language and cognitive skills between internationally adopted children (IA; mean age at adoption=2.24, SD=1.8) and their non-adopted peers from the US reared in biological families (BF) at two time points. We also examined the relationships between outcome measures and age at initial institutionalization, length of institutionalization, and age at adoption. On measures of general language, early literacy, and non-verbal IQ, the IA group performed significantly below their age-peers reared in biological families at both time points, but the group differences disappeared on receptive vocabulary and kindergarten concept knowledge at the second time point. Furthermore, the majority of children reached normative age expectations between 1 and 2 years post-adoption on all standardized measures. Although the age at adoption, age of institutionalization, length of institutionalization, and time in the adoptive family all demonstrated significant correlations with one or more outcome measures, the negative relationship between length of institutionalization and child outcomes remained most robust after controlling for the other variables. Results point to much flexibility and resilience in children's capacity for language acquisition as well as the potential primacy of length of institutionalization in explaining individual variation in IA children's outcomes. (1) Readers will be able to understand the importance of pre-adoption environment on language and early literacy development in internationally adopted children. (2) Readers will be able to compare the strength of the association between the length of institutionalization and language outcomes with the strength of the association between the latter and the age at adoption. (3) Readers will be able to understand that internationally adopted children are able to reach age expectations on expressive and receptive language measures despite adverse early experiences and a replacement of their first

  8. Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory.

    PubMed

    Jeffries, Mark; Phipps, Denham; Howard, Rachel L; Avery, Anthony; Rodgers, Sarah; Ashcroft, Darren

    2017-05-10

    Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care. This is a qualitative study informed by strong structuration theory. The analysis was thematic, using a template approach. An a priori set of thematic codes, based on strong structuration theory, was developed from the literature and applied to the transcripts. The coding template was then modified through successive readings of the data. Clinical commissioning group in the south of England. Four focus groups and five semi-structured interviews were conducted with 18 participants purposively sampled from a range of stakeholder groups (general practitioners, pharmacists, patients and commissioners). Using the system could lead to improved medication safety, but use was determined by broad institutional contexts; by the perceptions, dispositions and skills of users; and by the structures embedded within the technology. These included perceptions of the system as new and requiring technical competence and skill; the adoption of the system for information gathering; and interactions and relationships that involved individual, shared or collective use. The dynamics between these external, internal and technological structures affected the adoption and implementation of the system. Successful implementation of information technology interventions for medicine optimisation will depend on a combination of the infrastructure within primary care, social structures embedded in the technology and the conventions, norms and dispositions of those utilising it. Future interventions, using electronic audit and feedback tools to improve medication safety, should consider the complexity of the social and organisational contexts and how internal and external structures can affect the use of the technology in order to support effective implementation. © Article author(s) (or their

  9. Children adopted from China: a prospective study of their growth and development.

    PubMed

    Cohen, Nancy J; Lojkasek, Mirek; Zadeh, Zohreh Yaghoub; Pugliese, Mirella; Kiefer, Heidi

    2008-04-01

    China has become a lead country for international adoption because of the relatively young age of the children and reported positive conditions of the orphanages. This study examined the process and outcome of growth and development of children adopted from China over their first two years with their adoptive families. Seventy infant girls adopted from China at 8 to 21 months of age (Mean age = 13 months) were examined on arrival in Canada and 6, 12, and 24 months later. Comparisons were made with non-adopted Canadian girls of similar age and from a similar family background as adoptive parents on indices of growth and standardized measures of mental, psychomotor, and language development. At arrival, children adopted from China were smaller physically and exhibited developmental delays compared to current peers. Children adopted from China were functioning in the average range on physical and developmental measures within the first 6 months following adoption. However, they were not performing as well as current peers until the end of their second year after adoption. Even then, there was developmental variation in relation to comparison children and continuation of relatively smaller size with respect to height, weight, and head circumference. Physical measurement was related to outcomes at various points on all developmental measures. Deprivation in experience in the first year of life has more long-lasting effects on physical growth than on mental development. The variable most consistently related to development was height-to-age ratio. As a measure of nutritional status, the findings reinforce the critical importance of early nutrition.

  10. Building a house on shifting sand: methodological considerations when evaluating the implementation and adoption of national electronic health record systems

    PubMed Central

    2012-01-01

    Background A commitment to Electronic Health Record (EHR) systems now constitutes a core part of many governments’ healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively) short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Methods Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England’s National Health Service’s Care Records Service (NHS CRS). Results/discussion We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome). Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. Summary New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT) projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within multiple specific settings and

  11. Implementing a Workforce Development Pipeline

    NASA Technical Reports Server (NTRS)

    Hix, Billy

    2002-01-01

    Research shows that the number of highly trained scientists and engineers has continued a steady decline during the 1990's. Furthermore, at the high school level, almost 40% of the total high school graduates are seeking technical skills in preparation of entering the workforce directly. The decrease of students in technology and science programs, along with the lack of viable vocational programs, haunts educators and businesses alike. However, MSFC (Marshall Space Flight Center) has the opportunity to become a leading edge model of workforce development by offering a unified program of apprenticeships, workshops, and educational initiatives. These programs will be designed to encourage young people of all backgrounds to pursue the fields of technology and science, to assist research opportunities, and to support teachers in the systemic changes that they are facing. The emphasis of our program based on grade levels will be: Elementary Level: Exposure to the workforce. Middle School: Examine the workforce. High School and beyond: Instruct the workforce. It is proposed that MSFC create a well-integrated Workforce Development Pipeline Program. The program will act to integrate the many and varied programs offered across MSFC directorates and offices. It will offer a clear path of programs for students throughout middle school, high school, technical training, and college and universities. The end result would consist of technicians, bachelors degrees, masters degrees, and PhDs in science and engineering fields entering the nation's workforce, with a focus on NASA's future personnel needs.

  12. Facilitators and barriers for the adoption, implementation and monitoring of child safety interventions: a multinational qualitative analysis.

    PubMed

    Scholtes, Beatrice; Schröder-Bäck, Peter; MacKay, J Morag; Vincenten, Joanne; Förster, Katharina; Brand, Helmut

    2017-06-01

    The efficiency and effectiveness of child safety interventions are determined by the quality of the implementation process. This multinational European study aimed to identify facilitators and barriers for the three phases of implementation: adoption, implementation and monitoring (AIM process). Twenty-seven participants from across the WHO European Region were invited to provide case studies of child safety interventions from their country. Cases were selected by the authors to ensure broad coverage of injury issues, age groups and governance level of implementation (eg, national, regional or local). Each participant presented their case and provided a written account according to a standardised template. Presentations and question and answer sessions were recorded. The presentation slides, written accounts and the notes taken during the workshops were analysed using thematic content analysis to elicit facilitators and barriers. Twenty-six cases (from 26 different countries) were presented and analysed. Facilitators and barriers were identified within eight general themes, applicable across the AIM process: management and collaboration; resources; leadership; nature of the intervention; political, social and cultural environment; visibility; nature of the injury problem and analysis and interpretation. The importance of the quality of the implementation process for intervention effectiveness, coupled with limited resources for child safety makes it more difficult to achieve successful actions. The findings of this study, divided by phase of the AIM process, provide practitioners with practical suggestions, where proactive planning might help increase the likelihood of effective implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. State-wide dissemination of a school-based nutrition education programme: a RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) analysis.

    PubMed

    Dunton, Genevieve Fridlund; Liao, Yue; Grana, Rachel; Lagloire, Renee; Riggs, Nathaniel; Chou, Chih-Ping; Robertson, Trina

    2014-02-01

    The current study evaluated the overall public health impact of the 'Shaping Up My Choices' (SMC) programme, a 10-week school-based nutrition education curriculum developed for third-grade students, using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. Randomized controlled trial to evaluate the programme and secondary analysis of archival data to describe dissemination. Data were collected from programme records, teacher surveys and student pre-, post- and 3-month follow-up surveys. Public elementary schools in California. An evaluation sample (938 students and nineteen teachers) and a dissemination sample (195 245 students and 7359 teachers). In the evaluation sample, differences between the control and intervention groups were observed for nutrition knowledge, self-efficacy, outcome expectancies, and intakes of vegetables, fruit (girls only), soda, and low-nutrient high-energy foods from pre- to post-survey. Group differences in change in knowledge, outcome expectancies and vegetable intake were sustained through the 3-month follow-up (efficacy). One hundred per cent of intervention teachers in the evaluation sample implemented all of the lessons (implementation). The dissemination sample represented 42% of third-grade students (reach) and 39% of third-grade classrooms in public elementary schools in California during 2010-2011 (adoption). Thirty-seven per cent of third-grade teachers in the dissemination sample reordered SMC materials during the subsequent school year (2011-2012; maintenance). The SMC programme demonstrates the potential for moderate to high public health impact.

  14. Adopting the Test-Driven Development to Developing Numerical Weather Prediction Model by Using the pFUnit

    NASA Astrophysics Data System (ADS)

    Jun, S. Y.; Kim, J.; Song, I. S.

    2014-12-01

    Modern Numerical Weather Prediction (NWP) model is a complex software that consists of scientific and computational components over multiple software layers. Development of NWP model is complicated process bringing many risks arise from the software complexity and long-term developing period. The software engineering suggests that software testing is a requisite for developing the complex software because it can improve software quality and reduce risk. In particular, the Test-Driven Development (TDD) is known to the useful way in software testing enable to develop more productive software with writing more unit-tests. We utilize the pFUnit, which is the unit testing framework for Fortran with MPI extensions under the NASA open source license, for adopting TDD to developing the KIAPS-GM (Korea Institute of Atmospheric Prediction Systems-Global Model) framework. It is known that the pFUnit offers a convenient, lightweight mechanism for Fortran developers to create and run software tests that specify the desired behavior for a given piece of code. Our implementation of TDD with the pFUnit will be presented with test suite and unit-tests for infrastructure of the KIAPS-GM framework.

  15. Growth and development in internationally adopted children: extent and timing of recovery after early adversity.

    PubMed

    Palacios, Jesús; Román, Maite; Camacho, Carlos

    2011-03-01

    Following initial adversity, internationally adopted children arrive with significant growth and developmental delays. Post-placement recovery has been widely documented, but little has been known about its extent and timing several years after placement and in children with diverse pre-adoptive experiences. A total of 289 children adopted from six countries into Spanish families were studied. Growth and psychological development were considered on arrival and after an average of over 3 years. Growth and developmental initial delays affected a substantial percentage of the children. Post-adoption recovery seemed quicker and more complete in weight and height than in head circumference and psychological development. Initial and later values were correlated, but growth-development relation on arrival subsequently lost significance. Most of the catch-up happened in the first three post-adoption years. Adoption offers an impressive opportunity for recovery after previous adversity, although continuity between past and present persists. The improvement is more marked in some areas than in others and more substantial in the first post-adoption years. © 2010 Blackwell Publishing Ltd.

  16. Developing and Implementing a Marketing Plan.

    ERIC Educational Resources Information Center

    McCalmon, Byron G.

    1987-01-01

    A program focusing on recruitment of new freshmen at the University of Colorado at Boulder illustrates some major planning considerations in the development, implementation, and evaluation of a marketing plan. (MSE)

  17. Language development in internationally adopted children: a special case of early second language learning.

    PubMed

    Gauthier, Karine; Genesee, Fred

    2011-01-01

    The French language development of children adopted (n=24) from China was compared with that of control children matched for socioeconomic status, sex, and age. The children were assessed at 50 months of age, on average, and 16 months later. The initial assessment revealed that the 2 groups did not differ with respect to socioemotional adjustment or intellectual abilities. However, the adopted children's expressive language skills were significantly lower than those of the nonadopted children at both assessments. The receptive language skills were also significantly weaker for the adopted children at the second assessment. The results are discussed in terms of possible early age-of-acquisition effects that might affect adopted children's ability to acquire a second first language. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.

  18. Developments in Assisting Countries in Implementing the IAEA Additional Protocol

    SciTech Connect

    Killinger, Mark H.; Hansen, Linda H.; Cain, Ronald A.; Kovacic, Don N.; Apt, Kenneth E.; VanSickle, Matthew

    2010-08-11

    In 2008, the U.S. Department of Energy (DOE) began assisting selected non-nuclear weapon states in planning and preparing for implementation of the International Atomic Energy Agency’s Additional Protocol (AP). Since then, the AP international implementation program has contributed to the substantial progress made by Vietnam, Thailand, Iraq, and Malaysia in preparing for entry-into-force of the AP. An overall engagement plan has been developed with components designed to train government AP implementing agencies, inform policy makers, conduct outreach to industry and universities, make AP reporting software available and useful, and plan a detailed approach for implementing the declaration and complementary access provisions of the AP. DOE recently began collaborating with Indonesia, which has already entered the AP into force, requiring a second method of engagement somewhat different from that taken with countries that have not entered the AP into force. The AP international implementation program, administered by the International Nuclear Safeguards and Engagement Program, is working more closely with DOE’s International Nonproliferation Export Control Program to ensure countries are aware of and prepared to implement the export/import provisions of the AP. As the AP implementation program matures and helps move countries closer to entry-into-force or improved AP implementation, it is identifying characteristics of a country’s “end-state” that indicate that DOE assistance is no longer required. The U.S. AP Implementation Act and Senate Resolution of Ratification require the Administration to report annually to Congress on measures taken to achieve the adoption of the AP in non-nuclear weapon states. DOE’s AP international implementation program is a significant part of these measures. This paper describes recent developments to increase the scope and effectiveness of the program.

  19. Development and implementation of Strategic Environmental Assessment in Taiwan

    SciTech Connect

    Liou, M.-L.; Yu, Y.-H

    2004-04-01

    Taiwan is one of the few Asian countries to have officially adopted Strategic Environmental Assessment (SEA) as one important means towards the achievement of environmental conservation and sustainable development. Despite implementation almost a decade ago, SEA remains premature in its development. This paper analyzes the progress and characteristics of SEA in Taiwan and, through examination of its limited case studies, reveals the positive and apparent influence of SEA on policy making. This paper also identifies the barriers hindering SEA's advancement and concludes with recommendations on strategies to overcome these obstacles.

  20. Improvement of CSCW Software Implementation in NPD: The CAM Mechanism for a Better Adoption by Users

    ERIC Educational Resources Information Center

    Restrepo, Tomas; Arbelaez, Natalia; Millet, Dominique; Gidel, Thierry

    2010-01-01

    Cooperation between disseminated actors is a key factor in improving new product development (NPD) performance. In the last years, numerous CSCW software applications have been introduced in the industry to support NPD with a low success rate. This is partly due to the limited insight of the organisational and human factors influencing user…

  1. Improvement of CSCW Software Implementation in NPD: The CAM Mechanism for a Better Adoption by Users

    ERIC Educational Resources Information Center

    Restrepo, Tomas; Arbelaez, Natalia; Millet, Dominique; Gidel, Thierry

    2010-01-01

    Cooperation between disseminated actors is a key factor in improving new product development (NPD) performance. In the last years, numerous CSCW software applications have been introduced in the industry to support NPD with a low success rate. This is partly due to the limited insight of the organisational and human factors influencing user…

  2. Fulfilling the Promise of the Common Core State Standards: Moving from Adoption to Implementation to Sustainability

    ERIC Educational Resources Information Center

    ASCD, 2012

    2012-01-01

    First launched in April 2009, the Common Core State Standards Initiative was conceived to identify and develop college- and career-readiness standards that address what students are expected to know and be able to do when they have graduated from high school. The initiative introduced the final version of the standards in June 2010, and by…

  3. Fulfilling the Promise of the Common Core State Standards: Moving from Adoption to Implementation to Sustainability

    ERIC Educational Resources Information Center

    ASCD, 2012

    2012-01-01

    First launched in April 2009, the Common Core State Standards Initiative was conceived to identify and develop college- and career-readiness standards that address what students are expected to know and be able to do when they have graduated from high school. The initiative introduced the final version of the standards in June 2010, and by…

  4. Contribution of Professional Development to Standards Implementation

    ERIC Educational Resources Information Center

    Klieger, Aviva; Yakobovitch, Anat

    2012-01-01

    Teachers' professional development is a key to any educational change and is critical when leading and assimilating change, such as introducing standards into classrooms. A national professional development (PD) framework was developed for the implementation of science standards published by the Israeli Ministry of Education, which was activated…

  5. Contribution of Professional Development to Standards Implementation

    ERIC Educational Resources Information Center

    Klieger, Aviva; Yakobovitch, Anat

    2012-01-01

    Teachers' professional development is a key to any educational change and is critical when leading and assimilating change, such as introducing standards into classrooms. A national professional development (PD) framework was developed for the implementation of science standards published by the Israeli Ministry of Education, which was activated…

  6. Development of composite indices to measure the adoption of pro-environmental behaviours across Canadian provinces.

    PubMed

    Canuel, Magalie; Abdous, Belkacem; Bélanger, Diane; Gosselin, Pierre

    2014-01-01

    The adoption of pro-environmental behaviours reduces anthropogenic environmental impacts and subsequent human health effects. This study developed composite indices measuring adoption of pro-environmental behaviours at the household level in Canada. The 2007 Households and the Environment Survey conducted by Statistics Canada collected data on Canadian environmental behaviours at households' level. A subset of 55 retained questions from this survey was analyzed by Multiple Correspondence Analysis (MCA) to develop the index. Weights attributed by MCA were used to compute scores for each Canadian province as well as for socio-demographic strata. Scores were classified into four categories reflecting different levels of adoption of pro-environmental behaviours. Two indices were finally created: one based on 23 questions related to behaviours done inside the dwelling and a second based on 16 questions measuring behaviours done outside of the dwelling. British Columbia, Quebec, Prince-Edward-Island and Nova-Scotia appeared in one of the two top categories of adoption of pro-environmental behaviours for both indices. Alberta, Saskatchewan, Manitoba and Newfoundland-and-Labrador were classified in one of the two last categories of pro-environmental behaviours adoption for both indices. Households with a higher income, educational attainment, or greater number of persons adopted more indoor pro-environmental behaviours, while on the outdoor index, they adopted fewer such behaviours. Households with low-income fared better on the adoption of outdoors pro-environmental behaviours. MCA was successfully applied in creating Indoor and Outdoor composite Indices of pro-environmental behaviours. The Indices cover a good range of environmental themes and the analysis could be applied to similar surveys worldwide (as baseline weights) enabling temporal trend comparison for recurring themes. Much more than voluntary measures, the study shows that existing regulations, dwelling type

  7. Development of Composite Indices to Measure the Adoption of Pro-Environmental Behaviours across Canadian Provinces

    PubMed Central

    Canuel, Magalie; Abdous, Belkacem; Bélanger, Diane; Gosselin, Pierre

    2014-01-01

    Objective The adoption of pro-environmental behaviours reduces anthropogenic environmental impacts and subsequent human health effects. This study developed composite indices measuring adoption of pro-environmental behaviours at the household level in Canada. Methods The 2007 Households and the Environment Survey conducted by Statistics Canada collected data on Canadian environmental behaviours at households' level. A subset of 55 retained questions from this survey was analyzed by Multiple Correspondence Analysis (MCA) to develop the index. Weights attributed by MCA were used to compute scores for each Canadian province as well as for socio-demographic strata. Scores were classified into four categories reflecting different levels of adoption of pro-environmental behaviours. Results Two indices were finally created: one based on 23 questions related to behaviours done inside the dwelling and a second based on 16 questions measuring behaviours done outside of the dwelling. British Columbia, Quebec, Prince-Edward-Island and Nova-Scotia appeared in one of the two top categories of adoption of pro-environmental behaviours for both indices. Alberta, Saskatchewan, Manitoba and Newfoundland-and-Labrador were classified in one of the two last categories of pro-environmental behaviours adoption for both indices. Households with a higher income, educational attainment, or greater number of persons adopted more indoor pro-environmental behaviours, while on the outdoor index, they adopted fewer such behaviours. Households with low-income fared better on the adoption of outdoors pro-environmental behaviours. Conclusion MCA was successfully applied in creating Indoor and Outdoor composite Indices of pro-environmental behaviours. The Indices cover a good range of environmental themes and the analysis could be applied to similar surveys worldwide (as baseline weights) enabling temporal trend comparison for recurring themes. Much more than voluntary measures, the study shows that

  8. Adoption of a Portal for the Primary Care Management of Pediatric Asthma: A Mixed-Methods Implementation Study.

    PubMed

    Fiks, Alexander G; DuRivage, Nathalie; Mayne, Stephanie L; Finch, Stacia; Ross, Michelle E; Giacomini, Kelli; Suh, Andrew; McCarn, Banita; Brandt, Elias; Karavite, Dean; Staton, Elizabeth W; Shone, Laura P; McGoldrick, Valerie; Noonan, Kathleen; Miller, Dorothy; Lehmann, Christoph U; Pace, Wilson D; Grundmeier, Robert W

    2016-06-29

    treatment engagement, our results suggest that achieving widespread portal adoption is unlikely in the short term. Implementation efforts should include workflow redesign and prioritize enrollment of symptomatic children. Clinicaltrials.gov NCT01966068; https://clinicaltrials.gov/ct2/show/NCT01966068 (Archived by WebCite at http://www.webcitation.org/6i9iSQkm3).

  9. Adoption of a Portal for the Primary Care Management of Pediatric Asthma: A Mixed-Methods Implementation Study

    PubMed Central

    DuRivage, Nathalie; Mayne, Stephanie L; Finch, Stacia; Ross, Michelle E; Giacomini, Kelli; Suh, Andrew; McCarn, Banita; Brandt, Elias; Karavite, Dean; Staton, Elizabeth W; Shone, Laura P; McGoldrick, Valerie; Noonan, Kathleen; Miller, Dorothy; Lehmann, Christoph U; Pace, Wilson D; Grundmeier, Robert W

    2016-01-01

    . Conclusions Although use was associated with higher treatment engagement, our results suggest that achieving widespread portal adoption is unlikely in the short term. Implementation efforts should include workflow redesign and prioritize enrollment of symptomatic children. ClinicalTrial Clinicaltrials.gov NCT01966068; https://clinicaltrials.gov/ct2/show/NCT01966068 (Archived by WebCite at http://www.webcitation.org/6i9iSQkm3) PMID:27357835

  10. Adoption of clinical decision support systems in a developing country: Antecedents and outcomes of physician's threat to perceived professional autonomy.

    PubMed

    Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh; Nezakati, Hossein

    2015-08-01

    The basic objective of this research is to study the antecedents and outcomes of professional autonomy which is a central construct that affects physicians' intention to adopt clinical decision support systems (CDSS). The antecedents are physicians' attitude toward knowledge sharing and interactivity perception (about CDSS) and the outcomes are performance expectancy and intention to adopt CDSS. Besides, we include (1) the antecedents of attitude toward knowledge sharing-subjective norms, social factors and OCB (helping behavior) and (2) roles of physicians' involvement in decision making, computer self-efficacy and effort expectancy in our framework. Data from a stratified sample of 335 Malaysian physicians working in 12 public and private hospitals in Malaysia were collected to test the hypotheses using Structural Equation Modeling (SEM). The important findings of our research are: (1) factors such as perceived threat to professional autonomy, performance expectancy, and physicians' involvement in making decision about CDSS have significant impact on physicians' intention to adopt CDSS; (2) physicians' attitude toward knowledge sharing, interactivity perception and computer self-efficacy of physicians play a crucial role in influencing their perceived threat to professional autonomy; and (3) social network, shared goals and OCB (helping behavior) impact physicians' attitude toward knowledge sharing. The findings provide a comprehensive understanding of the factors that influence physicians' intention to adopt CDSS in a developing country. The results can help hospital managers manage CDSS implementation in an effective manner. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Factors influencing the implementation, adoption, use, sustainability and scalability of mLearning for medical and nursing education: a systematic review protocol.

    PubMed

    Krishnasamy, Charmaine; Ong, Sik Yin; Yock, Yvonne; Lim, Issac; Rees, Rebecca; Car, Josip

    2016-10-19

    mLearning is increasingly presented as an attractive novel educational strategy for medical and nursing education. Yet, evidence base for its effectiveness or factors which influence use, success, implementation or adoption are not clear. We aim to synthesise findings from qualitative studies to provide insight into the factors (barriers and facilitators) influencing adoption, implementation and use of mobile devices for learning in medical and nursing education. The review also aims to identify factors or actions which are considered to optimise the experience and satisfaction of educators and learners in using mobile technologies for medical and nursing education and to identify strategies for improving mLearning interventions for medical and nursing education. A systematic search will be conducted across a range of databases for studies describing or evaluating the experiences, barriers, facilitators and factors pertaining to the use of mLearning for medical and nursing education. The framework synthesis approach will be used to organise and bring different components of the results together. The confidence in the qualitative review findings will be assessed using the CERQual approach. This study will contribute to the planning and design of effective mLearning and the development of mLearning guidelines for medical and nursing education. PROSPERO CRD42016035411.

  12. Exploring barriers and opportunities in adopting crowdsourcing based new product development in manufacturing SMEs

    NASA Astrophysics Data System (ADS)

    Qin, Shengfeng; Van der Velde, David; Chatzakis, Emmanouil; McStea, Terry; Smith, Neil

    2016-10-01

    Crowdsourcing is an innovative business practice of obtaining needed services, ideas, or content or even funds by soliciting contributions from a large group of people (the `Crowd'). The potential benefits of utilizing crowdsourcing in product design are well-documented, but little research exists on what are the barriers and opportunities in adopting crowdsourcing in new product development (NPD) of manufacturing SMEs. In order to answer the above questions, a Proof of Market study is carried out on crowdsourcing-based product design under an Innovate UK funded Smart project, which aims at identifying the needs, challenges and future development opportunities associated with adopting crowdsourcing strategies for NPD. The research findings from this study are reported here and can be used to guide future development of crowdsourcing-based collaborative design methods and tools and provide some practical references for industry to adopt this new and emerging collaborative design method in their business.

  13. The Early Growth and Development Study: a prospective adoption study from birth through middle childhood.

    PubMed

    Leve, Leslie D; Neiderhiser, Jenae M; Shaw, Daniel S; Ganiban, Jody; Natsuaki, Misaki N; Reiss, David

    2013-02-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children recruited in two cohorts (N = 561 triads). The primary study aims are to examine how family, peer, and contextual processes affect children's adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Participants were recruited through adoption agencies located throughout the United States following the birth of a child. Assessments are ongoing, in 9-month intervals until the child reaches 3 years of age and in 1-year intervals thereafter through age 9. Data collection includes the following primary constructs: child temperament, social behavior, school performance, mental health, and health; birth and adoptive parent personality characteristics, mental health, competence, stress, health, context, substance use, parenting, and marital relations; and pregnancy use of drugs and maternal stress during pregnancy. DNA and salivary cortisol samples have also been collected. Analyses have indicated evidence for genotype-environment interactions during early childhood. Study procedures, sample representativeness (including tests of potential confounds in the adoption design), and an overview of findings to date are summarized, and future plans are described.

  14. The Early Growth and Development Study: A Prospective Adoption Study from Birth Through Middle Childhood

    PubMed Central

    Leve, Leslie D.; Neiderhiser, Jenae M.; Shaw, Daniel S.; Ganiban, Jody; Natsuaki, Misaki N.; Reiss, David

    2013-01-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children recruited in two cohorts (N = 561 triads). The primary study aims are to examine how family, peer, and contextual processes affect children’s adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Participants were recruited through adoption agencies located throughout the United States following the birth of a child. Assessments are ongoing, in 9-month intervals until the child reaches 3 years of age and in one-year intervals thereafter through age 9. Data collection includes the following primary constructs: child temperament, social behavior, school performance, mental health, and health; birth and adoptive parent personality characteristics, mental health, competence, stress, health, context, substance use, parenting, and marital relations; and pregnancy use of drugs and maternal stress during pregnancy. DNA and salivary cortisol samples have also been collected. Analyses have indicated evidence for genotype-environment interactions during early childhood. Study procedures, sample representativeness (including tests of potential confounds in the adoption design), and an overview of findings to date are summarized, and future plans are described. PMID:23218244

  15. Institutional care paths: Development, implementation, and evaluation.

    PubMed

    Leonard, Mandy C; Bauer, Seth R; Ahrens, Christine; Reddy, Anita; Katzan, Irene

    2017-09-15

    The Cleveland Clinic experience with care paths, including their creation and implementation, challenges overcome during development and testing, and outcomes of selected care path evaluations, is described. Care paths are tools to assist healthcare professionals in practicing evidence-based medicine. The Cleveland Clinic health system has implemented or is developing approximately 100 care paths, including care paths designed to optimize management of sepsis and septic shock and to promote timely use of i.v. tissue plasminogen activator and correct dosing of antithrombotics and statins in patients with stroke. Key steps in successful care path initiatives include (1) identifying key stakeholders, (2) achieving stakeholder consensus on a standardized approach to disease or condition management, (3) cultivating provider awareness of care paths, (4) incorporating care path tools into the electronic health record and workflow processes, and (5) securing the resources to develop, implement, and maintain care paths. Electronic health records facilitate the use of and adherence to care paths. After care path implementation, revisions are typically needed due to unexpected issues not initially identified and to optimize care path features and support resources for clinical practice. Ongoing evaluation is required to determine whether an implemented care path is producing the intended patient and quality performance outcomes. Care paths provide a standardized approach to treatment or prevention of a disease or condition, reducing unnecessary variability and expense while promoting optimal, cost-effective patient care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. Implementing Information Technology Projects in Developing Countries.

    ERIC Educational Resources Information Center

    Kanamugire, Athanase B.

    1993-01-01

    Reviews the problems of implementing information technology in developing countries and cites examples from African projects. The use of CD-ROM for access to information is examined, and experiences at the King Fahd University of Petroleum and Minerals in Saudi Arabia in introducing CD-ROM search services are described. (Contains five references.)…

  17. Interactive Test Analysis: Development, Implementation, and Evaluation.

    ERIC Educational Resources Information Center

    Lipe, Gary

    An interactive test analysis system was developed which interfaces a 3M DATRONICS system with a XEROX Sigma 9 computer. The computer programs were written in A Programming Language (APL). The current implementation of the program is characterized by its capability to: read responses from a DATRONIC answer sheet; allow the faculty member the option…

  18. Principles of adoption of the successful environmental practices used in developed countries into mining industry in developing countries.

    NASA Astrophysics Data System (ADS)

    Masaitis, Alexandra

    2013-04-01

    The successful implementation of the environmental practices in the mining industry is of a paramount importance, as it not only prevents both local and trans-border pollution but also guarantees clean and healthy environment for the people regardless of their place of habitation. It is especially important to encourage the progress of the environmental practices implementation in developing countries because such countries have resource-oriented economy based on exploitation of nonrenewable resources. Poor environmental practices in developing countries will lead to local environmental crises that could eventually spill into surrounding countries including the most economically advanced. This abstract is a summary of a two-year research project attempted (1) to determine deficiencies of the mining sector ecological practices in developing countries and (2) to suggest substitute practices from developed countries that could be adapted to the developing countries reality. The following research methods were used: 1. The method of the system analysis, where the system is an interaction of the sets of environmental practices with the global mining sector; 2. The comparative method of inquiry, where the comparison was made between environmental protection practices as implemented in the US (developed country) and the developing countries such as RF, Mongolia mining sectors; 3. Quantitative date analysis, where date was collected from "The collection of statistic data", Russian Geographic Society Annual reports, the US EPA open reports, and the USGS Reports; The following results were obtained: Identified the systemic crisis of the ecological environmental policies and practices in the mining sector in developing countries based on the exploitation of nonrenewable resources, absence of the ecological interest by the mining companies that lack mechanisms of environmental and public health protection, the lack of insurance policy, the lack of risk assistance, and in the

  19. The Third African Population Conference adopts the draft Dakar / Ngor Declaration on Population, Family and Sustainable Development.

    PubMed

    1993-01-01

    The 3rd African Population Conference, held in Dakar, Senegal, December 7-12, 1992, adopted the draft Dakar/Ngor Declaration on Population, Family and Sustainable Development in preparation for the 1994 Cairo International Conference on Population and Development. The meeting was attended by 50 member states and many observers from various United Nations Organizations and nongovernmental organizations (NGOs). The Conference reviewed the lessons learned from the implementation of the Kilimanjaro Program of Action on Population (KAP), which had been adopted in 1984. The draft Declaration focused on the following areas: a) population, sustained economic growth, and sustainable development; family; fertility and family planning; mortality, morbidity and AIDS; urbanization and migration; refugees and displaced persons; women in development; children; data collection and analysis, information dissemination, training and research; information, education and communication; b) the role of: private and nongovernmental organizations; the subregional and regional groupings; the World Bank and relevant organizations of the United Nations System; and the international community; c) resource mobilization; and d) implementation of the Declaration. African countries should integrate population policies so as to reduce population growth from the present rate of 3.0% per annum to 2.5% by the year 2000 and to 2% by the year 2010. Environmental issues and food security were given special attention. The targets set on the contraceptive prevalence rate for Africa were to reach 20% by the year 2000 and 40% by the year 2010. The following targets were to be attained by the year 2000: life expectancy in Africa at least 55 years; an infant mortality rate of less than 50 per 1000 live births; childhood mortality rate of 70 or less. Programs to prevent AIDS were also stressed. The Declaration called on UN organizations, the World Bank, the Organization of African Unity, and the African

  20. Innovative farmers and regulatory gatekeepers: Genetically modified crops regulation and adoption in developing countries

    PubMed Central

    Sinebo, Woldeyesus; Maredia, Karim

    2016-01-01

    ABSTRACT The regulation of genetically modified (GM) crops is a topical issue in agriculture and environment over the past 2 decades. The objective of this paper is to recount regulatory and adoption practices in some developing countries that have successfully adopted GM crops so that aspiring countries may draw useful lessons and best practices for their biosafatey regulatory regimes. The first 11 mega-GM crops growing countries each with an area of more than one million hectares in 2014 were examined. Only five out of the 11 countries had smooth and orderly adoption of these crops as per the regulatory requirement of each country. In the remaining 6 countries (all developing countries), GM crops were either introduced across borders without official authorization, released prior to regulatory approval or unapproved seeds were sold along with the approved ones in violation to the existing regulations. Rapid expansion of transgenic crops over the past 2 decades in the developing world was a result of an intense desire by farmers to adopt these crops irrespective of regulatory roadblocks. Lack of workable biosafety regulatory system and political will to support GM crops encouraged unauthorized access to GM crop varieties. In certain cases, unregulated access in turn appeared to result in the adoption of substandard or spurious technology which undermined performance and productivity. An optimal interaction among the national agricultural innovation systems, biosafety regulatory bodies, biotech companies and high level policy makers is vital in making a workable regulated progress in the adoption of GM crops. Factoring forgone opportunities to farmers to benefit from GM crops arising from overregulation into biosafety risk analysis and decision making is suggested. Building functional biosafety regulatory systems that balances the needs of farmers to access and utilize the GM technology with the regulatory imperatives to ensure adequate safety to the environment

  1. Innovative farmers and regulatory gatekeepers: Genetically modified crops regulation and adoption in developing countries.

    PubMed

    Sinebo, Woldeyesus; Maredia, Karim

    2016-01-02

    The regulation of genetically modified (GM) crops is a topical issue in agriculture and environment over the past 2 decades. The objective of this paper is to recount regulatory and adoption practices in some developing countries that have successfully adopted GM crops so that aspiring countries may draw useful lessons and best practices for their biosafatey regulatory regimes. The first 11 mega-GM crops growing countries each with an area of more than one million hectares in 2014 were examined. Only five out of the 11 countries had smooth and orderly adoption of these crops as per the regulatory requirement of each country. In the remaining 6 countries (all developing countries), GM crops were either introduced across borders without official authorization, released prior to regulatory approval or unapproved seeds were sold along with the approved ones in violation to the existing regulations. Rapid expansion of transgenic crops over the past 2 decades in the developing world was a result of an intense desire by farmers to adopt these crops irrespective of regulatory roadblocks. Lack of workable biosafety regulatory system and political will to support GM crops encouraged unauthorized access to GM crop varieties. In certain cases, unregulated access in turn appeared to result in the adoption of substandard or spurious technology which undermined performance and productivity. An optimal interaction among the national agricultural innovation systems, biosafety regulatory bodies, biotech companies and high level policy makers is vital in making a workable regulated progress in the adoption of GM crops. Factoring forgone opportunities to farmers to benefit from GM crops arising from overregulation into biosafety risk analysis and decision making is suggested. Building functional biosafety regulatory systems that balances the needs of farmers to access and utilize the GM technology with the regulatory imperatives to ensure adequate safety to the environment and human

  2. The Behavioral Development of Korean Children in Institutional Care and International Adoptive Families

    ERIC Educational Resources Information Center

    Lee, Richard M.; Seol, Kyoung Ok; Sung, Miyoung; Miller, Matthew J.

    2010-01-01

    In this study, the authors compared the behavioral development of 4- to 8-year-old South Korean children placed in institutional care (n = 230) or adopted internationally (n = 382), with age of entry, parental status, reason for institutionalization, and postinstitutionalization parental contact as risk factors for institutionalized children.…

  3. Developing the Level of Adoption Survey to Inform Collaborative Discussion regarding Educational Innovation

    ERIC Educational Resources Information Center

    Orr, Doug; Mrazek, Rick

    2009-01-01

    Learning organizations rely on collaborative information and understanding to support and sustain professional growth and development. A collaborative self-assessment instrument can provide clear articulation and characterization of the level of adoption of innovation such as the use of instructional technologies. Adapted from the "Level of…

  4. Concerns and Professional Development Needs of Science Faculty at Taibah University in Adopting Blended Learning

    ERIC Educational Resources Information Center

    AL-Sarrani, Nauaf

    2010-01-01

    The purpose of this study was to obtain Science faculty concerns and professional development needs to adopt blended learning in their teaching at Taibah University. To answer these two research questions the survey instrument was designed to collect quantitative and qualitative data from close-ended and open-ended questions. The participants'…

  5. Social Development from Infancy to Adolescence: Longitudinal and Concurrent Factors in an Adoption Sample

    ERIC Educational Resources Information Center

    Jaffari-Bimmel, Nicole; Juffer, Femmie; van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.; Mooijaart, Ab

    2006-01-01

    In the present longitudinal study, early adopted children (N = 160) were followed from infancy to adolescence to assess the influence of previous and concurrent factors on the children's social development. This study allowed for more conclusive evidence of the influence of early and concurrent rearing experiences and temperament on…

  6. Multi-criteria development and incorporation into decision tools for health technology adoption.

    PubMed

    Poulin, Paule; Austen, Lea; Scott, Catherine M; Waddell, Cameron D; Dixon, Elijah; Poulin, Michelle; Lafrenière, René

    2013-01-01

    When introducing new health technologies, decision makers must integrate research evidence with local operational management information to guide decisions about whether and under what conditions the technology will be used. Multi-criteria decision analysis can support the adoption or prioritization of health interventions by using criteria to explicitly articulate the health organization's needs, limitations, and values in addition to evaluating evidence for safety and effectiveness. This paper seeks to describe the development of a framework to create agreed-upon criteria and decision tools to enhance a pre-existing local health technology assessment (HTA) decision support program. The authors compiled a list of published criteria from the literature, consulted with experts to refine the criteria list, and used a modified Delphi process with a group of key stakeholders to review, modify, and validate each criterion. In a workshop setting, the criteria were used to create decision tools. A set of user-validated criteria for new health technology evaluation and adoption was developed and integrated into the local HTA decision support program. Technology evaluation and decision guideline tools were created using these criteria to ensure that the decision process is systematic, consistent, and transparent. This framework can be used by others to develop decision-making criteria and tools to enhance similar technology adoption programs. The development of clear, user-validated criteria for evaluating new technologies adds a critical element to improve decision-making on technology adoption, and the decision tools ensure consistency, transparency, and real-world relevance.

  7. Appalachia: Goals, Objectives and Development Strategies. Supplement 1: Resolutions Adopted December 1977.

    ERIC Educational Resources Information Center

    Appalachian Regional Commission, Washington, DC.

    Recommendations by task forces at the Appalachian Balanced Growth and Economic Development Conference in 1977 to the Appalachian Regional Commission (ARC) resulted in ARC's adoption of six resolutions which are listed in this supplement. Specific recommendations were made under the following resolution headings: (1) legislation for a national…

  8. Appalachia: Goals, Objectives and Development Strategies. Supplement 1: Resolutions Adopted December 1977.

    ERIC Educational Resources Information Center

    Appalachian Regional Commission, Washington, DC.

    Recommendations by task forces at the Appalachian Balanced Growth and Economic Development Conference in 1977 to the Appalachian Regional Commission (ARC) resulted in ARC's adoption of six resolutions which are listed in this supplement. Specific recommendations were made under the following resolution headings: (1) legislation for a national…

  9. Elementary Teachers' Simulation Adoption and Inquiry-Based Use Following Professional Development

    ERIC Educational Resources Information Center

    Gonczi, Amanda; Maeng, Jennifer; Bell, Randy

    2017-01-01

    The purpose of this study was to characterize and compare 64 elementary science teachers' computer simulation use prior to and following professional development (PD) aligned with Innovation Adoption Theory. The PD highlighted computer simulation affordances that elementary teachers might find particularly useful. Qualitative and quantitative…

  10. Concerns and Professional Development Needs of Science Faculty at Taibah University in Adopting Blended Learning

    ERIC Educational Resources Information Center

    AL-Sarrani, Nauaf

    2010-01-01

    The purpose of this study was to obtain Science faculty concerns and professional development needs to adopt blended learning in their teaching at Taibah University. To answer these two research questions the survey instrument was designed to collect quantitative and qualitative data from close-ended and open-ended questions. The participants'…

  11. Language Development in Internationally Adopted Children: A Special Case of Early Second Language Learning

    ERIC Educational Resources Information Center

    Gauthier, Karine; Genesee, Fred

    2011-01-01

    The French language development of children adopted (n = 24) from China was compared with that of control children matched for socioeconomic status, sex, and age. The children were assessed at 50 months of age, on average, and 16 months later. The initial assessment revealed that the 2 groups did not differ with respect to socioemotional…

  12. Assessing a Faculty Development Program for the Adoption of Brain-Based Learning Strategies

    ERIC Educational Resources Information Center

    Lavis, Catherine C.; Williams, Kimberly A.; Fallin, Jana; Barnes, Pamela K.; Fishback, Sarah J.; Thien, Stephen

    2016-01-01

    Kansas State University designed a 20-month faculty development program with the goal of fostering broad, institution-wide adoption of teaching practices that focus on brain-based learning. Components of the program included annual teaching and learning workshops, reading and discussion groups based on content of a book about how the brain learns…

  13. Diffusion and Adoption of Innovations in Fertilizer-Related Agricultural Production Technology in Developing Countries.

    ERIC Educational Resources Information Center

    Byrnes, Kerry J.

    This monograph reviews a wide range of research literature on the diffusion and adoption of innovations in agricultural production technology in the developing countries, with particular emphasis on the practice of using commercially purchased, inorganic fertilizer as a source of plant nutrients. It is intended that the report's documentation of…

  14. Diffusion and Adoption of Innovations in Fertilizer-Related Agricultural Production Technology in Developing Countries.

    ERIC Educational Resources Information Center

    Byrnes, Kerry J.

    This monograph reviews a wide range of research literature on the diffusion and adoption of innovations in agricultural production technology in the developing countries, with particular emphasis on the practice of using commercially purchased, inorganic fertilizer as a source of plant nutrients. It is intended that the report's documentation of…

  15. Developing and implementing dietary guidelines in India.

    PubMed

    Krishnaswamy, Kamala

    2008-01-01

    Single nutrients are no solution to the problem of malnutrition. It is essential that food based dietary guidelines (FBDG) are developed and implemented to overcome the diet related diseases and promote health in the population. A multidisciplinary group was constituted to develop FBDGs in India. A manual with scientific details and an abridged version were prepared with 6 goals and 14 dietary guidelines covering all age groups to overcome the public health nutritional problems. The guidelines are based on dietary patterns and specific outcomes of health and disease. Dietary diversification has been suggested as the practical approach. Diets from locally available and culturally accepted foods in household measures have been suggested to ensure optimal health. For successful implementation of FBDGs, political/bureaucratic commitment are essential. It must become a tool in the developmental plans for food, nutrition, agriculture, rural, educational and biotechnology policies. Workshops and meetings were organized to sensitise the administrative set-up. The intersectoral nature of FBDG for implementation was highlighted. The department of women and child development, which is responsible for implementing the National Nutritional Policy, was recognized as nodal agency. Meetings were organised for secondary target audiences. The press was invited to participate in popularization of the FBDGs. Social marketing strategies were used to match the local dietary and cultural aspects. Interpersonal communication and professional societies were used for better dissemination. Industry and legislative bodies were requested to take active action in this regard. The FBDGs have to be implemented to achieve food and nutrition security and the Millennium Development Goals.

  16. What influences government adoption of vaccines in developing countries? A policy process analysis.

    PubMed

    Munira, Syarifah Liza; Fritzen, Scott A

    2007-10-01

    This paper proposes a framework for examining the process by which government consideration and adoption of new vaccines takes place, with specific reference to developing country settings. The cases of early Hepatitis B vaccine adoption in Taiwan and Thailand are used to explore the relevance of explanatory factors identified in the literature as well as the need to go beyond a variable-centric focus by highlighting the role of policy context and process in determining the pace and extent of adoption. The cases suggest the feasibility and importance of modeling 'causal diversity'-the complex set of necessary and sufficient conditions leading to particular decisional outcomes-in a broad range of country contexts. A better understanding of the lenses through which government decision-makers filter information, and of the arenas in which critical decisions are shaped and taken, may assist both analysts (in predicting institutionalization of new vaccines) and advocates (in crafting targeted strategies to accelerate their diffusion).

  17. Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England.

    PubMed

    Takian, Amirhossein; Sheikh, Aziz; Barber, Nicholas

    2014-09-01

    To explore the role of organizational learning in enabling implementation and supporting adoption of electronic health record systems into two English hospitals. In the course of conducting our prospective and sociotechnical evaluation of the implementation and adoption of electronic health record into 12 "early adopter" hospitals across England, we identified two hospitals implementing virtually identical versions of the same "off-the-shelf" software (Millennium) within a comparable timeframe. We undertook a longitudinal qualitative case study-based analysis of these two hospitals (referred to hereafter as Alpha and Omega) and their implementation experiences. Data included the following: 63 in-depth interviews with various groups of internal and external stakeholders; 41-h on-site observation; and content analysis of 218 documents of various types. Analysis was both inductive and deductive, the latter being informed by the "sociotechnical changing" theoretical perspective. Although Alpha and Omega shared a number of contextual similarities, our evaluation revealed fundamental differences in visions of electronic health record and the implementation strategy between the hospitals, which resulted in distinct local consequences of electronic health record implementation and impacted adoption. Both hospitals did not, during our evaluation, see the hoped-for benefits to the organization as a result of the introduction of electronic health record, such as speeding-up tasks. Nonetheless, the Millennium software worked out to be easier to use at Omega. Interorganizational learning was at the heart of this difference. Despite the turbulent overall national "roll out" of electronic health record systems into the English hospitals, considerable opportunities for organizational learning were offered by sequential delivery of the electronic health record software into "early adopter" hospitals. We argue that understanding the process of organizational learning and its

  18. Adoption: Pediatric, Legislative and Social Issues

    PubMed Central

    Davis, Joseph H.; Brown, Dirck W.

    1981-01-01

    Physicians may find themselves involved in many phases of the adoption process, ranging from advising infertile couples who wish to adopt a child to caring for adopted children, adolescents or adults. Recent legislation has been aimed at making it possible for children to be adopted who have been receiving foster care and at providing financial assistance to implement the adoption of children with handicaps and with medical problems. The adoption process is becoming more open. Adoptees are searching for and finding their biological parents and all parties in the “adoption triangle” are developing relationships with one another. PMID:7257384

  19. The Morningside Initiative: Collaborative Development of a Knowledge Repository to Accelerate Adoption of Clinical Decision Support

    DTIC Science & Technology

    2010-01-01

    Initiative: Collaborative Development of a Knowledge Repository to Accelerate Adoption of Clinical Decision Support 5a. CONTRACT NUMBER 5b. GRANT NUMBER...Health Level Seven (HL7) in 1998; but a website for sharing of Arden Syntax Medical Logic Modules ( MLMs ) developed at Columbia University in the mid...the initial focus of the effort. In 2008, at about the same time as the Morningside Initiative was being formed, AHRQ issued contracts for two

  20. Developing and implementing a career ladder program.

    PubMed

    Wall, Michelle

    2007-01-01

    A career ladder program is a formal management tool used not only by managers looking to recognize and retain employees, but also by employees seeking growth opportunities. A career ladder program involves careful development, frequent and effective communication during implementation, and activities focused on measuring program effectiveness. Career ladders are a way to increase productivity and staff versatility; improve morale, clinical quality, and staff satisfaction; reduce turnover; promote professional growth and job enrichment; and improve patient care.

  1. On the Consideration of Adoption and Implementation of The Next Generation Science Standards in a Local-Control Context: Supporting the Epistemology of Science through Education Policy

    NASA Astrophysics Data System (ADS)

    Lazzaro, Christopher C.

    On the Consideration of Adoption and Implementation of The Next Generation Science Standards in a Local-Control Context: Supporting the Epistemology of Science through Education Policy. Christopher C Lazzaro. The primary purpose of this research is to understand how and why members at each of the three levels of the education system within a local-control state made the decisions they did in supporting or hindering the adoption and implementation of the Next Generation Science Standards. This research concentrates on three levels of the education system in a local-control state; 1) the state level, 2) the district level, and 3) the school/teacher level, while investigating the following questions: 1. To what extent, and in what ways, do members in each of the three levels of the state education system advocate for adoption and implementation of the Next Generation Science Standards? 2. Are the members in each of the three levels motivated or compelled to consider adoption and implementation of the Next Generation Science Standards, why or why not? 3. To what extent, and in what ways, do the members in each of the three levels take into account science epistemology in their overall consideration of adoption/implementation of the NGSS? The data drew from a series of interviews from a prior study, "Challenges of Implementing the Next Generation Science Standards in Local-Control States in the U.S." (Sevian, Foster, & Scheff, 2012). After these data were coded and analyzed around the three research questions, this phenomenographic research study identified four key findings: Key Finding 1 - As the District Coordinators are uniquely situated within the state education system to be able to see both the on-the-ground practical implications and the high-level policy pressures of adopting and implementing the NGSS, they reflect the deepest level of awareness of how to best advocate for adoption and implementation of the NGSS. Key Finding 2 - Motivation to adopt and

  2. Implementing quality: a study of the adoption and implementation of quality standards in the contracting process in a general practitioner multifund.

    PubMed

    Baeza, J I; Calnan, M

    1997-10-01

    The increase in managerialism in the 1980s and the 1990 NHS reforms have had major implications for the regulation of providers. Purchasers of health care in the UK are now expected to specify three factors in their contracts: volume, cost and quality. This paper focuses on one of these: i.e. the quality standards purchasers now include within their health service contracts. The case study is of a general practitioner multifund and the analysis focuses on how quality standards are derived and adopted in outpatient contracts. The data were derived from in-depth face-to-face interviews with the key participants in the contracting process. The evidence shows that the standards were derived and adopted with very little participation from the providers. The impact of the quality standards on hospitals consultants' behaviour was negligible, there was very little monitoring of the standards by the multifund, and providers accepted standards which they knew they could not meet. It is concluded that this non-participatory method of developing the quality standards is likely to mean that their impact on service delivery will be limited.

  3. Health Status, Cognitive and Motor Development of Young Children Adopted from China, East Asia, and Russia across the First 6 Months after Adoption

    ERIC Educational Resources Information Center

    Pomerleau, Andree; Malcuit, Gerard; Chicoine, Jean-Francois; Seguin, Renee; Belhumeur, Celine; Germain, Patricia; Amyot, Isabelle; Jeliu, Gloria

    2005-01-01

    We compared health status, anthropometric and psychological development of 123 children adopted before 18 months of age from China, East Asia (Vietnam, Taiwan, Thailand, South Korea, Cambodia), and Eastern Europe (mostly Russia). Data were collected close to the time of arrival, and 3 and 6 months later. Anthropometric measures included weight,…

  4. Health Status, Cognitive and Motor Development of Young Children Adopted from China, East Asia, and Russia across the First 6 Months after Adoption

    ERIC Educational Resources Information Center

    Pomerleau, Andree; Malcuit, Gerard; Chicoine, Jean-Francois; Seguin, Renee; Belhumeur, Celine; Germain, Patricia; Amyot, Isabelle; Jeliu, Gloria

    2005-01-01

    We compared health status, anthropometric and psychological development of 123 children adopted before 18 months of age from China, East Asia (Vietnam, Taiwan, Thailand, South Korea, Cambodia), and Eastern Europe (mostly Russia). Data were collected close to the time of arrival, and 3 and 6 months later. Anthropometric measures included weight,…

  5. Adopting best practices: "Agility" moves from software development to healthcare project management.

    PubMed

    Kitzmiller, Rebecca; Hunt, Eleanor; Sproat, Sara Breckenridge

    2006-01-01

    It is time for a change in mindset in how nurses operationalize system implementations and manage projects. Computers and systems have evolved over time from unwieldy mysterious machines of the past to ubiquitous computer use in every aspect of daily lives and work sites. Yet, disconcertingly, the process used to implement these systems has not evolved. Technology implementation does not need to be a struggle. It is time to adapt traditional plan-driven implementation methods to incorporate agile techniques. Agility is a concept borrowed from software development and is presented here because it encourages flexibility, adaptation, and continuous learning as part of the implementation process. Agility values communication and harnesses change to an advantage, which facilitates the natural evolution of an adaptable implementation process. Specific examples of agility in an implementation are described, and plan-driven implementation stages are adapted to incorporate relevant agile techniques. This comparison demonstrates how an agile approach enhances traditional implementation techniques to meet the demands of today's complex healthcare environments.

  6. Classroom modules for nanotechnology undergraduate education: development, implementation and evaluation

    NASA Astrophysics Data System (ADS)

    Shabani, R.; Massi, L.; Zhai, L.; Seal, S.; Cho, H. J.

    2011-05-01

    In order to address the challenges and restrictions given by a traditional classroom lecture environment, the top-down and bottom-up nanotechnology teaching modules were developed, implemented and evaluated. Then based on the hypothesis that instructors could further develop students' interest in this emerging area through the introduction of the teaching modules and a career module, an early stage evaluation of the effectiveness of the modules in selected engineering courses was conducted. The data suggested that adoption of modular lectures in regular engineering courses influenced attitude towards nanotechnology - overall, the teaching modules did a better job of piquing student's interest (albeit in the short term) in the subject, but there were also positive gains in interest in nanotechnology as a career. There was some evidence that the hands-on demonstration teaching modules with visual elements and the career module were more effective than traditional lecture presentations in the classroom.

  7. Implementation and adoption of nationwide electronic health records in secondary care in England: qualitative analysis of interim results from a prospective national evaluation

    PubMed Central

    Robertson, Ann; Cresswell, Kathrin; Takian, Amirhossein; Petrakaki, Dimitra; Crowe, Sarah; Cornford, Tony; Barber, Nicholas; Avery, Anthony; Fernando, Bernard; Jacklin, Ann; Prescott, Robin; Klecun, Ela; Paton, James; Lichtner, Valentina; Quinn, Casey; Ali, Maryam; Morrison, Zoe; Jani, Yogini; Waring, Justin; Marsden, Kate

    2010-01-01

    Objectives To describe and evaluate the implementation and adoption of detailed electronic health records in secondary care in England and thereby provide early feedback for the ongoing local and national rollout of the NHS Care Records Service. Design A mixed methods, longitudinal, multisite, socio-technical case study. Setting Five NHS acute hospital and mental health trusts that have been the focus of early implementation efforts and at which interim data collection and analysis are complete. Data sources and analysis Dataset for the evaluation consists of semi-structured interviews, documents and field notes, observations, and quantitative data. Qualitative data were analysed thematically with a socio-technical coding matrix, combined with additional themes that emerged from the data. Main results Hospital electronic health record applications are being developed and implemented far more slowly than was originally envisioned; the top-down, standardised approach has needed to evolve to admit more variation and greater local choice, which hospital trusts want in order to support local activity. Despite considerable delays and frustrations, support for electronic health records remains strong, including from NHS clinicians. Political and financial factors are now perceived to threaten nationwide implementation of electronic health records. Interviewees identified a range of consequences of long term, centrally negotiated contracts to deliver the NHS Care Records Service in secondary care, particularly as NHS trusts themselves are not party to these contracts. These include convoluted communication channels between different stakeholders, unrealistic deployment timelines, delays, and applications that could not quickly respond to changing national and local NHS priorities. Our data suggest support for a “middle-out” approach to implementing hospital electronic health records, combining government direction with increased local autonomy, and for restricting

  8. The BetterBirth Program: Pursuing Effective Adoption and Sustained Use of the WHO Safe Childbirth Checklist Through Coaching-Based Implementation in Uttar Pradesh, India

    PubMed Central

    Kara, Nabihah; Firestone, Rebecca; Kalita, Tapan; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Saurastri, Rajiv; Pratap Singh, Vinay; Maji, Pinki; Karlage, Ami; Hirschhorn, Lisa R; Semrau, Katherine EA

    2017-01-01

    Shifting childbirth into facilities has not improved health outcomes for mothers and newborns as significantly as hoped. Improving the quality and safety of care provided during facility-based childbirth requires helping providers to adhere to essential birth practices—evidence-based behaviors that reduce harm to and save lives of mothers and newborns. To achieve this goal, we developed the BetterBirth Program, which we tested in a matched-pair, cluster-randomized controlled trial in Uttar Pradesh, India. The goal of this intervention was to improve adoption and sustained use of the World Health Organization Safe Childbirth Checklist (SCC), an organized collection of 28 essential birth practices that are known to improve the quality of facility-based childbirth care. Here, we describe the BetterBirth Program in detail, including its 4 main features: implementation tools, an implementation strategy of coaching, an implementation pathway (Engage-Launch-Support), and a sustainability plan. This coaching-based implementation of the SCC motivates and empowers care providers to identify, understand, and resolve the barriers they face in using the SCC with the resources already available. We describe important lessons learned from our experience with the BetterBirth Program as it was tested in the BetterBirth Trial. For example, the emphasis on relationship building and respect led to trust between coaches and birth attendants and helped influence change. In addition, the cloud-based data collection and feedback system proved a valuable asset in the coaching process. More research on coaching-based interventions is required to refine our understanding of what works best to improve quality and safety of care in various settings. Note: At the time of publication of this article, the results of evaluation of the impact of the BetterBirth Program were pending publication in another journal. After the impact findings have been published, we will update this article with a

  9. Starting over: international adoption as a natural experiment in language development.

    PubMed

    Snedeker, Jesse; Geren, Joy; Shafto, Carissa L

    2007-01-01

    Language development is characterized by predictable shifts in the words children produce and the complexity of their utterances. Because acquisition typically occurs simultaneously with maturation and cognitive development, it is difficult to determine the causes of these shifts. We explored how acquisition proceeds in the absence of possible cognitive or maturational roadblocks, by examining the acquisition of English in internationally adopted preschoolers. Like infants, and unlike other second-language learners, these children acquire language from child-directed speech, without access to bilingual informants. Parental reports and speech samples were collected from 27 preschoolers, 3 to 18 months after they were adopted from China. These children showed the same developmental patterns in language production as monolingual infants (matched for vocabulary size). Early on, their vocabularies were dominated by nouns, their utterances were short, and grammatical morphemes were generally omitted. Children at later stages had more diverse vocabularies and produced longer utterances with more grammatical morphemes.

  10. Concerns and professional development needs of science faculty at Taibah University in adopting blended learning

    NASA Astrophysics Data System (ADS)

    Al-Sarrani, Nauaf

    The purpose of this study was to obtain Science faculty concerns and professional development needs to adopt blended learning in their teaching at Taibah University. To answer these two research questions the survey instrument was designed to collect quantitative and qualitative data from close-ended and open-ended questions. The participants' general characteristics were first presented, then the quantitative measures were presented as the results of the null hypotheses. The data analysis for research question one revealed a statistically significant difference in the participants' concerns in adopting BL by their gender sig = .0015. The significances were found in stages one (sig = .000) and stage five (sig = .006) for female faculty. Therefore, null hypothesis 1.1 was rejected (There are no statistically significant differences between science faculty's gender and their concerns in adopting BL). The data analysis indicated also that there were no relationships between science faculty's age, academic rank, nationality, country of graduation and years of teaching experience and their concerns in adopting BL in their teaching, so the null hypotheses 1.2-7 were accepted (There are no statistically significant differences between Science faculty's age and their concerns in adopting BL, there are no statistically significant differences between Science faculty's academic rank and their concerns in adopting BL, there are no statistically significant differences between Science faculty's nationality and their concerns in adopting BL, there are no statistically significant differences between Science faculty's content area and their concerns in adopting BL, there are no statistically significant differences between Science faculty's country of graduation and their concerns in adopting BL and there are no statistically significant differences between Science faculty's years of teaching experience and their concerns in adopting BL). The data analyses for research question

  11. Technology Development: From Idea to Implementation - 12131

    SciTech Connect

    Spires, Renee H.

    2012-07-01

    integrated into complicated flow sheets. Then fully informed decisions can be made to usher technology development ideas through project implementation. Examples from active technology development projects, Tank 48 Treatment and Enhanced Chemical Cleaning, are presented. This model for technology development integrates several tools and activities to provide a logical method for maturing new ideas and technologies. It provides a framework to develop a good idea into a full up design/build project. This model defines a set of integrated tasks to mature the technology and define scope, cost and schedule necessary to make business decisions for implementing technology development. (authors)

  12. Integrating guideline development and implementation: analysis of guideline development manual instructions for generating implementation advice

    PubMed Central

    2012-01-01

    Background Guidelines are important tools that inform healthcare delivery based on best available research evidence. Guideline use is in part based on quality of the guidelines, which includes advice for implementation and has been shown to vary. Others hypothesized this is due to limited instructions in guideline development manuals. The purpose of this study was to examine manual instructions for implementation advice. Methods We used a directed and summative content analysis approach based on an established framework of guideline implementability. Six manuals identified by another research group were examined to enumerate implementability domains and elements. Results Manuals were similar in content but lacked sufficient detail in particular domains. Most frequently this was Accomodation, which includes information that would help guideline users anticipate and/or overcome organizational and system level barriers. In more than one manual, information was also lacking for Communicability, information that would educate patients or facilitate their involvement in shared decision making, and Applicability, or clinical parameters to help clinicians tailor recommendations for individual patients. Discussion Most manuals that direct guideline development lack complete information about incorporating implementation advice. These findings can be used by those who developed the manuals to consider expanding their content in these domains. It can also be used by guideline developers as they plan the content and implementation of their guidelines so that the two are integrated. New approaches for guideline development and implementation may need to be developed. Use of guidelines might be improved if they included implementation advice, but this must be evaluated through ongoing research. PMID:22824094

  13. Evidence of the Adoption and Implementation of a Statewide Childhood Obesity Prevention Initiative in the New York State WIC Program: The "NY Fit WIC" Process Evaluation

    ERIC Educational Resources Information Center

    Sekhobo, Jackson P.; Egglefield, Katherine; Edmunds, Lynn S.; Shackman, Gene

    2012-01-01

    Process evaluations are critical in determining whether outcome evaluations are warranted. This study assessed the extent to which a childhood obesity prevention initiative, "NY Fit WIC", was adopted and implemented by the New York State Supplemental Nutrition Program for Women, Infants and Children (WIC). Process data came from…

  14. Evidence of the Adoption and Implementation of a Statewide Childhood Obesity Prevention Initiative in the New York State WIC Program: The "NY Fit WIC" Process Evaluation

    ERIC Educational Resources Information Center

    Sekhobo, Jackson P.; Egglefield, Katherine; Edmunds, Lynn S.; Shackman, Gene

    2012-01-01

    Process evaluations are critical in determining whether outcome evaluations are warranted. This study assessed the extent to which a childhood obesity prevention initiative, "NY Fit WIC", was adopted and implemented by the New York State Supplemental Nutrition Program for Women, Infants and Children (WIC). Process data came from…

  15. Performance and implementation of low impact development - A review.

    PubMed

    Eckart, Kyle; McPhee, Zach; Bolisetti, Tirupati

    2017-12-31

    Climate change, urbanization, and ecological concerns are all driving the need for new stormwater management strategies. The effects of urbanization are exaggerated by climate change and thus the development of innovative stormwater management techniques are necessary to mitigate these impacts. One emerging stormwater management philosophy is low impact development (LID). LID utilizes distributed stormwater controls (often green infrastructure) as well as green spaces and natural hydrologic features in order to bring the hydrology of urban catchments closer to pre-development conditions. The review provides a summary of the knowledge of LID as a stormwater management technique and climate change mitigation measure as well as the current state of research and implementation of this topic. In order to provide a better understanding of the extensive scope that should be considered for design of low impact developments, methods of optimization, modelling, monitoring and the performance of LID alternatives is covered. LID has been widely adopted and proven successful in many cases; however, there remains uncertainty of its benefits. This review brings together knowledge from many sources in order to provide an overview of LID and examine its performance and implementation. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Developing and Implementing an Academy of Preceptors

    PubMed Central

    Morgan, Jill A.; Layson-Wolf, Cherokee; Rodriguez de Bittner, Magaly

    2009-01-01

    In response to national trends for preceptor development, the University of Maryland School of Pharmacy conceived, developed, and implemented the Academy of Preceptors to foster preceptor development. The Academy's goals are to recognize preceptor excellence, improve experiential course delivery, develop preceptors' educational skills, and facilitate networking among preceptors. In 2004, the Academy's initial focus was development of live continuing education programs for preceptor development. A CD-ROM format also was developed for those who could not attend live sessions. Preceptors were asked to suggest additional topics of interest for future programs. In this paper, we describe our progress toward the goals, the School's benefits from the Academy, and the implications for the American Association of Colleges of Pharmacy (AACP). Preceptors provide 30% of pharmacy curricula; thus, the need for their training and ongoing professional development has been increasingly emphasized within experiential education. Priorities are to train preceptors to become better educators and motivate these practitioners to improve pharmacy education by sharing their valuable expertise with students. PMID:19513172

  17. Developing and Implementing a Professional Practice Model.

    PubMed

    Glassman, Kimberly S

    2016-10-01

    Professional practice models guide nursing practice by giving meaning to the work of nurses. They elevate the practice from tasks to theory, from skills to knowledge, and remind us that the patient and family are at the center of our practice. Professional practice models are one of the foundations of the Magnet Recognition Program. The purpose of this paper is to describe the development and implementation of a professional practice model in a healthcare system, which includes three hospitals and over 80 ambulatory practices in the New York City region. © The Author(s) 2016.

  18. The influence of rearing order on personality development within two adoption cohorts.

    PubMed

    Beer, J M; Horn, J M

    2000-08-01

    There is an extensive literature on the relationship between birth order and psychological traits, but no previous study has investigated the influence of ordinal position on personality development within adoptive siblings. Such a design is important because it effectively separates the effects of biological birth order and rearing order. Here we report data from two adoption cohorts in which subjects were biological first-borns reared in various ordinal positions. Data were analyzed with reference to Sulloway's (1996) evolutionarily based sibling rivalry theory of birth order effects. Between- and within-family analyses indicated that rearing order's influence on personality was very weak. The only clear difference was for conscientiousness, on which first-reared siblings scored higher. We draw possible implications for Sulloway's theory and speculate upon an alternative, prenatal biological process that may produce birth order differences.

  19. mHealth adoption in low-resource environments: a review of the use of mobile healthcare in developing countries.

    PubMed

    Chib, Arul; van Velthoven, Michelle Helena; Car, Josip

    2015-01-01

    The acknowledged potential of using mobile phones for improving healthcare in low-resource environments of developing countries has yet to translate into significant mHealth policy investment. The low uptake of mHealth in policy agendas may stem from a lack of evidence of the scalable, sustainable impact on health indicators. The mHealth literature in low- and middle-income countries reveals a burgeoning body of knowledge; yet, existing reviews suggest that the projects yield mixed results. This article adopts a stage-based approach to understand the varied contributions to mHealth research. The heuristic of inputs-mechanism-outputs is proposed as a tool to categorize mHealth studies. This review (63 articles comprising 53 studies) reveals that mHealth studies in developing countries tend to concentrate on specific stages, principally on pilot projects that adopt a deterministic approach to technological inputs (n = 32), namely introduction and implementation. Somewhat less studied were research designs that demonstrate evidence of outputs (n = 15), such as improvements in healthcare processes and public health indicators. The review finds a lack of emphasis on studies that provide theoretical understanding (n = 6) of adoption and appropriation of technological introduction that produces measurable health outcomes. As a result, there is a lack of dominant theory, or measures of outputs relevant to making policy decisions. Future work needs to aim for establishing theoretical and measurement standards, particularly from social scientific perspectives, in collaboration with researchers from the domains of information technology and public health. Priorities should be set for investments and guidance in evaluation disseminated by the scientific community to practitioners and policymakers.

  20. Prediction in Child Development: A Longitudinal Study of Adoptive and Nonadoptive Families. The Delaware Family Study.

    ERIC Educational Resources Information Center

    Hoopes, Janet L.

    A longitudinal study was conducted to determine factors predicting successful adoptions before placement and to identify differences and similarities between adoptive and biological families. Data collected on both adopted children and on their adoptive families before placement was related to data collected on the same children and families 6…

  1. Prediction in Child Development: A Longitudinal Study of Adoptive and Nonadoptive Families. The Delaware Family Study.

    ERIC Educational Resources Information Center

    Hoopes, Janet L.

    A longitudinal study was conducted to determine factors predicting successful adoptions before placement and to identify differences and similarities between adoptive and biological families. Data collected on both adopted children and on their adoptive families before placement was related to data collected on the same children and families 6…

  2. Implementing sustainable development programs in Chicago

    SciTech Connect

    Henderson, H.

    1994-12-31

    Achieving sustainable development requires a revision of the present view of the nature of the city as an environment, and its relation to a larger ecosystem of which it is an essential part. The environmental health of a wilderness area is inextricably related to the environmental, and economic, health of the great urban centers. The vitality of dense metropolitan areas, where population and economic activities are concentrated, is key to the preservation of productive farm lands, wildlife habitat, and open spaces. The social and economic crisis which grips many metropolitan centers, with attendant flight of industry and development to the so-called {open_quotes}greenfields,{close_quotes} fundamentally spreads a broader crisis to our common ecosystem. This crisis is marked by the obliteration of habitat necessary for biodiversity, loss of fertile farm land, and the contamination of air, water and land, as an unescapable effect of the sprawl created by flight from the urban centers. The removal of false conceptual distinctions between the city and nature, distinctions that are unfortunately at the heart of so much of American environmental philosophy, is key to the concept of `sustainable development.` This article sets forth how the City of Chicago is implementing this understanding of the nature of the urban environment, in pursuit of sustainable development within the city.

  3. A questionnaire measuring staff perceptions of Lean adoption in healthcare: development and psychometric testing.

    PubMed

    Kaltenbrunner, Monica; Bengtsson, Lars; Mathiassen, Svend Erik; Engström, Maria

    2017-03-24

    During the past decade, the concept of Lean has spread rapidly within the healthcare sector, but there is a lack of instruments that can measure staff's perceptions of Lean adoption. Thus, the aim of the present study was to develop a questionnaire measuring Lean in healthcare, based on Liker's description of Lean, by adapting an existing instrument developed for the service sector. A mixed-method design was used. Initially, items from the service sector instrument were categorized according to Liker's 14 principles describing Lean within four domains: philosophy, processes, people and partners and problem-solving. Items were lacking for three of Liker's principles and were therefore developed de novo. Think-aloud interviews were conducted with 12 healthcare staff from different professions to contextualize and examine the face validity of the questionnaire prototype. Thereafter, the adjusted questionnaire's psychometric properties were assessed on the basis of a cross-sectional survey among 386 staff working in primary care. The think-aloud interviews led to adjustments in the questionnaire to better suit a healthcare context, and the number of items was reduced. Confirmatory factor analysis of the adjusted questionnaire showed a generally acceptable correspondence with Liker's description of Lean. Internal consistency, measured using Cronbach's alpha, for the factors in Liker's description of Lean was 0.60 for the factor people and partners, and over 0.70 for the three other factors. Test-retest reliability measured by the intra-class correlation coefficient ranged from 0.77 to 0.88 for the four factors. We designed a questionnaire capturing staff's perceptions of Lean adoption in healthcare on the basis of Liker's description. This Lean in Healthcare Questionnaire (LiHcQ) showed generally acceptable psychometric properties, which supports its usability for measuring Lean adoption in healthcare. We suggest that further research focus on verifying the usability of

  4. Development and implementation of sepsis alert systems

    PubMed Central

    Harrison, Andrew M.; Gajic, Ognjen; Pickering, Brian W.; Herasevich, Vitaly

    2016-01-01

    Synopsis/Summary Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Important barriers to wider use of sepsis alerts include evolving clinical definitions of sepsis, information overload & alert fatigue, due to suboptimal alert performance. Outside the ICU, additional barriers include differences in health care delivery models, charting behaviors, and availability of electronic data. Currently available evidence does not support routine use of sepsis alert systems in clinical practice. However, continuous improvement in both the afferent (data availability and accuracy of detection algorithms) and efferent (evidence-based decision support and smoother integration into clinical workflow) limbs of sepsis alert systems will help translate theoretical advantages into measurable patient benefit. PMID:27229639

  5. A Quantitative Assessment of Factors Affecting the Technological Development and Adoption of Companion Diagnostics.

    PubMed

    Luo, Dee; Smith, James A; Meadows, Nick A; Schuh, A; Manescu, Katie E; Bure, Kim; Davies, Benjamin; Horne, Rob; Kope, Mike; DiGiusto, David L; Brindley, David A

    2015-01-01

    Rapid innovation in (epi)genetics and biomarker sciences is driving a new drug development and product development pathway, with the personalized medicine era dominated by biologic therapeutics and companion diagnostics. Companion diagnostics (CDx) are tests and assays that detect biomarkers and specific mutations to elucidate disease pathways, stratify patient populations, and target drug therapies. CDx can substantially influence the development and regulatory approval for certain high-risk biologics. However, despite the increasingly important role of companion diagnostics in the realization of personalized medicine, in the USA, there are only 23 Food and Drug Administration (FDA) approved companion diagnostics on the market for 11 unique indications. Personalized medicines have great potential, yet their use is currently constrained. A major factor for this may lie in the increased complexity of the companion diagnostic and corresponding therapeutic development and adoption pathways. Understanding the market dynamics of companion diagnostic/therapeutic (CDx/Rx) pairs is important to further development and adoption of personalized medicine. Therefore, data collected on a variety of factors may highlight incentives or disincentives driving the development of companion diagnostics. Statistical analysis for 36 hypotheses resulted in two significant relationships and 34 non-significant relationships. The sensitivity of the companion diagnostic was the only factor that significantly correlated with the price of the companion diagnostic. This result indicates that while there is regulatory pressure for the diagnostic and pharmaceutical industry to collaborate and co-develop companion diagnostics for the approval of personalized therapeutics, there seems to be a lack of parallel economic collaboration to incentivize development of companion diagnostics.

  6. A Quantitative Assessment of Factors Affecting the Technological Development and Adoption of Companion Diagnostics

    PubMed Central

    Luo, Dee; Smith, James A.; Meadows, Nick A.; Schuh, A.; Manescu, Katie E.; Bure, Kim; Davies, Benjamin; Horne, Rob; Kope, Mike; DiGiusto, David L.; Brindley, David A.

    2016-01-01

    Rapid innovation in (epi)genetics and biomarker sciences is driving a new drug development and product development pathway, with the personalized medicine era dominated by biologic therapeutics and companion diagnostics. Companion diagnostics (CDx) are tests and assays that detect biomarkers and specific mutations to elucidate disease pathways, stratify patient populations, and target drug therapies. CDx can substantially influence the development and regulatory approval for certain high-risk biologics. However, despite the increasingly important role of companion diagnostics in the realization of personalized medicine, in the USA, there are only 23 Food and Drug Administration (FDA) approved companion diagnostics on the market for 11 unique indications. Personalized medicines have great potential, yet their use is currently constrained. A major factor for this may lie in the increased complexity of the companion diagnostic and corresponding therapeutic development and adoption pathways. Understanding the market dynamics of companion diagnostic/therapeutic (CDx/Rx) pairs is important to further development and adoption of personalized medicine. Therefore, data collected on a variety of factors may highlight incentives or disincentives driving the development of companion diagnostics. Statistical analysis for 36 hypotheses resulted in two significant relationships and 34 non-significant relationships. The sensitivity of the companion diagnostic was the only factor that significantly correlated with the price of the companion diagnostic. This result indicates that while there is regulatory pressure for the diagnostic and pharmaceutical industry to collaborate and co-develop companion diagnostics for the approval of personalized therapeutics, there seems to be a lack of parallel economic collaboration to incentivize development of companion diagnostics. PMID:26858745

  7. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs.

    PubMed

    Peskin, Melissa F; Hernandez, Belinda F; Gabay, Efrat K; Cuccaro, Paula; Li, Dennis H; Ratliff, Eric; Reed-Hirsch, Kelly; Rivera, Yanneth; Johnson-Baker, Kimberly; Emery, Susan Tortolero; Shegog, Ross

    2017-01-01

    In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

  8. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs

    PubMed Central

    Peskin, Melissa F.; Hernandez, Belinda F.; Gabay, Efrat K.; Cuccaro, Paula; Li, Dennis H.; Ratliff, Eric; Reed-Hirsch, Kelly; Rivera, Yanneth; Johnson-Baker, Kimberly; Emery, Susan Tortolero; Shegog, Ross

    2017-01-01

    In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings. PMID:28848729

  9. Developing and implementing an OSCE in dentistry.

    PubMed

    Manogue, M; Brown, G

    1998-05-01

    The processes of development, implementation and perceived usefulness of an objective structured clinical examination in restorative dentistry (OSCE(D)) are reported. An OSCE is a system of assessment. It consists of a set of standardised 'stations'. At each station, a student is tested on a specific clinical task. Each student moves from one station to the next so that by the end of the OSCE, every student has completed every station. The primary purpose of this OSCE was to provide feedback to 49 4th year students on their performance in the clinical areas of conservative dentistry, periodontology and prosthetics. Individual profiles were provided to students and the overall results discussed by staff. There were no significant differences in overall performance between genders or between students in the morning and afternoon examinations. There was a significant difference between performance in prosthetics and the other areas and there were some significant differences among the skill clusters of clinical knowledge, procedures, clinical reasoning, history-taking, techniques and communication. Students and staff perceived the OSCE(D) as a valuable tool for providing feedback. The development of the OSCE and the findings described in this paper will be of value to clinical staff who are developing OSCEs in all areas of dentistry.

  10. Can gay and lesbian parents promote healthy development in high-risk children adopted from foster care?

    PubMed

    Lavner, Justin A; Waterman, Jill; Peplau, Letitia Anne

    2012-10-01

    Adoption is known to promote cognitive and emotional development in children from foster care, but policy debates remain regarding whether children adopted by gay and lesbian parents can achieve these positive outcomes. This study compared the cognitive development and behavior problems at 2, 12, and 24 months postplacement of 82 high-risk children adopted from foster care in heterosexual and gay or lesbian households. On average, children in both household types showed significant gains in cognitive development and maintained similar levels of behavior problems over time, despite gay and lesbian parents raising children with higher levels of biological and environmental risks prior to adoptive placement. Results demonstrated that high-risk children show similar patterns of development over time in heterosexual and gay and lesbian adoptive households.

  11. Economic development in an era of global environmentalism: Sustainable development and environmental policy implementation in China

    NASA Astrophysics Data System (ADS)

    Gao, Qingguo

    The primary purpose of this dissertation is to explore the opportunities and constraints of implementing environmental policy and sustainable development in China. As the most populous country on earth, China's development and survival has come to a turning point. Many scholars as well as the Chinese government have realized that there is only one way out of the impending environmental disaster. That is by adopting a policy of sustainable development to protect the already damaged environment. The study is centered by a case study of Yunnan Biomass-to-Electricity (BTE) Program, which is a joint research effort between American and Chinese institutions to implement biomass energy projects in rural areas of Yunnan province, China. By integrating energy production and environmental protection, the BTE Program could serve both the environmental and economic needs of the local regions. Therefore, the Yunnan BTE program can serve as a model of sustainable development. Furthermore, because the Yunnan BTE program was a cooperative research effort involving Chinese and American institutions, it also provides an opportunity to study and assess international joint policy implementation efforts. In this case study, we developed an analytical model that contains key factors, both constraints and opportunities, which may have affected the implementation of the BTE program. We explore the role of environmental policy and relationships among various relevant Chinese and American institutions involved in the BTE program. Through careful examination of these factors, and their roles in the process, we establish which facilitate and inhibit program implementation. The study of Mengpeng BTE project showed that all the factors in the analytical model influenced the outcome of the project implementation. Some played more vital roles while others were just minor players. The study demonstrated that preferential environmental policy and sound institutional setting are essential for the

  12. Plans to Adopt and Implement Common Core State Standards in the Southeast Region States. Issues & Answers. REL 2012-No. 136

    ERIC Educational Resources Information Center

    Anderson, Kim; Harrison, Tiffany; Lewis, Karla

    2012-01-01

    Based on interviews with state officials in the six Southeast Region states (Alabama, Florida, Georgia, Mississippi, North Carolina, and South Carolina), this study describes state processes for adopting the Common Core State Standards (a common set of expectations across states for what students are expected to know in English language arts and…

  13. Development and Adoption of a Watershed Approach to Compensatory Mitigation: Experiences in Colorado and California

    EPA Science Inventory

    In this article, we examine the adoption of the watershed approach and its technical methods into regulatory programs in Colorado and California. Specific steps and motives for the adoption are explained. Through close collaboration, regulators have systematically been made aware...

  14. Development and Adoption of a Watershed Approach to Compensatory Mitigation: Experiences in Colorado and California

    EPA Science Inventory

    In this article, we examine the adoption of the watershed approach and its technical methods into regulatory programs in Colorado and California. Specific steps and motives for the adoption are explained. Through close collaboration, regulators have systematically been made aware...

  15. Diffusion of Innovations in Schools: A Study of Adoption and Implementation of School-Based Tobacco Prevention Curriculum.

    ERIC Educational Resources Information Center

    McCormick, Laura K.; And Others

    1995-01-01

    This study examined the extent of implementation of school health education curricula (smoking prevention) in 21 school districts, identifying factors that affected implementation. Middle school teachers received training on curriculum use. Results indicated that larger organizational size, teacher training, and a favorable organizational climate…

  16. Adoption, family relations and psychotic symptoms among Palauan adolescents who are genetically at risk for developing schizophrenia.

    PubMed

    Ierago, Laura; Malsol, Cynthia; Singeo, Techong; Kishigawa, Yuri; Blailes, Francisca; Ord, Lisa; Florsheim, Paul; Phillips, Lisa; Kuartei, Stevenson; Tiobech, Josepha; Watson, Berrymoon; Ngiralmau, Hilda

    2010-12-01

    This paper focuses on the role of adoption and family relations as moderators of genetic risk for psychotic disorders. Participants included 184 adolescents in the Republic of Palau identified to be at genetic risk for schizophrenia and other psychotic disorders. Palau is an island nation in Micronesia with a lifetime prevalence of 1.99% for schizophrenia and 2.67% for psychotic disorders more broadly defined. In Palauan culture, kinship adoption is a common cultural practice; 47 of the 184 participants had been adopted at an early age. The current study was designed to test the hypothesis that adoption would function as a protective factor among Palauan youth at genetic risk for the development of psychotic symptoms. Participants were evaluated for psychotic and other psychiatric symptoms using KSADS-PL. Concurrently, the Youth Self Report was used to assess the perceived quality of family relationships. Results indicated that adopted adolescents were more likely to develop psychotic symptoms than non-adopted adolescents. However, perceived family relations moderated the association between adoption status and psychotic symptoms, such that adopted adolescents with poorer family relations reported disproportionately higher rates of psychotic symptoms. Family relations also moderated the association between level of genetic risk and psychotic symptoms, independently of adoption status. Consistent with previous research, adolescents at high genetic risk who reported more positive family relations also reported fewer psychotic symptoms.

  17. A qualitative study assessing the acceptability and adoption of implementing a results based financing intervention to improve maternal and neonatal health in Malawi.

    PubMed

    Wilhelm, Danielle J; Brenner, Stephan; Muula, Adamson S; De Allegri, Manuela

    2016-08-17

    Results Based Financing (RBF) interventions have recently gained significant momentum, especially in sub-Saharan Africa. However, most of the research has focused on the evaluation of the impacts of this approach, providing little insight into how the contextual circumstances surrounding the implementation have contributed to its success or failure. This study aims to fill a void in the current literature on RBF by focusing explicitly on the process of implementing a RBF intervention rather than on its impact. Specifically, this study focuses on the acceptability and adoption of the RBF intervention's implementation among local and international key stakeholders with the aim to inform further implementation. The Results Based Financing for Maternal and Neonatal Health (RBF4MNH) Initiative is currently being implemented in Malawi. Our study employed an exploratory cross-sectional qualitative design to explore the factors affecting the acceptability and adoption of the intervention's implementation. Purposeful sampling techniques were used to identify each key stakeholder who participated in all or parts of the implementation process. In-depth interviews were conducted and analyzed using a deductive open coding approach. The final interpretation of the findings emerged through active discussion among the co-authors. Despite encountering several challenges, such as delay in procurement of equipment and difficulties in arranging local bank accounts, all stakeholders responded positively to the RBF4MNH Initiative. Stakeholders' acceptance of the RBF4MNH Initiative grew stronger over time as understanding of the intervention improved and was supported by early inclusion during the design and implementation process. In addition, stakeholders took on functions not directly incentivized by the intervention, suggesting that they turned adoption into actual ownership. All stakeholders raised concerns that the intervention may not be sustainable after its initial program phase

  18. Load-bearing masonry system adoption and performance: A case study of construction company in a developing country

    NASA Astrophysics Data System (ADS)

    Ramli, Nor Azlinda; Abdullah, Che Sobry; Nawi, Mohd Nasrun Mohd; Bahaudin, Ahmad Yusni

    2016-08-01

    This study addresses the factors that influence the adoption of load-bearing masonry (LBM) system. A case study of the load-bearing masonry (LBM) system adoption is conducted through an interview to explore the situation of the technology adoption in a construction company. The finding indicates the factors influence the adoption of LBM system for the construction company are: organizational resources, usefulness, less maintenance, reduce construction time and cost. From the findings, these factors consistent with previous literature. Furthermore, the performance of the company was measured by looking into the financial and non-financial aspects. The LBM system brings good performance as it increased the profits of the company, a good quality of product and attracts more demand from customers. Thus, these factors should be considered for the other companies that are interested in implementing the LBM system in their projects.

  19. Pre-menarche pubertal development following unique form of immigration: the case of girls adopted from China.

    PubMed

    Tan, Tony Xing; Camras, Linda A

    2015-02-01

    Our study tested the hypothesis that drastic social-cultural change has an impact on girls' pre-menarche pubertal development. We focused on a unique group of Chinese immigrants who migrated out of China in infancy through international adoption. Our sample included 298 Chinese girls who were 7.3-11.1 years in 2011 (Mean = 8.8, SD = 0.9) and were adopted at 7-24 months (Mean = 12.6, SD = 3.4). We found that 34% showed at least one of four signs of pubertal development: Growth spurt, body fat increase, breast development, and body hair. Logistic regression analyses showed that the odds of growth spurt was raised by the girls' age in 2011, behavior problems in 2005, but lowered by the adoptive families' household income; the odds of body fat increase in 2011 was raised by the adopted Chinese girls' weight in 2007 and behavior problems in 2005, but was lowered by the adoptive mother's education level; the odds for breast development in 2011 was raised by the girls' age in 2011, weight in 2007, and behavior problems in 2009. For body hair, none of the factors predicted the odds. Prevalence of precocious puberty, based on the criterion of breast development before 8 years, was 3.5%. Overall, our study suggests that the pre-menarche pubertal development of adopted Chinese girls may be slightly advanced but also is affected by factors that affect non-adopted girls' pubertal development.

  20. Development and adoption of a simple nonpoint source pollution model for Port Phillip Bay, Australia.

    PubMed

    Argent, Robert M; Mitchell, V Grace

    2003-09-01

    New computing tools and approaches allow tailored development of software to meet the needs of environmental managers. The processes required for such tailoring fit well with adaptive management concepts where, as knowledge and system understanding develop among managers, the software can be developed or replaced to match. This paper reports on development and adoption of a simple nonpoint source pollution modeling tool, including technical aspects of data support for modeling and social aspects of software design. The software, named FILTER, used a unit load model to generate expected pollutant loads from subcatchments of Port Phillip Bay, Australia. Monitoring data were used for calibration to modify the delivery of generated pollutants to receiving waters. Spatial, tabular, and charting software components were used to provide alternative forms of output visualization. FILTER was developed using a process that resulted in manager-stakeholders taking responsibility for setting of model parameter values and operation of the user interface, thereby encouraging uptake. The inclusive development process, tailoring of the software to manager needs and styles of usage, and matching of model complexity to data and knowledge, resulted in a successful application that has become the current agreed system representation among disparate stakeholder organizations.

  1. FROM Qutn TO Bt COTTON: DEVELOPMENT, ADOPTION AND PROSPECTS. A REVIEW.

    PubMed

    Maik, W; Abid, M A; Cheema, H M N; Khan, A A; Iqbal, M Z; Qayyum, A; Hanif, M; Bibi, N; Yuan, S N; Yasmeen, A; Mahmood, A; Ashraf, J

    2015-01-01

    Cotton has unique history of domestication, diversification, and utilization. Globally it is an important cash crop that provides raw material for textile industry. The story of cotton started from human civilization and the climax arrived with the efforts of developing transgenic cotton for various traits. Though conventional breeding brought steady improvement in developing resistance against biotic stresses but recent success story of gene transferfrom Bacillus thuringiensis into cotton showed game changing effects on cotton cultivation. Amongst various families of insecticidal proteins Bt Cry-toxins received more attention because of specificity against receptors on the cell membranes of insect midgut epithelial cells. Rapid Bt cotton adoption by farmers due to its economic and environmental benefits has changed the landscape of cotton cultivation in many countries. But the variable expression of Bt transgene in the newly developed Bt cotton genotypes in tropical environment is questionable. Variability of toxin level in different plant parts at various life stage of plant is an outcome of genotypic interaction with environmental factors. Temporal gene expression of Cry1Ac is also blamed for the epigenetic background in which transgene has been inserted. The presence of genotypes with sub-lethal level of Bt toxin might create resistance in Lepidopteron insects, limiting the use of Bt cotton in future, with the opportunityfor other resistance development strategies to get more attention like gene stacking. Until the farmers get access to more recent technology, best option is to delay the development of resistance by applying Insect Resistance Management (IRM) strategies.

  2. Quantitative assessment of barriers to the clinical development and adoption of cellular therapies: A pilot study

    PubMed Central

    Rikabi, Sarah; French, Anna; Pinedo-Villanueva, Rafael; Morrey, Mark E; Wartolowska, Karolina; Judge, Andrew; MacLaren, Robert E; Mathur, Anthony; Williams, David J; Wall, Ivan; Birchall, Martin; Reeve, Brock; Atala, Anthony; Barker, Richard W; Cui, Zhanfeng; Furniss, Dominic; Bure, Kim; Snyder, Evan Y; Karp, Jeffrey M; Price, Andrew; Carr, Andrew; Brindley, David A

    2014-01-01

    There has been a large increase in basic science activity in cell therapy and a growing portfolio of cell therapy trials. However, the number of industry products available for widespread clinical use does not match this magnitude of activity. We hypothesize that the paucity of engagement with the clinical community is a key contributor to the lack of commercially successful cell therapy products. To investigate this, we launched a pilot study to survey clinicians from five specialities and to determine what they believe to be the most significant barriers to cellular therapy clinical development and adoption. Our study shows that the main concerns among this group are cost-effectiveness, efficacy, reimbursement, and regulation. Addressing these concerns can best be achieved by ensuring that future clinical trials are conducted to adequately answer the questions of both regulators and the broader clinical community. PMID:25383173

  3. Adoption of conserved developmental genes in development and origin of the medusa body plan.

    PubMed

    Kraus, Johanna E M; Fredman, David; Wang, Wei; Khalturin, Konstantin; Technau, Ulrich

    2015-01-01

    The metagenesis of sessile polyps into pelagic medusae in cnidarians represents one of the most ancient complex life cycles in animals. Interestingly, scyphozoans and hydrozoans generate medusae by apparently fundamentally different processes. It is therefore unclear whether medusa formation has evolved independently in different medusozoans. To this end, a thorough understanding of the correspondence of polyp and medusa is required. We monitored the expression patterns of conserved developmental genes in developing medusae of Clytia hemisphaerica (Hydrozoa) and Aurelia aurita (Scyphozoa) and found that developing medusae and polyps share similarities in their morphology and developmental gene expression. Unexpectedly, however, polyp tentacle marker genes were consistently expressed in the developing medusa bell, suggesting that the bell of medusae corresponds to modified and fused polyp tentacle anlagen. Our data represent the first comparative gene expression analysis of developing medusae in two representatives of Scyphozoa and Hydrozoa. The results challenge prevailing views about polyp medusa body plan homology. We propose that the evolution of a new life stage may be facilitated by the adoption of existing developmental genes.

  4. Walking the Talk: Adopting and Adapting Sustainable Scientific Software Development processes in a Small Biology Lab

    PubMed Central

    Crusoe, Michael R.; Brown, C. Titus

    2016-01-01

    The khmer software project provides both research and production functionality for largescale nucleic-acid sequence analysis. The software implements several novel data structures and algorithms that perform data pre-fltering for common bioinformatics tasks, including sequence mapping and de novo assembly. Development is driven by a small lab with one full-time developer (MRC), as well as several graduate students and a professor (CTB) who contribute regularly to research features. Here we describe our efforts to bring better design, testing, and more open development to the khmer software project as of version 1.1. The khmer software is developed openly at http://github.com/dib-lab/khmer/. PMID:27942385

  5. Facilitating School Change Using the Change Communication Model: The Adoption and Implementation of a New Student Information System

    ERIC Educational Resources Information Center

    Rutschke, Linda Louise

    2010-01-01

    This study examines how the Change Communication Model can be used to implement a new student information system (SIS) in a school district. The impetus of the study came from government mandates requiring district accountability through data-driven decision making. Data-driven decision making is only possible when student data are collected,…

  6. The Role of District Office Leaders in the Adoption and Implementation of the Common Core State Standards in Elementary Schools

    ERIC Educational Resources Information Center

    Durand, Francesca T.; Lawson, Hal A.; Wilcox, Kristen Campbell; Schiller, Kathryn S.

    2016-01-01

    Purpose: This multiple case study investigated district leaders' orientations and strategies as their elementary schools proceeded with state-mandated implementation of the Common Core State Standards (CCSS). We identified differences between schools achieving above-predicted outcomes on state CCSS assessments ("odds-beaters") and…

  7. The Role of District Office Leaders in the Adoption and Implementation of the Common Core State Standards in Elementary Schools

    ERIC Educational Resources Information Center

    Durand, Francesca T.; Lawson, Hal A.; Wilcox, Kristen Campbell; Schiller, Kathryn S.

    2016-01-01

    Purpose: This multiple case study investigated district leaders' orientations and strategies as their elementary schools proceeded with state-mandated implementation of the Common Core State Standards (CCSS). We identified differences between schools achieving above-predicted outcomes on state CCSS assessments ("odds-beaters") and…

  8. The Early Growth and Development Study: Using the Prospective Adoption Design to Examine Genotype–Environment Interplay

    PubMed Central

    Neiderhiser, Jenae M.; Scaramella, Laura V.; Reiss, David

    2017-01-01

    The Early Growth and Development Study (EGDS) is a prospective adoption design consisting of 360 linked sets of birth parents, adoptive parents, and adopted children followed from 3 months postpartum through child age 7 years and an additional 200 linked sets for whom recruitment is underway. The EGDS brings together the study of genotype–environment correlation and Genotype × Environment (G × E) interaction to inform intervention development by examining mechanisms whereby family processes mediate or moderate the expression of genetic influences. Participants in the EGDS are recruited through domestic adoption agencies located throughout the United States of America. The assessments occur at 6-month intervals until child age 4-½ years and at ages 6 and 7, when the children are in their 1st and 2nd years of formal schooling (kindergarten and first grade). The data collection includes measures of child characteristics, birth and adoptive parent characteristics, adoptive parenting, prenatal exposure to drugs and maternal stress, birth parent and adopted child salivary cortisol reactivity, and DNA from all participants. The preliminary analyses suggest evidence for G×E interaction beginning in infancy. An intervention perspective on future developments in the field of behavioral genetics is described. PMID:20358398

  9. The Early Growth and Development Study: Using the Prospective Adoption Design to Examine Genotype–Environment Interplay

    PubMed Central

    Leve, Leslie D.; Neiderhiser, Jenae M.; Scaramella, Laura V.; Reiss, David

    2009-01-01

    The Early Growth and Development Study (EGDS) is a prospective adoption design consisting of 360 linked sets of birth parents, adoptive parents, and adopted children followed from 3 months postpartum through child age 7 years, and an additional 200 linked sets for whom recruitment is underway. The EGDS brings together the study of genotype–environment correlation (rGE) and Genotype x Environment (GxE) interaction to inform intervention development by examining mechanisms whereby family processes mediate or moderate the expression of genetic influences. Participants in the EGDS are recruited through domestic adoption agencies located throughout the United States of America. The assessments occur at 6-month intervals until child age 4-½ years and at ages 6 and 7, when the children are in their 1st and 2nd years of formal schooling (kindergarten and first grade). The data collection includes measures of child characteristics, birth and adoptive parent characteristics, adoptive parenting, prenatal exposure to drugs and maternal stress, birth parent and adopted child salivary cortisol reactivity, and DNA from all participants. The preliminary analyses suggest evidence for GxE interaction beginning in infancy. An intervention perspective on future developments in the field of behavioral genetics is described. PMID:19458782

  10. Development of an SSVEP-based BCI spelling system adopting a QWERTY-style LED keyboard.

    PubMed

    Hwang, Han-Jeong; Lim, Jeong-Hwan; Jung, Young-Jin; Choi, Han; Lee, Sang Woo; Im, Chang-Hwan

    2012-06-30

    In this study, we introduce a new mental spelling system based on steady-state visual evoked potential (SSVEP), adopting a QWERTY style layout keyboard with 30 LEDs flickering with different frequencies. The proposed electroencephalography (EEG)-based mental spelling system allows the users to spell one target character per each target selection, without the need for multiple step selections adopted by conventional SSVEP-based mental spelling systems. Through preliminary offline experiments and online experiments, we confirmed that human SSVEPs elicited by visual flickering stimuli with a frequency resolution of 0.1 Hz could be classified with classification accuracy high enough to be used for a practical brain-computer interface (BCI) system. During the preliminary offline experiments performed with five participants, we optimized various factors influencing the performance of the mental spelling system, such as distances between adjacent keys, light source arrangements, stimulating frequencies, recording electrodes, and visual angles. Additional online experiments were conducted with six participants to verify the feasibility of the optimized mental spelling system. The results of the online experiments were an average typing speed of 9.39 letters per minute (LPM) with an average success rate of 87.58%, corresponding to an average information transfer rate of 40.72 bits per minute, demonstrating the high performance of the developed mental spelling system. Indeed, the average typing speed of 9.39 LPM attained in this study was one of the best LPM results among those reported in previous BCI literatures. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Evidence of the adoption and implementation of a statewide childhood obesity prevention initiative in the New York State WIC Program: the NY Fit WIC process evaluation.

    PubMed

    Sekhobo, Jackson P; Egglefield, Katherine; Edmunds, Lynn S; Shackman, Gene

    2012-04-01

    Process evaluations are critical in determining whether outcome evaluations are warranted. This study assessed the extent to which a childhood obesity prevention initiative, NY Fit WIC, was adopted and implemented by the New York State Supplemental Nutrition Program for Women, Infants and Children (WIC). Process data came from qualitative telephone interviews of 101 WIC local agency directors, following NY Fit WIC trainings. Activities were summarized and cross-tabulated by target level (i.e. participant, staff, agency or community) and by theoretical construct (i.e. knowledge promotion, skill building, self-efficacy or role modeling). Approximately 528 activities were reported across all WIC agencies. When activities were grouped into similar categories, 123 unique activities were identified. Agencies were more likely to implement physical activity-related activities (67%) than nutrition-related activities (33%). The majority of activities targeted WIC participants (47%) and staff (22%) and focused on skill building/self-efficacy (67%) among participants and on role modeling (61%) among staff. The involvement of all agencies shows a high level of adoption of the initiative. The diverse number of activities suggests that WIC local agencies tailored implementation to match their resources and clients' needs as planned. These results suggest that an outcome evaluation is warranted to determine whether meaningful behavioral changes occurred among WIC participants and staff.

  12. Influence of regional development policies and clean technology adoption on future air pollution exposure

    NASA Astrophysics Data System (ADS)

    Hixson, Mark; Mahmud, Abdullah; Hu, Jianlin; Bai, Song; Niemeier, Debbie A.; Handy, Susan L.; Gao, Shengyi; Lund, Jay R.; Sullivan, Dana Coe; Kleeman, Michael J.

    2010-02-01

    Future air pollution emissions in the year 2030 were estimated for the San Joaquin Valley (SJV) in central California using a combined system of land use, mobile, off-road, stationary, area, and biogenic emissions models. Four scenarios were developed that use different assumptions about the density of development and level of investment in transportation infrastructure to accommodate the expected doubling of the SJV population in the next 20 years. Scenario 1 reflects current land-use patterns and infrastructure while scenario 2 encouraged compact urban footprints including redevelopment of existing urban centers and investments in transit. Scenario 3 allowed sprawling development in the SJV with reduced population density in existing urban centers and construction of all planned freeways. Scenario 4 followed currently adopted land use and transportation plans for the SJV. The air quality resulting from these urban development scenarios was evaluated using meteorology from a winter stagnation event that occurred on December 15th, 2000 to January 7th 2001. Predicted base-case PM2.5 mass concentrations within the region exceeded 35 μg m -3 over the 22-day episode. Compact growth reduced the PM2.5 concentrations by ˜1 μg m -3 relative to the base-case over most of the SJV with the exception of increases (˜1 μg m -3) in urban centers driven by increased concentrations of elemental carbon (EC) and organic carbon (OC). Low-density development increased the PM2.5 concentrations by 1-4 μg m -3 over most of the region, with decreases (0.5-2 μg m -3) around urban areas. Population-weighted average PM2.5 concentrations were very similar for all development scenarios ranging between 16 and 17.4 μg m -3. Exposure to primary PM components such as EC and OC increased 10-15% for high density development scenarios and decreased by 11-19% for low-density scenarios. Patterns for secondary PM components such as nitrate and ammonium ion were almost exactly reversed, with a 10

  13. How do social networks and faculty development courses affect clinical supervisors' adoption of a medical education innovation? An exploratory study.

    PubMed

    Jippes, Erik; Steinert, Yvonne; Pols, Jan; Achterkamp, Marjolein C; van Engelen, Jo M L; Brand, Paul L P

    2013-03-01

    To examine the impact of social networks and a two-day faculty development course on clinical supervisors' adoption of an educational innovation. During 2007-2010, 571 residents and 613 clinical supervisors in four specialties in the Netherlands were invited to complete a Web-based questionnaire. Residents rated their clinical supervisors' adoption of an educational innovation, the use of structured and constructive (S&C) feedback. Clinical supervisors self-assessed their adoption of this innovation and rated their communication intensity with other clinical supervisors in their department. For each supervisor, a centrality score was calculated, representing the extent to which the supervisor was connected to departmental colleagues. The authors analyzed the effects of supervisor centrality and participation in a two-day Teach-the-Teacher course on the degree of innovation adoption using hierarchical linear modeling, adjusting for age, gender, and attitude toward the S&C feedback innovation. Respondents included 370 (60%) supervisors and 357 (63%) residents. Although Teach-the-Teacher course participation (n=172; 46.5%) was significantly related to supervisors' self-assessments of adoption (P=.001), it had no effect on residents' assessments of supervisors' adoption (P=.371). Supervisor centrality was significantly related to innovation adoption in both residents' assessments (P=.023) and supervisors' self-assessments (P=.024). A clinical supervisor's social network may be as important as faculty development course participation in determining whether the supervisor adopts an educational innovation. Faculty development initiatives should use faculty members' social networks to improve the adoption of educational innovations and help build and maintain communities of practice.

  14. Evidence-based practice implementation: the impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice.

    PubMed

    Aarons, Gregory A; Sommerfeld, David H; Walrath-Greene, Christine M

    2009-12-31

    The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.

  15. Evidence-based practice implementation: The impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

    PubMed Central

    2009-01-01

    Background The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings. PMID

  16. Integration of Nuclear Safeguards Infrastructure Development with UNSCR 1540 Implementation - Context and Challenges

    SciTech Connect

    Dreicer, M; Essner, J

    2008-11-03

    On 28 April 2004, the UN Security Council adopted Resolution 1540 (2004), obliging States, inter alia, to refrain from supporting by any means non-State actors from developing, acquiring, manufacturing, possessing, transporting, transferring or using nuclear, chemical or biological weapons and their delivery systems. It imposes binding obligations on all States to establish domestic controls to prevent the proliferation of nuclear, chemical and biological weapons, and their means of delivery, including by establishing appropriate controls over related materials. This mandate was extended an additional two years with the adoption of Resolution 1673 (2006) and an additional three years with the adoption of Resolution 1810 (2008). UNSCR 1540 is a key nonproliferation and counterterrorism tool that needs to be implemented well. Its obligations are a core part of nuclear infrastructure development.

  17. Adoptive parenting.

    PubMed

    Grotevant, Harold D; Lo, Albert Yh

    2017-06-01

    Challenges in adoptive parenting continue to emerge as adoption policies and practices evolve. We review three areas of research in adoptive parenting that reflect contemporary shifts in adoption. First, we highlight recent findings concerning openness in adoption contact arrangements, or contact between a child's families of birth and rearing. Second, we examine research regarding racial and cultural socialization in transracial and international adoptions. Finally, we review investigations of parenting experiences of lesbian and gay adoptive parents. Overall, parenting processes (e.g., supportive vs. problematic family interaction) are better predictors of child adjustment than are group differences (e.g., open vs. closed adoptions; adoption by heterosexual vs. same-sex parents). The distinctive needs of adopted children call for preparation of adoption-competent mental health, casework, education, and health care professionals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Conflict in Staff Development Implementation: A Case Study

    ERIC Educational Resources Information Center

    Ponticell, Judith A.; Thomas, Julie A.; Cooper, Sandra B.

    2006-01-01

    Staff development is aimed at changing practice. Change creates conflict. Little work has been done to gain insight into the conflict that teachers experience in the implementation of staff development. This study examines conflict in a staff development project aimed at increasing teachers' knowledge and implementation of problem-based integrated…

  19. 42 CFR 441.575 - Development and Implementation Council.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Development and Implementation Council. 441.575 Section 441.575 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...) § 441.575 Development and Implementation Council. (a) States must establish a Development and...

  20. 42 CFR 441.575 - Development and Implementation Council.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Development and Implementation Council. 441.575 Section 441.575 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...) § 441.575 Development and Implementation Council. (a) States must establish a Development and...

  1. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health.

    PubMed

    Miller, Eric; Sikes, Hadley D

    Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs.

  2. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health

    PubMed Central

    Miller, Eric; Sikes, Hadley D.

    2015-01-01

    Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs. PMID:26594252

  3. Inkster Public Schools Implement Child Development Center.

    ERIC Educational Resources Information Center

    Inkster Public Schools, MI. Lincoln Child Development Center.

    An innovative kindergarten program was established as a federally funded project to pursue the following objectives: (1) to discover and develop the potential ability of each child, (2) to develop feelings of autonomy and self-worth, (3) to provide experiences for developing inquiring attitudes and for development of self-confidence and positive…

  4. DEVELOPING THE NATIONAL GEOTHERMAL DATA SYSTEM ADOPTION OF CKAN FOR DOMESTIC & INTERNATIONAL DATA DEPLOYMENT

    SciTech Connect

    Clark, Ryan J.; Kuhmuench, Christoph; Richard, Stephen M.

    2013-03-01

    The National Geothermal Data System (NGDS) De- sign and Testing Team is developing NGDS software currently referred to as the “NGDS Node-In-A-Box”. The software targets organizations or individuals who wish to host at least one of the following: • an online repository containing resources for the NGDS; • an online site for creating metadata to register re- sources with the NGDS • NDGS-conformant Web APIs that enable access to NGDS data (e.g., WMS, WFS, WCS); • NDGS-conformant Web APIs that support dis- covery of NGDS resources via catalog service (e.g. CSW) • a web site that supports discovery and under- standing of NGDS resources A number of different frameworks for development of this online application were reviewed. The NGDS Design and Testing Team determined to use CKAN (http://ckan.org/), because it provides the closest match between out of the box functionality and NGDS node-in-a-box requirements. To achieve the NGDS vision and goals, this software development project has been inititated to provide NGDS data consumers with a highly functional inter- face to access the system, and to ease the burden on data providers who wish to publish data in the sys- tem. It is important to note that this software package constitutes a reference implementation. The NGDS software is based on open standards, which means other server software can make resources available, and other client applications can utilize NGDS data. A number of international organizations have ex- pressed interest in the NGDS approach to data access. The CKAN node implementation can provide a sim- ple path for deploying this technology in other set- tings.

  5. Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in healthcare. study protocol.

    PubMed

    Kyratsis, Yiannis; Ahmad, Raheelah; Holmes, Alison

    2012-03-21

    We know that patient care can be improved by implementing evidence-based innovations and applying research findings linked to good practice. Successfully implementing innovations in complex organisations, such as the UK's National Health Service (NHS), is often challenging as multiple contextual dynamics mediate the process. Research studies have explored the challenges of introducing innovations into healthcare settings and have contributed to a better understanding of why potentially useful innovations are not always implemented in practice, even if backed by strong evidence. Mediating factors include health policy and health system influences, organisational factors, and individual and professional attitudes, including decision makers' perceptions of innovation evidence. There has been limited research on how different forms of evidence are accessed and utilised by organisational decision makers during innovation adoption. We also know little about how diverse healthcare professionals (clinicians, administrators) make sense of evidence and how this collective sensemaking mediates the uptake of innovations. The study will involve nine comparative case study sites of acute care organisations grouped into three regional clusters across England. Each of the purposefully selected sites represents a variety of trust types and organisational contexts. We will use qualitative methods, in-depth interviews, observation of key meetings, and systematic analysis of relevant secondary data to understand the rationale and challenges involved in sourcing and utilising innovation evidence in the empirical setting of infection prevention and control. We will use theories of innovation adoption and sensemaking in organisations to interpret the data. The research will provide lessons for the uptake and continuous use of innovations in the English and international health systems. Unlike most innovation studies, which involve single-level analysis, our study will explore the

  6. Optimizing technology development and adoption in medical imaging using the principles of innovation diffusion, part II: practical applications.

    PubMed

    Reiner, Bruce I

    2012-02-01

    Successful adoption of new technology development can be accentuated by learning and applying the scientific principles of innovation diffusion. This is of particular importance to areas within the medical imaging practice which have lagged in innovation; perhaps, the most notable of which is reporting which has remained relatively stagnant for over a century. While the theoretical advantages of structured reporting have been well documented throughout the medical imaging community, adoption to date has been tepid and largely relegated to the academic and breast imaging communities. Widespread adoption will likely require an alternative approach to innovation, which addresses the heterogeneity and diversity of the practicing radiologist community along with the ever-changing expectations in service delivery. The challenges and strategies for reporting innovation and adoption are discussed, with the goal of adapting and customizing new technology to the preferences and needs of individual end-users.

  7. Developing and validating a model to predict the success of an IHCS implementation: the Readiness for Implementation Model

    PubMed Central

    Gustafson, David H; Hawkins, Robert P; Brennan, Patricia F; Dinauer, Susan; Johnson, Pauley R; Siegler, Tracy

    2010-01-01

    Objective To develop and validate the Readiness for Implementation Model (RIM). This model predicts a healthcare organization's potential for success in implementing an interactive health communication system (IHCS). The model consists of seven weighted factors, with each factor containing five to seven elements. Design Two decision-analytic approaches, self-explicated and conjoint analysis, were used to measure the weights of the RIM with a sample of 410 experts. The RIM model with weights was then validated in a prospective study of 25 IHCS implementation cases. Measurements Orthogonal main effects design was used to develop 700 conjoint-analysis profiles, which varied on seven factors. Each of the 410 experts rated the importance and desirability of the factors and their levels, as well as a set of 10 different profiles. For the prospective 25-case validation, three time-repeated measures of the RIM scores were collected for comparison with the implementation outcomes. Results Two of the seven factors, ‘organizational motivation’ and ‘meeting user needs,’ were found to be most important in predicting implementation readiness. No statistically significant difference was found in the predictive validity of the two approaches (self-explicated and conjoint analysis). The RIM was a better predictor for the 1-year implementation outcome than the half-year outcome. Limitations The expert sample, the order of the survey tasks, the additive model, and basing the RIM cut-off score on experience are possible limitations of the study. Conclusion The RIM needs to be empirically evaluated in institutions adopting IHCS and sustaining the system in the long term. PMID:20962135

  8. Developing and validating a model to predict the success of an IHCS implementation: the Readiness for Implementation Model.

    PubMed

    Wen, Kuang-Yi; Gustafson, David H; Hawkins, Robert P; Brennan, Patricia F; Dinauer, Susan; Johnson, Pauley R; Siegler, Tracy

    2010-01-01

    To develop and validate the Readiness for Implementation Model (RIM). This model predicts a healthcare organization's potential for success in implementing an interactive health communication system (IHCS). The model consists of seven weighted factors, with each factor containing five to seven elements. Two decision-analytic approaches, self-explicated and conjoint analysis, were used to measure the weights of the RIM with a sample of 410 experts. The RIM model with weights was then validated in a prospective study of 25 IHCS implementation cases. Orthogonal main effects design was used to develop 700 conjoint-analysis profiles, which varied on seven factors. Each of the 410 experts rated the importance and desirability of the factors and their levels, as well as a set of 10 different profiles. For the prospective 25-case validation, three time-repeated measures of the RIM scores were collected for comparison with the implementation outcomes. Two of the seven factors, 'organizational motivation' and 'meeting user needs,' were found to be most important in predicting implementation readiness. No statistically significant difference was found in the predictive validity of the two approaches (self-explicated and conjoint analysis). The RIM was a better predictor for the 1-year implementation outcome than the half-year outcome. The expert sample, the order of the survey tasks, the additive model, and basing the RIM cut-off score on experience are possible limitations of the study. The RIM needs to be empirically evaluated in institutions adopting IHCS and sustaining the system in the long term.

  9. Academic Leaders' Perspectives on Adopting ePortfolios for Developing and Assessing Professional Capabilities in Australian Business Education

    ERIC Educational Resources Information Center

    Holt, Dale; McGuigan, Nicholas; Kavanagh, Marie; Leitch, Shona; Ngo, Leanne; Salzman, Scott; Watty, Kim; McKay, Jade

    2016-01-01

    This paper represents a major stage of data collection and reporting on an Australian Office for Learning and Teaching Innovation and Development grant investigating the adoption of ePortfolios for developing and assessing professional capabilities in Australian undergraduate business education. Assessing desired capabilities with and through…

  10. Reliability and Validity Study of the Mobile Learning Adoption Scale Developed Based on the Diffusion of Innovations Theory

    ERIC Educational Resources Information Center

    Celik, Ismail; Sahin, Ismail; Aydin, Mustafa

    2014-01-01

    In this study, a mobile learning adoption scale (MLAS) was developed on the basis of Rogers' (2003) Diffusion of Innovations Theory. The scale that was developed consists of four sections. These sections are as follows: Stages in the innovation-decision process, Types of m-learning decision, Innovativeness level and attributes of m-learning.…

  11. Reliability and Validity Study of the Mobile Learning Adoption Scale Developed Based on the Diffusion of Innovations Theory

    ERIC Educational Resources Information Center

    Celik, Ismail; Sahin, Ismail; Aydin, Mustafa

    2014-01-01

    In this study, a mobile learning adoption scale (MLAS) was developed on the basis of Rogers' (2003) Diffusion of Innovations Theory. The scale that was developed consists of four sections. These sections are as follows: Stages in the innovation-decision process, Types of m-learning decision, Innovativeness level and attributes of m-learning. There…

  12. Academic Leaders' Perspectives on Adopting ePortfolios for Developing and Assessing Professional Capabilities in Australian Business Education

    ERIC Educational Resources Information Center

    Holt, Dale; McGuigan, Nicholas; Kavanagh, Marie; Leitch, Shona; Ngo, Leanne; Salzman, Scott; Watty, Kim; McKay, Jade

    2016-01-01

    This paper represents a major stage of data collection and reporting on an Australian Office for Learning and Teaching Innovation and Development grant investigating the adoption of ePortfolios for developing and assessing professional capabilities in Australian undergraduate business education. Assessing desired capabilities with and through…

  13. Infant Communicative Development: Evidence from Adoptive and Biological Families for Genetic and Environmental Influences on Rate Differences.

    ERIC Educational Resources Information Center

    Hardy-Brown, Karen; Plomin, Robert

    1985-01-01

    Parent/infant relationships were investigated among 50 biologically related families selected to provide a control group for an adoption study of rate differences in communicative development in infancy. In addition, a path analysis of genetic and environmental influences on communicative development is presented incorporating the overall sample.…

  14. Water-energy-food nexus for adopting sustainable development goals in Asia

    NASA Astrophysics Data System (ADS)

    Taniguchi, M.

    2016-12-01

    Water, energy, and food are the most essential and fundamental resources for human well-beings, a sustainable society, and global sustainability. These are inextricably linked, and there are complex synergies and tradeoffs among the three resources. More issues arise and attention must be paid when it comes to the Water-Energy-Food (WEF) Nexus. Lack of integrated research between a nexus and policy implementation is the most concerning. The United Nations Sustainable Development Goals (SDGs) aim to end poverty, protect the planet, and ensure prosperity for all, and are scheduled to be achieved by 2030. Of the 17 SDGs, Goal 2, 6 and 7 are directly related to food, water, and energy sectors. However, there are no integrated SDGs related to the Water-Energy-Food Nexus. Two different directions of nexus research exist in developing and industrialized worlds, and synthesis of both are needed. Developing countries are striving to increase their Human Development Index (HDI) while keeping Ecological Footprints, including Nexus Footprint, low. On the other hand, industrialized countries are targeting to maintain their high HDI and reduce their Ecological Footprints. Both are challenging tasks under the restrictions of planetary boundaries (limited nature) and doughnut economy (limited society). In this study, WEF Nexus research in Asian countries, including developing and industrialized countries, demonstrates the different types of nexus approaches to achieve SDGs through renewable energy, agriculture and aquaculture as food, and water management in Monsoon and semi-arid Asia. Mutual learning between the two types of nexus approaches can be made in the Asian area.

  15. The implementation leadership scale (ILS): development of a brief measure of unit level implementation leadership

    PubMed Central

    2014-01-01

    Background In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Methods Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. Results The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. Conclusions The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation

  16. The Implementation Leadership Scale (ILS): development of a brief measure of unit level implementation leadership.

    PubMed

    Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R

    2014-04-14

    In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation. The ILS also holds promise as a tool for

  17. Applying an Implementation Science Framework for Adoption of a Comprehensive Program for High School Students with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Odom, Samuel L.; Duda, Michelle A.; Kucharczyk, Suzanne; Cox, Ann W.; Stabel, Aaron

    2014-01-01

    Post-school outcomes for adolescents and young adults with autism spectrum disorder (ASD) are exceedingly poor. The convergence of adolescence as a development period, the expression of ASD during adolescence, and the complicated logistic nature of high schools create a perfect storm of complexity that may pose challenges and establish barriers to…

  18. Applying an Implementation Science Framework for Adoption of a Comprehensive Program for High School Students with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Odom, Samuel L.; Duda, Michelle A.; Kucharczyk, Suzanne; Cox, Ann W.; Stabel, Aaron

    2014-01-01

    Post-school outcomes for adolescents and young adults with autism spectrum disorder (ASD) are exceedingly poor. The convergence of adolescence as a development period, the expression of ASD during adolescence, and the complicated logistic nature of high schools create a perfect storm of complexity that may pose challenges and establish barriers to…

  19. Chapter 4: Short-Cycle Higher Education in the Netherlands--Adoption and Implementation of the New Associate Degree Qualification

    ERIC Educational Resources Information Center

    Daale, Hans

    2010-01-01

    Since 2006, the Netherlands has been actively engaged in a process of developing, piloting, and institutionalizing a new 2-year, short-cycle higher education degree, titled the "associate degree". This initiative evolved as a collaborative grassroots effort spearheaded by several Dutch national higher education and business organizations…

  20. Evidence Related to Awareness, Adoption, and Implementation of the Standards for Technological Literacy: Content for the Study of Technology

    ERIC Educational Resources Information Center

    Russell, Jill F.

    2005-01-01

    Over the past twenty years American education has seen many changes, and most notable have been those related to accountability and assessment. One aspect of these changes has been the movement toward more specified student learning outcomes. In discipline after discipline content standards have been developed outlining that which students should…

  1. Chapter 4: Short-Cycle Higher Education in the Netherlands--Adoption and Implementation of the New Associate Degree Qualification

    ERIC Educational Resources Information Center

    Daale, Hans

    2010-01-01

    Since 2006, the Netherlands has been actively engaged in a process of developing, piloting, and institutionalizing a new 2-year, short-cycle higher education degree, titled the "associate degree". This initiative evolved as a collaborative grassroots effort spearheaded by several Dutch national higher education and business organizations…

  2. Yield model development project implementation plan

    NASA Technical Reports Server (NTRS)

    Ambroziak, R. A.

    1982-01-01

    Tasks remaining to be completed are summarized for the following major project elements: (1) evaluation of crop yield models; (2) crop yield model research and development; (3) data acquisition processing, and storage; (4) related yield research: defining spectral and/or remote sensing data requirements; developing input for driving and testing crop growth/yield models; real time testing of wheat plant process models) and (5) project management and support.

  3. Development, implementation of industrial lasers reviewed

    NASA Astrophysics Data System (ADS)

    Rybakov, N.

    1985-05-01

    The Experimental Scientific Research Institute of Metal-Cutting Machine Tools developed the first laser systems for industry only ten years ago. In place of the usual cutting tool these systems used a laser beam. Up till now there was no equipment available to drill with high precision holes of complex configuration in hard to machine materials like ceramics and diamonds. Lasers comparatively quickly found application in communication equipment. The beam can accommodate and transmit a tremendous amount of information. The use of laser beams has now found wide application. A prototype of a diagnostic laser system for screening bearings was developed and tested.

  4. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study.

    PubMed

    Chimeddamba, Oyun; Ayton, Darshini; Bazarragchaa, Nansalmaa; Dorjsuren, Bayarsaikhan; Peeters, Anna; Joyce, Catherine

    2016-04-07

    (1) BACKGROUND: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2) METHODS: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3) RESULTS: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4) CONCLUSIONS: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines.

  5. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study

    PubMed Central

    Chimeddamba, Oyun; Ayton, Darshini; Bazarragchaa, Nansalmaa; Dorjsuren, Bayarsaikhan; Peeters, Anna; Joyce, Catherine

    2016-01-01

    (1) Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2) Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3) Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4) Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines. PMID:27070630

  6. Student Adoption & Development of Digital Learning Media: Action Research and Recommended Practices

    ERIC Educational Resources Information Center

    Tabor, Sharon W.; Minch, Robert P.

    2013-01-01

    Digital technologies offer many opportunities for creating engaging course content. In this study we captured student perceptions and adoption choices related to creating and using digital media as learning tools. Podcasts, video and other media were integrated in a variety of contexts and tasks in two undergraduate information technology (IT)…

  7. Medical Issues in International Adoption and Their Influence on Language Development

    ERIC Educational Resources Information Center

    Ladage, Jennifer S.

    2009-01-01

    As the number of international adoptions has increased over the past 2 decades, so has awareness and understanding of the risks associated with the conditions to which these children have been exposed. Prenatal alcohol and/or drug exposure, infectious diseases, malnutrition, and psychosocial deprivation all contribute to the profound growth and…

  8. Challenges of Adopting the Use of Technology in Less Developed Countries: The Case of Cambodia

    ERIC Educational Resources Information Center

    Richardson, Jayson W.

    2011-01-01

    Drawing on Everett Rogers's theory of the diffusion of innovations, this article identifies the barriers, challenges, and successes in the adoption of technology training by teacher trainers in Cambodia. The analysis was based on data collected from an open-ended survey, face-to-face interviews, and document analysis. Findings reveal that the…

  9. Communication Patterns between Internationally Adopted Children and Their Mothers: Implications for Language Development

    ERIC Educational Resources Information Center

    Gauthier, K.; Genesee, F.; Dubois, M. E.; Kasparian K.

    2013-01-01

    This study presents findings on patterns of communication between internationally adopted children and their mothers in order to better understand the nature of these interactions and their influence on language learning. We examined maternal language use and joint attention behaviors of mothers and their children in 21 mother-child pairs: 10…

  10. Communication Patterns between Internationally Adopted Children and Their Mothers: Implications for Language Development

    ERIC Educational Resources Information Center

    Gauthier, K.; Genesee, F.; Dubois, M. E.; Kasparian K.

    2013-01-01

    This study presents findings on patterns of communication between internationally adopted children and their mothers in order to better understand the nature of these interactions and their influence on language learning. We examined maternal language use and joint attention behaviors of mothers and their children in 21 mother-child pairs: 10…

  11. Student Adoption & Development of Digital Learning Media: Action Research and Recommended Practices

    ERIC Educational Resources Information Center

    Tabor, Sharon W.; Minch, Robert P.

    2013-01-01

    Digital technologies offer many opportunities for creating engaging course content. In this study we captured student perceptions and adoption choices related to creating and using digital media as learning tools. Podcasts, video and other media were integrated in a variety of contexts and tasks in two undergraduate information technology (IT)…

  12. Determinants of E-Learning Adoption in Universities: Evidence from a Developing Country

    ERIC Educational Resources Information Center

    Ansong, Eric; Lovia Boateng, Sheena; Boateng, Richard

    2017-01-01

    This study sought to explore the technological, organizational, and environmental determinants of e-learning adoption in University of Ghana using a multistakeholder approach. Another construct (nature of the course) was added to the traditional constructs of the technology-organization-environment framework. Using survey research, e-learning…

  13. Sustaining Instructional Change: The Impact of Professional Development on Teacher Adoption of a New Instructional Strategy

    ERIC Educational Resources Information Center

    Richards, Jennifer; Skolits, Gary

    2009-01-01

    Adolescents learn best when actively engaged with the content; yet, many teachers rely on passive learning strategies in their classrooms. This study investigated teacher (n = 6) use and adoption of an active learning instructional strategy (Role, Audience, Format, Topic). The study purposes were to: (a) determine how and to what extent teachers…

  14. Medical Issues in International Adoption and Their Influence on Language Development

    ERIC Educational Resources Information Center

    Ladage, Jennifer S.

    2009-01-01

    As the number of international adoptions has increased over the past 2 decades, so has awareness and understanding of the risks associated with the conditions to which these children have been exposed. Prenatal alcohol and/or drug exposure, infectious diseases, malnutrition, and psychosocial deprivation all contribute to the profound growth and…

  15. Challenges of Adopting the Use of Technology in Less Developed Countries: The Case of Cambodia

    ERIC Educational Resources Information Center

    Richardson, Jayson W.

    2011-01-01

    Drawing on Everett Rogers's theory of the diffusion of innovations, this article identifies the barriers, challenges, and successes in the adoption of technology training by teacher trainers in Cambodia. The analysis was based on data collected from an open-ended survey, face-to-face interviews, and document analysis. Findings reveal that the…

  16. Implementation and Performance of Low Impact Development

    EPA Science Inventory

    This workshop will provide participants with a basic understanding of LID approaches and techniques and how these techniques help achieve stormwater management goals and protect water quality and stream health. The workshop will cover impacts of land development on hydrology and...

  17. Developing and Implementing a Counselor Evaluation Program.

    ERIC Educational Resources Information Center

    Bell, Priscilla J.; Acker, Kathleen E.

    In the past several years, Tacoma Community College (TCC) has devoted increasing attention to evaluating faculty and staff performance. In recognition of the benefits of a growth-oriented evaluation process over a summative evaluation, the counselors and the Dean for Student Services at TCC developed a comprehensive evaluation system for…

  18. Implementation and Performance of Low Impact Development

    EPA Science Inventory

    This workshop will provide participants with a basic understanding of LID approaches and techniques and how these techniques help achieve stormwater management goals and protect water quality and stream health. The workshop will cover impacts of land development on hydrology and...

  19. Staff Development; Mini Models for College Implementation.

    ERIC Educational Resources Information Center

    Peterson, Gary T., Ed.

    One hundred twenty-seven participants at a June 1975 symposium in Squaw Valley, California, made use of a prescribed problem-solving process in order to originate a number of parts of a total staff development effort for a simulated community college. The developmental stages in the process included brainstorming, needs assessment, resource…

  20. The first results of the development and implementation of the upper extremity exoskeleton "EXAR"

    NASA Astrophysics Data System (ADS)

    Vorobiev, A. A.; Krivonozhkina, P. S.; Zasypkina, O. A.; Andrewshenko, F. A.

    2015-11-01

    This research considers the first results of the development and implementation of the upper extremity exoskeleton "EXAR". Made anatomical parameterization developed the device the testing of the apparatus have been conducted in accordance with the bioethics regulations with the girl I. Sh. at the age of 4 years suffering the artrogryposis. The parameters of the exoskeleton "EXAR" selected according to our methods allowed us to conduct its use in the period of 4 months. There have been no defects at all. By the analysis of the first results of the passive upper limb skeleton EXAR development we should consider them as positive and worthy of the widespread adoption in the remedial practice.

  1. The Morningside Initiative: Collaborative Development of a Knowledge Repository to Accelerate Adoption of Clinical Decision Support

    PubMed Central

    Greenes, Robert; Bloomrosen, Meryl; Brown-Connolly, Nancy E.; Curtis, Clayton; Detmer, Don E; Enberg, Robert; Fridsma, Douglas; Fry, Emory; Goldstein, Mary K; Haug, Peter; Hulse, Nathan; Hongsermeier, Tonya; Maviglia, Saverio; Robbins, Craig W; Shah, Hemant

    2010-01-01

    The Morningside Initiative is a public-private activity that has evolved from an August, 2007, meeting at the Morningside Inn, in Frederick, MD, sponsored by the Telemedicine and Advanced Technology Research Center (TATRC) of the US Army Medical Research Materiel Command. Participants were subject matter experts in clinical decision support (CDS) and included representatives from the Department of Defense, Veterans Health Administration, Kaiser Permanente, Partners Healthcare System, Henry Ford Health System, Arizona State University, and the American Medical Informatics Association (AMIA). The Morningside Initiative was convened in response to the AMIA Roadmap for National Action on Clinical Decision Support and on the basis of other considerations and experiences of the participants. Its formation was the unanimous recommendation of participants at the 2007 meeting which called for creating a shared repository of executable knowledge for diverse health care organizations and practices, as well as health care system vendors. The rationale is based on the recognition that sharing of clinical knowledge needed for CDS across organizations is currently virtually non-existent, and that, given the considerable investment needed for creating, maintaining and updating authoritative knowledge, which only larger organizations have been able to undertake, this is an impediment to widespread adoption and use of CDS. The Morningside Initiative intends to develop and refine (1) an organizational framework, (2) a technical approach, and (3) CDS content acquisition and management processes for sharing CDS knowledge content, tools, and experience that will scale with growing numbers of participants and can be expanded in scope of content and capabilities. Intermountain Healthcare joined the initial set of participants shortly after its formation. The efforts of the Morningside Initiative are intended to serve as the basis for a series of next steps in a national agenda for CDS. It

  2. DOE guideline: Guide to good practices for the design, development, and implementation of examinations

    SciTech Connect

    Not Available

    1992-07-01

    The purpose of the Department of Energy (DOE) Guide to Good Practices for the Design, Development, and Implementation of Examinations is to provide DOE contractor organizations with information that can be used to modify existing programs or to develop new programs. DOE contractors should not feel obligated to adopt all parts of this guide. Rather, they can use the information in this guide to develop programs that apply to their facility. This guide is to provide direction to training personnel in the broad areas of design, development, and implementation of examinations. This guide can be used as an aid in the construction and administration of written, oral, and performance examinations. Course designers, developers, instructors, and training managers may find this guide useful.

  3. A question-based approach to adopting pharmacogenetics to understand risk for clinical variability in pharmacokinetics in early drug development.

    PubMed

    Evers, R; Blanchard, R L; Warner, A W; Cutler, D; Agrawal, N G B; Shaw, P M

    2014-09-01

    Understanding genetic variations that influence pharmacokinetics (PK) in humans is important for optimal clinical use of drugs. Guidances for making decisions on when to conduct pharmacogenetic research during drug development have been proposed by regulatory agencies, but their uniform adoption presents problems due to an inherent lack of flexibility. A questions-based approach (QBA) was developed to enable drug development teams at Merck to iteratively and flexibly evaluate the potential impact of pharmacogenetics (PGx) on clinical pharmacokinetic variability.

  4. Solar Energy Forecast System Development and Implementation

    NASA Astrophysics Data System (ADS)

    Jascourt, S. D.; Kirk-Davidoff, D. B.; Cassidy, C.

    2012-12-01

    Forecast systems for predicting real-time solar energy generation are being developed along similar lines to those of more established wind forecast systems, but the challenges and constraints are different. Clouds and aerosols play a large role, and for tilted photovoltaic panels and solar concentrating plants, the direct beam irradiance, which typically has much larger forecast errors than global horizontal irradiance, must be utilized. At MDA Information Systems, we are developing a forecast system based on first principles, with the well-validated REST2 clear sky model (Gueymard, 2008) at its backbone. In tuning the model and addressing aerosol scattering and surface albedo, etc., we relied upon the wealth of public data sources including AERONET (aerosol optical depth at different wavelengths), Suominet (GPS integrated water vapor), NREL MIDC solar monitoring stations, SURFRAD (includes upwelling shortwave), and MODIS (albedo in different wavelength bands), among others. The forecast itself utilizes a blend of NWP model output, which must be brought down to finer time resolution based on the diurnal cycle rather than simple interpolation. Many models currently do not output the direct beam irradiance, and one that does appears to have a bias relative to its global horizontal irradiance, with equally good performance attained by utilizing REST2 and the model global radiation to estimate the direct component. We will present a detailed assessment of various NWP solar energy products, evaluating forecast skill at a range of photovoltaic installations.

  5. Recommendations of the Curriculum Development and Supplemental Materials Commission: California Basic Instructional Materials in English-Language Arts, 1988 Adoption.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This catalog lists both recommended and non-recommended bibliographies of instructional materials for California kindergarten through eighth grade English/language arts teachers and explains the choices of the Curriculum Development and Supplemental Materials Commission. The California State Board of Education adopted the commission's…

  6. An Integrated Approach to Disability Policy Development, Implementation, and Evaluation

    ERIC Educational Resources Information Center

    Shogren, Karrie A.; Luckasson, Ruth; Schalock, Robert L.

    2017-01-01

    This article provides a framework for an integrated approach to disability policy development, implementation, and evaluation. The article discusses how a framework that combines systems thinking and valued outcomes can be used by coalition partners across ecological systems to implement disability policy, promote the effective use of resources,…

  7. Generating and Implementing School Based Management of Program Development.

    ERIC Educational Resources Information Center

    Moeller, Jean

    Described are the efforts of generating and implementing a generic model for program development at a kindergarten through sixth-grade elementary school in order to satisfy identified needs for program improvements in science. The implementation of the program involved a steering committee, the teaching staff, community members and external…

  8. Applying Behavior Change Theories and Qualitative Methods in Substance Misuse Implementation Research: Conceptualizing the Adoption of Breaking Free Online in Real-World Clinical Practice.

    PubMed

    Dugdale, Stephanie; Elison, Sarah; Davies, Glyn; Ward, Jonathan

    2017-06-01

    There is insufficient research examining the implementation of complex novel interventions within health care. This may be due to a lack of qualitative research providing subjective insights into these implementation processes. The authors investigate the advantages of applying behavior change theories to conceptualize qualitative data describing the processes of implementation of complex interventions. Breaking Free Online (BFO), a digital treatment intervention for substance misuse, is described as an example of a complex intervention. The authors review previous qualitative research which explored initial diffusion, or spread, of the BFO program, and its subsequent normalization as part of standard treatment for substance misuse within the health and social care charity, "Change, Grow, Live" (CGL). The use of behavior change models to structure qualitative interview findings enabled identification of facilitators and barriers to the use of BFO within CGL. These findings have implications for the development of implementation research in novel health care interventions.

  9. Development and Implementation of GPS Correlator Structures in MATLAB and Simulink with Focus on SDR Applications: Implementation of a Standard GPS Correlator Architecture (Baseline) Implementation of the MIT Quicksynch Sparse Algorithm Development and Implementation of Parallel Circular Correlator Constructs

    DTIC Science & Technology

    2014-05-01

    and Implementation of GPS Correlator Structures in MATLAB and Simulink with Focus on SDR Applications: Implementation of a Standard GPS Correlator...Correlator Structures in MATLAB and Simulink with Focus on SDR Applications: Implementation of a Standard GPS Correlator Architecture (Baseline...Development and Implementation of GPS Correlator Structures in MATLAB and Simulink with Focus on SDR Applications Implementation of a

  10. Developing eLearning Technologies to Implement Competency Based Medical Education: Experiences from Muhimbili University of Health and Allied Sciences

    ERIC Educational Resources Information Center

    Nagunwa, Thomas; Lwoga, Edda

    2012-01-01

    This paper provides the practical experience of developing an eLearning technology as a tool to implement Competency-based Medical Education (CBME) in Tanzania medical universities, with a specific focus on Muhimbili University of Health and Allied Sciences. The paper provides a background to eLearning and the early attempt to adopt it in 2006 at…

  11. Implementation of the Master Plan for Statewide Professional Staff Development for 2012-2013: An Evaluation Study

    ERIC Educational Resources Information Center

    Hammer, Patricia Cahape

    2014-01-01

    In this evaluation, as in previous years, four main aspects of the implementation of the West Virginia Board of Education's Master Plan for Statewide Professional Development were examined: (a) basic information reported by providers about the size and scope of the effort, including attendance, and adherence to the newly adopted standards for…

  12. Development and Implementation of Quality Rating and Improvement Systems in Midwest Region States. REL 2016-143

    ERIC Educational Resources Information Center

    Faria, Ann-Marie; Greenberg, Ariela; Hawkinson, Laura; Metzger, Ivan

    2016-01-01

    This report describes common and unique approaches that Regional Educational Laboratory (REL) Midwest Region states have adopted in developing and implementing their quality rating and improvement systems (QRISs). A QRIS is a method for assessing, improving, and communicating the quality of early childhood education and care providers. The study…

  13. Implementing Policy Options to Strengthen the Nexus between Postsecondary Education and Workforce Development. Commission Report 08-07

    ERIC Educational Resources Information Center

    California Postsecondary Education Commission, 2008

    2008-01-01

    In December 2007, the California Postsecondary Education adopted the last in an initial series of reports on the nexus between postsecondary education and workforce development by requesting staff to return with plans and priorities to pursue implementation of ten general policy options, grouped into three categories. One option is already being…

  14. Pricing Health Behavior Interventions to Promote Adoption

    PubMed Central

    Ribisl, Kurt M.; Leeman, Jennifer; Glasser, Allison M.

    2015-01-01

    The relatively high cost of delivering many public health interventions limits their potential for broad public impact by reducing their likelihood of adoption and maintenance over time. Practitioners identify cost as the primary factor for which interventions they select to implement, but researchers rarely disseminate cost information or consider its importance when developing new interventions. A new approach is proposed, whereby intervention developers assess what individuals and agencies adopting their interventions are willing to pay and then design interventions that are responsive to this price range. The ultimate goal is to develop effective and affordable interventions, called lean interventions, which are widely adopted and have greater public health impact. PMID:24842743

  15. The Agway Management Development Program: Design and Implementation

    ERIC Educational Resources Information Center

    Barth, Anthony L.; Engfer, Robert T.

    1977-01-01

    Focus is on the Agway (a farm supply and food marketing cooperative) retail store system in this informational case history and how-to approach for designing, developing, and implementing a formal corporate management program. (Editor/TA)

  16. Transmission from theory to practice: Experiences using open-source code development and a virtual short course to increase the adoption of new theoretical approaches

    NASA Astrophysics Data System (ADS)

    Harman, C. J.

    2015-12-01

    Even amongst the academic community, new theoretical tools can remain underutilized due to the investment of time and resources required to understand and implement them. This surely limits the frequency that new theory is rigorously tested against data by scientists outside the group that developed it, and limits the impact that new tools could have on the advancement of science. Reducing the barriers to adoption through online education and open-source code can bridge the gap between theory and data, forging new collaborations, and advancing science. A pilot venture aimed at increasing the adoption of a new theory of time-variable transit time distributions was begun in July 2015 as a collaboration between Johns Hopkins University and The Consortium of Universities for the Advancement of Hydrologic Science (CUAHSI). There were four main components to the venture: a public online seminar covering the theory, an open source code repository, a virtual short course designed to help participants apply the theory to their data, and an online forum to maintain discussion and build a community of users. 18 participants were selected for the non-public components based on their responses in an application, and were asked to fill out a course evaluation at the end of the short course, and again several months later. These evaluations, along with participation in the forum and on-going contact with the organizer suggest strengths and weaknesses in this combination of components to assist participants in adopting new tools.

  17. Technoeconomic assumptions adopted for the development of a long-term electricity supply model for Cyprus.

    PubMed

    Taliotis, Constantinos; Taibi, Emanuele; Howells, Mark; Rogner, Holger; Bazilian, Morgan; Welsch, Manuel

    2017-10-01

    The generation mix of Cyprus has been dominated by oil products for decades. In order to conform with European Union and international legislation, a transformation of the supply system is called for. Energy system models can facilitate energy planning into the future, but a large volume of data is required to populate such models. The present data article provides information on key modelling assumptions and input data adopted with the aim of representing the electricity supply system of Cyprus in a separate research article. Data in regards to renewable energy technoeconomic characteristics and investment cost projections, fossil fuel price projections, storage technology characteristics and system operation assumptions are described in this article.

  18. Predicting Portuguese Psychology Students' Attitudes Toward the Psychological Development of Children Adopted by Lesbians and Gay Men.

    PubMed

    Gato, Jorge; Fontaine, Anne Marie

    2016-11-01

    The present study seeks to ascertain the attitudes of Portuguese psychology students (future psychologists) toward the development of children adopted by lesbian and gay parents. Each participant (N = 182) read a vignette describing an adoption of a child by lesbian and gay persons. After reading the vignette, participants rated four different aspects of the future development of the adopted child (psychosocial adjustment, victimization, psychological disturbance, and normative sexuality). Furthermore, participants were asked about their gender, interpersonal contact with lesbians and gay men, gender role attitudes, and attitudes toward lesbians and gay men. Future psychologists' attitudes toward the developmental outcomes of children adopted by lesbians and gay men were associated with negative attitudes toward non-heterosexuals, which in turn correlated to interpersonal contact with lesbians and gay men and adherence to gender conservative values. These results clearly highlight the central role of social attitudes and the need for cultural competence training of future psychologists that encourages interpersonal contact with non-heterosexuals and discourages traditional gender roles and negative attitudes toward lesbian and gay men.

  19. Developing a rural community-based disability service: (I) service framework and implementation strategy.

    PubMed

    Kuipers, P; Kendall, E; Hancock, T

    2001-02-01

    In response to widely recognised dilemmas associated with rehabilitation and disability service provision in remote and rural areas of Australia, a community-based, participatory approach to service development was adapted for a disability service project in central Queensland. The service framework, known as Community Based Rehabilitation (CBR), fosters the involvement of community members in disability service provision. Although this framework has been described previously, few guidelines exist regarding appropriate implementation of such an approach. Consequently, the implementation strategy known as Participatory Rural Appraisal (PRA) was adopted. Participatory Rural Appraisal has been reported to foster the participation and decision-making of community members in community projects. The present article describes the application of this implementation strategy to disability service provision in a relatively under-resourced rural shire. The rationale, framework and process of the pilot are described. A subsequent publication will document the service component, detail evaluation findings and describe the long-term outcomes of this research.

  20. Developing knowledge resources to support precision medicine: principles from the Clinical Pharmacogenetics Implementation Consortium (CPIC).

    PubMed

    Hoffman, James M; Dunnenberger, Henry M; Kevin Hicks, J; Caudle, Kelly E; Whirl Carrillo, Michelle; Freimuth, Robert R; Williams, Marc S; Klein, Teri E; Peterson, Josh F

    2016-07-01

    To move beyond a select few genes/drugs, the successful adoption of pharmacogenomics into routine clinical care requires a curated and machine-readable database of pharmacogenomic knowledge suitable for use in an electronic health record (EHR) with clinical decision support (CDS). Recognizing that EHR vendors do not yet provide a standard set of CDS functions for pharmacogenetics, the Clinical Pharmacogenetics Implementation Consortium (CPIC) Informatics Working Group is developing and systematically incorporating a set of EHR-agnostic implementation resources into all CPIC guidelines. These resources illustrate how to integrate pharmacogenomic test results in clinical information systems with CDS to facilitate the use of patient genomic data at the point of care. Based on our collective experience creating existing CPIC resources and implementing pharmacogenomics at our practice sites, we outline principles to define the key features of future knowledge bases and discuss the importance of these knowledge resources for pharmacogenomics and ultimately precision medicine.

  1. Using Blogs to Be Aware of the Development and Adoption of Professional Skills

    ERIC Educational Resources Information Center

    Pinya, Carme; Rosselló, Maria Rosa

    2016-01-01

    In view of the challenges facing universities in our days and in accordance with the guidelines of the EHEA, the present article presents the results of a project which aims to unite the use of blogs and a competency approach. Specifically, the project is structured around two basic, complementary aims: 1. The design and implementation of a…

  2. Using Blogs to Be Aware of the Development and Adoption of Professional Skills

    ERIC Educational Resources Information Center

    Pinya, Carme; Rosselló, Maria Rosa

    2016-01-01

    In view of the challenges facing universities in our days and in accordance with the guidelines of the EHEA, the present article presents the results of a project which aims to unite the use of blogs and a competency approach. Specifically, the project is structured around two basic, complementary aims: 1. The design and implementation of a…

  3. Open Adoption

    ERIC Educational Resources Information Center

    Baran, Annette; And Others

    1976-01-01

    Adult adoptees are increasingly challenging the practice of sealing their birth records. The authors examine the historical roots of adoptive practices in this country and suggest that the time has come for open adoption to gain acceptance as an alternative. (Author)

  4. Focused ultrasound development and clinical adoption: 2013 update on the growth of the field

    PubMed Central

    2014-01-01

    The field of therapeutic focused ultrasound, which first emerged in the 1940s, has seen significant growth, particularly over the past decade. The eventual widespread clinical adoption of this non-invasive therapeutic modality require continued progress, in a multitude of activities including technical, pre-clinical, and clinical research, regulatory approval and reimbursement, manufacturer growth, and other commercial and public sector investments into the field, all within a multi-stakeholder environment. We present here a snapshot of the field of focused ultrasound and describe how it has progressed over the past several decades. It is assessed using metrics which include quantity and breadth of academic work (presentations, publications), funding trends, manufacturer presence in the field, number of treated patients, number of indications reaching first-in-human status, and quantity and breadth of clinical indications. PMID:25512866

  5. Surveying general prospects and challenges of GIS implementation in developing countries: a SWOT-AHP approach

    NASA Astrophysics Data System (ADS)

    Taleai, Mohammad; Mansourian, Ali; Sharifi, Ali

    2009-09-01

    We propose a combined method based on the strengths, weaknesses, opportunities and threats (SWOT) and analytic hierarchy process (AHP) to investigate the challenges and prospects of adopting geographic information systems (GIS) in developing countries. In this context, we identify, group, and analyse SWOT indicators in relation to the main GIS components: data, people, and technology. The relative significance of each SWOT indicator and its related SWOT groups in each GIS component is quantified. The method is then applied in a situation assessment of GIS adoption in the governmental organisations and strategic planning. The SWOT-AHP approach proves to be very useful in identifying and quantifying the relative significance of the major factors affecting GIS implementation, and effectively facilitates GIS strategic planning.

  6. Classroom Modules for Nanotechnology Undergraduate Education: Development, Implementation and Evaluation

    ERIC Educational Resources Information Center

    Shabani, R.; Massi, L.; Zhai, L.; Seal, S.; Cho, H. J.

    2011-01-01

    In order to address the challenges and restrictions given by a traditional classroom lecture environment, the top-down and bottom-up nanotechnology teaching modules were developed, implemented and evaluated. Then based on the hypothesis that instructors could further develop students' interest in this emerging area through the introduction of the…

  7. The Implementation of Technology-Based SME Management Development Programmes

    ERIC Educational Resources Information Center

    Carr, James

    2005-01-01

    Learning technology is seen as one solution to the problem of delivering management training in Small and Medium-sized Enterprises (SMEs). This paper investigates how the Higher Education (HE) sector can use its growing expertise in learning technology implementation to develop effective SME management development solutions. It is found that there…

  8. Classroom Modules for Nanotechnology Undergraduate Education: Development, Implementation and Evaluation

    ERIC Educational Resources Information Center

    Shabani, R.; Massi, L.; Zhai, L.; Seal, S.; Cho, H. J.

    2011-01-01

    In order to address the challenges and restrictions given by a traditional classroom lecture environment, the top-down and bottom-up nanotechnology teaching modules were developed, implemented and evaluated. Then based on the hypothesis that instructors could further develop students' interest in this emerging area through the introduction of the…

  9. Aggressive Neglect, Matrix Organization, and Student Development Implementation

    ERIC Educational Resources Information Center

    Borland, David T.

    1977-01-01

    Organizational facilitation of student development is a significant but difficult process in colleges and universities with traditional priorities on academic concerns. Organizational factors are analyzed and a model is proposed implementing student development through the accommodation of diverse organizational elements and by an integrated…

  10. The Development and Implementation of a Community Pharmacy Practice Clerkship.

    ERIC Educational Resources Information Center

    Weissman, Fred G.; And Others

    1984-01-01

    A clerkship at the University of Southern California School of Pharmacy was developed to provide students with (1) experience in the identification, development,, implementation, and evaluation of patient care services in community pharmacies and (2) the skills required to successfully operate a community pharmacy on a day-to-day basis.…

  11. The Development and Implementation of a Community Pharmacy Practice Clerkship.

    ERIC Educational Resources Information Center

    Weissman, Fred G.; And Others

    1984-01-01

    A clerkship at the University of Southern California School of Pharmacy was developed to provide students with (1) experience in the identification, development,, implementation, and evaluation of patient care services in community pharmacies and (2) the skills required to successfully operate a community pharmacy on a day-to-day basis.…

  12. Perceived Requirements of MIS Curriculum Implementation in Bilingual Developing Countries

    ERIC Educational Resources Information Center

    Kabeil, Magdy M.

    2005-01-01

    This paper addresses additional requirements associated with implementing a standard curriculum of Management Information Systems (MIS) in bilingual developing countries where both students and workplace users speak English as a second language. In such countries, MIS graduates are required to develop bilingual computer applications and to…

  13. The Implementation of Technology-Based SME Management Development Programmes

    ERIC Educational Resources Information Center

    Carr, James

    2005-01-01

    Learning technology is seen as one solution to the problem of delivering management training in Small and Medium-sized Enterprises (SMEs). This paper investigates how the Higher Education (HE) sector can use its growing expertise in learning technology implementation to develop effective SME management development solutions. It is found that there…

  14. Adoption of a clinical pharmacogenomics implementation program during outpatient care--initial results of the University of Chicago "1,200 Patients Project".

    PubMed

    O'Donnell, Peter H; Danahey, Keith; Jacobs, Michael; Wadhwa, Nisha R; Yuen, Shennin; Bush, Angela; Sacro, Yasmin; Sorrentino, Matthew J; Siegler, Mark; Harper, William; Warrick, Andrea; Das, Soma; Saner, Don; Corless, Christopher L; Ratain, Mark J

    2014-03-01

    Pharmacogenomic testing is viewed as an integral part of precision medicine. To achieve this, we originated The 1,200 Patients Project which offers broad, preemptive pharmacogenomic testing to patients at our institution. We analyzed enrollment, genotype, and encounter-level data from the first year of implementation to assess utility of providing pharmacogenomic results. Results were delivered via a genomic prescribing system (GPS) in the form of traffic lights: green (favorable), yellow (caution), and red (high risk). Additional supporting information was provided as a virtual pharmacogenomic consult, including citation to relevant publications. Currently, 812 patients have participated, representing 90% of those approached; 608 have been successfully genotyped across a custom array. A total of 268 clinic encounters have occurred at which results were accessible via the GPS. At 86% of visits, physicians accessed the GPS, receiving 367 result signals for medications patients were taking: 57% green lights, 41% yellow lights, and 1.4% red lights. Physician click frequencies to obtain clinical details about alerts varied according to color severity (100% of red were clicked, 72% yellow, 20% green). For 85% of visits, clinical pharmacogenomic information was available for at least one drug the patient was taking, suggesting relevance of the delivered information. We successfully implemented an individualized health care model of preemptive pharmacogenomic testing, delivering results along with pharmacogenomic decision support. Patient interest was robust, physician adoption of information was high, and results were routinely utilized. Ongoing examination of a larger number of clinic encounters and inclusion of more physicians and patients is warranted. © 2014 Wiley Periodicals, Inc.

  15. Ethics of Implementing Electronic Health Records in Developing Countries: Points to Consider

    PubMed Central

    Were, Martin C.; Meslin, Eric M.

    2011-01-01

    Electronic Health Record systems (EHRs) are increasingly being used in many developing countries, several of which have moved beyond isolated pilot projects to active large-scale implementation as part of their national health strategies. Despite growing enthusiasm for adopting EHRs in resource poor settings, almost no attention has been paid to the ethical issues that might arise. In this article we argue that these ethical issues should be addressed now if EHRs are to be appropriately implemented in these settings. We take a systematic approach guided by a widely accepted ethical framework currently in use for developing countries to first describe the ethical issues, and then propose a set of ‘Points to Consider’ to guide further thinking and decision-making. PMID:22195214

  16. Development and Implementation of Culturally Tailored Offline Mobile Health Surveys

    PubMed Central

    2016-01-01

    Background In low and middle income countries (LMICs), and other areas with low resources and unreliable access to the Internet, understanding the emerging best practices for the implementation of new mobile health (mHealth) technologies is needed for efficient and secure data management and for informing public health researchers. Innovations in mHealth technology can improve on previous methods, and dissemination of project development details and lessons learned during implementation are needed to provide lessons learned to stakeholders in both the United States and LMIC settings. Objective The aims of this paper are to share implementation strategies and lessons learned from the development and implementation stages of two survey research projects using offline mobile technology, and to inform and prepare public health researchers and practitioners to implement new mobile technologies in survey research projects in LMICs. Methods In 2015, two survey research projects were developed and piloted in Puerto Rico and pre-tested in Costa Rica to collect face-to-face data, get formative evaluation feedback, and to test the feasibility of an offline mobile data collection process. Fieldwork in each setting involved survey development, back translation with cultural tailoring, ethical review and approvals, data collector training, and piloting survey implementation on mobile tablets. Results Critical processes and workflows for survey research projects in low resource settings were identified and implemented. This included developing a secure mobile data platform tailored to each survey, establishing user accessibility, and training and eliciting feedback from data collectors and on-site LMIC project partners. Conclusions Formative and process evaluation strategies are necessary and useful for the development and implementation of survey research projects using emerging mHealth technologies in LMICs and other low resource settings. Lessons learned include: (1) plan

  17. Development and implementation of a residency project advisory board.

    PubMed

    Dagam, Julie K; Iglar, Arlene; Kindsfater, Julie; Loeb, Al; Smith, Chad; Spexarth, Frank; Brierton, Dennis; Woller, Thomas

    2017-06-15

    The development and implementation of a residency project advisory board (RPAB) to manage multiple pharmacy residents' yearlong projects across several residency programs are described. Preceptor and resident feedback during our annual residency program review and strategic planning sessions suggested the implementation of a more-coordinated approach to the identification, selection, and oversight of all components of the residency project process. A panel of 7 department leaders actively engaged in residency training and performance improvement was formed to evaluate the residency project process and provide recommendations for change. These 7 individuals would eventually constitute the RPAB. The primary objective of the RPAB at Aurora Health Care is to provide oversight and a structured framework for the selection and execution of multiple residents' yearlong projects across all residency programs within our organization. Key roles of the RPAB include developing expectations, coordinating residency project ideas, and providing oversight and feedback. The development and implementation of the RPAB resulted in a significant overhaul of our entire yearlong resident project process. Trends toward success were realized after the first year of implementation, including consistent expectations, increased clarity and engagement in resident project ideas, and more projects meeting anticipated endpoints. The development and implementation of an RPAB have provided a framework to optimize the organization, progression, and outcomes of multiple pharmacy resident yearlong projects in all residency programs across our pharmacy enterprise. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. A Curriculum-Linked Professional Development Approach to Support Teachers' Adoption of Web GIS Tectonics Investigations

    ERIC Educational Resources Information Center

    Bodzin, Alec; Anastasio, David; Sahagian, Dork; Henry, Jill Burrows

    2016-01-01

    A curriculum-linked professional development approach designed to support middle level science teachers' understandings about tectonics and geospatial pedagogical content knowledge was developed. This approach takes into account limited face-to-face professional development time and instead provides pedagogical support within the design of a…

  19. A Curriculum-Linked Professional Development Approach to Support Teachers' Adoption of Web GIS Tectonics Investigations

    ERIC Educational Resources Information Center

    Bodzin, Alec; Anastasio, David; Sahagian, Dork; Henry, Jill Burrows

    2016-01-01

    A curriculum-linked professional development approach designed to support middle level science teachers' understandings about tectonics and geospatial pedagogical content knowledge was developed. This approach takes into account limited face-to-face professional development time and instead provides pedagogical support within the design of a…

  20. Human Resource Development Issues in the Implementation of the Western China Development Strategy

    ERIC Educational Resources Information Center

    Xiao, Mingzheng

    2007-01-01

    This paper systematically illustrates the value and role of human resource development in the implementation of the Western China development strategy. It analyzes in details some current human resource issues constraining the implementation of the Western China development strategy and those on the sustainable development process of economic…

  1. Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions

    PubMed Central

    Leeman, Jennifer; Calancie, Larissa; Kegler, Michelle C.; Escoffery, Cam T.; Herrmann, Alison K.; Thatcher, Esther; Hartman, Marieke A.; Fernandez, Maria

    2017-01-01

    Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts. PMID:26500080

  2. Developing Theory to Guide Building Practitioners' Capacity to Implement Evidence-Based Interventions.

    PubMed

    Leeman, Jennifer; Calancie, Larissa; Kegler, Michelle C; Escoffery, Cam T; Herrmann, Alison K; Thatcher, Esther; Hartman, Marieke A; Fernandez, Maria E

    2017-02-01

    Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners' capacity to adopt and implement a variety of EBIs across diverse practice contexts.

  3. Development and Validation of a Principal Implementation Practices Measure: The Principal Implementation Questionnaire

    PubMed Central

    Nettles, Stephen M.; Petscher, Yaacov

    2015-01-01

    Measurement of principal implementation behaviors has proved difficult to researchers in educational leadership due to a lack of consensus on the operational definitions of leadership constructs. The Principal Implementation Questionnaire (PIQ) was developed and validated with the intention of providing clarity in the assessment of principal leadership behaviors in the implementation of effective reading programs. Constructs were operationally defined within the context of the population of interest, with subsequent item writing centered around the constructs. A resulting calibration sample of principals from Florida Reading First schools was used to test the hypothesized measurement model to determine how well the items were described by the proposed factors. Results from LISREL analyses revealed a well-fitted model, based on numerous fit indices. PMID:26366043

  4. Teachers' perspective: Developing and implementing an sts curriculum

    NASA Astrophysics Data System (ADS)

    Mitchener, Carole P.; Anderson, Ronald D.

    This article explores science TEACHERS' perceptions of and consequent decisions about the development and implementation of a nontraditional science curriculum. It is a case-study analysis that examines the perceptions of 14 secondary teachers of a model science/technology/society (STS) curriculum designed to promote scientific literacy.Although the TEACHERS' decisions varied on whether to accept, alter, or reject the STS curriculum, they shared similar concerns about the development and implementation of this multidisciplinary curriculum. There existed a common set of five factors that the teachers believed to be critical, and that strongly affected their daily teaching decisions.This study offers insights into how science teachers perceive an STS curriculum, and the influence those perceptions have on their teaching decisions. It explores curricular issues from the frame of reference of teachers, the key factor in successfully implementing innovations.

  5. Disassociating Maturation and Language Development: Evidence from Internationally Adopted and Deaf Children

    ERIC Educational Resources Information Center

    Geren, Joy Celeste

    2010-01-01

    Typically language development in children closely coincides with development in many other areas. This makes it difficult to determine whether observed correlations are coincidental or causal in nature. The three studies presented here explore these relationships by looking at two populations of learners who are delayed in exposure to English,…

  6. Toward a Perspective on Workforce Preparation & Economic Development, Adopted Spring 2002.

    ERIC Educational Resources Information Center

    Academic Senate for California Community Colleges, Sacramento.

    Using a hierarchical legislative framework (federal, state, and local), this paper unfolds the chronologically circuitous path of policy development and its impact on organizational structures, funding streams, and timelines that are included in the workforce development system in California. The document provides a summary discussion of the…

  7. The Impact of Formal and Informal Professional Development Opportunities on Primary Teachers' Adoption of Interactive Whiteboards

    ERIC Educational Resources Information Center

    Lewin, Cathy; Scrimshaw, Peter; Somekh, Bridget; Haldane, Maureen

    2009-01-01

    This paper reports on the approaches undertaken to support the development of teachers' uses of interactive whiteboards in the Primary Schools Whiteboard Expansion project. Mixed methods were used to identify practices and staff perceptions about the extent and impact of professional development through surveys (initially from 528 schools),…

  8. Disassociating Maturation and Language Development: Evidence from Internationally Adopted and Deaf Children

    ERIC Educational Resources Information Center

    Geren, Joy Celeste

    2010-01-01

    Typically language development in children closely coincides with development in many other areas. This makes it difficult to determine whether observed correlations are coincidental or causal in nature. The three studies presented here explore these relationships by looking at two populations of learners who are delayed in exposure to English,…

  9. Vermont Hub-and-Spoke Model of Care for Opioid Use Disorder: Development, Implementation, and Impact.

    PubMed

    Brooklyn, John R; Sigmon, Stacey C

    Opioid use disorders (OUDs) are reaching epidemic proportions in the United States, and many geographic areas struggle with a persistent shortage in availability of opioid agonist treatment. Over the past 5 years, Vermont addiction medicine physicians and public health leaders have responded to these challenges by developing an integrated hub-and-spoke opioid treatment network. In the present report, we review the development, implementation, and impact of this novel hub-and-spoke model for expanding OUD treatment in Vermont. Vermont's hub-and-spoke system has been implemented state-wide and well-received by providers and patients alike. Adoption of this model has been associated with substantial increases in the state's OUD treatment capacity, with Vermont now having the highest capacity for treating OUD in the United States with 10.56 people in treatment per 1000. There has been a 64% increase in physicians waivered to prescribe buprenorphine, a 50% increase in patients served per waivered physician, and a robust bidirectional transfer of patients between hubs and spokes based upon clinical need. Challenges to system implementation and important future directions are discussed. Development and implementation of a hub-and-spoke system of care has contributed substantially to improvements in opioid agonist treatment capacity in Vermont. This system may serve as a model for other states grappling with the current opioid use epidemic.

  10. Development of allogeneic NK cell adoptive transfer therapy in metastatic melanoma patients: in vitro preclinical optimization studies.

    PubMed

    Besser, Michal J; Shoham, Tsipi; Harari-Steinberg, Orit; Zabari, Naama; Ortenberg, Rona; Yakirevitch, Arkadi; Nagler, Arnon; Loewenthal, Ron; Schachter, Jacob; Markel, Gal

    2013-01-01

    Natural killer (NK) cells have long been considered as potential agents for adoptive cell therapy for solid cancer patients. Until today most studies utilized autologous NK cells and yielded disappointing results. Here we analyze various modular strategies to employ allogeneic NK cells for adoptive cell transfer, including donor-recipient HLA-C mismatching, selective activation and induction of melanoma-recognizing lysis receptors, and co-administration of antibodies to elicit antibody-dependent cell cytotoxicity (ADCC). We show that NK cell activation and induction of the relevant lysis receptors, as well as co-administration of antibodies yield substantial anti-cancer effects, which are functionally superior to HLA-C mismatching. Combination of the various strategies yielded improved effects. In addition, we developed various clinically-compatible ex vivo expansion protocols that were optimized according to fold expansion, purity and expression of lysis receptors. The main advantages of employing allogeneic NK cells are accessibility, the ability to use a single donor for many patients, combination with various strategies associated with the mechanism of action, e.g. antibodies and specific activation, as well as donor selection according to HLA or CD16 genotypes. This study rationalizes a clinical trial that combines adoptive transfer of highly potent allogeneic NK cells and antibody therapy.

  11. Adoption of new health products in low and middle income settings: how product development partnerships can support country decision making.

    PubMed

    Wells, William A; Brooks, Alan

    2011-03-31

    When a new health product becomes available, countries have a choice to adopt the product into their national health systems or to pursue an alternate strategy to address the public health problem. Here, we describe the role for product development partnerships (PDPs) in supporting this decision-making process. PDPs are focused on developing new products to respond to health problems prevalent in low and middle income settings. The impact of these products within public sector health systems can only be realized after a country policy process. PDPs may be the organizations most familiar with the evidence which assists decision making, and this generally translates into involvement in international policy development, but PDPs have limited reach into endemic countries. In a few individual countries, there may be more extensive involvement in tracking adoption activities and generating local evidence. This local PDP involvement begins with geographical prioritization based on disease burden, relationships established during clinical trials, PDP in-country resources, and other factors. Strategies adopted by PDPs to establish a presence in endemic countries vary from the opening of country offices to engagement of part-time consultants or with long-term or ad hoc committees. Once a PDP commits to support country decision making, the approaches vary, but include country consultations, regional meetings, formation of regional, product-specific committees, support of in-country advocates, development of decision-making frameworks, provision of technical assistance to aid therapeutic or diagnostic guideline revision, and conduct of stakeholder and Phase 4 studies. To reach large numbers of countries, the formation of partnerships, particularly with WHO, are essential. At this early stage, impact data are limited. But available evidence suggests PDPs can and do play an important catalytic role in their support of country decision making in a number of target countries.

  12. Adoption of new health products in low and middle income settings: how product development partnerships can support country decision making

    PubMed Central

    2011-01-01

    When a new health product becomes available, countries have a choice to adopt the product into their national health systems or to pursue an alternate strategy to address the public health problem. Here, we describe the role for product development partnerships (PDPs) in supporting this decision-making process. PDPs are focused on developing new products to respond to health problems prevalent in low and middle income settings. The impact of these products within public sector health systems can only be realized after a country policy process. PDPs may be the organizations most familiar with the evidence which assists decision making, and this generally translates into involvement in international policy development, but PDPs have limited reach into endemic countries. In a few individual countries, there may be more extensive involvement in tracking adoption activities and generating local evidence. This local PDP involvement begins with geographical prioritization based on disease burden, relationships established during clinical trials, PDP in-country resources, and other factors. Strategies adopted by PDPs to establish a presence in endemic countries vary from the opening of country offices to engagement of part-time consultants or with long-term or ad hoc committees. Once a PDP commits to support country decision making, the approaches vary, but include country consultations, regional meetings, formation of regional, product-specific committees, support of in-country advocates, development of decision-making frameworks, provision of technical assistance to aid therapeutic or diagnostic guideline revision, and conduct of stakeholder and Phase 4 studies. To reach large numbers of countries, the formation of partnerships, particularly with WHO, are essential. At this early stage, impact data are limited. But available evidence suggests PDPs can and do play an important catalytic role in their support of country decision making in a number of target countries. PMID

  13. Preferral Antibiotic Treatment Policy to be adopted in the 'Integrated Management of Childhood Illness Strategy in all 
the Developing Countries?

    PubMed

    Al-Fannah, Fannah; Khandekar, Rajiv; Kurup, Padmamohan; Shah, Samir

    2009-10-01

    To review the rationale and practice for the use of single dose antibiotics in 'children below five years' as pre-referral treatment in the emergency triage and treatment protocol of IMCI in the developing countries and also, to assess the available evidence on the suitability of adopting the use of pre-referral antibiotic treatment as a standard strategy of Emergency Triage and Treatment (ETAT) in "Integrated Management of Childhood Illnesses" (IMCI) for all developing countries. Scientific, reliable information from the international articles (published and unpublished) were collected. A series of Medline search with key words were performed. Opinions of epidemiologists, public health officers and researchers University Alumni and senior health officials of some developing countries were included in this review. Indirect evidence regarding for or against adopting pre-referral antibiotic treatment were found in developing countries where IMCI was implemented. It was also noted that the efficiency ranking based on the health system performance correlated negatively with the per capita income (r=-0.7, p=<0.001) and the per capita health expenditure. (r=-0.6, p=0.001). The gap between mortality rates of the '<1' and '1 to 4' years age groups was narrower in countries such as Oman and Argentina compared to the other developing countries. While the doctor population ratio was higher in countries with better efficiency rankings, (r=-0.66, p=0.01). The differences found within the developing world indicate that the use of pre-referral antibiotic is certainly open to modification depending on the resources and health system performance.

  14. Development and Implementation of a Pilot Middle School Guidance Program.

    ERIC Educational Resources Information Center

    Jones, Charles A.

    This practicum report describes the development and implementation of a comprehensive pilot middle school guidance program. Staff members reviewed the literature on middle schools in general and guidance programs in specific, explored programs in operation throughout the state of California, and consulted with members from the State Department of…

  15. Typical School Personnel Developing and Implementing Basic Behavior Support Plans

    ERIC Educational Resources Information Center

    Strickland-Cohen, M. Kathleen; Horner, Robert H.

    2015-01-01

    We evaluated the ability of typical school personnel with basic behavioral training to develop and implement function-based supports for students with mild to moderate problem behaviors. Descriptive results indicated that following four 1-hr training sessions, 13 participants were able to (a) identify interventions that were and were not…

  16. Professional Development. State Implementation of Common Core State Standards

    ERIC Educational Resources Information Center

    Anderson, Kimberly; Mira, Mary Elizabeth

    2014-01-01

    The following profiles address how the state departments of education are helping educators prepare for and implement the Common Core and aligned assessments through professional learning. The major professional development efforts around the Common Core were examined in order to understand the overall efforts of each state. An exhaustive list of…

  17. Development and Implementation of a Bus Driver Training Program.

    ERIC Educational Resources Information Center

    Buchovecky, John G.

    A bus driver training program was developed and implemented in a rural school district in an effort to improve the driving skills of the bus drivers. The program was tailored to meet the needs of the bus drivers and utilized various community agencies for demonstration and teaching purposes. The subject areas included in the program were driver…

  18. Development and Implementation of an Administrative Internship Program

    ERIC Educational Resources Information Center

    Wermuth, Esther; Quezada, Edwin M.

    2017-01-01

    This article describes the development and implementation of a pilot program to prepare teachers seeking New York state certification as school district administrators, by assigning them as administrative interns to a school district. The superintendent of a large urban school district and the director of a college program to prepare school…

  19. Appreciative Inquiry and Implementation Science in Leadership Development.

    PubMed

    Bleich, Michael R; Hessler, Christine

    2016-05-01

    Appreciative inquiry was developed to initiate and animate change. As implementation science gains a foothold in practice settings to bridge theory, evidence, and practice, appreciative inquiry takes on new meaning as a leadership intervention and training tool. J Contin Educ Nurs. 2016;47(5):207-209. Copyright 2016, SLACK Incorporated.

  20. Typical School Personnel Developing and Implementing Basic Behavior Support Plans

    ERIC Educational Resources Information Center

    Strickland-Cohen, M. Kathleen; Horner, Robert H.

    2015-01-01

    We evaluated the ability of typical school personnel with basic behavioral training to develop and implement function-based supports for students with mild to moderate problem behaviors. Descriptive results indicated that following four 1-hr training sessions, 13 participants were able to (a) identify interventions that were and were not…

  1. Implementing a Collaborative Model of Action Research for Teacher Development

    ERIC Educational Resources Information Center

    Angelides, Panayiotis; Evangelou, Maria; Leigh, James

    2005-01-01

    In this article the authors develop and implement a collaborative model of action research. An academic and a teacher collaborate with the purpose of improving the teaching practice and the teaching abilities of the teacher in mixed ability classes, and the collaborative ability of both academic and teacher. After a year of collaboration certain…

  2. American Indian Breast Cancer Project: Educational Development and Implementation.

    ERIC Educational Resources Information Center

    Hodge, Felicia Schanche; Casken, John

    1999-01-01

    Describes the development, implementation, and evaluation of Pathways to Health, a breast cancer education program targeting American Indian women in California. Discusses initial focus group results concerning belief in breast cancer risk, barriers to cancer screening and treatment, culturally sensitive issues, and illness beliefs. Describes…

  3. School Development Program Effects: Linking Implementation to Outcomes.

    ERIC Educational Resources Information Center

    Haynes, Norris M.; Emmons, Christine L.; Woodruff, Darren W.

    1998-01-01

    The effects of the School Development Program (SDP) of James Comer on a variety of student outcomes are reviewed in this summary of previous evaluations in SDP schools. Assessments of the quality of SDP implementation in schools in New York (New York), Washington (District of Columbia), and New Haven (Connecticut) are considered. (SLD)

  4. Developing and Implementing a Computerized SDI Service for Educational Administrators.

    ERIC Educational Resources Information Center

    Sanders, Jean E.

    This practicum report describes the development and implementation of an SDI (Selective Dissemination of Information) system for administrators. The purpose of the SDI system was to provide current and economical retrieval and dissemination of the published educational literature in order to encourage educational improvements. Practicum procedures…

  5. Implementing Ethics Policies in Developing Countries: Ploughing on Parched Ground?

    ERIC Educational Resources Information Center

    Mazonde, Isaac N.; Jackson-Malete, Jose; Sugarman, Jeremy

    2007-01-01

    It is globally expected that universities will ensure that policies guiding researchers' conduct are in place and adhered to. This expectation is not waived in developing countries. Successful implementation of an ethics policy is facilitated by an appropriate national regulatory framework on which to base the argument for compliance. However, it…

  6. Developing and Implementing an Assessment Technique to Measure Linked Concepts

    ERIC Educational Resources Information Center

    Ye, Li; Oueini, Razanne; Lewis, Scott E.

    2015-01-01

    The links students make among chemistry content is considered essential for a robust, enduring understanding in multiple learning theories. This article describes the development and implementation of an assessment technique, termed a Measure of Linked Concepts, designed to inform instructors on students' understanding of linking content…

  7. Recommendations for implementing telemedicine in the developing world.

    PubMed

    Alajmi, Dana; Almansour, Shaima; Househ, Mowafa S

    2013-01-01

    Telemedicine is a tool used to deliver health care from a distance. Developing countries can benefit from telemedicine because these countries face such issues as a lack of specialists and medical infrastructure. Telemedicine in the developing world can offer solutions to healthcare access for people in rural areas, reduce healthcare costs, and possibly improve healthcare quality. A major benefit for patients is that they will be more involved in maintaining their health without the constant need to visit healthcare centers. The purpose of this paper is to provide solutions and recommendations for the implementation of telemedicine in the developing world. A comprehensive search of both academic and gray literature was conducted in September 2012. The results show that there are potential benefits of and challenges in the implementation of telemedicine in developing countries. How to overcome the key challenges related to financial issues, acceptance, health infrastructure, and legal and privacy issues is discussed.

  8. Challenges and Potential Solutions for Big Data Implementations in Developing Countries

    PubMed Central

    Mayan, J.C; García, M.J.; Almerares, A.A.; Househ, M.

    2014-01-01

    Summary Background The volume of data, the velocity with which they are generated, and their variety and lack of structure hinder their use. This creates the need to change the way information is captured, stored, processed, and analyzed, leading to the paradigm shift called Big Data. Objectives To describe the challenges and possible solutions for developing countries when implementing Big Data projects in the health sector. Methods A non-systematic review of the literature was performed in PubMed and Google Scholar. The following keywords were used: “big data”, “developing countries”, “data mining”, “health information systems”, and “computing methodologies”. A thematic review of selected articles was performed. Results There are challenges when implementing any Big Data program including exponential growth of data, special infrastructure needs, need for a trained workforce, need to agree on interoperability standards, privacy and security issues, and the need to include people, processes, and policies to ensure their adoption. Developing countries have particular characteristics that hinder further development of these projects. Conclusions The advent of Big Data promises great opportunities for the healthcare field. In this article, we attempt to describe the challenges developing countries would face and enumerate the options to be used to achieve successful implementations of Big Data programs. PMID:25123719

  9. Challenges and potential solutions for big data implementations in developing countries.

    PubMed

    Luna, D; Mayan, J C; García, M J; Almerares, A A; Househ, M

    2014-08-15

    The volume of data, the velocity with which they are generated, and their variety and lack of structure hinder their use. This creates the need to change the way information is captured, stored, processed, and analyzed, leading to the paradigm shift called Big Data. To describe the challenges and possible solutions for developing countries when implementing Big Data projects in the health sector. A non-systematic review of the literature was performed in PubMed and Google Scholar. The following keywords were used: "big data", "developing countries", "data mining", "health information systems", and "computing methodologies". A thematic review of selected articles was performed. There are challenges when implementing any Big Data program including exponential growth of data, special infrastructure needs, need for a trained workforce, need to agree on interoperability standards, privacy and security issues, and the need to include people, processes, and policies to ensure their adoption. Developing countries have particular characteristics that hinder further development of these projects. The advent of Big Data promises great opportunities for the healthcare field. In this article, we attempt to describe the challenges developing countries would face and enumerate the options to be used to achieve successful implementations of Big Data programs.

  10. Assisting adoptive families: children adopted at older ages.

    PubMed

    Singer, Ellen; Krebs, Madeleine

    2008-01-01

    Understanding the adoption experience can help health care providers develop sensitivity to the special tasks of adopted children and their families. Children who are adopted at older ages may face particular challenges. Age at adoptive placement, the burden of loss, pre-adoptive experiences, and the challenge of attachment are all significant issues in older-child adoption. Pediatric nurses demonstrate sensitivity and support to adopted children and their families by using appropriate language about adoption; understanding the significance of missing health information; providing appropriate referrals as needed; and displaying an open, caring attitude.

  11. Standard Review Plan Update and Development Program. Implementing Procedures Document

    SciTech Connect

    Not Available

    1992-05-01

    This implementing procedures document (IPD) was prepared for use in implementing tasks under the standard review plan update and development program (SRP-UDP). The IPD provides comprehensive guidance and detailed procedures for SRP-UDP tasks. The IPD is mandatory for contractors performing work for the SRP-UDP. It is guidance for the staff. At the completion of the SRP-UDP, the IPD will be revised (to remove the UDP aspects) and will replace NRR Office Letter No. 800 as long-term maintenance procedures.

  12. Review on development and community implementation of oral rehydration therapy.

    PubMed

    Sengupta, P G; Mondal, S K; Ghosh, S; Gupta, D N; Sikder, S N; Sircar, B K

    1994-01-01

    The review of the current status and implementation of Oral Rehydration Therapy at the community level have been presented in this communication with special emphasis on its development, ORS access rate, ORS use rate and home available fluids. The global ORS supply has gone up an increased eleven folds since 1981. Similarly the ORS access rate has also increase from 46% to 68% in 1991. However, the global ORS use rate was low (21%). The major constraints during ORT implementation which have been reported by several scientists are also discussed.

  13. The Development, Endorsement and Adoption of a National Standard for Principals in Australia

    ERIC Educational Resources Information Center

    Dinham, Stephen; Collarbone, Patricia; Evans, Margery; Mackay, Anthony

    2013-01-01

    Principals play key roles in creating the conditions in which teachers can teach effectively and students can learn. Principals are increasingly being held accountable both for teacher quality and for student learning and development so that young people can become 'successful learners, confident and creative individuals and active and informed…

  14. Designing for Sustained Adoption: A Model of Developing Educational Innovations for Successful Propagation

    ERIC Educational Resources Information Center

    Khatri, Raina; Henderson, Charles; Cole, Renée; Froyd, Jeffrey E.; Friedrichsen, Debra; Stanford, Courtney

    2016-01-01

    The physics education research community has produced a wealth of knowledge about effective teaching and learning of college level physics. Based on this knowledge, many research-proven instructional strategies and teaching materials have been developed and are currently available to instructors. Unfortunately, these intensive research and…

  15. An Examination of Three Theories of Sex Role Development in a Sample of Adoptive Parents.

    ERIC Educational Resources Information Center

    Travis, Cheryl; Francis, Becky

    The purpose of the present study was to assess the explanatory powers of three theories of sex role development: secondary reinforcement through parental nurturance; instrumental conditioning by dating partners; and social learning through observations of outcomes for mothers. Subjects' responses to questionnaire items were utilized to measure the…

  16. The Multiple Roles that Youth Development Program Leaders Adopt with Youth

    ERIC Educational Resources Information Center

    Walker, Kathrin C.

    2011-01-01

    The roles that program leaders establish in their relationships with youth structure how leaders are able to foster youth development. This article examines the complex roles program leaders create in youth programs and investigates how they balanced multiple roles to most effectively respond to the youth they serve. Analyses of qualitative data…

  17. Teaching the Very Able Child: Developing a Policy and Adopting Strategies for Provision.

    ERIC Educational Resources Information Center

    Wallace, Belle

    This guide is intended to provide guidelines, from a British perspective, for group discussion of issues relevant to developing a school policy to meet the needs of students who are very able. The guide utilizes short case studies and a series of mindmaps to illustrate issues and highlight key planning and decision-making points. The guide begins…

  18. The Adaptation and Adoption of Research and Development Products for Institutionalization of Change.

    ERIC Educational Resources Information Center

    Bergman, Wayne; Quirk, William

    The field-based masters degree program at Emporia State University was designed to meet the needs of fully employed teachers and supervisors. The curriculum materials and delivery system sought to address the following research-based needs: (1) create an ongoing organizational policy making structure; (2) develop a method of shared decision making…

  19. Designing for Sustained Adoption: A Model of Developing Educational Innovations for Successful Propagation

    ERIC Educational Resources Information Center

    Khatri, Raina; Henderson, Charles; Cole, Renée; Froyd, Jeffrey E.; Friedrichsen, Debra; Stanford, Courtney

    2016-01-01

    The physics education research community has produced a wealth of knowledge about effective teaching and learning of college level physics. Based on this knowledge, many research-proven instructional strategies and teaching materials have been developed and are currently available to instructors. Unfortunately, these intensive research and…

  20. Strategy development for the implementation of telenursing in Korea.

    PubMed

    Yun, Eun Kyoung; Park, Hyeoun-Ae

    2007-01-01

    This study aimed to evaluate the feasibility of telenursing, to analyze the issues that should be considered for the development of telenursing in the future, and to provide efficient strategies for the implementation of telenursing in Korea. The authors used the Delphi survey method and a strengths, weaknesses, opportunities, and threats analysis. A total of 30 experts and specialists in the field of nursing informatics and telemedicine contributed to a three-round Delphi survey. The results of the study suggest that telenursing can potentially be implemented in Korea. However, to implement telenursing in Korea, it is necessary to identify telenursing specialties, to construct an infrastructure within which telenursing can function, to develop a business model, and to integrate strategies with government plans to develop the e-health industry. The issues that emerged as important requirements for the successful introduction of telenursing were classified as systematic, economic, societal, or technical. Issues such as driving force, target market, and expense sharing were examined in detail from both ideal and realistic points of view. The results of this study will enable health professionals to appreciate the feasibility of implementing telenursing in Korea. In addition, the study suggests that telenursing could be used efficiently in a variety of environments as a practical strategy to improve healthcare in Korea.

  1. Development of framework for sustainable Lean implementation: an ISM approach

    NASA Astrophysics Data System (ADS)

    Jadhav, Jagdish Rajaram; Mantha, S. S.; Rane, Santosh B.

    2014-07-01

    The survival of any organization depends upon its competitive edge. Even though Lean is one of the most powerful quality improvement methodologies, nearly two-thirds of the Lean implementations results in failures and less than one-fifth of those implemented have sustained results. One of the most significant tasks of top management is to identify, understand and deploy the significant Lean practices like quality circle, Kanban, Just-in-time purchasing, etc. The term `bundle' is used to make groups of inter-related and internally consistent Lean practices. Eight significant Lean practice bundles have been identified based on literature reviewed and opinion of the experts. The order of execution of Lean practice bundles is very important. Lean practitioners must be able to understand the interrelationship between these practice bundles. The objective of this paper is to develop framework for sustainable Lean implementation using interpretive structural modelling approach.

  2. In situ vitrification model development and implementation plan

    SciTech Connect

    MacKinnon, R.J.; Murray, P.E.; Johnson, R.W.; Hagrman, D.L.; Slater, C.E.; Marwil, E.S.

    1990-08-01

    This document describes the In Situ Vitrification (ISV) Analysis Package being developed at the INEL to provide analytical support for (ISV) safety analysis and treatment performance predictions. Mathematical models and features which comprise this analysis package are presented and the proposed approach to model development and implementation is outlined. The objective of this document is two fold: to define preliminary design information and modeling objectives so that ISV modeling personnel can effectively modify existing models and formulate new models which are consistent with the objectives of the ISV treatability study and to provide sufficient technical information for internal and external reviewers to detect any shortcomings in model development and implementation plans. 27 refs., 17 figs., 3 tabs.

  3. The dynamics of de-adoption: a case study of policy change, de-adoption, and replacement of an evidence-based HIV intervention.

    PubMed

    McKay, Virginia R; Margaret Dolcini, M; Hoffer, Lee D

    2017-04-10

    Evidence-based intervention (EBI) de-adoption and its influence on public health organizations are largely unexplored within public health implementation research. However, a recent shift in support for HIV prevention EBIs by the Centers for Disease Control and Prevention provides an opportunity to explore EBI de-adoption. The current mixed-method study examines EBI de-adoption and the subsequent impact on a community-based organization (CBO) dedicated to HIV prevention. We conducted a case study with a CBO implementing RESPECT, an HIV prevention EBI, over 5 years (2010-2014), but then de-adopted the intervention. We collected archival data documenting RESPECT implementation and conducted two semi-structured interviews with RESPECT staff (N = 5). Using Fixsen and colleagues' implementation framework, we developed a narrative of RESPECT implementation, delivery, and de-adoption and a thematic analysis to understand additional consequences of RESPECT de-adoption. Discontinuation of RESPECT activities unfolded in a process over time, requiring effort by RESPECT staff. RESPECT de-adoption had wide-reaching influences on individual staff, interactions between the staff and the community, the agency overall, and for implementation of future EBIs. We propose a revision of the implementation framework, incorporating EBI de-adoption as a phase of the implementation cycle. Furthermore, EBI de-adoption may have important, unintended consequences and can inform future HIV prevention strategies and guide research focusing on EBI de-adoption.

  4. A framework for implementing systems engineering development of complex systems

    NASA Astrophysics Data System (ADS)

    Brunson, Karl Leonard

    The Department of Defense and the aerospace industry are responsible for decades of successful implementation of systems engineering process models used for the development of complex systems. The process models implemented throughout acquisition life cycles have proven to be comprehensive and flexible, and hence are designed to reduce acquisition schedule variability and the inherent risks of life-cycle cost overruns. While implementing the appropriate process model is important, various process models do not evaluate and quantify potential technical, manufacturing, scheduling and cost risks that may impact acquisition activities throughout the acquisition life cycle of the complex system. A potential way to effectively manage these risks with the appropriate process model is through the incorporation of the Synthesized Framework , the proposed method developed in this dissertation. With the described Synthesized Framework (SF), process models and risk drivers can be analyzed using this comprehensive approach, which implements qualitative and quantitative risk analysis techniques through Monte Carlo simulation. The result is a repeatable, inherent, risk-driven commitment process that can stabilize and synchronize both systems engineering and acquisition processes.

  5. Subsidized Adoption in America.

    ERIC Educational Resources Information Center

    Gallagher, Ursula; Katz, Sanford N.

    The Model State Subsidized Adoption Act, developed to supplement existing state statutes, is presented in full, with accompanying Model Regulations. The act is designed to help provide a child in special circumstances with a permanent adoptive home. When efforts to achieve placement without subsidy have failed, the Act would provide that the child…

  6. IS0 9000 Implementation and Assessment: A Guide to Developing and Evaluating Quality Management Systems

    NASA Technical Reports Server (NTRS)

    Navarro, Robert J.; Grimm, Barry

    1996-01-01

    The agency has developed this reference publication to aid NASA organizations and their suppliers in the transition to IS0 9000. This guide focuses on the standard s intent, clarifies its requirements, offers implementation examples and highlights interrelated areas. It can assist anyone developing or evaluating NASA or supplier quality management systems. The IS0 9000 standards contain the basic elements for managing those processes that affect an organization's ability to consistently meet customer requirements. IS0 9000 was developed through the International Organization for Standardization and has been adopted as the US. national standard. These standards define a flexible foundation for customer focused process measurement, management and improvement that is the hallmark of world class enterprises.

  7. Development, evaluation and implementation of video-EEG telemetry at home.

    PubMed

    Brunnhuber, Franz; Amin, Devyani; Nguyen, Yan; Goyal, Sushma; Richardson, Mark P

    2014-05-01

    To describe the development and implementation of video EEG telemetry (VT) in the patient's home (home video telemetry, HVT) in a single centre. HVT met the UK Medical Research Council definition of a complex intervention, and we used its guidance to evaluate the process of piloting, evaluating, developing and implementing this new clinical service. The first phase was a feasibility study, comparing inpatient VT (IVT) with HVT in a test-retest design (n=5), to assess data quality and yield of clinically relevant events. The second phase was a pre-implementation study (n=8), to examine acceptability and satisfaction as well as the costs of IVT and HVT. Subsequently, we implemented the service, and reviewed the outcomes of the first 34 patients. The feasibility study found no difference in the quality of recording or clinical yield between IVT and HVT. The pre-implementation study showed excellent patient satisfaction. We also discuss the findings of the main stakeholder survey (consultants and technicians). Our economic modelling demonstrates a clear financial superiority of HVT over IVT. Our findings show that diagnostic HVT for seizure classification and polysomnographies can be carried out safely in the patients' home and poses no security risks for staff. HVT can be effectively integrated into an existing tertiary care service as a routine home or community-based procedure. We hope to encourage other clinical neurophysiology departments and epilepsy centres to take advantage of our experience and consider adopting and implementing HVT, with the aim of a nationwide coverage. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  8. Design of Complete Dentures by Adopting CAD Developed for Fixed Prostheses.

    PubMed

    Li, Yanfeng; Han, Weili; Cao, Jing; Iv, Yuan; Zhang, Yue; Han, Yishi; Shen, Yi; Ma, Zheng; Liu, Huanyue

    2016-11-21

    The demand for complete dentures is expected to increase worldwide, but complete dentures are mainly designed and fabricated manually involving a broad series of clinical and laboratory procedures. Therefore, the quality of complete dentures largely depends on the skills of the dentist and technician, leading to difficulty in quality control. Computer-aided design and manufacturing (CAD/CAM) has been used to design and fabricate various dental restorations including dental inlays, veneers, crowns, partial crowns, and fixed partial dentures (FPDs). It has been envisioned that the application of CAD/CAM technology could reduce intensive clinical/laboratory work for the fabrication of complete dentures; however, CAD/CAM is seldom used to fabricate complete dentures due to the lack of suitable CAD software to design virtual complete dentures although the CAM techniques are in a much advanced stage. Here we report the successful design of virtual complete dentures using CAD software of 3Shape Dental System 2012, which was developed for designing fixed prostheses instead of complete dentures. Our results demonstrated that complete dentures could be successfully designed by the combination of two modeling processes, single coping and full anatomical FPD, available in the 3Shape Dental System 2012. © 2016 by the American College of Prosthodontists.

  9. Implementing a nursing systems framework in a developing country.

    PubMed

    Cannaby, A M; Gkantaras, I; Finn, A; Foreman, B; Butler, G; Topping, A; Gray, R

    2017-09-01

    To test the effect on patient mortality of implementing a nursing systems framework across a national health system. There have been five previous observational studies that have tested the effect of a nursing systems framework on clinical outcomes for patients. Implementation of a nursing systems framework in the health system of a developing country has not been evaluated. Quasi-experimental (before and after) study. A nursing systems framework consisting of six themes: (i) Professionalisation; (ii) Education; (iii) Structure; (iv) Quality of nursing care; (v) An academic health system; and (vi) Communication (Professional), was implemented across the national health system of Qatar in March 2015. Routine administrative data were extracted (March 2014-February 2016) for elective admissions. Our primary and secondary outcomes were, respectively, all cause mortality at discharge and readmission to hospital (within 28 days of discharge). We split the data into two time periods: before (March 2014-February 2015) and after (March 2015-February 2016) the implementation of the nursing systems framework. Multivariable regression modelling was used to examine the effect of the framework on patient mortality, after adjusting for key confounding variables (patient age, episode acuity, intensive care admission and length of stay). Data were extracted for 318 548 patients (year 1 = 130 829; year 2 = 187 725). After adjusting for confounding, there was a significant association between the implementation of the nursing systems framework, mortality and readmission. Our observations suggest that the implementation of a nursing systems framework may be important in improving outcomes for patients in emerging health systems. © 2017 International Council of Nurses.

  10. Development of a Survey to Explore Factors Influencing the Adoption of Best Practices for Diabetic Foot Ulcer Offloading.

    PubMed

    Bleau Lavigne, Maude; Reeves, Isabelle; Sasseville, Marie-Josée; Loignon, Christine

    The primary purpose of this study was to develop 2 survey tools to explore factors influencing adoption of best practices for diabetic foot ulcer offloading treatment in primary health care settings. One survey was intended for the patients receiving care for a diabetic foot ulcer in primary health care settings and the other was intended for the health professionals providing treatment. The second purpose of this study was to evaluate the psychometric properties of the 2 surveys. Development and validation of survey instruments. Two surveys were developed using a published guide. Following review of pertinent literature and identification of variables to be measured, a bank of items was developed and pretested to determine clarity of the item and responses. Psychometric testing comprised measurement of content validity index (CVI) and intraclass correlation coefficient (ICC). Only items obtaining satisfactory CVI and ICC scores were included in the final version of the surveys. The final version of the patient survey contained 41 items and the final version of the survey for health care professionals contained 21 items. The patient-intended survey's items demonstrate high content validity scores and satisfactory test-retest reliability scores. The overall CVI score was 0.98. Forty of the 49 items eligible for testing obtain satisfactory ICC scores. One item's test-retest reliability could not be tested but it was retained based on its high CVI. The health professional-intended survey, an overall CVI score of 0.91 but items had lower ICC scores (63%, 31 of the 49 items), did not achieve a satisfactory ICC score for inclusion in the final instrument. This project led to development of 2 instruments designed to identify and explore factors influencing adoption of best practices for diabetic foot ulcer offloading treatment in the primary health care setting. Future research and testing is required to translate these French surveys into English and additional languages

  11. Development and implementation of custom root-cause systems

    SciTech Connect

    Paradies, M.; Unger, L.

    1990-06-01

    Almost anyone investigating an operating problem can expect their management and the US Nuclear Regulatory Commission (NRC) to ask them if they have really uncovered the root cause of the event. This paper outlines a proven method to develop a custom system to identify and analyze the root causes of events. The method has led to the successful implementation of root-cause analysis systems at the Savannah River Plant and at Philadelphia Electric's Peach Bottom and Limerick nuclear generating stations. The methods are currently being used by System Improvements to develop a root-cause system to be used by the NRC to identify human performance problems at utilities. This paper also outlines the common problems that may be encountered when implementing a root-cause program.

  12. A work force model to support the adoption of best practice care in chronic diseases – a missing piece in clinical guideline implementation

    PubMed Central

    Segal, Leonie; Dalziel, Kim; Bolton, Tom

    2008-01-01

    The development and implementation of an evidence-based approach to health workforce planning is a necessary step to achieve access to best practice chronic disease management. In its absence, the widely reported failure in implementation of clinical best practice guidelines is almost certain to continue. This paper describes a demand model to estimate the community-based primary care health workforce consistent with the delivery of best practice chronic disease management and prevention. The model takes a geographic region as the planning frame and combines data about the health status of the regional population by disease category and stage, with best practice guidelines to estimate the clinical skill requirement or competencies for the region. The translation of the skill requirement into a service requirement can then be modelled, incorporating various assumptions about the occupation group to deliver nominated competencies. The service requirement, when compared with current service delivery, defines the gap or surplus in services. The results of the model could be used to inform service delivery as well as a workforce supply strategy. PMID:18559116

  13. Local collaborations: development and implementation of Boston's bioterrorism surveillance system.

    PubMed

    McKenna, Verna B; Gunn, Julia E; Auerbach, John; Brinsfield, Kathryn H; Dyer, K Sophia; Barry, M Anita

    2003-01-01

    The Boston Public Health Commission developed and implemented an active surveillance system for bioterrorism and other infectious disease emergencies. A bioterrorism Surveillance Task Force was formed with representatives from local emergency medicine, infection control, infectious diseases, public health, and emergency medical services. These local agencies worked together to develop a reliable, easy to use electronic surveillance system. Collaboration at the local level and building on existing relationships is a key component of this system. Effective follow-up systems and technology back-up plans are essential. Improved communication networks and increased bioterrorism education for clinicians and the general public have also been achieved.

  14. Photovoltaic module certification/laboratory accreditation criteria development: Implementation handbook

    SciTech Connect

    Osterwald, C.R.; Hammond, R.L.; Wood, B.D.; Backus, C.E.; Sears, R.L.; Zerlaut, G.A.; D`Aiello, R.V.

    1996-08-01

    This document covers the second phase of a two-part program. Phase I provided an overview of the structure and function of typical product certification/laboratory accreditation programs. This report (Phase H) provides most of the draft documents that will be necessary for the implementation of a photovoltaic (PV) module certification/laboratory accreditation program. These include organizational documents such as articles of incorporation, bylaws, and rules of procedure, as well as marketing and educational program documents. In Phase I, a 30-member criteria development committee was established to guide, review and reach a majority consensus regarding criteria for a PV certification/laboratory accreditation program. Committee members represented PV manufacturers, end users, standards and codes organizations, and testing laboratories. A similar committee was established for Phase II; the criteria implementation committee consisted of 29 members. Twenty-one of the Phase I committee members also served on the Phase II committee, which helped to provide program continuity during Phase II.

  15. The clinical adoption meta-model: a temporal meta-model describing the clinical adoption of health information systems

    PubMed Central

    2014-01-01

    Health information systems (HISs) hold the promise to transform health care; however, their adoption is challenged. We have developed the Clinical Adoption Meta-Model (CAMM) to help describe processes and possible challenges with clinical adoption. The CAMM, developed through an action research study to evaluate a provincial HIS, is a temporal model with four dimensions: availability, use, behaviour changes, and outcome changes. Seven CAMM archetypes are described, illustrating classic trajectories of adoption of HISs over time. Each archetype includes an example from the literature. The CAMM and its archetypes can support HIS implementers, evaluators, learners, and researchers. PMID:24884588

  16. Intention to adopt clinical decision support systems in a developing country: effect of Physician’s perceived professional autonomy, involvement and belief: a cross-sectional study

    PubMed Central

    2012-01-01

    Background Computer-based clinical decision support systems (CDSS) are regarded as a key element to enhance decision-making in a healthcare environment to improve the quality of medical care delivery. The concern of having new CDSS unused is still one of the biggest issues in developing countries for the developers and implementers of clinical IT systems. The main objectives of this study are to determine whether (1) the physician’s perceived professional autonomy, (2) involvement in the decision to implement CDSS and (3) the belief that CDSS will improve job performance increase the intention to adopt CDSS. Four hypotheses were formulated and tested. Methods A questionnaire-based survey conducted between July 2010 and December 2010. The study was conducted in seven public and five private hospitals in Kuala Lumpur, Malaysia. Before contacting the hospitals, necessary permission was obtained from the Ministry of Health, Malaysia and the questionnaire was vetted by the ethics committee of the ministry. Physicians working in 12 hospitals from 10 different specialties participated in the study. The sampling method used was stratified random sampling and the physicians were stratified based on the specialty. A total of 450 physicians were selected using a random number generator. Each of these physicians was given a questionnaire and out of 450 questionnaires, 335 (response rate – 74%) were returned and 309 (69%) were deemed usable. Results The hypotheses were tested using Structural Equation Modeling (SEM). Salient results are: (1) Physicians’ perceived threat to professional autonomy lowers the intention to use CDSS (p < 0.01); (2) Physicians involvement in the planning, design and implementation increases their intention to use CDSS (p < 0.01); (3) Physicians belief that the new CDSS will improve his/her job performance increases their intention to use CDSS (p < 0.01). Conclusion The proposed model with the three main constructs (physician’s professional

  17. Teachers' Self-Directed Professional Development: Science and Mathematics Teachers' Adoption of ICT as a Professional Development Strategy

    ERIC Educational Resources Information Center

    Mushayikwa, Emmanuel

    2013-01-01

    This paper is part of a larger study that was carried out to investigate the use of Information and Communication Technology (ICT) in the self-directed professional development on the self-directed professional development (SDPD) of mathematics and science teachers in Zimbabwe. The educational context provides an example of how teachers…

  18. Women Education and Economic Development in Kenya: Implications for Curriculum Development and Implementation Processes

    ERIC Educational Resources Information Center

    Syomwene, Anne; Kindiki, Jonah Nyaga

    2015-01-01

    This paper is a discussion of the relationship between women education and sustainable economic development in Kenya and its implications for curriculum development and implementation processes. The argument advanced in this paper is that the solution to the development problems in Kenya and other developing nations lies on women education.…

  19. Legacy of implementing industrial health and safety in developing countries.

    PubMed

    Ahasan, R

    2001-11-01

    Aiming to develop public attention to the hindrance of national and international efforts on industrial health and safety, this paper explores some important issues, such as the reasons for the lack of motivation to implement necessary measures in developing countries. Examples are likewise given to show why working people are significantly exposed to a number of occupational problems that are reflected in a deterioration of their health, safety and well being. In lieu thereof, an introduction of health and safety is not itself a solution, if certain changes are not rationalised according to the local need. While health and safety intervention is concerned, then local need is of prime importance. If individual situation is not clearly outlined, then preventive and control measures can be treated as a de facto measure. Hence immediate attention, collaboration and co-operation is needed from all the concerned parties such as local government authorities, semi-government or private organisations and international communities for proper implementation of work regulations as well as industrial acts and rules in various workplaces in each of the developing countries.

  20. The Medical Library Association Benchmarking Network: development and implementation*

    PubMed Central

    Dudden, Rosalind Farnam; Corcoran, Kate; Kaplan, Janice; Magouirk, Jeff; Rand, Debra C.; Smith, Bernie Todd

    2006-01-01

    Objective: This article explores the development and implementation of the Medical Library Association (MLA) Benchmarking Network from the initial idea and test survey, to the implementation of a national survey in 2002, to the establishment of a continuing program in 2004. Started as a program for hospital libraries, it has expanded to include other nonacademic health sciences libraries. Methods: The activities and timelines of MLA's Benchmarking Network task forces and editorial board from 1998 to 2004 are described. Results: The Benchmarking Network task forces successfully developed an extensive questionnaire with parameters of size and measures of library activity and published a report of the data collected by September 2002. The data were available to all MLA members in the form of aggregate tables. Utilization of Web-based technologies proved feasible for data intake and interactive display. A companion article analyzes and presents some of the data. MLA has continued to develop the Benchmarking Network with the completion of a second survey in 2004. Conclusions: The Benchmarking Network has provided many small libraries with comparative data to present to their administrators. It is a challenge for the future to convince all MLA members to participate in this valuable program. PMID:16636702

  1. Development and implementation of an interdisciplinary plan of care.

    PubMed

    Lewis, Cynthia; Hoffmann, Mary Lou; Gard, Angela; Coons, Jacqueline; Bichinich, Pat; Euclid, Jeff

    2005-01-01

    In January 2002 Aurora Health Care Metro Region chartered an interdisciplinary team to develop a process and structure for patient-centered interdisciplinary care planning. This unique endeavor created a process that includes the patient, family, and all clinical disciplines involved in planning and providing care to patients from system point of entry throughout the entire acute care episode. The interdisciplinary plan of care (IPOC) demonstrates the integration of prioritized problems, outcomes, and measurement toward goal attainment. This article focuses on the journey of this team to the successful implementation of an IPOC.

  2. Development and Implementation of a Lab Course for Introductory Astronomy

    NASA Astrophysics Data System (ADS)

    McCrady, Nate; Rice, Emily

    The typical "Astro 101" lecture-based course is passive, and adding well- designed learner-centered labs allows students to experience science as a pattern of thought. In this article, we present an approach to developing an introductory lab course. Identification of goals and student outcomes, particularly skills, and process and attitudinal goals, is a key step. We apply constructivist principles to the lab course and structure content around core concepts to provide cohesion and facilitate knowledge transfer. We discuss the role of the teaching assistant and assessment in a successful implementation of our approach.

  3. Development, implementation, and test results on integrated optics switching matrix

    NASA Technical Reports Server (NTRS)

    Rutz, E.

    1982-01-01

    A small integrated optics switching matrix, which was developed, implemented, and tested, indicates high performance. The matrix serves as a model for the design of larger switching matrices. The larger integrated optics switching matrix should form the integral part of a switching center with high data rate throughput of up to 300 megabits per second. The switching matrix technique can accomplish the design goals of low crosstalk and low distortion. About 50 illustrations help explain and depict the many phases of the integrated optics switching matrix. Many equations used to explain and calculate the experimental data are also included.

  4. Plans to Adopt and Implement Common Core State Standards in the Southeast Region States. Summary. Issues & Answers. REL 2012-No. 136

    ERIC Educational Resources Information Center

    Anderson, Kim; Harrison, Tiffany; Lewis, Karla

    2012-01-01

    Based on interviews with state officials in the six Southeast Region states (Alabama, Florida, Georgia, Mississippi, North Carolina, and South Carolina), this study describes state processes for adopting the Common Core State Standards (a common set of expectations across states for what students are expected to know in English language arts and…

  5. Implementing a skillslab training program in a developing country.

    PubMed

    Tran, Trung Quang; Scherpbier, Albert; van Dalen, Jan; van Do, Dung; Wright, E Pamela

    2014-01-01

    Eight skills laboratories (skillslabs) were established by consensus of Vietnamese medical universities, with international support. A national list of basic skills needed for medical practice and suitable for skillslab training was developed; models, medical and teaching equipment were supplied; learning material was developed and core staff and teachers were trained. This study was designed to assess how closely eight schools in Vietnam came to implementing all recommended skills on list developed by educators of that country, and identify the facilitating factors and barriers to skillslab use within the country's largest school. Data were collected from reports from the eight skillslabs. Students and trainers from the largest university were surveyed for their perceptions of the quality of training on eight selected skills. Results of students' skill assessments were gathered, and focus group discussions with trainers were conducted. SPSS 16 was used to analyze the quantitative data and cluster analysis was used to test for differences. Only one medical school was able to train all 56 basic skills proposed by consensus among the eight Vietnamese medical universities. Deeper exploration within the largest school revealed that its skillslab training was successful for most skills, according to students' postprogram skills assessment and to students' and trainers' perceptions. However, through focus group discussions we learned that the quantity of training aids was perceived to be insufficient; some models/manikins were inappropriate for training; more consideration was needed in framing the expected requirements of students within each skill; too little time was allocated for the training of one of the eight skills investigated; and further curriculum development is needed to better integrate the skills training program into the broader curriculum. The fact that one medical school could teach all skills recommended for skillslab training demonstrates that all

  6. Development, Implementation, and Compliance of Treatment Pathways in Radiation Medicine

    PubMed Central

    Potters, Louis; Raince, Jadeep; Chou, Henry; Kapur, Ajay; Bulanowski, Daniel; Stanzione, Regina; Lee, Lucille

    2013-01-01

    Introduction: While much emphasis on safety in the radiation oncology clinic is placed on process, there remains considerable opportunity to increase safety, enhance outcomes, and avoid ad hoc care by instituting detailed treatment pathways. The purpose of this study was to review the process of developing evidence and consensus-based, outcomes-oriented treatment pathways that standardize treatment and patient management in a large multi-center radiation oncology practice. Further, we reviewed our compliance in incorporating these directives into our day-to-day clinical practice. Methods: Using the Institute of Medicine guideline for developing treatment pathways, 87 disease specific pathways were developed and incorporated into the electronic medical system in our multi-facility radiation oncology department. Compliance in incorporating treatment pathways was assessed by mining our electronic medical records (EMR) data from January 1, 2010 through February 2012 for patients with breast and prostate cancer. Results: This retrospective analysis of data from EMR found overall compliance to breast and prostate cancer treatment pathways to be 97 and 99%, respectively. The reason for non-compliance proved to be either a failure to complete the prescribed care based on grade II or III toxicity (n = 1 breast, 3 prostate) or patient elected discontinuance of care (n = 1 prostate) or the physician chose a higher dose for positive/close margins (n = 3 breast). Conclusion: This study demonstrates that consensus and evidence-based treatment pathways can be developed and implemented in a multi-center department of radiation oncology. And that for prostate and breast cancer there was a high degree of compliance using these directives. The development and implementation of these pathways serve as a key component of our safety program, most notably in our effort to facilitate consistent decision-making and reducing variation between physicians. PMID:23653892

  7. Development and implementation of an integrated EHR for Homecare Service: a South American experience.

    PubMed

    Aguilera Díaz, Jerónimo; Arias, Antonio Eduardo; Budalich, Cintia Mabel; Benítez, Sonia Elizabeth; López, Gastón; Borbolla, Damián; Plazzotta, Fernando; Luna, Daniel; de Quirós, Fernán González Bernaldo

    2010-01-01

    This paper describes the development and implementation of a web based electronic health record for the Homecare Service program in the Hospital Italiano de Buenos Aires. It reviews the process of the integration of the new electronic health record to the hospital information system, allowing physicians to access the clinical data repository from their Pc's at home and with the capability of consulting past and present history of the patient health care, order, tests, and referrals with others professionals trough the new Electronic Health Record. We also discuss how workflow processes were changed and improved for the physicians, nurses, and administrative personnel of the Homecare Services and the educational methods used to improve acceptance and adoption of these new technologies. We also briefly describe the validation of physicians and their field work with electronic signatures.

  8. Fidelity of implementation: development and testing of a measure

    PubMed Central

    2010-01-01

    Background Along with the increasing prevalence of chronic illness has been an increase in interventions, such as nurse case management programs, to improve outcomes for patients with chronic illness. Evidence supports the effectiveness of such interventions in reducing patient morbidity, mortality, and resource utilization, but other studies have produced equivocal results. Often, little is known about how implementation of an intervention actually occurs in clinical practice. While studies often assume that interventions are used in clinical practice exactly as originally designed, this may not be the case. Thus, fidelity of an intervention's implementation reflects how an intervention is, or is not, used in clinical practice and is an important factor in understanding intervention effectiveness and in replicating the intervention in dissemination efforts. The purpose of this paper is to contribute to the understanding of implementation science by (a) proposing a methodology for measuring fidelity of implementation (FOI) and (b) testing the measure by examining the association between FOI and intervention effectiveness. Methods We define and measure FOI based on organizational members' level of commitment to using the distinct components that make up an intervention as they were designed. Semistructured interviews were conducted among 18 organizational members in four medical centers, and the interviews were analyzed qualitatively to assess three dimensions of commitment to use--satisfaction, consistency, and quality--and to develop an overall rating of FOI. Mixed methods were used to explore the association between FOI and intervention effectiveness (inpatient resource utilization and mortality). Results Predictive validity of the FOI measure was supported based on the statistical significance of FOI as a predictor of intervention effectiveness. The strongest relationship between FOI and intervention effectiveness was found when an alternative measure of FOI was

  9. Developing a National-Level Concept Dictionary for EHR Implementations in Kenya.

    PubMed

    Keny, Aggrey; Wanyee, Steven; Kwaro, Daniel; Mulwa, Edwin; Were, Martin C

    2015-01-01

    The increasing adoption of Electronic Health Records (EHR) by developing countries comes with the need to develop common terminology standards to assure semantic interoperability. In Kenya, where the Ministry of Health has rolled out an EHR at 646 sites, several challenges have emerged including variable dictionaries across implementations, inability to easily share data across systems, lack of expertise in dictionary management, lack of central coordination and custody of a terminology service, inadequately defined policies and processes, insufficient infrastructure, among others. A Concept Working Group was constituted to address these challenges. The country settled on a common Kenya data dictionary, initially derived as a subset of the Columbia International eHealth Laboratory (CIEL)/Millennium Villages Project (MVP) dictionary. The initial dictionary scope largely focuses on clinical needs. Processes and policies around dictionary management are being guided by the framework developed by Bakhshi-Raiez et al. Technical and infrastructure-based approaches are also underway to streamline workflow for dictionary management and distribution across implementations. Kenya's approach on comprehensive common dictionary can serve as a model for other countries in similar settings.

  10. Considerations in implementing integrated biomass energy systems in developing countries

    SciTech Connect

    Perlack, R.D.; Ranney, J.W.

    1993-08-01

    In this paper, we discuss the issues and barriers associated with implementing integrated biomass energy systems in developing countries. An integrated biomass energy system in dependent on sustainably grown and managed energy crops, is supportive of rural development, is environmentally beneficial (locally and globally), is adapted to local conditions, takes advantage of by- and co-products, and uses conversion technologies that have been optimized for biomass. A preliminary evaluation of a biomass to electricity project relying on plantation grown feedstocks in rural Yunnan Province in Southwest China provided some financial/economic results, general conclusions, and an initial framework for conducting such assessments. Our assessment indicates that social and environmental benefits are substantial and that investment in the facility is well-justified. However, there are so many considerations to take into account when assessing biomass energy systems that their evaluation is exceedingly complex. These considerations are grouped into biomass production, biomass logistics and transport, and biomass conversion. Implementing such systems requires another grouping of considerations into energy and economics, institutional and social issues, and environmental issues. These are further defined in an effort to establish a framework of evaluation and assessment for other such projects. The conclusions that such a project would be viable in rural China is shadowed by many site-specific circumstances and highlights the need for systematic and integrated appraisal.

  11. Development, Implementation, and Assessment of a Genetics Curriculum Across Institutions

    PubMed Central

    Dotters-Katz, Sarah; Hocutt, Ginger; Osborne, C Michael; Hardisty, Emily E.; Demmer, Laurie; Vora, Neeta

    2016-01-01

    Objective Many residency programs offer limited exposure and minimal didactic time genetics, despite its frequent use in obstetrics and gynecology. The objective of this study was to develop, pilot, and assess a three-module women's health genetics curriculum for residents that was easily transferable between institutions. Methods An interactive three-module genetics curriculum covering basic principles, prenatal screening/diagnosis, and cancer genetics was developed. A pre- and posttests were used to assess improvement in knowledge. Subjective feedback was obtained to assess curricular satisfaction. The data were analyzed with descriptive statistics. Results The curriculum was administered at two institutions. Forty-eight residents attended ≥ 1 session. Twenty completed the pretest, and 23 completed the posttest. At the first institution, using audience response system, the percentage correct per question increased on 10/14 questions between pre- and posttests. All students felt the curriculum was useful and would strongly recommend to other residents. At the second institution, pre/posttests were distributed on paper. Mean scores significantly improved between pre- and posttests (p = 0.007). On the pretest, no residents scored > 70%. However, 8/13 scored > 70% on the posttest (p = 0.002). Instructors at both institutions described the curriculum as easy to use/implement. Conclusion This three-module workshop on women's health genetics was easily implemented across institutions and led to increased knowledge. PMID:27822431

  12. Development and implementation of a PACS network and resource manager

    NASA Astrophysics Data System (ADS)

    Stewart, Brent K.; Taira, Ricky K.; Dwyer, Samuel J., III; Huang, H. K.

    1992-07-01

    Clinical acceptance of PACS is predicated upon maximum uptime. Upon component failure, detection, diagnosis, reconfiguration and repair must occur immediately. Our current PACS network is large, heterogeneous, complex and wide-spread geographically. The overwhelming number of network devices, computers and software processes involved in a departmental or inter-institutional PACS makes development of tools for network and resource management critical. The authors have developed and implemented a comprehensive solution (PACS Network-Resource Manager) using the OSI Network Management Framework with network element agents that respond to queries and commands for network management stations. Managed resources include: communication protocol layers for Ethernet, FDDI and UltraNet; network devices; computer and operating system resources; and application, database and network services. The Network-Resource Manager is currently being used for warning, fault, security violation and configuration modification event notification. Analysis, automation and control applications have been added so that PACS resources can be dynamically reconfigured and so that users are notified when active involvement is required. Custom data and error logging have been implemented that allow statistics for each PACS subsystem to be charted for performance data. The Network-Resource Manager allows our departmental PACS system to be monitored continuously and thoroughly, with a minimal amount of personal involvement and time.

  13. Implementation

    EPA Pesticide Factsheets

    Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.

  14. Development of sensorial experiments and their implementation into undergraduate laboratories

    NASA Astrophysics Data System (ADS)

    Bromfield Lee, Deborah Christina

    "Visualization" of chemical phenomena often has been limited in the teaching laboratories to the sense of sight. We have developed chemistry experiments that rely on senses other than eyesight to investigate chemical concepts, make quantitative determinations, and familiarize students with chemical techniques traditionally designed using only eyesight. Multi-sensory learning can benefit all students by actively engaging them in learning through stimulation or an alternative way of experiencing a concept or ideas. Perception of events or concepts usually depends on the information from the different sensory systems combined. The use of multi-sensory learning can take advantage of all the senses to reinforce learning as each sense builds toward a more complete experience of scientific data. Research has shown that multi-sensory representations of scientific phenomena is a valuable tool for enhancing understanding of chemistry as well as displacing misconceptions through experience. Multi-sensory experiences have also been shown to enrich memory performance. There are few experiments published which utilize multiple senses in the teaching laboratory. The sensorial experiments chosen were conceptually similar to experiments currently performed in undergraduate laboratories; however students collect different types of data using multi-sensory observations. The experiments themselves were developed by using chemicals that would provide different sensory changes or capitalizing on sensory observations that were typically overlooked or ignored and obtain similar and precise results as in traditional experiments. Minimizing hazards and using safe practices are especially essential in these experiments as students utilize senses traditionally not allowed to be used in the laboratories. These sensorial experiments utilize typical equipment found in the teaching laboratories as well as inexpensive chemicals in order to aid implementation. All experiments are rigorously tested

  15. Smart Sensor Node Development, Testing and Implementation for ISHM

    NASA Technical Reports Server (NTRS)

    Mengers, Timothy; Shipley, John; Merrill, Richard; Eggett, Mark; Lemon, Leon; Johnson, Mont; Morris, Jonathan; Figueroa, Fernando; Schmalzel, John; Turowski, Mark

    2007-01-01

    A main design criterion for a robust Integrated Systems Health Management (ISHM) system is summed up best by the statement "No data is better than bad data". Traditional data acquisition systems are calibrated in a controlled environment and guaranteed to perform bounded by their tested conditions. To successfully design and implement a real world ISHM system, the data acquisition and signal conditioning needs to function in an uncontrolled environment. Development and testing focuses on a design with the ability to self check in order to extend calibration times, report internal faults and drifts and notify the overall system when the data acquisition is not performing as it should. All of this will be designed in a system that is flexible, requiring little redesign to be deployed on a wide variety of systems. Development progress and testing results will be reported.

  16. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    PubMed Central

    Levy, Rebecca; Pantanowitz, Liron; Cloutier, Darlene; Provencher, Jean; McGirr, Joan; Stebbins, Jennifer; Cronin, Suzanne; Wherry, Josh; Fenton, Joseph; Donelan, Eileen; Johari, Vandita; Andrzejewski, Chester

    2010-01-01

    Background: Electronic medical records (EMRs) provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS) involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution's initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting) strategy within the EMR. Methods: A focus group of our hospital's transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium) for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater realered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encount by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also enhance data mining

  17. [International adoption: children's health risk evolution].

    PubMed

    Dartiguenave, C

    2012-05-01

    The socioeconomic and sanitary conditions in many countries make it necessary to weigh as precisely as possible the uncertainties which might affect the health of internationally adopted children, which is one of the key drivers to adoption decision. Indeed, health troubles are more and more frequent among children proposed by countries, at a time when there are fewer children to be adopted. Hence the institutions and the actors in the field of international adoption are compelled to frequently update their professional practices, so as to cope both with the declining offer for adoptable children and with the increasing pressure from the birth countries of children to make host countries adopt children with high age or with special needs. It also requires from the administrations the will to provide better initial information and to implement the demand for an agreement. Meanwhile, in spite of those growing constraints, adopting families have been more and more risk adverse during the latest decades, this being a common trend in our developed countries.

  18. Design and Implementation of Alkali Activated Cement For Sustainable Development

    NASA Astrophysics Data System (ADS)

    Moseson, Alexander James

    Herein, progress is presented on the design and implementation of technology for sustainable development in general and international development in particular. Necessarily interdisciplinary, the work draws upon the tools and techniques of Mechanical, Materials, and Civil Engineering; and History & Politics. The work was conducted along two paths, the first being the theory and methodology of sustainable development. A flexible design and dissemination framework was developed, Technology Seeding, defined as: development by the transfer and participatory adaptation of appropriate proven conceptual designs. The methodology was developed in part through two case studies which implemented, respectively, wood-turning lathes in Tanzania and upland rice planters in Thailand. The second path is the design and investigation of alkali-activated cements (AACs) for practical use. Those developed herein, for US markets, comprise ground granulated blast furnace slag, soda ash (sodium carbonate), and up to 68 wt.% granular limestone. Mixture Design of Experiment (DOE) was utilized to guide empirical and theoretical analysis of performance (e.g. compressive strength), economic & ecological aspects (e.g. cost, CO2 production, energy consumption), and chemistry (e.g. Rietveld analysis of x-ray diffractograms). Models were derived to understand the impact of mix design on performance and for optimization. Successful formulations are hydraulic and cure at room temperature, with strengths as high as 41 MPa at 3 days and 65 MPa at 28 days. Some of these formulations, compared to OPC, are competitive in performance, reduce cost by up to 40%, and reduce both CO2 production and energy consumption by up to 97%. Major chemical products include calcium silicate hydrates / calcium aluminum silicate hydrates (C-(A)-S-H), gaylussite, and calcite (both newly formed and remaining from limestone). Calcite/dolomite and C-(A)-S-H both contribute to strength. A fraction of the limestone is consumed

  19. Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations.

    PubMed

    Black, Maureen M; Pérez-Escamilla, Rafael; Rao, Sylvia Fernandez

    2015-11-01

    The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children's linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5.

  20. Extent of Implementation of Minimum Standards of Basic Education for the Realisation of the Second Millennium Development Goal in Bayelsa State

    ERIC Educational Resources Information Center

    Ogochukwu, Emeka; Gbendu, Olaowei Godiva

    2015-01-01

    The study was carried out in Salga Education Zone of Bayelsa State specifically to determine the extent of implementation of the minimum standards for basic education in order to ensure the realization of the second millennium development goal. The study adopted the descriptive research design. The population of the study comprised of all the…

  1. Development and implementation of a business continuity management risk index.

    PubMed

    Kadar, Michael

    This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.

  2. What Are the Factors Influencing Implementation of Advanced Access in Family Medicine Units? A Cross-Case Comparison of Four Early Adopters in Quebec.

    PubMed

    Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Gaboury, Isabelle; Loignon, Christine; Breton, Mylaine

    2017-01-01

    Advanced access is an organizational model that has shown promise in improving timely access to primary care. In Quebec, it has recently been introduced in several family medicine units (FMUs) with a teaching mission. The objectives of this paper are to analyze the principles of advanced access implemented in FMUs and to identify which factors influenced their implementation. A multiple case study of four purposefully selected FMUs was conducted. Data included document analysis and 40 semistructured interviews with health professionals and staff. Cross-case comparison and thematic analysis were performed. Three out of four FMUs implemented the key principles of advanced access at various levels. One scheduling pattern was observed: 90% of open appointment slots over three- to four-week periods and 10% of prebooked appointments. Structural and organizational factors facilitated the implementation: training of staff to support change, collective leadership, and openness to change. Conversely, family physicians practicing in multiple clinical settings, lack of team resources, turnover of clerical staff, rotation of medical residents, and management capacity were reported as major barriers to implementing the model. Our results call for multilevel implementation strategies to improve the design of the advanced access model in academic teaching settings.

  3. What Are the Factors Influencing Implementation of Advanced Access in Family Medicine Units? A Cross-Case Comparison of Four Early Adopters in Quebec

    PubMed Central

    Touati, Nassera; Maillet, Lara; Gaboury, Isabelle

    2017-01-01

    Introduction Advanced access is an organizational model that has shown promise in improving timely access to primary care. In Quebec, it has recently been introduced in several family medicine units (FMUs) with a teaching mission. The objectives of this paper are to analyze the principles of advanced access implemented in FMUs and to identify which factors influenced their implementation. Methods A multiple case study of four purposefully selected FMUs was conducted. Data included document analysis and 40 semistructured interviews with health professionals and staff. Cross-case comparison and thematic analysis were performed. Results Three out of four FMUs implemented the key principles of advanced access at various levels. One scheduling pattern was observed: 90% of open appointment slots over three- to four-week periods and 10% of prebooked appointments. Structural and organizational factors facilitated the implementation: training of staff to support change, collective leadership, and openness to change. Conversely, family physicians practicing in multiple clinical settings, lack of team resources, turnover of clerical staff, rotation of medical residents, and management capacity were reported as major barriers to implementing the model. Conclusion Our results call for multilevel implementation strategies to improve the design of the advanced access model in academic teaching settings. PMID:28775899

  4. The Challenges of Precision Oncology Drug Development and Implementation.

    PubMed

    Hollingsworth, Simon J; Biankin, Andrew V

    2015-01-01

    The drivers of precision medicine are clear: for patients (and physicians)--more options, durable clinical benefit, reduced exposure to non-effective drugs and potential to leverage current scientific and technological advances; for the pharmaceutical industry--the potential to tackle core challenges in discovering and developing better and more efficacious medicines, to reduce rates of attrition in drug development and to reduce development costs; for healthcare systems and payers--improved efficiency through the provision of effective care and avoiding ineffective treatments. Oncology has been at the vanguard, the improvements gained in patient survival notable. However, the increasing number of molecular subgroups requires an equally increasing number (and new generation) of highly selective agents targeting inevitably lower incidence molecular segments. Innovative trial designs (umbrella/basket studies) are emerging as a patient-centric approach to drug development, and the rise in public-private partnerships, cross-industry, government and non-profit sector collaborations is enabling implementation of complex clinical trial designs. This poses significant challenges for healthcare systems and regulatory approval. Further substantial evolution of policy and processes, particularly regulatory requirements for approval for new therapeutics, are required.

  5. Assessing the development of murine plasmacytoid dendritic cells in Peyer's patches using adoptive transfer of hematopoietic progenitors.

    PubMed

    Li, Haiyan S; Watowich, Stephanie S

    2014-03-17

    This protocol details a method to analyze the ability of purified hematopoietic progenitors to generate plasmacytoid dendritic cells (pDC) in intestinal Peyer's patch (PP). Common dendritic cell progenitors (CDPs, lin(-) c-kit(lo) CD115(+) Flt3(+)) were purified from the bone marrow of C57BL6 mice by FACS and transferred to recipient mice that lack a significant pDC population in PP; in this case, Ifnar(-/-) mice were used as the transfer recipients. In some mice, overexpression of the dendritic cell growth factor Flt3 ligand (Flt3L) was enforced prior to adoptive transfer of CDPs, using hydrodynamic gene transfer (HGT) of Flt3L-encoding plasmid. Flt3L overexpression expands DC populations originating from transferred (or endogenous) hematopoietic progenitors. At 7-10 days after progenitor transfer, pDCs that arise from the adoptively transferred progenitors were distinguished from recipient cells on the basis of CD45 marker expression, with pDCs from transferred CDPs being CD45.1(+) and recipients being CD45.2(+). The ability of transferred CDPs to contribute to the pDC population in PP and to respond to Flt3L was evaluated by flow cytometry of PP single cell suspensions from recipient mice. This method may be used to test whether other progenitor populations are capable of generating PP pDCs. In addition, this approach could be used to examine the role of factors that are predicted to affect pDC development in PP, by transferring progenitor subsets with an appropriate knockdown, knockout or overexpression of the putative developmental factor and/or by manipulating circulating cytokines via HGT. This method may also allow analysis of how PP pDCs affect the frequency or function of other immune subsets in PPs. A unique feature of this method is the use of Ifnar(-/-) mice, which show severely depleted PP pDCs relative to wild type animals, thus allowing reconstitution of PP pDCs in the absence of confounding effects from lethal irradiation.

  6. Implementing a Community Empowerment Center to Build Capacity for Developing, Implementing, and Sustaining Interventions to Promote Community Health.

    PubMed

    Smallwood, Stacy W; Freedman, Darcy A; Pitner, Ronald O; Sharpe, Patricia A; Cole, Jennie Ann; Hastie, Shanna; Hunter, Brittney

    2015-12-01

    The Community Empowerment Center used a community-engaged approach to build capacity among residents to develop and implement interventions focused on creating a healthier environment. The Center partnered with residents living in a public housing community and adjacent low-income neighborhood and provided support through a mini-grant program. A six-session training program guided community members in mini grant development; 25 individuals attended at least one session. Six grant proposals were submitted; three were awarded $12,000 each for intervention implementation. Findings offer a model for engaging residents from low-resource settings in intervention development, implementation, and sustainability for community health promotion.

  7. Development and Implementation of Radiation-Hydrodynamics Verification Test Problems

    SciTech Connect

    Marcath, Matthew J.; Wang, Matthew Y.; Ramsey, Scott D.

    2012-08-22

    Analytic solutions to the radiation-hydrodynamic equations are useful for verifying any large-scale numerical simulation software that solves the same set of equations. The one-dimensional, spherically symmetric Coggeshall No.9 and No.11 analytic solutions, cell-averaged over a uniform-grid have been developed to analyze the corresponding solutions from the Los Alamos National Laboratory Eulerian Applications Project radiation-hydrodynamics code xRAGE. These Coggeshall solutions have been shown to be independent of heat conduction, providing a unique opportunity for comparison with xRAGE solutions with and without the heat conduction module. Solution convergence was analyzed based on radial step size. Since no shocks are involved in either problem and the solutions are smooth, second-order convergence was expected for both cases. The global L1 errors were used to estimate the convergence rates with and without the heat conduction module implemented.

  8. Development and implementation of the specialty certificate examinations.

    PubMed

    Mucklow, John

    2011-06-01

    Following successful pilots in 2006, knowledge-based assessments for those engaged in specialty training have been developed and implemented in 11 medical specialties, by the Federation of Royal Colleges of Physicians in partnership with the specialist societies. Over 400 physicians have been involved in a project that has required recruitment and training of up to 25 question writers in each discipline, and the constitution of examining boards and standard setting advisory groups in each specialty. The assessments (now known as the specialty certificate examinations) are delivered by computer-based testing in centres throughout the UK and overseas. This paper analyses the outcome of 14 examination diets, sat by 948 candidates, of whom 72% were occupying UK numbered training posts. A total of 786 candidates sat the examination in the UK, 162 in overseas centres. Pass rates among UK trainees have generally exceeded 80%, with reliability coefficients well in excess of 0.8.

  9. Developing a DICOM Middleware to Implement ECG Conversion and Viewing.

    PubMed

    Ling-Ling, Wang; Ni-Ni, Rao; Li-Xin, Pu; Gang, Wang

    2005-01-01

    Nowadays, medical environment is integrated and complicated, involving large amounts of various medical data, such as images, waveforms and other digital data. For the interoperability of images and waveforms in imaging context, the images and waveforms usually need to be interchanged and stored using one standard. DICOM is the best choice, which is an international standard for the communication and storage of medical information. In this paper, we developed a DICOM middleware with capability of converting SCP-ECG, the European standard for resting ECGs, into DICOM ECGs. Then an ECG viewing component is implemented, which can parse and display SCP-ECG records and DICOM ECGs. The research results show that our work can realize seamless workflows in multi-vendor environment, contribute to the harmonization of ECG standards, and facilitate digital ECG applications.

  10. Design Based Research: The Way of Developing and Implementing

    ERIC Educational Resources Information Center

    Štemberger, Tina; Cencic, Majda

    2016-01-01

    The appropriate implementation of innovation is a crucial factor in improving educational practice. In the implementation process, there is, however, often a lack of interaction between designers and practitioners that would enable the latter to become competent enough to implement theoretical knowledge into practice and to have an ongoing support…

  11. Therapeutic hypothermia at an urban public hospital: Development, implementation, experience and outcomes.

    PubMed

    Gueret, Renaud M; Bailitz, John M; Sahni, Ashima S; Tulaimat, Aiman

    Therapeutic hypothermia (TH) improves the outcome of comatose patients suffering an out-of-hospital sudden cardiac arrest (SCA) with shockable rhythm and return of spontaneous circulation (ROSC). Evidence supporting its use in other circumstances is weak and the adoption of TH remains limited. Describe the development and implementation of a TH program at an urban public hospital and report outcomes of out-of-hospital and in-hospital SCA and important quality measures. The protocol was developed at 464-bed urban public hospital. We assembled historical and prospective samples of patients suffering an SCA. We measured the neurologic outcome of patients at the time of hospital discharge who underwent TH after SCA. We compared outcomes and important quality measures (duration of arrest, time to cooling, and time to target temperature) to existing literature. We determined reasons for not using TH in patients with in-hospital SCA. We described the development of our TH program and the challenges we faced implementing it. Of 45 patients treated with TH after SCA, 23 (51%) survived to discharge, 14 (31%) with good neurologic outcomes. In comparison to historical controls, TH did not improve outcome of in-hospital SCA. SCA from a shockable rhythm was associated with the best outcome. The time from return of spontaneous circulation to initiation of TH was consistently within 8 h. Despite logistical and financial constraints, we were able to rapidly implement a TH program with quality and outcomes similar to published data. TH did not improve outcomes for patients with an in-hospital SCA. Published by Elsevier Inc.

  12. Development and Implementation of Collaborative e-Infrastructures and Data Management for Global Change Research

    NASA Astrophysics Data System (ADS)

    Allison, M. Lee; Davis, Rowena

    2016-04-01

    An e-infrastructure that supports data-intensive, multidisciplinary research is needed to accelerate the pace of science to address 21st century global change challenges. Data discovery, access, sharing and interoperability collectively form core elements of an emerging shared vision of e-infrastructure for scientific discovery. The pace and breadth of change in information management across the data lifecycle means that no one country or institution can unilaterally provide the leadership and resources required to use data and information effectively, or needed to support a coordinated, global e-infrastructure. An 18-month long process involving ~120 experts in domain, computer, and social sciences from more than a dozen countries resulted in a formal set of recommendations that were adopted in fall, 2015 by the Belmont Forum collaboration of national science funding agencies and international bodies on what they are best suited to implement for development of an e-infrastructure in support of global change research, including: • adoption of data principles that promote a global, interoperable e-infrastructure, that can be enforced • establishment of information and data officers for coordination of global data management and e-infrastructure efforts • promotion of effective data planning and stewardship • determination of international and community best practices for adoptiondevelopment of a cross-disciplinary training curriculum on data management and curation The implementation plan is being executed under four internationally-coordinated Action Themes towards a globally organized, internationally relevant e-infrastructure and data management capability drawn from existing components, protocols, and standards. The Belmont Forum anticipates opportunities to fund additional projects to fill key gaps and to integrate best practices into an e-infrastructure to support their programs but that can also be scaled up and deployed more widely. Background

  13. The development of a highly constrained health level 7 implementation guide to facilitate electronic laboratory reporting to ambulatory electronic health record systems.

    PubMed

    Sujansky, Walter V; Overhage, J Marc; Chang, Sophia; Frohlich, Jonah; Faus, Samuel A

    2009-01-01

    Electronic laboratory interfaces can significantly increase the value of ambulatory electronic health record (EHR) systems by providing laboratory result data automatically and in a computable form. However, many ambulatory EHRs cannot implement electronic laboratory interfaces despite the existence of messaging standards, such as Health Level 7, version 2 (HL7). Among several barriers to implementing laboratory interfaces is the extensive optionality within the HL7 message standard. This paper describes the rationale for and development of an HL7 implementation guide that seeks to eliminate most of the optionality inherent in HL7, but retain the information content required for reporting outpatient laboratory results. A work group of heterogeneous stakeholders developed the implementation guide based on a set of design principles that emphasized parsimony, practical requirements, and near-term adoption. The resulting implementation guide contains 93% fewer optional data elements than HL7. This guide was successfully implemented by 15 organizations during an initial testing phase and has been approved by the HL7 standards body as an implementation guide for outpatient laboratory reporting. Further testing is required to determine whether widespread adoption of the implementation guide by laboratories and EHR systems can facilitate the implementation of electronic laboratory interfaces.

  14. Selection and Implementation of the ISO9001 Standard to Support Biobanking Research Infrastructure Development.

    PubMed

    Davis, Emma; Hampson, Katie; Bray, Christopher; Dixon, Kate; Ollier, William; Yuille, Martin

    2012-04-01

    The UK DNA Banking Network (UDBN) undertakes biobanking for genetic epidemiology research projects. A task assigned to it is the addition of scientific value to the resources under its management. This task is implemented by enabling appropriate access to the resources. We reasoned that access requires not only a fair access policy but also a quality policy implemented via a Quality Management System (QMS). UDBN decided to achieve consistency in sample management by identifying and implementing a suitable QMS with external certification. UDBN selected ISO9001 as a QMS. It was soon recognized that the QMS needed to encompass not only UDBN but also the academic department in which UDBN sits. An external certification body was selected and a post was dedicated to the role of QMS-Management Representative. Specialized software was acquired. A Quality Manual, individual training files and Standard Operating Procedures (SOPs) were prepared. QMS training was provided. These actions led to the approval of the ISO9001:2000 standard. This is the first report of an academic genetic epidemiology research laboratory receiving approval of the ISO9001 standard to validate the consistency of its operations. ISO9001 was selected because of its greater breadth of scope compared with other QMSs. We found that while laboratory protocols are transferable between labs, QMS SOPs are not transferable. This has consequences for efforts to ensure consistency across a biobank network: joint adoption of one multiparty QMS is probably required. We found that it was not possible to implement a QMS for biobanking in isolation: its host university department needed to be included. We have found that ISO9001 helps enable longitudinal accrual of data on the use of biobanking methods. Thus ISO9001 is not only a management tool to improve access to a biobanking research infrastructure but also a research tool for research infrastructure development.

  15. Gene Therapy for Brain Tumors: Basic Developments and Clinical Implementation

    PubMed Central

    Assi, Hikmat; Candolfi, Marianela; Baker, Gregory; Mineharu, Yohei; Lowenstein, Pedro R; Castro, Maria G

    2012-01-01

    Glioblastoma multiforme (GBM) is the most common and deadliest of adult primary brain tumors. Due to its invasive nature and sensitive location, complete resection remains virtually impossible. The resistance of GBM against chemotherapy and radiotherapy necessitate the development of novel therapies. Gene therapy is proposed for the treatment of brain tumors and has demonstrated pre-clinical efficacy in animal models. Here we review the various experimental therapies that have been developed for GBM including both cytotoxic and immune stimulatory approaches. We also review the combined conditional cytotoxic immune stimulatory therapy that our lab has developed which is dependent on the adenovirus mediated expression of the conditional cytotoxic gene, Herpes Simplex Type 1 Thymidine Kinase (TK) and the powerful DC growth factor Fms-like tyrosine kinase 3 ligand (Flt3L). Combined delivery of these vectors elicits tumor cell death and an anti-tumor adaptive immune response that requires TLR2 activation. The implications of our studies indicate that the combined cytotoxic and immunotherapeutic strategies are effective strategies to combat deadly brain tumors and warrant their implementation in human Phase I clinical trials for GBM. PMID:22906921

  16. Gene therapy for brain tumors: basic developments and clinical implementation.

    PubMed

    Assi, Hikmat; Candolfi, Marianela; Baker, Gregory; Mineharu, Yohei; Lowenstein, Pedro R; Castro, Maria G

    2012-10-11

    Glioblastoma multiforme (GBM) is the most common and deadliest of adult primary brain tumors. Due to its invasive nature and sensitive location, complete resection remains virtually impossible. The resistance of GBM against chemotherapy and radiotherapy necessitate the development of novel therapies. Gene therapy is proposed for the treatment of brain tumors and has demonstrated pre-clinical efficacy in animal models. Here we review the various experimental therapies that have been developed for GBM including both cytotoxic and immune stimulatory approaches. We also review the combined conditional cytotoxic immune stimulatory therapy that our lab has developed which is dependent on the adenovirus mediated expression of the conditional cytotoxic gene, Herpes Simplex Type 1 Thymidine Kinase (TK) and the powerful DC growth factor Fms-like tyrosine kinase 3 ligand (Flt3L). Combined delivery of these vectors elicits tumor cell death and an anti-tumor adaptive immune response that requires TLR2 activation. The implications of our studies indicate that the combined cytotoxic and immunotherapeutic strategies are effective strategies to combat deadly brain tumors and warrant their implementation in human Phase I clinical trials for GBM.

  17. Development and implementation cost analysis of telephone- and Internet-based interventions for the maintenance of weight loss

    PubMed Central

    Meenan, Richard T.; Stevens, Victor J.; Funk, Kristine; Bauck, Alan; Jerome, Gerald J.; Lien, Lillian F.; Appel, Lawrence; Hollis, Jack F.; Brantley, Phillip L.; Svetkey, Laura P.

    2013-01-01

    Objectives The Weight Loss Maintenance Trial (WLM) was a multi-center, randomized trial comparing two weight loss maintenance interventions, a personal contact program (PC) with primarily telephone-based monthly contacts, and an Internet-based program (IT), to a self-directed control group, among overweight or obese individuals at high cardiovascular risk. This paper describes implementation costs of both interventions as well as IT development costs. Methods Resources were micro-costed in 2006 dollars from the primary perspective of a sponsoring healthcare system considering adopting an extant intervention, rather than developing its own. Costs were discounted at 3% annually. Length of trial participation was 30 months (randomization during February-November 2004). IT development costs were assessed over 36 months. Univariate and multivariate, including probabilistic, sensitivity analyses were performed. Results Total discounted IT development costs over 36 months were $839,949 ($2,414 per IT participant). Discounted 30-month implementation costs for 342 PC participants were $537,242 ($1,571 per participant), and for 348 IT participants, were $214,879 ($617 per participant). Under all plausible scenarios, PC implementation costs exceeded IT implementation costs. Conclusions Costs of implementing and operating an Internet-based intervention for weight loss maintenance were substantially less than analogous costs of an intervention using standard phone and in-person contacts, and are of a magnitude that would be attractive to many health systems, subject to demonstration of cost-effectiveness. PMID:19619360

  18. Assessing integrated pest management adoption: measurement problems and policy implications.

    PubMed

    Puente, Molly; Darnall, Nicole; Forkner, Rebecca E

    2011-11-01

    For more than a decade, the U.S. government has promoted integrated pest management (IPM) to advance sustainable agriculture. However, the usefulness of this practice has been questioned because of lagging implementation. There are at least two plausible rationales for the slow implementation: (1) growers are not adopting IPM-for whatever reason-and (2) current assessment methods are inadequate at assessing IPM implementation. Our research addresses the second plausibility. We suggest that the traditional approach to measuring IPM implementation on its own fails to assess the distinct, biologically hierarchical components of IPM, and instead aggregates growers' management practices into an overall adoption score. Knowledge of these distinct components and the extent to which they are implemented can inform government officials as to how they should develop targeted assistance programs to encourage broader IPM use. We address these concerns by assessing the components of IPM adoption and comparing our method to the traditional approach alone. Our results indicate that there are four distinct components of adoption-weed, insect, general, and ecosystem management-and that growers implement the first two components significantly more often than the latter two. These findings suggest that using a more nuanced measure to assess IPM adoption that expands on the traditional approach, allows for a better understanding of the degree of IPM implementation.

  19. Implementation of human papillomavirus immunization in the developing world.

    PubMed

    Kane, Mark A; Serrano, Beatriz; de Sanjosé, Silvia; Wittet, Scott

    2012-11-20

    Cervical cancer is the second leading cause of cancer death in women in less developed regions of the world and the leading cause of cancer deaths in GAVI-eligible countries, where 54% of worldwide cervical cancer deaths occur. If prevention is not implemented in these countries, population growth alone will lead to a 63% increase in deaths by 2025. Human papillomavirus (HPV) vaccines are routinely used in the National Immunization Programs in most industrial countries, and the decision by the GAVI Alliance to accept applications from eligible developing countries for HPV vaccine support is the single most important opportunity for children in these countries to be protected against HPV-related diseases. As it has done for other vaccines, such as Haemophilus influenzae type b, rotavirus and pneumococcal conjugate vaccines, GAVI should strongly consider developing and funding a group dedicated to working on all aspects of HPV vaccine introduction in the developing world. Immunization in middle-income developing countries not eligible for GAVI support will depend on "tiered" pricing policies or regional procurement schemes to make vaccine available at prices significantly lower than those in industrial countries. Immunization coverage of infants has reached high levels in many of the poorest developing countries where complementary strategies for HPV control, such as adult screening and treatment, are poorly developed. Immunizing young adolescents will require expansion of immunization infrastructure to reach cohorts that currently are largely unreached, but the success of school-based strategies in industrial countries and developing country demonstration projects provides hope that relatively high coverage may be achieved in many countries. Communication and advocacy strategies for HPV control need to carefully consider local cultural attitudes toward HPV-related issues. Current strategies supported by health economic analyses call for female only immunization, but

  20. Development and implementation of IT require focus on user participation, acceptance and workflow.

    PubMed

    Sølling, Ina Koldkjær; Carøe, Per; Mathiesen, Kirsten Siggaard

    2014-01-01

    The study "Online Care" follows a municipal project "Online Welfare" where a nurse's presence in the citizen's own home was replaced by online communication. The paper is based on a citizen's perspective and seeks to develop meaningful workflow for the benefit of citizens with medical problems. The study examines five citizens' opinions on whether online communication in a meaningful way supports the citizens in what they associate with a good life. In addition, relatives and the citizen's nurse were interviewed individually concerning the same issues as the citizens. The study has been approved by the Danish System of Ethics in Science and is conducted in collaboration with Aalborg University, Aalborg Municipality and DanAge, (NGO). The municipality's goal of efficiency and financial savings regarding "Online Welfare" was not honored due to insufficient network infrastructure and technical problems. An adoption barrier was that the municipality did not determine the efforts and the goal of the project, who could benefit from participating and the requirements of the professionals and the organization including ethical considerations.It was difficult to find citizens who were willing to participate. Citizens, who were included in the study accepted and adopted the technology however, "Online Welfare" could not replace the care they used to receive. Therefore, the offer was perceived as an "appendix" which tended to meaninglessness by some of the citizens.The nurses' perception of nursing care and their limited IT skills was a barrier to acceptance, adoption and development of technology opportunities in nursing. The citizens' disability, the screen appearance, and the technology setup meant that the citizens perceived poor usability of the equipment. The study showed a change in workflow, as the cooperation between the citizen and the professional developed. New roles occurred for the professionals.The citizens had many ideas concerning the development of the