Artful Dodgers: An Arts Education Research Project in Early Education Settings

ERIC Educational Resources Information Center

Hayes, Nóirín; Maguire, Jackie; Corcoran, Lucie; O'Sullivan, Carmel

2017-01-01

Artful Dodgers is an arts education project developed by two artists and delivered in two early years settings located in two areas of urban disadvantage. It is a music and visual arts programme designed and implemented with early years teachers of children aged 3-5 years. It explored whether the provision of high-quality arts experiences could…

Exploring School Exclusion and Oppression with Boal

ERIC Educational Resources Information Center

Meaney, Sarah Elizabeth

2016-01-01

This article is an overview of research underway which investigates early school leavers' experience of school exclusion and oppression. Augusto Boal's "Theatre of the Oppressed" has been implemented as a research methodology to provoke dialogue on this aspect of early school leaving, and to afford participants in second-chance education…

The Community Options Program: An Evaluation of Early Implementation Experience.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Health and Social Services, Madison.

This document contains a preliminary report on the implementation of Wisconsin's Community Options Program (COP), a program designed both to divert persons from entering nursing homes and to deinstitutionalize current nursing home residents who can be effectively served by community-based alternatives. The introduction of this report provides a…

The Application of a Transdisciplinary Model for Early Intervention Services

ERIC Educational Resources Information Center

King, Gillian; Strachan, Deborah; Tucker, Michelle; Duwyn, Betty; Desserud, Sharon; Shillington, Monique

2009-01-01

This article reviews the literature on the transdisciplinary approach to early intervention services and identifies the essential elements of this approach. A practice model describing the implementation of the approach is then presented, based on the experiences of staff members in a home visiting program for infants that has been in existence…

Re-Emphasizing Character Education in Early Childhood Programs: Korean Children's Experiences

ERIC Educational Resources Information Center

Lee, Guang-Lea

2013-01-01

Character education efforts are influenced by the cultures in which they are implemented. This article describes the character education provided to children in Korea, both in school and at home. The author explores how the Korean early childhood education system strives to ensure positive character development among children. These discussions…

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

ERIC Educational Resources Information Center

Akinrotimi, Adenike A.; Olowe, Peter K.

2016-01-01

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

The openEHR Java reference implementation project.

PubMed

Chen, Rong; Klein, Gunnar

2007-01-01

The openEHR foundation has developed an innovative design for interoperable and future-proof Electronic Health Record (EHR) systems based on a dual model approach with a stable reference information model complemented by archetypes for specific clinical purposes.A team from Sweden has implemented all the stable specifications in the Java programming language and donated the source code to the openEHR foundation. It was adopted as the openEHR Java Reference Implementation in March 2005 and released under open source licenses. This encourages early EHR implementation projects around the world and a number of groups have already started to use this code. The early Java implementation experience has also led to the publication of the openEHR Java Implementation Technology Specification. A number of design changes to the specifications and important minor corrections have been directly initiated by the implementation project over the last two years. The Java Implementation has been important for the validation and improvement of the openEHR design specifications and provides building blocks for future EHR systems.

Designing and Implementing a Mentoring Program to Support Clinically-Based Teacher Education

ERIC Educational Resources Information Center

Henning, John E.; Gut, Dianne; Beam, Pamela

2015-01-01

This article describes one teacher preparation program's approach to designing and implementing a mentoring program to support clinically-based teacher education. The design for the program is based on an interview study that compared the mentoring experiences of 18 teachers across three different contexts: student teaching, early field…

Playing Golf Is Elementary

ERIC Educational Resources Information Center

Goldman, Jill S.; Pfluge, Kevin F.

2010-01-01

Golf is a lifelong activity that people of all ages can enjoy if they experience success and have fun. Early involvement in the sport facilitates the development of the ability to strike an object with an implement. Striking with implements can be challenging for young children and teachers, but golf can be taught in all elementary school settings…

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

ERIC Educational Resources Information Center

Stump, Erika K.; Silvernail, David L.

2014-01-01

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

Exploring the Basic Principles of Electric Motors and Generators with a Low-Cost Sophomore-Level Experiment

ERIC Educational Resources Information Center

Schubert, T. F.; Jacobitz, F. G.; Kim, E. M.

2009-01-01

In order to meet changing curricular needs, an electric motor and generator laboratory experience was designed, implemented, and assessed. The experiment is unusual in its early placement in the curriculum and in that it focuses on modeling electric motors, predicting their performance, and measuring efficiency of energy conversion. While…

General practice recruitment for people at risk of schizophrenia: the Buckingham experience.

PubMed

Falloon, I R

2000-11-01

The process of detecting people at high risk of schizophrenia from a community sample is a major challenge for prevention of psychotic disorders. The aim of this paper is to describe early detection procedures that can be implemented in primary care settings. A selected literature review is supplemented by experiences and data obtained during the Buckingham Integrated Mental Health Care Project. General medical practitioners have been favoured as the agents most likely to prove helpful in detecting the key risk factors that predict the onset of schizophrenic disorders, as well as in recognising the earliest signs and symptoms of these conditions. However, the practical problems of screening for multiple and subtle risk factors in general practice are substantial, and general practitioners (GPs) often have difficulty recognising the earliest signs of a psychotic episode. A range of strategies to assist GPs detect early signs of psychosis in their patients are considered. It is feasible to implement primary care setting early detection procedures for people at risk of schizophrenia. Implementation is aided by the use of a brief screening questionnaire, training sessions and case supervision; and increased collaboration with mental health services and other community agencies.

IMPLEMENTING AN ATTACHMENT-BASED PARENTING INTERVENTION WITHIN HOME-BASED EARLY HEAD START: HOME-VISITORS' PERCEPTIONS AND EXPERIENCES.

PubMed

West, Allison L; Aparicio, Elizabeth M; Berlin, Lisa J; Jones Harden, Brenda

2017-07-01

Implementation of evidence-based interventions in "real-world" settings is enhanced when front-line staff view the intervention as acceptable, appropriate, and feasible. This qualitative study addresses Early Head Start (EHS) home visitors' perceptions and experiences of an evidence-based parenting intervention, the Attachment and Biobehavioral Catch-up program (M. Dozier, O. Lindhiem, & J. Ackerman, 2005), when added to EHS services as usual within the context of a research-practice partnership. Thematic analysis of in-depth, qualitative interviews indicates that home visitors experienced the intervention as positive and helpful for EHS families. Some challenges included scheduling and uncertainty regarding the goals of the intervention. Concerns over participation in the research centered on information exchange, confidentiality, and time limitations. © 2017 Michigan Association for Infant Mental Health.

Early intervention for psychotic disorders: Real-life implementation in Hong Kong.

PubMed

Wong, Gloria H Y; Hui, Christy L M; Tang, Jennifer Y M; Chang, Wing-Chung; Chan, Sherry K W; Xu, Jia-Qi; Lin, Jessie J X; Lai, Dik-Chee; Tam, Wendy; Kok, Joy; Chung, Dicky; Hung, S F; Chen, Eric Y H

2012-03-01

Hong Kong is among the first few cities in Asia to have implemented early intervention for psychosis in 2001. Substantial changes in psychosis service have since taken place. We reviewed available outcome data in Hong Kong, with reference to the philosophy of early intervention in psychosis, discussing experience and lessons learned from the implementation process, and future opportunities and challenges. Data accumulated in the past decade provided evidence for the benefits and significance of early intervention programmes: patients under the care of early intervention service showed improved functioning, milder symptoms, and fewer hospitalizations and suicides. Early intervention is more cost-effective compared with standard care. Stigma and misconception remains an issue, and public awareness campaigns are underway. In recent years, a critical mass is being formed, and Hong Kong has witnessed the unfolding of public service extension, new projects and organizations, and increasing interest from the community. Several major platforms are in place for coherent efforts, including the public Early Assessment Service for Young people with psychosis (EASY) programme, the Psychosis Studies and Intervention (PSI) research unit, the independent Hong Kong Early Psychosis Intervention Society (EPISO), the Jockey Club Early Psychosis (JCEP) project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. The first decade of early intervention work has been promising; consolidation and further development is needed on many fronts of research, service and education. Copyright © 2012 Elsevier B.V. All rights reserved.

Virtually Exploring A Pillar Of Experimental Physics: The Hertz Experiment

NASA Astrophysics Data System (ADS)

Bonanno, A.; Sapia, P.; Camarca, M.; Oliva, A.

2008-05-01

In the present work we report on the implementation and early assessment of a multimedia learning object, developed using the Java programming language, which also integrates in a creative way some internet freely available educational resources, intended to support the teaching/learning process of the historical Hertz experiment.

Visual Arts for Emotionally Handicapped Early Adolescents Theory and Resultant Guidelines.

ERIC Educational Resources Information Center

Shields, Roscoe, Jr.

The paper discusses the theory and implementation guidelines of a visual arts curriculum for emotionally handicapped adolescents. The author stresses the importance of expressive arts and of identification with the art experience, and suggests that a curriculum should start with themes, experiences, and ideas worth communicating. Expressive…

When the healthcare does not follow the evidence: The case of the lack of early intervention programs for psychosis in Spain.

PubMed

Arango, Celso; Bernardo, Miguel; Bonet, Pere; Cabrera, Ana; Crespo-Facorro, Benedicto; Cuesta, Manuel J; González, Nel; Parrabera, Sílvia; Sanjuan, Julio; Serrano, Alfonso; Vieta, Eduard; Lennox, Belinda R; Melau, Marianne

There is now sufficient evidence to support the importance of interventions in the early stages of psychosis. The delay in the detection and treatment of the first-episode psychosis is related to a lower and slower recovery, as well as a higher risk of relapse. Despite this fact, early intervention units or teams are still not regularly implemented in mental health service settings in Spain. In this opinion article, a review is presented of the main arguments for defending the need to implement these programs and strategies in order to achieve this aim. There are a number of programs for early intervention for psychosis currently working in other countries, with a therapeutic program that includes pharmacological and psychosocial interventions, together with public awareness, information dissemination, and family-professional collaboration activities. Published literature on the experience of these programs indicates that early intervention is not only effective in terms of the improvement of health status, but is also economically efficient. The main steps and recommendations needed to implement such early intervention programs in our country are described. Copyright © 2017 SEP y SEPB. All rights reserved.

Adult age differences in subjective and objective measures of strategy use on a sequentially cued prediction task

PubMed Central

Seaman, Kendra L.; Howard, Darlene V.; Howard, James H.

2015-01-01

Differences in strategy use are thought to underlie age-related performance deficits on many learning and decision-making tasks. Recently, age-related differences in learning to make predictions were reported on the Triplets Prediction Task (TPT; Seaman, Howard & Howard, 2013). Notably, deficits appeared early in training and continued with experience. To assess if age differences were due to early strategy use, neural networks were used to objectively assess the strategies implemented by participants during Session 1. Then the relationship between these strategies and performance was examined. Results revealed that older adults were more likely to implement a disadvantageous strategy early in learning, and this led to poorer task performance. Importantly the relationship between age and task performance was partially mediated by early strategy use, suggesting that early strategy selection played a role in the lower quality of predictions in older adults. PMID:24673615

"It's a Mystery!": A Case Study of Implementing Forensic Science in Preschool as Scientific Inquiry

ERIC Educational Resources Information Center

Howitt, Christine; Upson, Emily; Lewis, Simon

2011-01-01

Children have immense curiosity, a thirst for knowledge and a questioning attitude. They are innate scientists. The challenge for early childhood educators is to fuel this curiosity through the provision of appropriate learning experiences and an engaging environment within early learning centres. This paper presents a detailed case study of how a…

Implementations of Sensor Webs Utilizing Uninhabited Aerial Systems

NASA Technical Reports Server (NTRS)

Sullivan, Donald V.

2009-01-01

In this paper we describe the web services, processes, communication protocols and ad-hoc service chains utilized in the late summer and early fall 2007 Ikhana UAS response to the wildfires burning in southern California. Additionally, we describe the lessons learned that will be applied to the upcoming Global Hawk UAS Aura Satellite Validation Experiment planned for early 2009.

Investigating Pre-Service Early Childhood Teachers' Attitudes towards the Computer Based Education in Science Activities

ERIC Educational Resources Information Center

Yilmaz, Nursel; Alici, Sule

2011-01-01

The purpose of this study was to investigate pre-service early childhood teachers' attitudes towards using Computer Based Education (CBE) while implementing science activities. More specifically, the present study examined the effect of different variables such as gender, year in program, experience in preschool, owing a computer, and the…

A Mixed-Methods Study of Early Intervention Implementation in the Commonwealth of Pennsylvania: Supports, Services, and Policies for Young Children with Developmental Delays and Disabilities

ERIC Educational Resources Information Center

Mattern, Janet A.

2015-01-01

Participation in high quality early intervention programs is critical for eligible young children who experience atypical development for their future academic success. High quality programs promote access to services, incorporate instructional strategies that encourage children's participation, and advocate public policy that supports…

Improving Early-Grade Literacy in East Africa: Experimental Evidence from Kenya and Uganda

ERIC Educational Resources Information Center

Lucas, Adrienne M.; McEwan, Patrick J.; Ngware, Moses; Oketch, Moses

2014-01-01

Primary school enrollments have increased rapidly in sub-Saharan Africa, spurring concerns about low levels of learning. We analyze field experiments in Kenya and Uganda that assessed whether the Reading to Learn intervention, implemented by the Aga Khan Foundation in both countries, improved early-grade literacy as measured by common assessments.…

Taking Ownership: The Implementation of a Non-Aboriginal Early Education Programme for on-Reserve Children

ERIC Educational Resources Information Center

Beatch, Michelle; Le Mare, Lucy

2007-01-01

In this qualitative study, over the period of one year, we assessed the appropriateness of a mainstream early childhood education intervention, the Home Instruction for Parents of Preschool Youngsters (HIPPY) programme, in five on-reserve First Nations communities, by focusing on the experiences of the Aboriginal women who delivered the programme.…

Exploring Three-Phase Systems and Synchronous Motors: A Low-Voltage and Low-Cost Experiment at the Sophomore Level

ERIC Educational Resources Information Center

Schubert, T. F., Jr.; Jacobitz, F. G.; Kim, E. M.

2011-01-01

In order to meet changing curricular and societal needs, a three-phase system and synchronous motor laboratory experience for sophomore-level students in a wide variety of engineering majors was designed, implemented, and assessed. The experiment is unusual in its early placement in the curriculum, and in that it focuses primarily on basic…

How To Implement a Tech Prep Program Based on the Rhode Island Model. Tech Prep Associate Degree Program. Technical Programs. Business/Office Administration Programs. Allied Health/Dental Health Programs.

ERIC Educational Resources Information Center

Community Coll. of Rhode Island, Warwick.

This implementation guide contains information based on experiences that occurred during the development and implementation of the Rhode Island Tech Prep Model. It is intended to assist educators in addressing challenges and obstacles faced by the program early in the planning process. It begins with a rationale for tech prep. Rhode Island…

Implementing enhanced recovery in gynaecology oncology.

PubMed

Rooth, Carolyn; Sidhu, Amar

Enhanced recovery involves the adoption of a selected number of evidence-based interventions used together and implemented in a 'fast track' care pathway during preoperative management, surgery itself and throughout the immediate postoperative period. Aimed at promoting effective patient recovery after surgery, this has been shown to improve the patient experience and facilitate early patient discharge following major surgery in some clinical areas (Department of Health, 2010). Applied to the clinical management and nursing care of women affected by gynaecological malignancies in one London tertiary referral centre hospital, enhanced recovery has been seen to improve patient experience and shorten the length of overall hospital stay. Implementation requires careful planning, appointment of key practitioners and commitment of the multidisciplinary team to realise successful outcomes. The authors' experience suggests that challenges are associated with changing practice and that while careful planning is essential, successes are to be gained, which significantly benefit patients, staff and the NHS Trust. In sharing this experience of implementing enhanced recovery, the authors hope to encourage others to consider application of this innovative strategy.

Early Results in Capella's Prior Learning Assessment Experimental Site Initiative

ERIC Educational Resources Information Center

Klein, Jillian

2017-01-01

In July 2014, the U.S. Department of Education announced a new round of experimental sites focusing on competency-based education. Capella University was selected to participate in three of the Department of Education's competency-based education (CBE) experiments and began by implementing the prior learning assessment experiment, which allows…

Experiences of Early Transdisciplinary Teams in Pediatric Community Rehabilitation

ERIC Educational Resources Information Center

Aubin, Tamie; Mortenson, Patricia

2015-01-01

Although a transdisciplinary approach (TA) is considered best practice for children aged 0-3 years, there is limited information for professionals on how to successfully implement TA services. Using qualitative inquiry, in-depth interviews were conducted to explore the experiences of 6 service providers and managers who took part in early…

Engaging Students in Early Exploration of Nanoscience Topics Using Hands-On Activities and Scanning Tunneling Microscopy

ERIC Educational Resources Information Center

Furlan, Ping Y.

2009-01-01

This manuscript reports on efforts to introduce beginning college students to the modern nanoscience field. These include: implementing selected experiments into sequencing core first-year and second-year chemistry laboratory courses; providing students with a first research experience; and engaging them in service learning and outreach programs…

Utilizing Field Experiences in an Early Childhood Center To Increase Competencies in Teacher Training.

ERIC Educational Resources Information Center

Sutton, Alfred L.

The director of career education and coordinator of the department of human growth and development at a private college implemented a practicum designed to expand the knowledge level of early childhood students in teacher training by requiring that they participate in the college's day care center. The primary purpose of the practicum was to…

"It's the Bread and Butter of Our Practice": Experiencing the Early Years Foundation Stage

ERIC Educational Resources Information Center

Roberts-Holmes, Guy

2012-01-01

This article presents the experiences of nursery and primary head teachers (n = 12) on the English Early Years Foundation Stage (EYFS) after its first year of implementation in 2010. Findings are drawn from a subset of data (head teachers of primary and nursery schools) which forms part of a larger Department for Children, Schools and Families…

Leading Technological Change: A Qualitative Study of High School Leadership in the Implementation of One-To-One Computing

ERIC Educational Resources Information Center

Cohen, Maureen McCallion

2017-01-01

The purpose of this basic qualitative study was to identify and understand the leadership strategies used by Massachusetts high school administrators during the early implementation (first four years) of one-to-one computing. The study was guided by two research questions: (1) How do high school administrators describe their experience leading the…

Investigating and Learning Lessons from Early Experiences of Implementing ePrescribing Systems into NHS Hospitals: A Questionnaire Study

PubMed Central

Cresswell, Kathrin; Coleman, Jamie; Slee, Ann; Williams, Robin; Sheikh, Aziz

2013-01-01

Background ePrescribing systems have significant potential to improve the safety and efficiency of healthcare, but they need to be carefully selected and implemented to maximise benefits. Implementations in English hospitals are in the early stages and there is a lack of standards guiding the procurement, functional specifications, and expected benefits. We sought to provide an updated overview of the current picture in relation to implementation of ePrescribing systems, explore existing strategies, and identify early lessons learned. Methods A descriptive questionnaire-based study, which included closed and free text questions and involved both quantitative and qualitative analysis of the data generated. Results We obtained responses from 85 of 108 NHS staff (78.7% response rate). At least 6% (n = 10) of the 168 English NHS Trusts have already implemented ePrescribing systems, 2% (n = 4) have no plans of implementing, and 34% (n = 55) are planning to implement with intended rapid implementation timelines driven by high expectations surrounding improved safety and efficiency of care. The majority are unclear as to which system to choose, but integration with existing systems and sophisticated decision support functionality are important decisive factors. Participants highlighted the need for increased guidance in relation to implementation strategy, system choice and standards, as well as the need for top-level management support to adequately resource the project. Although some early benefits were reported by hospitals that had already implemented, the hoped for benefits relating to improved efficiency and cost-savings remain elusive due to a lack of system maturity. Conclusions Whilst few have begun implementation, there is considerable interest in ePrescribing systems with ambitious timelines amongst those hospitals that are planning implementations. In order to ensure maximum chances of realising benefits, there is a need for increased guidance in relation to implementation strategy, system choice and standards, as well as increased financial resources to fund local activities. PMID:23335961

Effect of promoting self-esteem by participatory learning process on emotional intelligence among early adolescents.

PubMed

Munsawaengsub, Chokchai; Yimklib, Somkid; Nanthamongkolchai, Sutham; Apinanthavech, Suporn

2009-12-01

To study the effect of promoting self-esteem by participatory learning program on emotional intelligence among early adolescents. The quasi-experimental study was conducted in grade 9 students from two schools in Bangbuathong district, Nonthaburi province. Each experimental and comparative group consisted of 34 students with the lowest score of emotional intelligence. The instruments were questionnaires, Program to Develop Emotional Intelligence and Handbook of Emotional Intelligence Development. The experimental group attended 8 participatory learning activities in 4 weeks to Develop Emotional Intelligence while the comparative group received the handbook for self study. Assessment the effectiveness of program was done by pre-test and post-test immediately and 4 weeks apart concerning the emotional intelligence. Implementation and evaluation was done during May 24-August 12, 2005. Data were analyzed by frequency, percentage, mean, standard deviation, Chi-square, independent sample t-test and paired sample t-test. Before program implementation, both groups had no statistical difference in mean score of emotional intelligence. After intervention, the experimental group had higher mean score of emotional intelligence both immediately and 4 weeks later with statistical significant (p = 0.001 and < 0.001). At 4 weeks after experiment, the mean score in experimental group was higher than the mean score at immediate after experiment with statistical significance (p < 0.001). The program to promote self-esteem by participatory learning process could enhance the emotional intelligence in early-adolescent. This program could be modified and implemented for early adolescent in the community.

Decision, Implementation, and Confirmation: Experiences of Instructors behind Tourism and Hospitality MOOCs

ERIC Educational Resources Information Center

Lin, Jingjing; Cantoni, Lorenzo

2018-01-01

As the popularity of Massive Open Online Courses (MOOCs) continues to grow, studies are emerging to investigate various topics in this area. Most have focused on the learners' perspective, leaving a gap in the literature about MOOC instructors. The current research--conducted in the field of tourism and hospitality--explored early experiences of…

Accelerating development of late-successional features in second-growth pine stands of the Goosenest Adaptive Management Area

Treesearch

Martin W. Ritchie; Kathleen A. Harcksen

2005-01-01

This paper describes implementation and early results of a large-scale, interdisciplinary experiment in the Goosenest Adaptive Management Area in northeastern California. The study is designed to investigate development of late-successional forest attributes in second-growth ponderosa pine stands. The experiment has four treatments replicated five times and encompasses...

Enhancing Hispanic Minority Undergraduates' Botany Laboratory Experiences: Implementation of an Inquiry-Based Plant Tissue Culture Module Exercise

ERIC Educational Resources Information Center

Siritunga, Dimuth; Navas, Vivian; Diffoot, Nanette

2012-01-01

Early involvement of students in hands-on research experiences are known to demystify research and promote the pursuit of careers in science. But in large enrollment departments such opportunities for undergraduates to participate in research are rare. To counteract such lack of opportunities, inquiry-based laboratory module in plant tissue…

Early phase clinical trials with human immunodeficiency virus-1 and malaria vectored vaccines in The Gambia: frontline challenges in study design and implementation.

PubMed

Afolabi, Muhammed O; Adetifa, Jane U; Imoukhuede, Egeruan B; Viebig, Nicola K; Kampmann, Beate; Bojang, Kalifa

2014-05-01

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and malaria are among the most important infectious diseases in developing countries. Existing control strategies are unlikely to curtail these diseases in the absence of efficacious vaccines. Testing of HIV and malaria vaccines candidates start with early phase trials that are increasingly being conducted in developing countries where the burden of the diseases is high. Unique challenges, which affect planning and implementation of vaccine trials according to internationally accepted standards have thus been identified. In this review, we highlight specific challenges encountered during two early phase trials of novel HIV-1 and malaria vectored vaccine candidates conducted in The Gambia and how some of these issues were pragmatically addressed. We hope our experience will be useful for key study personnel involved in day-to-day running of similar clinical trials. It may also guide future design and implementation of vaccine trials in resource-constrained settings.

Integrating care for frequent users of emergency departments: implementation evaluation of a brief multi-organizational intensive case management intervention.

PubMed

Kahan, Deborah; Leszcz, Molyn; O'Campo, Patricia; Hwang, Stephen W; Wasylenki, Donald A; Kurdyak, Paul; Wise Harris, Deborah; Gozdzik, Agnes; Stergiopoulos, Vicky

2016-04-27

Addressing the needs of frequent users of emergency departments (EDs) is a health system priority in many jurisdictions. This study describes stakeholder perspectives on the implementation of a multi-organizational brief intervention designed to support integration and continuity of care for frequent ED users with mental health and addictions problems, focusing on perceived barriers and facilitators to early implementation in a large urban centre. Coordinating Access to Care from Hospital Emergency Departments (CATCH-ED) is a brief case management intervention bridging hospital, primary and community care for frequent ED users experiencing mental illness and addictions. To examine barriers and facilitators to early implementation of this multi-organizational intervention, between July and October 2012, 47 stakeholders, including direct service providers, managers and administrators participated in 32 semi-structured qualitative interviews and one focus group exploring their experience with the intervention and factors that helped or hindered successful early implementation. Qualitative data were analyzed using thematic analysis. Stakeholders valued the intervention and its potential to support continuity of care for this population. Service delivery system factors, including organizational capacity and a history of collaborative relationships across the healthcare continuum, and support system factors, such as training and supervision, emerged as key facilitators of program implementation. Operational challenges included early low program referral rates, management of a multi-organizational initiative, variable adherence to the model among participating organizations, and scant access to specialty psychiatric resources. Factors contributing to these challenges included lack of dedicated staff in the ED and limited local system capacity to support this population, and insufficient training and technical assistance available to participating organizations. A multi-organizational brief intervention is an acceptable model to support integration of hospital, primary and community care for frequent ED users. The study highlights the importance of early implementation evaluation to identify potential solutions to implementation barriers that may be applicable to many jurisdictions.

Early experience with human papillomavirus vaccine introduction in the United States, Canada and Australia.

PubMed

Shefer, Abigail; Markowitz, Lauri; Deeks, Shelley; Tam, Theresa; Irwin, Kathleen; Garland, Suzanne M; Schuchat, Anne

2008-08-19

Successful incorporation of a new vaccine into a nation's vaccination program requires addressing a number of issues, including: 1) establishing national recommendations; 2) assuring education of and acceptance by the public and medical community; 3) establishing and maintaining an appropriate infrastructure for vaccine delivery; 4) financing the vaccine and the program, in addition to political will. This article reviews the early experience with implementation of human papillomavirus (HPV) vaccination programs. It focuses on the United States of America and Canada and provides a brief report on Australia, where introduction is underway.

The Myth of Free and Barrier-Free Access: India's Right to Education Act--Private Schooling Costs and Household Experiences

ERIC Educational Resources Information Center

Srivastava, Prachi; Noronha, Claire

2016-01-01

We examine relative household costs and experiences of accessing private and government schooling under India's "Right of Children to Free and Compulsory Education Act, 2009" in the early implementation phase. The Act deems that no child should incur any fee, charges, or expenses in accessing schooling. Private schools are mandated to…

Health Care IT Collaboration in Massachusetts: The Experience of Creating Regional Connectivity

PubMed Central

Halamka, John; Aranow, Meg; Ascenzo, Carl; Bates, David; Debor, Greg; Glaser, John; Goroll, Allan; Stowe, Jim; Tripathi, Micky; Vineyard, Gordon

2005-01-01

The state of Massachusetts has significant early experience in planning for and implementing interoperability networks for exchange of clinical and financal data. Members of our evolving data-sharing organizations gained valuable experience that is of potential benefit to others regarding the governance, policies, and technologies underpinning regional health information organizations. We describe the history, roles, and evolution of organizations and their plans for and success with pilot projects. PMID:16049225

Design Tools for Cost-Effective Implementation of Planetary Protection Requirements

NASA Technical Reports Server (NTRS)

Hamlin, Louise; Belz, Andrea; Evans, Michael; Kastner, Jason; Satter, Celeste; Spry, Andy

2006-01-01

Since the Viking missions to Mars in the 1970s, accounting for the costs associated with planetary protection implementation has not been done systematically during early project formulation phases, leading to unanticipated costs during subsequent implementation phases of flight projects. The simultaneous development of more stringent planetary protection requirements, resulting from new knowledge about the limits of life on Earth, together with current plans to conduct life-detection experiments on a number of different solar system target bodies motivates a systematic approach to integrating planetary protection requirements and mission design. A current development effort at NASA's Jet Propulsion Laboratory is aimed at integrating planetary protection requirements more fully into the early phases of mission architecture formulation and at developing tools to more rigorously predict associated cost and schedule impacts of architecture options chosen to meet planetary protection requirements.

Encouraging family forest owners to create early successional wildlife habitat in Southern New England.

PubMed

Buffum, Bill; Modisette, Christopher; McWilliams, Scott R

2014-01-01

Encouraging family forest owners to create early successional habitat is a high priority for wildlife conservation agencies in the northeastern USA, where most forest land is privately owned. Many studies have linked regional declines in wildlife populations to the loss of early successional habitat. The government provides financial incentives to create early successional habitat, but the number of family forest owners who actively manage their forests remains low. Several studies have analyzed participation of family forest owners in federal forestry programs, but no study to date has focused specifically on creation of wildlife habitat. The objective of our study was to analyze the experience of a group of wildlife-oriented family forest owners who were trained to create early successional habitat. This type of family forest owners represents a small portion of the total population of family forest owners, but we believe they can play an important role in creating wildlife habitat, so it is important to understand how outreach programs can best reach them. The respondents shared some characteristics but differed in terms of forest holdings, forestry experience and interest in earning forestry income. Despite their strong interest in wildlife, awareness about the importance of early successional habitat was low. Financial support from the federal government appeared to be important in motivating respondents to follow up after the training with activities on their own properties: 84% of respondents who had implemented activities received federal financial support and 47% would not have implemented the activities without financial assistance. In order to mobilize greater numbers of wildlife-oriented family forest owners to create early successional habitat we recommend focusing outreach efforts on increasing awareness about the importance of early successional habitat and the availability of technical and financial assistance.

Encouraging Family Forest Owners to Create Early Successional Wildlife Habitat in Southern New England

PubMed Central

Buffum, Bill; Modisette, Christopher; McWilliams, Scott R.

2014-01-01

Encouraging family forest owners to create early successional habitat is a high priority for wildlife conservation agencies in the northeastern USA, where most forest land is privately owned. Many studies have linked regional declines in wildlife populations to the loss of early successional habitat. The government provides financial incentives to create early successional habitat, but the number of family forest owners who actively manage their forests remains low. Several studies have analyzed participation of family forest owners in federal forestry programs, but no study to date has focused specifically on creation of wildlife habitat. The objective of our study was to analyze the experience of a group of wildlife-oriented family forest owners who were trained to create early successional habitat. This type of family forest owners represents a small portion of the total population of family forest owners, but we believe they can play an important role in creating wildlife habitat, so it is important to understand how outreach programs can best reach them. The respondents shared some characteristics but differed in terms of forest holdings, forestry experience and interest in earning forestry income. Despite their strong interest in wildlife, awareness about the importance of early successional habitat was low. Financial support from the federal government appeared to be important in motivating respondents to follow up after the training with activities on their own properties: 84% of respondents who had implemented activities received federal financial support and 47% would not have implemented the activities without financial assistance. In order to mobilize greater numbers of wildlife-oriented family forest owners to create early successional habitat we recommend focusing outreach efforts on increasing awareness about the importance of early successional habitat and the availability of technical and financial assistance. PMID:24587160

Hickam Air Force Base Fuel Cell Vehicles : Early Implementation Experience

DOT National Transportation Integrated Search

2008-07-01

This report describes operations at Alameda-Contra Costa Transit District (AC Transit) for three prototype fuel cell buses and six diesel buses operating from the same location. This is the third evaluation report for this site, and it describes new ...

The urgency-gating model can explain the effects of early evidence.

PubMed

Carland, Matthew A; Thura, David; Cisek, Paul

2015-12-01

In a recent report, Winkel, Keuken, van Maanen, Wagenmakers & Forstmann (Psychonomics Bulletin and Review 21(3): 777-784, 2014) show that during a random-dot motion discrimination task, early differences in motion evidence can influence reaction times (RTs) and error rates in human subjects. They use this as an argument in favor of the drift-diffusion model and against the urgency-gating model. However, their implementation of the urgency-gating model is incomplete, as it lacks the low-pass filter that is necessary to deal with noisy input such as the motion signal used in their experimental task. Furthermore, by focusing analyses solely on comparison of mean RTs they overestimate how long early information influences individual trials. Here, we show that if the urgency-gating model is correctly implemented, including a low-pass filter with a 250 ms time constant, it can successfully reproduce the results of the Winkel et al. experiment.

ICU early physical rehabilitation programs: financial modeling of cost savings.

PubMed

Lord, Robert K; Mayhew, Christopher R; Korupolu, Radha; Mantheiy, Earl C; Friedman, Michael A; Palmer, Jeffrey B; Needham, Dale M

2013-03-01

To evaluate the potential annual net cost savings of implementing an ICU early rehabilitation program. Using data from existing publications and actual experience with an early rehabilitation program in the Johns Hopkins Hospital Medical ICU, we developed a model of net financial savings/costs and presented results for ICUs with 200, 600, 900, and 2,000 annual admissions, accounting for both conservative- and best-case scenarios. Our example scenario provided a projected financial analysis of the Johns Hopkins Medical ICU early rehabilitation program, with 900 admissions per year, using actual reductions in length of stay achieved by this program. U.S.-based adult ICUs. Financial modeling of the introduction of an ICU early rehabilitation program. Net cost savings generated in our example scenario, with 900 annual admissions and actual length of stay reductions of 22% and 19% for the ICU and floor, respectively, were $817,836. Sensitivity analyses, which used conservative- and best-case scenarios for length of stay reductions and varied the per-day ICU and floor costs, across ICUs with 200-2,000 annual admissions, yielded financial projections ranging from -$87,611 (net cost) to $3,763,149 (net savings). Of the 24 scenarios included in these sensitivity analyses, 20 (83%) demonstrated net savings, with a relatively small net cost occurring in the remaining four scenarios, mostly when simultaneously combining the most conservative assumptions. A financial model, based on actual experience and published data, projects that investment in an ICU early rehabilitation program can generate net financial savings for U.S. hospitals. Even under the most conservative assumptions, the projected net cost of implementing such a program is modest relative to the substantial improvements in patient outcomes demonstrated by ICU early rehabilitation programs.

Implementation of critical care response team.

PubMed

Al Shimemeri, Abdullah

2014-04-01

Analyses of hospital deaths have indicated that a significant proportion of the reported deaths might have been prevented had the patients received intensive level care early enough. Over the past few decades the critical care response team has become an important means of preventing these deaths. As the proactive arm of intensive care delivery, the critical care response team places emphasis on early identification of signs of clinical deterioration, which then prompts the mobilization of intensive care brought right to the patient's bedside. However, the setting up of a critical care response team is a difficult undertaking involving different levels of cooperation between all service stakeholders, and a bringing together of professional expertise and experience in its operations. The implementation of a critical care response team often involves a high-level restructuring of a hospital's service orientation. In the present work, the various factors and different models to be considered in implementing a critical care response team are addressed.

The Midwifery Services Framework: Lessons learned from the initial stages of implementation in six countries.

PubMed

Garg, Shantanu; Moyo, Nester T; Nove, Andrea; Bokosi, Martha

2018-07-01

In 2015, the International Confederation of Midwives (ICM) launched the Midwifery Services Framework (MSF): an evidence-based tool to guide countries through the process of improving their sexual, reproductive, maternal and newborn health services through strengthening and developing the midwifery workforce. The MSF is aligned with key global architecture for sexual, reproductive, maternal and newborn health and human resources for health. This third in a series of three papers describes the experience of starting to implement the MSF in the first six countries that requested ICM support to adopt the tool, and the lessons learned during these early stages of implementation. The early adopting countries selected a variety of priority work areas, but nearly all highlighted the importance of improving the attractiveness of midwifery as a career so as to improve attraction and retention, and several saw the need for improvements to midwifery regulation, pre-service education, availability and/or accessibility of midwives. Key lessons from the early stages of implementation include the need to ensure a broad range of stakeholder involvement from the outset and the need for an in-country lead organisation to maintain the momentum of implementation even when there are changes in political leadership, security concerns or other barriers to progress. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Neurosequential Model in Education and School Improvement

ERIC Educational Resources Information Center

Walter, Shawna Lee

2016-01-01

The purpose of this qualitative research assignment was to explore experiences with the early implementation stages of the Neurosequential Model in Education (NME) in an elementary classroom setting. Data gathered from four participant interviews, three elementary teachers and one educational assistant, revealed three categories surrounding the…

Communication Intervention for Young Children with Severe Neurodevelopmental Disabilities Via Telehealth.

PubMed

Simacek, Jessica; Dimian, Adele F; McComas, Jennifer J

2017-03-01

Young children with neurodevelopmental disorders such as autism spectrum disorders (ASD) and Rett syndrome often experience severe communication impairments. This study examined the efficacy of parent-implemented communication assessment and intervention with remote coaching via telehealth on the acquisition of early communication skills of three young children with ASD (2) and Rett syndrome (1). Efficacy of the intervention was evaluated using single-case experimental designs. First, functional assessment was used to identify idiosyncratic/potentially communicative responses and contexts for each child. Next, parents implemented functional communication training (FCT). All of the children acquired the targeted communication responses. The findings support the efficacy of telehealth as a service delivery model to coach parents on intervention strategies for their children's early communication skills.

Space Station Freedom Toxic and Reactive Materials Handling

NASA Technical Reports Server (NTRS)

Baugher, Charles R. (Editor)

1990-01-01

Viable research in materials processing in space requires the utilization of a wide variety of chemicals and materials, many of which are considered toxic and/or highly reactive with other substances. A realistic view of the experiments which are most likely to be accomplished in the early Space Station phases are examined and design issues addressed which are related to their safe implementation. Included are discussions of materials research on Skylab, Spacelab, and the Shuttle mid-deck; overviews of early concepts for specialized Space Station systems designed to help contain potential problems; descriptions of industrial experience with ground-based research; and an overview of the state-of-the-art in contamination detection systems.

Mentoring for Mentors: The Music Mentor Plus Program

ERIC Educational Resources Information Center

Berg, Margaret H.; Rickels, David A.

2018-01-01

The Music Mentor Plus program was designed to introduce mentoring strategies teachers can implement during supervision of student teachers and early field experience interns, while also fostering connections between field-based modeling and university methods course content. Throughout the 2015-2016 school year, seven music teachers and two…

Virtual Reality: Teaching Tool of the Twenty-First Century?

ERIC Educational Resources Information Center

Hoffman, Helene; Vu, Dzung

1997-01-01

Virtual reality-based procedural and surgical simulations promise to revolutionize medical training. A wide range of simulations representing diverse content areas and varied implementation strategies are under development or in early use. The new systems will make broad-based training experiences available for students at all levels without risks…

Resource-Based Intervention: Success with Community-Centered Practices

ERIC Educational Resources Information Center

Torrey, Michelle Kerber; Leginus, Mary Anne; Cecere, Susan

2011-01-01

In this commentary the authors share their experiences on the design and implementation of community-centered early intervention programs in Prince George's County, MD. Their aim in designing community-centered programs was to provide infants and toddlers opportunities for learning, language, and motor development in natural environments with…

Communication Intervention for Young Children with Severe Neurodevelopmental Disabilities via Telehealth

ERIC Educational Resources Information Center

Simacek, Jessica; Dimian, Adele F.; McComas, Jennifer J.

2017-01-01

Young children with neurodevelopmental disorders such as autism spectrum disorders (ASD) and Rett syndrome often experience severe communication impairments. This study examined the efficacy of parent-implemented communication assessment and intervention with remote coaching via telehealth on the acquisition of early communication skills of three…

Early Field Experiences in Language Teacher Education: An Ecological Analysis of a Program Implementation

ERIC Educational Resources Information Center

Rodriguez Arroyo, Sandra

2009-01-01

Language teacher education (LTE) has received increased attention over the last several decades. Language teacher educators, university researchers, classroom teachers, and future teachers have contributed immensely to existing knowledge on how language teachers learn to teach. Researchers and practitioners have finally acknowledged that future…

The SAFER Latinos Project: Addressing a Community Ecology Underlying Latino Youth Violence

ERIC Educational Resources Information Center

Edberg, Mark; Cleary, Sean D.; Collins, Elizabeth; Klevens, Joanne; Leiva, Rodrigo; Bazurto, Martha; Rivera, Ivonne; del Cid, Alex Taylor; Montero, Luisa; Calderon, Melba

2010-01-01

This paper describes the intervention model, early implementation experience, and challenges for the "Seguridad, Apoyo, Familia, Educacion, y Recursos" (SAFER) Latinos project. The SAFER Latinos project is an attempt to build the evidence for a multilevel participatory youth violence prevention model tailored to the specific circumstances of…

Highlighting in Early Childhood: Learning Biases Through Attentional Shifting.

PubMed

Burling, Joseph M; Yoshida, Hanako

2017-02-01

The literature on human and animal learning suggests that individuals attend to and act on cues differently based on the order in which they were learned. Recent studies have proposed that one specific type of learning outcome, the highlighting effect, can serve as a framework for understanding a number of early cognitive milestones. However, little is known how this learning effect itself emerges among children, whose memory and attention are much more limited compared to adults. Two experiments were conducted using different versions of the general highlighting paradigm: Experiment 1 tested 3 to 6 year olds with a newly developed image-based version of the paradigm, which was designed specifically to test young children. Experiment 2 tested the validity of an image-based implementation of the highlighting paradigm with adult participants. The results from Experiment 1 provide evidence for the highlighting effect among children 3-6 years old, and they suggest age-related differences in dividing attention among multiple cues during learning. Experiment 2 replicated results from previous studies by showing robust biases for both image-based and text-based versions of the highlighting task. This study suggests that sensitivity to learning order emerges early through the process of cued attention, and the role of the highlighting effect in early language learning is discussed. Copyright © 2016 Cognitive Science Society, Inc.

Assessing early implementation of state autism insurance mandates.

PubMed

Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

2016-10-01

In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states' experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants' perceptions about states' experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services. © The Author(s) 2015.

Implementing universal HIV treatment in a high HIV prevalence and rural South African setting – Field experiences and recommendations of health care providers

PubMed Central

Gumede, Dumile; Boyer, Sylvie; Pillay, Deenan; Dabis, François; Seeley, Janet; Orne-Gliemann, Joanna

2017-01-01

Background We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP) regarding the implementation of universal antiretroviral therapy (ART) in rural KwaZulu-Natal, South Africa. Methods In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH) is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria) was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April–July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants) were conducted, audio-recorded, transcribed, and thematically analyzed. Results All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services. Conclusions The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery. PMID:29155832

Implementing universal HIV treatment in a high HIV prevalence and rural South African setting - Field experiences and recommendations of health care providers.

PubMed

Plazy, Melanie; Perriat, Delphine; Gumede, Dumile; Boyer, Sylvie; Pillay, Deenan; Dabis, François; Seeley, Janet; Orne-Gliemann, Joanna

2017-01-01

We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP) regarding the implementation of universal antiretroviral therapy (ART) in rural KwaZulu-Natal, South Africa. In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH) is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria) was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April-July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants) were conducted, audio-recorded, transcribed, and thematically analyzed. All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services. The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery.

Community Clinicians and the Veterans Choice Program for PTSD Care: Understanding Provider Interest During Early Implementation.

PubMed

Finley, Erin P; Noël, Polly H; Mader, Michael; Haro, Elizabeth; Bernardy, Nancy; Rosen, Craig S; Bollinger, Mary; Garcia, Hector; Sherrieb, Kathleen; Pugh, Mary Jo V

2017-07-01

In 2014, the Department of Veterans Affairs (VA) implemented the Veterans Choice Program (VCP) to provide reimbursement for community-based care to eligible veterans. Inadequate networks of participating providers may impact the utility of VCP for veterans with posttraumatic stress disorder (PTSD), a complex condition occurring at lower frequency among civilians. To compare characteristics and attitudes of community-based primary care and mental health providers reporting interest or no interest in VCP participation during early implementation; and to examine perceptions and experiences of VCP among "early adopters." Cross-sectional surveys with 2 samples: a stratified random sample of mental health and primary care prescribers and psychotherapists drawn from state licensing boards (Community Sample); and a stratified random sample of prescribers and psychotherapists identified as VCP-authorized providers (VCP-Authorized). Five hundred fifty-three respondents in the Community Sample and 115 in the VCP-Authorized (total, n=668; 21.1% response). Surveys assessed provider and practice characteristics, attitudes to VA and VCP, and experiences and satisfaction with the VCP; an open-ended survey item assessed providers' reasons for interest or lack of interest in VCP participation. Few providers reported VCP participation during this period. Interest in VCP participation was associated across provider groups with factors including being a veteran and receiving VA reimbursement; currently providing treatment for PTSD was associated with interest in VCP participation among psychotherapists, but not prescribers. Developing networks of VCP providers to serve Veterans with PTSD is likely to require targeting more receptive provider groups, reducing barriers to participation, and more effectively communicating the value of VCP participation to providers.

The EURECA telecommanding chain: Experience with packet telecommand and telemetry systems

NASA Technical Reports Server (NTRS)

Mueller, C.; Bater, R.; Sorensen, E. M.

1993-01-01

The European Retrieval Carrier (EURECA) was launched on its first flight on the 31st July 1992 by the Space Shuttle Atlantis. EURECA is characterized by several new on-board features, most notable Packet Telemetry and a partial implementation of Packet Telecommanding using an early version of the Command Operation Procedure (COP-1) protocol. EURECA has also very low contact time with its Ground Station, with a consequent high number of out-of-visibility onboard operations. This paper concentrates on the implementation and operational experience with the COP-1 Protocol and the effect the short ground contact time has on the design of the Commanding System. Another interesting feature is that the COP-1 is implemented at the control center rather than at the ground station. The COP-1 protocol also successfully supported the mission during the launch where commands were sent via NASCOM and the Shuttle.

Use of implementation theory: a focus on PARIHS.

PubMed

Ullrich, Philip M; Sahay, Anju; Stetler, Cheryl B

2014-02-01

Limited understanding and application of theory in implementation research contributes to variable effectiveness of implementation studies. Better understanding of direct experiences with theory could improve implementation research and the potency of interventions. This study was a conceptual exercise aimed at characterizing experiences with and applications of the Promoting Action on Research Implementation in Health Services (PARIHS) framework. This was a structured, qualitative study involving document reviews and interviews used to answer the following overarching questions about nine implementation research centers: Why and how was PARIHS used? What strengths and weaknesses were identified for PARIHS? PARIHS was being used for varied purposes, at varied levels, in varied ways, and to a varying extent within and across centers. Lack of implementation theory use in investigators' early years was common. Variability in the nature of theory use was attributable to characteristics of the centers, individual investigators, and features of PARIHS. Strengths and weaknesses of the PARIHS framework were identified. The study provides information to researchers and theorists about the use of one well-known implementation framework. The information suggests areas for improvements in PARIHS as well as theory use in general, and should assist in the development of theory-based programs of research. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

78 FR 5035 - Final Priorities; Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

... flexibility where possible, and develop and implement a study design that would answer important questions... basic design requirements--for both program management and evaluation purposes--for data and account... commenter stated that based on its experience with schools, local governments, and others in the design and...

Dynamical Geometry: Analysis of Mistakes in Student Constructions

ERIC Educational Resources Information Center

Vanicek, Jiri

2007-01-01

In the early stages of working with dynamical geometry environments, students make many more mistakes than if they thought out and implemented the same constructions on paper. Most Czech teachers have very little experience of doing geometry using computers. A methodology which could help them to teach students to avoid mistakes dependent on the…

Languages Are More than Words: Spanish and American Sign Language in Early Childhood Settings

ERIC Educational Resources Information Center

Sherman, Judy; Torres-Crespo, Marisel N.

2015-01-01

Capitalizing on preschoolers' inherent enthusiasm and capacity for learning, the authors developed and implemented a dual-language program to enable young children to experience diversity and multiculturalism by learning two new languages: Spanish and American Sign Language. Details of the curriculum, findings, and strategies are shared.

Provider Perspectives on Adopting and Using Collaborative Consultation in Natural Environments

ERIC Educational Resources Information Center

Salisbury, Christine L.; Woods, Juliann; Copeland, Christina

2010-01-01

An exploratory case study was undertaken to investigate the perspectives and experiences of six early intervention providers as they adopted and implemented a collaborative consultation approach to home visiting in urban neighborhoods. Survey, semistructured interview, and focus group methods were used over a 2-year period to obtain data about…

Experiences from site-specific landslide early warning systems

NASA Astrophysics Data System (ADS)

Michoud, C.; Bazin, S.; Blikra, L. H.; Derron, M.-H.; Jaboyedoff, M.

2013-10-01

Landslide early warning systems (EWSs) have to be implemented in areas with large risk for populations or infrastructures when classical structural remediation measures cannot be set up. This paper aims to gather experiences of existing landslide EWSs, with a special focus on practical requirements (e.g., alarm threshold values have to take into account the smallest detectable signal levels of deployed sensors before being established) and specific issues when dealing with system implementations. Within the framework of the SafeLand European project, a questionnaire was sent to about one-hundred institutions in charge of landslide management. Finally, we interpreted answers from experts belonging to 14 operational units related to 23 monitored landslides. Although no standard requirements exist for designing and operating EWSs, this review highlights some key elements, such as the importance of pre-investigation work, the redundancy and robustness of monitoring systems, the establishment of different scenarios adapted to gradual increasing of alert levels, and the necessity of confidence and trust between local populations and scientists. Moreover, it also confirms the need to improve our capabilities for failure forecasting, monitoring techniques and integration of water processes into landslide conceptual models.

Evaluation of a peer mentoring program for early career gerontological nursing faculty and its potential for application to other fields in nursing and health sciences.

PubMed

Brody, Abraham A; Edelman, Linda; Siegel, Elena O; Foster, Victoria; Bailey, Donald E; Bryant, Ashley Leak; Bond, Stewart M

2016-01-01

As the retirement rate of senior nursing faculty increases, the need to implement new models for providing mentorship to early career academics will become key to developing and maintaining an experienced faculty. This evaluation of a peer mentorship program for predoctoral and postdoctoral gerontological nurses examined its efficacy, utility, and potential for improvement. A web-based survey was developed, implemented, and completed by 22 mentees and 17 mentors (71% and 61% response rates, respectively) as part of the evaluation. The peer mentorship program was found to be valuable by both mentors (64.7%) and mentees (72.7%) in helping mentees further develop their careers and networks and providing mentors with supported mentorship experience. The peer mentorship program could serve as a model for other professional organizations, academic institutions, and consortiums to enhance and extend the formal vertical mentorship provided to early academic career individuals. Published by Elsevier Inc.

Evaluation of a peer mentoring program for early career gerontological nursing faculty and its potential for application to other fields in nursing and health sciences

PubMed Central

Brody, Abraham A.; Edelman, Linda; Siegel, Elena O.; Foster, Victoria; Bailey, Donald E.; Bryant, Ashley Leak; Bond, Stewart M.

2018-01-01

Background As the retirement rate of senior nursing faculty increases, the need to implement new models for providing mentorship to early career academics will become key to developing and maintaining an experienced faculty. Purpose This evaluation of a peer mentorship program for predoctoral and postdoctoral gerontological nurses examined its efficacy, utility, and potential for improvement. Methods A web-based survey was developed, implemented, and completed by 22 mentees and 17 mentors (71% and 61% response rates, respectively) as part of the evaluation. Discussion The peer mentorship program was found to be valuable by both mentors (64.7%) and mentees (72.7%) in helping mentees further develop their careers and networks and providing mentors with supported mentorship experience. Conclusion The peer mentorship program could serve as a model for other professional organizations, academic institutions, and consortiums to enhance and extend the formal vertical mentorship provided to early academic career individuals. PMID:27156778

Notice, Explore, and Talk About Mathematics: Making a Positive Difference for Preschool Children, Families, and Educators in Australian Communities That Experience Multiple Disadvantages.

PubMed

Gervasoni, Ann; Perry, Bob

2017-01-01

Let's Count is a preschool mathematics intervention implemented by The Smith Family from 2012 to the present in "disadvantaged" communities across Australia. It is based on current mathematics and early childhood education research and aligns with the Australian Early Years Learning Framework. Let's Count has been shown to be effective in enhancing mathematics learning and dispositions of young children, early childhood educators, and families through a longitudinal evaluation undertaken from 2012 to 2015. In this chapter, the authors explore the development, implementation, and evaluation of Let's Count and highlight the importance of adults noticing, exploring, and talking about children's mathematics. The findings from the longitudinal evaluation of Let's Count suggest that when adults notice children's mathematics, then children's learning thrives, and the positive dispositions and confidence of parents and educators increase. Let's Count has made a positive difference for many children and adults across Australia. © 2017 Elsevier Inc. All rights reserved.

Barriers Inhibiting Inquiry-Based Science Teaching and Potential Solutions: Perceptions of Positively Inclined Early Adopters

NASA Astrophysics Data System (ADS)

Fitzgerald, Michael; Danaia, Lena; McKinnon, David H.

2017-07-01

In recent years, calls for the adoption of inquiry-based pedagogies in the science classroom have formed a part of the recommendations for large-scale high school science reforms. However, these pedagogies have been problematic to implement at scale. This research explores the perceptions of 34 positively inclined early-adopter teachers in relation to their implementation of inquiry-based pedagogies. The teachers were part of a large-scale Australian high school intervention project based around astronomy. In a series of semi-structured interviews, the teachers identified a number of common barriers that prevented them from implementing inquiry-based approaches. The most important barriers identified include the extreme time restrictions on all scales, the poverty of their common professional development experiences, their lack of good models and definitions for what inquiry-based teaching actually is, and the lack of good resources enabling the capacity for change. Implications for expectations of teachers and their professional learning during educational reform and curriculum change are discussed.

[Early prenatal interview: implementation of a sheet link "carried" by patient. The Aurore perinatal network experience].

PubMed

Dupont, C; Gonnaud, F; Touzet, S; Luciani, F; Perié, M-A; Molenat, F; Evrard, A; Fernandez, M-P; Roy, J; Rudigoz, R-C

2008-11-01

Early prenatal interview has needed the implementation of a new communication tool between follow-up pregnancy professionals: a link sheet filled and carried by patients. To assess the utilization of link sheet by trained professionals, the contribution of the interview and the patient acceptation of the link sheet. Descriptive survey from the database of link sheets returned by professionals to Aurore perinatal network and semi-guided interviews with 100 randomized patients. One thousand one hundred and nineteen link sheets were sent to Aurore perinatal network by 55 professionals out of 78 trained. For primipare, precocious prenatal interview contribution has concerned health care security (60%) and emotional security (56%). For multipare, this contribution has concerned mainly emotional security (80%). No interviewed patient has refused link sheet principle. Link sheet principle, like implemented by Aurore perinatal network, seems pertinent to professionals and patients but it constitutes only one of the elements of network elaboration of personalized care.

Translational Medicine Guide transforms drug development processes: the recent Merck experience.

PubMed

Dolgos, Hugues; Trusheim, Mark; Gross, Dietmar; Halle, Joern-Peter; Ogden, Janet; Osterwalder, Bruno; Sedman, Ewen; Rossetti, Luciano

2016-03-01

Merck is implementing a question-based Translational Medicine Guide (TxM Guide) beginning as early as lead optimization into its stage-gate drug development process. Initial experiences with the TxM Guide, which is embedded into an integrated development plan tailored to each development program, demonstrated opportunities to improve target understanding, dose setting (i.e., therapeutic index), and patient subpopulation selection with more robust and relevant early human-based evidence, and increased use of biomarkers and simulations. The TxM Guide is also helping improve organizational learning, costs, and governance. It has also shown the need for stronger external resources for validating biomarkers, demonstrating clinical utility, tracking natural disease history, and biobanking. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Implementation of early intensive behavioural intervention for children with autism in Switzerland.

PubMed

Studer, Nadja; Gundelfinger, Ronnie; Schenker, Tanja; Steinhausen, Hans-Christoph

2017-01-21

There is a major gap between the US and most European countries regarding the implementation of early intensive behavioural intervention (EIBI) for children with autism. The present paper reports on the current status of EIBI in Switzerland and on the effectiveness of EIBI under clinical conditions in a Swiss pilot project. The paper combines a narrative report of the care system for children with autism in Switzerland and an initial evaluation of EIBI as implemented in the Department of Child and Adolescent Psychiatry, University of Zurich. The current situation of the implementation of EIBI for children with autism in Switzerland is characterized by marked deficits in its acceptance. Major reasons include insufficient governmental approval and lacking legal and financial support. In addition, ignorance among health care providers and educational professionals has contributed to this situation precluding that children with autism receive the most beneficial assistance. The authors have initiated and been working in an intervention centre offering EIBI for a decade and report on their experience with the implementation of EIBI. Based on their clinical practice, they document that EIBI also works efficiently under ordinary mental health service conditions. EIBI needs to be implemented more intensively in Switzerland. Although the effects of EIBI as implemented in Zurich are promising, the results are not as pronounced as under controlled research conditions.

Do they see it coming? Using expectancy violation to gauge the success of pedagogical reforms

NASA Astrophysics Data System (ADS)

Gaffney, Jon D. H.; Gaffney, Amy L. Housley; Beichner, Robert J.

2010-06-01

We present a measure, which we have named the Pedagogical Expectancy Violation Assessment (PEVA), for instructors to gauge one aspect of the success of their implementation of pedagogical reform by assessing the expectations and experiences of the students in the classroom. We implemented the PEVA in four physics classes at three institutions that used the Student Centered Active Learning Environment for Undergraduate Programs (SCALE-UP) pedagogy in order to gain an understanding of students’ initial expectations, how those expectations are shifted during early classes, and what students report experiencing at the end of the semester. The results indicate appropriate shifts in student expectations during orientation, but some gaps between student expectations and experiences persisted. Students rated the communication aspects of SCALE-UP as desirable and indicated an overall positive affect toward the pedagogy, indicating that violations of their initial expectations were largely positive. By studying the patterns of the shifts in students’ expectations and gaps between those expectations and their experiences, we gain insight for improving both the orientation of the students and the implementation of the course.

State experiences implementing youth sports concussion laws: challenges, successes, and lessons for evaluating impact.

PubMed

Lowrey, Kerri McGowan; Morain, Stephanie R

2014-01-01

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws' impacts and the development of future public health laws. We conducted key-informant interviews in 35 states with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws' provisions and to identify successful legal approaches to protecting young athletes. © 2014 American Society of Law, Medicine & Ethics, Inc.

Initial experiences with building a health care infrastructure based on Java and object-oriented database technology.

PubMed

Dionisio, J D; Sinha, U; Dai, B; Johnson, D B; Taira, R K

1999-01-01

A multi-tiered telemedicine system based on Java and object-oriented database technology has yielded a number of practical insights and experiences on their effectiveness and suitability as implementation bases for a health care infrastructure. The advantages and drawbacks to their use, as seen within the context of the telemedicine system's development, are discussed. Overall, these technologies deliver on their early promise, with a few remaining issues that are due primarily to their relative newness.

Apollo experience report: Manned thermal-vacuum testing of spacecraft

NASA Technical Reports Server (NTRS)

Mclane, J. C., Jr.

1974-01-01

Manned thermal-vacuum tests of the Apollo spacecraft presented many first-time problems in the areas of test philosophy, operational concepts, and program implementation. The rationale used to resolve these problems is explained and examined critically in view of actual experience. The series of 12 tests involving 1517 hours of chamber operating time resulted in the disclosure of numerous equipment and procedural deficiencies of significance to the flight mission. Test experience and results in view of subsequent flight experience confirmed that thermal-vacuum testing of integrated manned spacecraft provides a feasible, cost-effective, and safe technique with which to obtain maximum confidence in spacecraft flight worthiness early in the program.

Early Experience with a Health Promotion Course for Pharmacy Students in Indonesia

ERIC Educational Resources Information Center

Kristina, Susi Ari; Yulianto, Yulianto; Prabandari, Yayi Suryo

2018-01-01

Objective: To implement a new health promotion course as part of pharmacy public health practices and to identify pharmacy students' knowledge, perceived role and self-efficacy with respect to what was learned through this. Method: A total of 119 fifth-year pharmacy students undertook a new health promotion course in a pharmacy school in…

Seeding Entrepreneurship across Campus: Early Implementation Experiences of the Kauffman Campuses Initiative. Final Report

ERIC Educational Resources Information Center

Hulsey, Lara; Rosenberg, Linda; Kim, Benita

2006-01-01

Although entrepreneurship has long been considered a fundamental aspect of American society, its development as an academic field in U.S. colleges and universities is relatively recent and on-campus entrepreneurship programs have been most commonly found in business schools. Because entrepreneurs and innovative ideas can arise from within any…

Experiences and Lessons of the School-to-Work/Youth Apprenticeship Demonstration. Research and Evaluation Report Series 97-E.

ERIC Educational Resources Information Center

Employment and Training Administration (DOL), Washington, DC.

This report presents a final assessment of the early implementation of the School-to-Work (STW)/Youth Apprenticeship Demonstration programs and participants. Chapter I describes the evolution of STW policy. Chapter II discusses marketing methods, the student selection process and selection criteria, reasons for student participation, and number…

Flexible Learning Options: The Experiences and Perceptions of Regional Youth

ERIC Educational Resources Information Center

Msapenda, Vanessa; Hudson, Cate

2013-01-01

Over the past few decades a variety of alternative or re-entry educational programs have been developed in Australia as an approach to address early school leaving and promote engagement with learning. In South Australia, one of the largest initiatives has been the implementation of Flexible Learning Programs (FLPs) as part of the State…

Early Implementation Experiences of the 2010 Teacher Incentive Fund Grantees. NCEE Study Snapshot. NCEE 2014-4021

ERIC Educational Resources Information Center

National Center for Education Evaluation and Regional Assistance, 2014

2014-01-01

The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

Supporting New Academics' Use of Student Centred Strategies in Traditional University Teaching

ERIC Educational Resources Information Center

Plush, Sally E.; Kehrwald, Benjamin A.

2014-01-01

Despite the perceived advantages of student centred learning (SCL) in higher education, novice teaching academics' attempts to implement such approaches may be thwarted by a lack of experience with teaching in general and with SCL in particular, difficulties locating suitable practical advice on SCL, and the demands of early career academic…

A Mixed-Methods Study of Early Intervention Implementation in the Commonwealth of Pennsylvania

ERIC Educational Resources Information Center

Mattern, Janet Anne

2013-01-01

Children grow and change more rapidly during the first eight years of life than any other time in their life span. Progression through the physical, cognitive, and social-emotional developmental stages varies for each individual child. Children with atypical development experience a wide spectrum of variability in their development. Over the past…

Accountability and Rural Development Partnerships: A Study of Objective 5b EAGGF Funding in South West England

ERIC Educational Resources Information Center

Whittaker, Julie; Warren, Martyn; Turner, Martin; Hutchcroft, Ian

2004-01-01

Funding for Rural Development Partnerships has signalled a shift in rural policy, towards actively involving the rural population in determining the direction and implementation of change. However, early experience with partnerships has indicated that the funding bodies have retained significant control. One reason for this is that they are…

Descubriendo la lectura: An Early Intervention Spanish Language Literacy Project.

ERIC Educational Resources Information Center

Escamilla, Kathy; And Others

During the 1989-90 school year, Descubriendo la Lectura, a Spanish-language adaptation of the English Reading Recovery project was implemented in a large urban school district in Arizona. The program is designed to identify first-grade students at risk of becoming poor readers and to provide a series of intense short-term learning experiences that…

Click, Clack, Moo: Designing Effective Reading Instruction for Children in Preschool and Early Primary Grades

ERIC Educational Resources Information Center

Barclay, Kathy

2009-01-01

As teachers have struggled to implement scientifically based instructional practices in reading, some researchers have begun to focus on ways to "boost the value of reading aloud to young children". Such studies seek ways to promote oral language as well as comprehension and vocabulary through read-aloud experiences. Interactive read-alouds…

Shifting from Enrollment-to Performance-Based Funding in Higher Education: What Can We Learn from Washington's Experience?

ERIC Educational Resources Information Center

Kaikkonen, Darby

2016-01-01

Performance-based funding (PBF) in higher education has grown in recent years as a means of institutional accountability and incentive for improving student success. Although most states have successfully implemented their respective systems, research on early funding models suggests a difficult fiscal environment can introduce tension between…

Toward a space materials systems program

NASA Technical Reports Server (NTRS)

Vontiesenhausen, G. F.

1981-01-01

A program implementation model is presented which covers the early stages of space material processing and manufacturing. The model includes descriptions of major program elements, development and experiment requirements in space materials processing and manufacturing, and an integration of the model into NASA's long range plans as well as its evolution from present Materials Processing in Space plans.

WE-E-304-00: Implementing SBRT Protocols

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

NONE

2015-06-15

SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. A number of national protocols have been and are being developed to assess the clinical efficacy of SBRT for various anatomical sites, such as lung and spine. Physics credentialing for participating and implementation of trial protocols involve a broad spectrum of requirements from image guidance, motion management, to planning technology and dosimetric constrains. For radiation facilities that do not have extensive experiences in SBRT treatment and protocol credentialing, these complex processes of credentialing and implementation could be very challenging and, sometimes, may lead to ineffective evenmore » unsuccessful execution of these processes. In this proposal, we will provide comprehensive review of some current SBRT protocols, explain the requirements and their underline rationales, illustrate representative failed and successful experiences, related to SBRT credentialing, and discuss strategies for effective SBRT credentialing and implementation. Learning Objectives: Understand requirements and challenges of SBRT credentailing and implentation Discuss processes and strategies of effective SBRT credentailing Discuss practical considerations, potential pitfalls and solutions of SBRT implentation.« less

WE-E-304-02: Implementing SBRT Protocols: A NRG CIRO Perspective

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

Xiao, Y.

2015-06-15

SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. A number of national protocols have been and are being developed to assess the clinical efficacy of SBRT for various anatomical sites, such as lung and spine. Physics credentialing for participating and implementation of trial protocols involve a broad spectrum of requirements from image guidance, motion management, to planning technology and dosimetric constrains. For radiation facilities that do not have extensive experiences in SBRT treatment and protocol credentialing, these complex processes of credentialing and implementation could be very challenging and, sometimes, may lead to ineffective evenmore » unsuccessful execution of these processes. In this proposal, we will provide comprehensive review of some current SBRT protocols, explain the requirements and their underline rationales, illustrate representative failed and successful experiences, related to SBRT credentialing, and discuss strategies for effective SBRT credentialing and implementation. Learning Objectives: Understand requirements and challenges of SBRT credentailing and implentation Discuss processes and strategies of effective SBRT credentailing Discuss practical considerations, potential pitfalls and solutions of SBRT implentation.« less

The Machine / Job Features Mechanism

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

Alef, M.; Cass, T.; Keijser, J. J.

Within the HEPiX virtualization group and the Worldwide LHC Computing Grid’s Machine/Job Features Task Force, a mechanism has been developed which provides access to detailed information about the current host and the current job to the job itself. This allows user payloads to access meta information, independent of the current batch system or virtual machine model. The information can be accessed either locally via the filesystem on a worker node, or remotely via HTTP(S) from a webserver. This paper describes the final version of the specification from 2016 which was published as an HEP Software Foundation technical note, and themore » design of the implementations of this version for batch and virtual machine platforms. We discuss early experiences with these implementations and how they can be exploited by experiment frameworks.« less

Implementation of the IHR Joint External Evaluation: Taiwan's Experiences.

PubMed

Lo, Yi-Chun

In February 2016, the World Health Organization developed the Joint External Evaluation (JEE) tool to independently assess country capacity to prevent, detect, and respond to public health threats as part of the International Health Regulations (IHR) (2005) monitoring and evaluation framework. In light of this, the Taiwan government actively engaged at least 19 government agencies or institutions and voluntarily implemented the JEE. An External Assessment Team consisting of 6 US subject matter experts conducted the external evaluation, including site visits, from June 21 to July 1, 2016. The results, published on October 18, 2016, are useful and will be translated into actions and change in the system. Based on Taiwan's experiences, early stakeholder engagement and an experts' pre-JEE pilot visit would contribute to a successful JEE process.

The machine/job features mechanism

NASA Astrophysics Data System (ADS)

Alef, M.; Cass, T.; Keijser, J. J.; McNab, A.; Roiser, S.; Schwickerath, U.; Sfiligoi, I.

2017-10-01

Within the HEPiX virtualization group and the Worldwide LHC Computing Grid’s Machine/Job Features Task Force, a mechanism has been developed which provides access to detailed information about the current host and the current job to the job itself. This allows user payloads to access meta information, independent of the current batch system or virtual machine model. The information can be accessed either locally via the filesystem on a worker node, or remotely via HTTP(S) from a webserver. This paper describes the final version of the specification from 2016 which was published as an HEP Software Foundation technical note, and the design of the implementations of this version for batch and virtual machine platforms. We discuss early experiences with these implementations and how they can be exploited by experiment frameworks.

Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

PubMed

Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

Implementation of the guidelines for targeted temperature management after cardiac arrest: a longitudinal qualitative study of barriers and facilitators perceived by hospital resuscitation champions.

PubMed

Kim, Young-Min; Lee, Seung Joon; Jo, Sun Jin; Park, Kyu Nam

2016-01-05

To identify the barriers to and facilitators of implementing guidelines for targeted temperature management (TTM) after cardiac arrest perceived by hospital resuscitation champions and to investigate the changes in their perceptions over the early implementation period. A longitudinal qualitative study (up to 2 serial semistructured interviews over 1 year and focus groups). The individual interviews and focus groups were transcribed and coded by 2 independent assessors. Contents were analysed thematically; group interaction was also examined. 21 hospitals, including community and tertiary care centres in South Korea. 21 hospital champions (14 acting champions and 7 managerial champions). The final data set included 40 interviews and 2 focus groups. The identified barriers and facilitators could be classified into 3 major themes: (1) healthcare professionals' perceptions of the guidelines and protocols, (2) interdisciplinary and interprofessional collaboration and (3) organisational resources. Lack of resources was the most commonly agreed on barrier for the acting champions, whereas lack of interdisciplinary collaboration was the most common barrier for the managerial champions. Educational activities and sharing successfully treated cases were the most frequently identified facilitators. Most of the participants identified and agreed that cooling equipment was an important barrier as well as a facilitator of successful TTM implementation. Perception of the guidelines and protocols has improved with the accumulation of clinical experience over the study period. Healthcare professionals' internal barriers to TTM implementation may be influenced by new guidelines and can be changed with the accumulation of successful clinical experiences during the early implementation period. Promoting interprofessional and interdisciplinary collaboration through educational activities and the use of cooling equipment with an automated feedback function can improve adherence to guidelines in hospitals with limited human resources in critical care. 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/

Implementation of the guidelines for targeted temperature management after cardiac arrest: a longitudinal qualitative study of barriers and facilitators perceived by hospital resuscitation champions

PubMed Central

Kim, Young-Min; Lee, Seung Joon; Jo, Sun Jin; Park, Kyu Nam

2016-01-01

Objectives To identify the barriers to and facilitators of implementing guidelines for targeted temperature management (TTM) after cardiac arrest perceived by hospital resuscitation champions and to investigate the changes in their perceptions over the early implementation period. Design A longitudinal qualitative study (up to 2 serial semistructured interviews over 1 year and focus groups). The individual interviews and focus groups were transcribed and coded by 2 independent assessors. Contents were analysed thematically; group interaction was also examined. Setting 21 hospitals, including community and tertiary care centres in South Korea. Participants 21 hospital champions (14 acting champions and 7 managerial champions). Results The final data set included 40 interviews and 2 focus groups. The identified barriers and facilitators could be classified into 3 major themes: (1) healthcare professionals’ perceptions of the guidelines and protocols, (2) interdisciplinary and interprofessional collaboration and (3) organisational resources. Lack of resources was the most commonly agreed on barrier for the acting champions, whereas lack of interdisciplinary collaboration was the most common barrier for the managerial champions. Educational activities and sharing successfully treated cases were the most frequently identified facilitators. Most of the participants identified and agreed that cooling equipment was an important barrier as well as a facilitator of successful TTM implementation. Perception of the guidelines and protocols has improved with the accumulation of clinical experience over the study period. Conclusions Healthcare professionals’ internal barriers to TTM implementation may be influenced by new guidelines and can be changed with the accumulation of successful clinical experiences during the early implementation period. Promoting interprofessional and interdisciplinary collaboration through educational activities and the use of cooling equipment with an automated feedback function can improve adherence to guidelines in hospitals with limited human resources in critical care. PMID:26733568

Implementation of Evidence-Based Book-Reading Strategies by Head Start Teachers: Benefits of Professional Development and Effect on Children's Literacy Outcomes

ERIC Educational Resources Information Center

Butler, Michelyn Cynthia

2012-01-01

Evidence strongly supports shared book-reading (SBR) as an opportune intervention for developing early literacy and language development in at-risk preschool-aged children. Many teachers of high-risk preschoolers, however, lack the instructional skills and evidence-based strategies essential for the most effective storybook experience.…

Too early to tell, or too late to rescue? Adaptive management under scrutiny.

Treesearch

Sally Duncan

2001-01-01

Key to the long-term success of implementing the Northwest Forest Plan (NWFP) is adaptive management—the idea of treating management policies as experiments, learning from them, and using them as a basis for changes and adjustments. Although much of the NWFP involves standards and guides that prescribe future management, and restrictive allocations such as...

Engaging Disconnected Young People in Education and Work: Findings from the Project Rise Implementation Evaluation

ERIC Educational Resources Information Center

Manno, Michelle S.; Yang, Edith; Bangser, Michael

2015-01-01

Educational attainment and early work experience provide a crucial foundation for future success. However, many young adults are disconnected from both school and the job market. Neglecting these young people can exact a heavy toll on not only the individuals but also society as a whole, for example, through lost productivity and tax…

Introducing Chemical Reactions Concepts in K-6 through a Hands-On Food Spherification and Spaghetti-Fication Experiment

ERIC Educational Resources Information Center

Gupta, Anju; Hill, Nicole; Valenzuela, Patricia; Johnson, Eric

2017-01-01

Recruiting students in STEM majors to fill the gap in STEM workforce is a continued challenge, which can be addressed by introducing scientific principles through hand-on activities to the students at an early stage. This paper presents the design, implementation and assessment of a chemistry-related workshop for sixth grade students that were…

Protocol for a pre-implementation and post-implementation study on shared decision-making in the surgical treatment of women with early-stage breast cancer.

PubMed

Savelberg, Wilma; Moser, Albine; Smidt, Marjolein; Boersma, Liesbeth; Haekens, Christel; van der Weijden, Trudy

2015-03-31

The majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients' informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to β test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting. This paper concerns a pre-implementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid. This protocol was approved by the Maastricht University Medical Centre (MUMC) ethics committee. The findings will be disseminated through peer-reviewed journal articles and presentations at national conferences. Findings will be used to finalise a multi-faceted implementation strategy to test the implementation of SDM and a patient decision aid in terms of cost-effectiveness, in a multicentre cluster randomised controlled trial (RCT). NTR4879. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[A new concept of organization and scope of neurosurgical care in the US army during armed conflicts in the early 2000s].

PubMed

Khrapov, Yu V; Alekseev, D E; Svistov, D V

Military operations in various parts of the world in the early 2000s are becoming more regionalized; new warfare tactics emerge, which makes it necessary to review and modify the neurosurgical care system. The article reviews the results of original studies on this issue and summarizes the experience of the US Army medical service in Afghanistan and Iraq. The article discusses the structure of sanitary losses, organization and scope of medical and evacuation neurosurgical measures, types and techniques of surgical interventions, and the rate of complications. We describe five levels of neurosurgical care echelons and an implemented "injury control - neurosurgery" concept; particular attention is paid to the peculiarities of research and specialist training. We demonstrate that implementation of the new concept for organization and scope of neurosurgical care has improved treatment outcomes and reduced the mortality rate in the mentioned military conflicts of recent years compared to those in the Vietnam War. We may conclude that the described experience of the US Army can be used to improve the efficacy of neurosurgical care to the wounded and victims of armed conflicts.

Radiation protection issues on preparedness and response for a severe nuclear accident: experiences of the Fukushima accident.

PubMed

Homma, T; Takahara, S; Kimura, M; Kinase, S

2015-06-01

Radiation protection issues on preparedness and response for a severe nuclear accident are discussed in this paper based on the experiences following the accident at Fukushima Daiichi nuclear power plant. The criteria for use in nuclear emergencies in the Japanese emergency preparedness guide were based on the recommendations of International Commission of Radiological Protection (ICRP) Publications 60 and 63. Although the decision-making process for implementing protective actions relied heavily on computer-based predictive models prior to the accident, urgent protective actions, such as evacuation and sheltering, were implemented effectively based on the plant conditions. As there were no recommendations and criteria for long-term protective actions in the emergency preparedness guide, the recommendations of ICRP Publications 103, 109, and 111 were taken into consideration in determining the temporary relocation of inhabitants of heavily contaminated areas. These recommendations were very useful in deciding the emergency protective actions to take in the early stages of the Fukushima accident. However, some suggestions have been made for improving emergency preparedness and response in the early stages of a severe nuclear accident. © The Chartered Institution of Building Services Engineers 2014.

Evaluating Niger's experience in strengthening supervision, improving availability of child survival drugs through cost recovery, and initiating training for Integrated Management of Childhood Illness (IMCI)

PubMed Central

Tawfik, Youssef M; Legros, Stephane; Geslin, Colette

2001-01-01

Background WHO and UNICEF have recently developed the "Integrated Management of Childhood Illness" (IMCI) as an efficient strategy to assist developing countries reduce childhood mortality. Early experience with IMCI implementation suggests that clinical training is essential but not sufficient for the success of the strategy. Attention needs to be given to strengthening health systems, such as supervision and drug supply. Results This paper presents results of evaluating an innovative approach for implementing IMCI in Niger. It starts with strengthening district level supervision and improving the availability of child survival drugs through cost recovery well before the beginning of IMCI clinical training. The evaluation documented the effectiveness of the initial IMCI clinical training and referral. Conclusions Strengthening supervision and assuring the availability of essential drugs need to precede the initiation of IMCI Clinical training. Longer term follow up is necessary to confirm the impact of the approach on IMCI preparation and implementation. PMID:11504567

Evaluating the Social Validity of the Early Start Denver Model: A Convergent Mixed Methods Study.

PubMed

Ogilvie, Emily; McCrudden, Matthew T

2017-09-01

An intervention has social validity to the extent that it is socially acceptable to participants and stakeholders. This pilot convergent mixed methods study evaluated parents' perceptions of the social validity of the Early Start Denver Model (ESDM), a naturalistic behavioral intervention for children with autism. It focused on whether the parents viewed (a) the ESDM goals as appropriate for their children, (b) the intervention procedures as acceptable and appropriate, and (c) whether changes in their children's behavior was practically significant. Parents of four children who participated in the ESDM completed the TARF-R questionnaire and participated in a semi-structured interview. Both data sets indicated that parents rated their experiences with the ESDM positively and rated it as socially-valid. The findings indicated that what was implemented in the intervention is complemented by how it was implemented and by whom.

[The general criteria and recommendations for the elaboration of programs for the early detection of breast cancer and cervical cancer in Spain. The Working Group for the Early Detection of Breast Cancer and Cervical Cancer].

PubMed

Ascunze Elizaga, N; González Enríquez, J; González Navarro, A; Herranz Fernández, C; Marqués Bravo, A; Martín Pérez, J

1993-01-01

Cancer screening and primary prevention of cancer are effective strategies to reduce cancer morbidity and mortality. The experience gained in several European countries about breast and cervical cancer has been growing in the last decades. This fact facilitates the adoption of the most convenient strategies to implement screening programmes in Spain. The Spanish Ministry of Health and Consumer Affairs set up a work group of experts and health managers to make recommendations and to define the basic criteria to take into account when planning and implementing these programmes. The article describes those recommendations as well as the priorities to be established regarding the target population, and the strategies to increase efficiency of those programmes. Recommendations were made according with scientific evidences and the current situation and resources in Spain.

Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries.

PubMed

Creswell, Jacob; Codlin, Andrew J; Andre, Emmanuel; Micek, Mark A; Bedru, Ahmed; Carter, E Jane; Yadav, Rajendra-Prasad; Mosneaga, Andrei; Rai, Bishwa; Banu, Sayera; Brouwer, Miranda; Blok, Lucie; Sahu, Suvanand; Ditiu, Lucica

2014-01-02

The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the versatility and impact of the technology, but also outlines various surmountable barriers to implementation. The study is not representative of all early implementer experiences with MTB/RIF testing but rather provides an overview of the shared issues as well as the many different approaches to programmatic MTB/RIF implementation.

Targeting Classrooms' Emotional Climate and Preschoolers' Socioemotional Adjustment: Implementation of the Chicago School Readiness Project

PubMed Central

Li-Grining, Christine P.; Raver, C. Cybele; Jones-Lewis, Darlene; Madison-Boyd, Sybil; Lennon, Jaclyn

2015-01-01

Children living in low-income families are more likely to experience less self-regulation, greater behavior problems, and lower academic achievement than higher income children. To help prevent children's later socioemotional and academic difficulties, the Chicago School Readiness Project (CSRP) team implemented a clustered, randomized controlled trial (RCT) in early childhood programs with Head Start funding. Head Start sites were randomly assigned to receive CSRP services, which were offered as part of a multi-component, classroom-based mental health intervention. Here, we provide an overview of the CSRP model, its components, and a descriptive portrait of its implementation. In so doing, we address various aspects of the implementation of three of its components: 1) the training of teachers, 2) MHCs' coaching of teachers, and 3) teachers' behavior management of children. We conclude with a discussion of factors potentially related to the implementation of CSRP and directions for future research. PMID:25321641

The impact of global budgets on pharmaceutical spending and utilization: early experience from the alternative quality contract.

PubMed

Afendulis, Christopher C; Fendrick, A Mark; Song, Zirui; Landon, Bruce E; Safran, Dana Gelb; Mechanic, Robert E; Chernew, Michael E

2014-01-01

In 2009, Blue Cross Blue Shield of Massachusetts implemented a global budget-based payment system, the Alternative Quality Contract (AQC), in which provider groups assumed accountability for spending. We investigate the impact of global budgets on the utilization of prescription drugs and related expenditures. Our analyses indicate no statistically significant evidence that the AQC reduced the use of drugs. Although the impact may change over time, early evidence suggests that it is premature to conclude that global budget systems may reduce access to medications. © The Author(s) 2014.

Sleep to implement an intention.

PubMed

Diekelmann, Susanne; Wilhelm, Ines; Wagner, Ullrich; Born, Jan

2013-01-01

Sleep supports the consolidation of new memories. However, this effect has mainly been shown for memories of past events. Here we investigated the role of sleep for the implementation of intentions for the future. Subjects were instructed on a plan that had to be executed after a delay of 2 days. After plan instruction, subjects were either allowed to sleep or stayed awake for one night (Exp. 1) or had a 3-h sleep period either during the early night (SWS-rich sleep) or late night (REM-rich sleep; Exp. 2). In both experiments, retesting took place 2 days later after one recovery night. Sleep laboratory. A total of 56 healthy young adults participated in the study. N/A. All of the subjects who were allowed to sleep after plan instruction executed the intention 2 days later, whereas only 61% of wake subjects did so (P = 0.004; Exp. 1). Also after early SWS-rich sleep all of the subjects remembered to execute the intention, but only 55% did so after late REM-rich sleep (P = 0.015; Exp. 2). Sleep, especially SWS, plays an important role for the successful implementation of delayed intentions.

Early Childhood Educators' Meta-Cognitive Knowledge of Problem-Solving Strategies and Quality of Childcare Curriculum Implementation

ERIC Educational Resources Information Center

Kim, Yeon Ha

2016-01-01

This study aims to explore the impact of early childhood educators' meta-cognitive knowledge on the quality of their childcare curriculum implementation, and to gain insights regarding successful problem-solving strategies associated with early education and care. Early childhood educators' implementation of general problem-solving strategies in…

Operational research leading to rapid national policy change: tuberculosis-diabetes collaboration in India.

PubMed

Kumar, A M V; Satyanarayana, S; Wilson, N C; Chadha, S S; Gupta, D; Nair, S; Zachariah, R; Kapur, A; Harries, A D

2014-06-21

In 2011, bi-directional screening for tuberculosis (TB) and diabetes mellitus (DM) was recommended by the World Health Organization (WHO), although how best to implement the activity was not clear. In India, with early engagement of national programme managers and all important stakeholders, a countrywide, multicentre operational research (OR) project was designed in October 2011 and completed in 2012. The results led to a rapid national policy decision to routinely screen all TB patients for DM in September 2012. The process, experience and enablers of implementing this unique and successful collaborative model of operational research are presented.

The Indiana Public Health Emergency Surveillance System: Ongoing Progress, Early Findings, and Future Directions

PubMed Central

Grannis, Shaun; Wade, Michael; Gibson, Joseph; Overhage, J. Marc

2006-01-01

Beginning in 2004, the Indiana State Department of Health (ISDH) partnered with the Regenstrief Institute on a 4-year project to implement a statewide biosurveillance system incorporating more than 110 hospitals. This paper describes our evolving experience with the system including ongoing implementation challenges, how the system has helped to uncover events of public health significance, and future directions. The system currently receives emergency department visit data from 50 hospitals totaling nearly 5,000 visits per day, and is projected to have 65 hospitals connected by August 2006. PMID:17238352

Implementation of a Hydrotherapy Protocol to Improve Postpartum Pain Management.

PubMed

Batten, Meghann; Stevenson, Eleanor; Zimmermann, Deb; Isaacs, Christine

2017-03-01

A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth. The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center. All women who met criteria were offered a 30-minute warm water immersion bath at one hour postpartum. Pain scores were assessed prior to the bath, at 15 minutes after onset, and again at the conclusion (30 minutes). Women who completed the bath were also asked to complete a brief survey on their experience with postpartum hydrotherapy. In women who used the bath (N = 45), there was a significant reduction in pain scores (P < .001) between the onset of the bath and scores at both 15 minutes and 30 minutes. There was no significant difference between pain scores at 15 minutes and 30 minutes (P = .97). Of those women who completed a survey (n = 43), 97.7% reported both that the bath reduced their pain and improved their birth experience. One hundred percent reported they would use it again in another birth. This project demonstrated successful implementation of a hydrotherapy protocol as an alternative or adjunct to medication for early postpartum pain management that significantly reduced pain and improved the birth experience for those who used it. It offers a nonpharmacologic alternative where there have traditionally been limited options. © 2017 by the American College of Nurse-Midwives.

Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

PubMed

Kelsey, Meredith; Layzer, Jean

2014-03-01

This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Early experiences in evolving an enterprise-wide information model for laboratory and clinical observations.

PubMed

Chen, Elizabeth S; Zhou, Li; Kashyap, Vipul; Schaeffer, Molly; Dykes, Patricia C; Goldberg, Howard S

2008-11-06

As Electronic Healthcare Records become more prevalent, there is an increasing need to ensure unambiguous data capture, interpretation, and exchange within and across heterogeneous applications. To address this need, a common, uniform, and comprehensive approach for representing clinical information is essential. At Partners HealthCare System, we are investigating the development and implementation of enterprise-wide information models to specify the representation of clinical information to support semantic interoperability. This paper summarizes our early experiences in: (1) defining a process for information model development, (2) reviewing and comparing existing healthcare information models, (3) identifying requirements for representation of laboratory and clinical observations, and (4) exploring linkages to existing terminology and data standards. These initial findings provide insight to the various challenges ahead and guidance on next steps for adoption of information models at our organization.

Swingbed Amine Carbon Dioxide Removal Flight Experiment - Feasibility Study and Concept Development for Cost-Effective Exploration Technology Maturation on The International Space Station

NASA Technical Reports Server (NTRS)

Hodgson, Edward; Papale, William; Nalette, Timothy; Graf, John; Sweterlitsch, Jeffery; Hayley, Elizabeth; Williams, Antony; Button, Amy

2011-01-01

The completion of International Space Station Assembly and transition to a full six person crew has created the opportunity to create and implement flight experiments that will drive down the ultimate risks and cost for human space exploration by maturing exploration technologies in realistic space environments that are impossible or incredibly costly to duplicate in terrestrial laboratories. An early opportunity for such a technology maturation experiment was recognized in the amine swingbed technology baselined for carbon dioxide and humidity control on the Orion spacecraft and Constellation Spacesuit System. An experiment concept using an existing high fidelity laboratory swing bed prototype has been evaluated in a feasibility and concept definition study leading to the conclusion that the envisioned flight experiment can be both feasible and of significant value for NASA s space exploration technology development efforts. Based on the results of that study NASA has proceeded with detailed design and implementation for the flight experiment. The study effort included the evaluation of technology risks, the extent to which ISS provided unique opportunities to understand them, and the implications of the resulting targeted risks for the experiment design and operational parameters. Based on those objectives and characteristics, ISS safety and integration requirements were examined, experiment concepts developed to address them and their feasibility assessed. This paper will describe the analysis effort and conclusions and present the resulting flight experiment concept. The flight experiment, implemented by NASA and launched in two packages in January and August 2011, integrates the swing bed with supporting elements including electrical power and controls, sensors, cooling, heating, fans, air- and water-conserving functionality, and mechanical packaging structure. It is now on board the ISS awaiting installation and activation.

Accountable Care Organization Implementation Experiences and Rural Participation: Considerations for Nurses.

PubMed

Bagwell, Matt Thomas; Bushy, Angeline; Ortiz, Judith

2017-01-01

Little is known about how accountable care organizations (ACOs) participate with rural health providers. This pilot study examines ACO participation with rural health clinics (RHCs). Telephone interviews with 8 ACO administrators were conducted to determine the early implementation experiences of these organizations, and their participation with rural health providers, such as RHCs, using qualitative content analysis, ACO characteristics, and emerging themes from the ACO executive responses was identified. Three predominant themes emerged: 1) ACOs are growing in size and number and have various organizational structures; 2) there is an expanding emphasis on preventive primary care and chronic disease management for patients; and 3) there is a need for improved information technology integration with clinical services and financial systems. Of 8 participants, 7 reported that their ACO was planning to expand into rural areas and partner with rural providers.

[The role of supply-side characteristics of services in AIDS mortality in Mexico].

PubMed

Bautista-Arredondo, Sergio; Serván-Mori, Edson; Silverman-Retana, Omar; Contreras-Loya, David; Romero-Martínez, Martín; Magis-Rodríguez, Carlos; Uribe-Zúñiga, Patricia; Lozano, Rafael

2015-01-01

To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

Working with and promoting early career scientists within a larger community

NASA Astrophysics Data System (ADS)

Pratt, K.

2017-12-01

For many scientific communities, engaging early career researchers is critical for success. These young scientists (graduate students, postdocs, and newly appointed professors) are actively forming collaborations and instigating new research programs. They also stand to benefit hugely from being part of a scientific community, gaining access to career development activities, becoming part of strong collaborator networks, and achieving recognition in their field of study — all of which will help their professional development. There are many ways community leaders can work proactively to support and engage early career scientists, and it it is often a community manager's job to work with leadership to implement such activities. In this presentation, I will outline ways of engaging early career scientists at events and tailored workshops, of promoting development of their leadership skills, and of creating opportunities for recognizing early career scientists within larger scientific communities. In this talk, I will draw from my experience working with the Deep Carbon Observatory Early Career Scientist Network, supported by the Alfred P. Sloan Foundation.

Early experiences with the multidose drug dispensing system – A matter of trust?

PubMed Central

Wekre, Liv Johanne; Melby, Line; Grimsmo, Anders

2011-01-01

Objective To study early experiences with multidose drug dispensing (MDD) among different groups of health personnel. Design Qualitative study based on focus-group interviews. Setting Primary health care, Trondheim, Norway. Main outcome The importance of trust in the technology and in collaborating partners is actualized in the early implementation of MDD. Results GPs, home-care nurses, pharmacists, and medical secretaries trusted the new MDD technology. The quality of the GPs’ medication records improved. However, health personnel, including the GPs themselves, would not always trust the medication records of the GPs. Checking the multidose bags arriving from the pharmacy was considered unnecessary in the written routines dealing with MDD. However, home-care nurses experienced errors and continued to manually check the bags. Nurses in the home-care service felt a loss of knowledge with regard to the patients’ medications and in turn experienced reduced ability to give medical information to patients and to observe the effects of the drugs. The home-care services’ routines for drug handling were not always trusted by the other groups of health personnel involved. Conclusion Health personnel faced some challenges during the implementation of the MDD system, but most of them remained confident in the new system. Building trust has to be a process that runs in parallel with the introduction of new technology and the establishment of new routines for improving the quality in handling of medicines and to facilitate better cooperation and communication. PMID:21323496

Big data managing in a landslide early warning system: experience from a ground-based interferometric radar application

NASA Astrophysics Data System (ADS)

Intrieri, Emanuele; Bardi, Federica; Fanti, Riccardo; Gigli, Giovanni; Fidolini, Francesco; Casagli, Nicola; Costanzo, Sandra; Raffo, Antonio; Di Massa, Giuseppe; Capparelli, Giovanna; Versace, Pasquale

2017-10-01

A big challenge in terms or landslide risk mitigation is represented by increasing the resiliency of society exposed to the risk. Among the possible strategies with which to reach this goal, there is the implementation of early warning systems. This paper describes a procedure to improve early warning activities in areas affected by high landslide risk, such as those classified as critical infrastructures for their central role in society. This research is part of the project LEWIS (Landslides Early Warning Integrated System): An Integrated System for Landslide Monitoring, Early Warning and Risk Mitigation along Lifelines. LEWIS is composed of a susceptibility assessment methodology providing information for single points and areal monitoring systems, a data transmission network and a data collecting and processing center (DCPC), where readings from all monitoring systems and mathematical models converge and which sets the basis for warning and intervention activities. The aim of this paper is to show how logistic issues linked to advanced monitoring techniques, such as big data transfer and storing, can be dealt with compatibly with an early warning system. Therefore, we focus on the interaction between an areal monitoring tool (a ground-based interferometric radar) and the DCPC. By converting complex data into ASCII strings and through appropriate data cropping and average, and by implementing an algorithm for line-of-sight correction, we managed to reduce the data daily output without compromising the capability for performing.

Using Skype to support remote clinical supervision for health professionals delivering a sustained maternal early childhood programme: a phenomenographical study.

PubMed

Bruce, Tracey; Byrne, Fiona; Kemp, Lynn

2018-02-01

Skype technology was implemented by the Australian Maternal Early Childhood Sustained Home-visiting (MECSH) Support Service as a tool for the remote provision of clinical supervision for clinicians working in the MECSH program in Seoul, South Korea. To gain a better understanding of the processes underpinning sustainable delivery of remote clinical supervision using digital technologies. A phenomenographical study. Recorded notes and reflections on each supervision session, noting exemplars and characteristics of the experience were read and re-read to derive the characterizations of the experience. The experience has provided learnings in three domains: (1) the processes in using Skype; (2) supervisory processes; and (3) language translation, including managing clarity of, and time for translation. Skype has potential for use in remote provision of clinical supervision, including where translation is required. Further research evaluating the benefit of telesupervision from supervisor and supervisee perspectives is necessary to determine if it is a sustainable process.

How did we make the Interdisciplinary Generalist Curriculum Project work? School-level efforts to facilitate success.

PubMed

Matson, C; Davis, A; Steinkohl, D C; Blavo, C

2001-04-01

This article examines how the schools funded by the Interdisciplinary Generalist Curriculum (IGC) Project handled the process of planning and implementing their proposals; incorporated the IGC requirements as templates for changes in educational programs and organizational infrastructures; and identified key educational and management issues that emerged over time. How collaboration flourished at each IGC school was the central functional ingredient for successful implementation. Shared power and support from the dean were essential for success. The need for excellent channels of communication among all constituencies in the process of curricular change cannot be overemphasized. The most common approach was the addition of the new interdisciplinary clinical curriculum to the existing, usually discipline-based, curriculum, with attempts to establish integrative horizontal connections among concurrent courses in years one and two. The integration, sequencing, and correlating of basic science and clinical material occupied much of the IGC course directors' time in the early stages. Several approaches were used to help ensure a beneficial initial clinical experience for medical students, while accepting that a uniform experience for all students was not attainable or necessary. Encouraging active learning on the part of students was a goal of IGC schools' planning in and of itself. The splash of establishing interdisciplinary communication structures and greater melding of disciplinary cultures that occurred at and among the IGC schools appeared to lead to ripple effects that were recognized within the first year of planning and early implementation.

Project EAGLE (Early Academic Gifted Learning Experience): A Program for Gifted and Talented Students (Grades K-3)--Animals 3; Magnets; Sight; Geoboards 3; Dinosaurs 3; and Groups 3.

ERIC Educational Resources Information Center

Merkoski, Kay

Six thematic activity booklets are presented for implementing Project EAGLE, an enrichment program for gifted and talented primary-level children. "Animals 3" introduces endangered animals and locates their home areas on maps or globes, using nine learning activities involving science and creative writing. "Magnets" discusses…

"We Were Told We're Not Teachers... It Gets Difficult to Draw the Line": Negotiating Roles in Peer-Assisted Study Sessions (PASS)

ERIC Educational Resources Information Center

Brown, Kim; Nairn, Karen; van der Meer, Jacques; Scott, Carole

2014-01-01

Peer learning models in pre-service teacher education are in the early stages of implementation. In this article, we evaluated a pilot Peer-Assisted Study Sessions (PASS) program that supplemented a course for pre-service teachers at one New Zealand university. PASS participants discussed experiences of the program, revealing tensions between what…

Lived Experiences of Sex Life Difficulties in Men and Women with Early RA - The Swedish TIRA Project.

PubMed

Östlund, Gunnel; Björk, Mathilda; Valtersson, Eva; Sverker, Annette

2015-12-01

Men and women with rheumatoid arthritis (RA) experience restrictions in everyday life, in spite of the development of new medications. Recent research has described in detail how participation limitations are experienced in everyday life from a patient perspective. However, knowledge of how sex and intimate relationships are affected is still scarce. The aim of the present study was to explore sex life experiences in relation to sexual function and sexual relationships in men and women with early RA. The study formed part of TIRA-2 (the Swedish acronym for the prospective multicentre early arthritis project). The data collection included 45 interviews with 21 men and 24 women, aged 20-63, which were recorded and transcribed verbatim. The critical incident technique was used to collect data, and content analysis to categorize the results. Half the participants stated that RA affected their sex life. The general descriptions formed five categories: sex life and tiredness; sex life and ageing; emotional consequences of impaired sexual function; facilitators of sexual function and sexual relationships; and strain on the sexual relationship. Sex life is affected in early RA, in spite of new effective treatment strategies. New strategies of communication, assessment and self-managing interventions concerning the sex lives of patients with RA need to be implemented by a multidisciplinary healthcare team. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Translating evidence-based interventions for implementation: Experiences from Project HEAL in African American churches.

PubMed

Holt, Cheryl L; Tagai, Erin K; Scheirer, Mary Ann; Santos, Sherie Lou Z; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie L; Wang, Min Qi; Whitehead, Tony

2014-05-31

Community-based approaches have been increasing in the effort to raise awareness and early detection for cancer and other chronic disease. However, many times, such interventions are tested in randomized trials, become evidence-based, and then fail to reach further use in the community. Project HEAL (Health through Early Awareness and Learning) is an implementation trial that aims to compare two strategies of implementing evidence-based cancer communication interventions in African American faith-based organizations. This article describes the community-engaged process of transforming three evidence-based cancer communication interventions into a coherent, branded strategy for training community health advisors with two delivery mechanisms. Peer community health advisors receive training through either a traditional classroom approach (with high technical assistance/support) or a web-based training portal (with low technical assistance/support). We describe the process, outline the intervention components, report on the pilot test, and conclude with lessons learned from each of these phases. Though the pilot phase showed feasibility, it resulted in modifications to data collection protocols and team and community member roles and expectations. Project HEAL offers a promising strategy to implement evidence-based interventions in community settings through the use of technology. There could be wider implications for chronic disease prevention and control.

Competency-based education: programme design and challenges to implementation.

PubMed

Gruppen, Larry D; Burkhardt, John C; Fitzgerald, James T; Funnell, Martha; Haftel, Hilary M; Lypson, Monica L; Mullan, Patricia B; Santen, Sally A; Sheets, Kent J; Stalburg, Caren M; Vasquez, John A

2016-05-01

Competency-based education (CBE) has been widely cited as an educational framework for medical students and residents, and provides a framework for designing educational programmes that reflect four critical features: a focus on outcomes, an emphasis on abilities, a reduction of emphasis on time-based training, and promotion of learner centredness. Each of these features has implications and potential challenges for implementing CBE. As an experiment in CBE programme design and implementation, the University of Michigan Master of Health Professions Education (UM-MHPE) degree programme was examined for lessons to be learned when putting CBE into practice. The UM-MHPE identifies 12 educational competencies and 20 educational entrustable professional activities (EPAs) that serve as the vehicle for both learning and assessment. The programme also defines distinct roles of faculty members as assessors, mentors and subject-matter experts focused on highly individualised learning plans adapted to each learner. Early experience with implementing the UM-MHPE indicates that EPAs and competencies can provide a viable alternative to traditional courses and a vehicle for rigorous assessment. A high level of individualisation is feasible but carries with it significant costs and makes intentional community building essential. Most significantly, abandoning a time-based framework is a difficult innovation to implement in a university structure that is predicated on time-based education. © 2016 John Wiley & Sons Ltd.

Early Warning System Implementation Guide: For Use with the National High School Center's Early Warning System Tool v2.0

ERIC Educational Resources Information Center

Therriault, Susan Bowles; Heppen, Jessica; O'Cummings, Mindee; Fryer, Lindsay; Johnson, Amy

2010-01-01

This Early Warning System (EWS) Implementation Guide is a supporting document for schools and districts that are implementing the National High School Center's Early Warning System (EWS) Tool v2.0. Developed by the National High School Center at the American Institutes for Research (AIR), the guide and tool support the establishment and…

BookFun--"There's More to It than Reading a Book"--Implementing a Danish Early Literacy Programme That Supports Professionalism, Language Development and Social Inclusion

ERIC Educational Resources Information Center

Clasen, Line Engel; Jensen de López, Kristine

2017-01-01

Several early literacy programmes have documented their effectiveness in enhancing children's early literacy and language development. Despite recent interest in implementing evidence-based programmes, only a few studies have set out to capture the implementation process of early literacy programmes as seen from the programme users' perspectives.…

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

PubMed

Cortés-Bordoy, Javier; Martinón-Torres, Federico

2010-08-01

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

Insights from Australian parents into educational experiences in the early postnatal period.

PubMed

McKellar, Lois V; Pincombe, Jan I; Henderson, Ann M

2006-12-01

to investigate the provision of parent education during the early postnatal period in order to gain insight that, through stakeholder collaboration, will contribute to the development of innovative strategies to enhance the provision of postnatal education in a contemporary health-care environment. the study comprises the first stage of an action-research project. The first stage of research sought to explore the experiences of mothers and fathers in the early postnatal period by conducting a questionnaire within 4 weeks of the birth of their baby. The data obtained from the questionnaire is to inform an action-research group for stage two of the project. The Children, Youth and Women's Health Service, a large city maternity hospital in South Australia, covering a range of socio-economic strata. 85 parents completed and returned the questionnaire, comprising 52 mothers and 33 fathers. an anonymous self-report questionnaire was purpose designed to provide each parent with an opportunity to reflect on their own experience, with particular emphasis given to the provision of education and support during the early postnatal period. a number of themes emerged, including a window of opportunity during the postnatal hospital stay to provide education and support, despite the reduction in the length of stay; the need for a family-centred approach to maternity services; and the significance of self and social network in the early transition to parenthood. The findings from this stage of the research, combined with a review of the literature, provide insight that will contribute to stage two of the study. At this stage, an action-research group will continue planning to develop specific actions to enhance the provision of education to parents in the early postnatal period. These actions will subsequently be implemented and assessed.

Reported experiences from occupational therapists interacting with teachers in inclusive early childhood classrooms.

PubMed

Bose, Pia; Hinojosa, Jim

2008-01-01

This grounded theory study described the perspectives of school-based occupational therapists working in inclusive early childhood classrooms emphasizing interactions with teaching staff. Six therapists were interviewed multiple times over several months. The participants viewed their interactions with teaching staff as challenging but potentially rewarding experiences. Viewing collaboration as valuable, their descriptions nonetheless generally omitted many collaborative features, with therapists often assigned the role of "expert." Data analysis revealed four major themes: (1) "It's Not Like I Don't Value Collaboration" (the benefits of collaboration); (2) "Collaboration--I Can't Do It Alone" (the challenges of interactions); (3) "My Opinion, Please Ask for It" (attachment to the expert status), and (4) "Is This Collaboration?" (interactions in practice). The results of this study suggest that current recommendations for collaboration for inclusion in school-based occupational therapy are not optimally implemented in all practice settings.

Community-Level Challenges in Implementing a Mixed Delivery Prekindergarten System: A Brief Review of Research and Field Experience. School Community Partnerships Project. Policy Brief I

ERIC Educational Resources Information Center

Stephens, Samuel A.

2014-01-01

Over the past decade, states have dramatically expanded prekindergarten services (Pre-K), given the evidence that high-quality early childhood education can put children on a path to success in school and later life. To support the expansion, most of those states have adopted a mixed delivery system, developing the new educational opportunities in…

Implementation of an Evidence-Based and Content Validated Standardized Ostomy Algorithm Tool in Home Care: A Quality Improvement Project.

PubMed

Bare, Kimberly; Drain, Jerri; Timko-Progar, Monica; Stallings, Bobbie; Smith, Kimberly; Ward, Naomi; Wright, Sandra

Many nurses have limited experience with ostomy management. We sought to provide a standardized approach to ostomy education and management to support nurses in early identification of stomal and peristomal complications, pouching problems, and provide standardized solutions for managing ostomy care in general while improving utilization of formulary products. This article describes development and testing of an ostomy algorithm tool.

Multinational Experiment 7. Regional Analysis: Western Indian Ocean

DTIC Science & Technology

2013-03-01

its five Working Groups as observers. Decisions must be taken by consensus by the members of CGPCS. As of February 2013 representatives of71...action against pirate supply bases onshore. The decision was implemented for the first time on May 15 as helicopters destroyed a number of fast...regime. As of early 2013, however, we do not believe that those efforts have been decisive in reducing piracy activities. Presently, two regimes

A Novel early pregnancy assessment unit/Gynaecology assessment unit dashboard: An experience from a UK district general hospital.

PubMed

Wahba, K; Shah, A; Hill, K; Hosni, M M

2015-01-01

The establishment of early pregnancy assessment units (EPAUs)/Gynaecology assessment units (GAUs) started more than 20 years ago in the UK to decrease hospital admissions of patients with early pregnancy problems. However, there are still wide variations in the quality of services provided by these units. The objective of this study was to create a method that can be used for continuous assessment of these units on a regular basis. We designed a dashboard covering all aspects of EPAU/GAU activities depending upon the early pregnancy unit association guidelines, and the department of health data and statistics. The EPAU/GAU dashboard has been used successfully in the early assessment pregnancy unit of Yeovil District hospital for few years and is still implemented until now. It is an excellent tool for continuous audit. It is a simple method that should be adopted by different EPAUs/GAUs for their objective assessment in order to improve the services provided by these units.

WE-E-304-01: SBRT Credentialing: Understanding the Process From Inquiry to Approval

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

Followill, D.

SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. A number of national protocols have been and are being developed to assess the clinical efficacy of SBRT for various anatomical sites, such as lung and spine. Physics credentialing for participating and implementation of trial protocols involve a broad spectrum of requirements from image guidance, motion management, to planning technology and dosimetric constrains. For radiation facilities that do not have extensive experiences in SBRT treatment and protocol credentialing, these complex processes of credentialing and implementation could be very challenging and, sometimes, may lead to ineffective evenmore » unsuccessful execution of these processes. In this proposal, we will provide comprehensive review of some current SBRT protocols, explain the requirements and their underline rationales, illustrate representative failed and successful experiences, related to SBRT credentialing, and discuss strategies for effective SBRT credentialing and implementation. Learning Objectives: Understand requirements and challenges of SBRT credentailing and implentation Discuss processes and strategies of effective SBRT credentailing Discuss practical considerations, potential pitfalls and solutions of SBRT implentation.« less

Early risk assessment for viral haemorrhagic fever: experience at the Hospital for Tropical Diseases, London, UK.

PubMed

Woodrow, Charles J; Eziefula, Alice C; Agranoff, Dan; Scott, Geoffrey M; Watson, Julie; Chiodini, Peter L; Lockwood, Diana N J; Grant, Alison D

2007-01-01

To implement a policy of systematic screening for viral haemorrhagic fever (VHF) among travellers returning from African countries with fever, commencing at initial clinical contact. A protocol based on UK Advisory Committee on Dangerous Pathogens guidance was developed collaboratively by medical, nursing and laboratory staff. Audit was carried out to quantify resource demands and effects on time to diagnose malaria, the main differential diagnosis. A protocol is now implemented for all patients presenting to HTD with fever, with clear guidelines for interaction with clinical and laboratory staff at each stage. The protocol required moderate amounts of clinical and laboratory staff time and resulted in some additional hospital admissions. The time to a diagnosis of malaria increased from a median of 90 (range 50-125) min in patients without VHF risk to a median of 140 (range 101-225) min (p=0.0025) in those assessed as at risk. Although all acute medical services need to have robust procedures for early detection of patients with serious transmissible conditions, few implement such a policy. Our protocol requires increased human and other resources but has no important impact on the rapidity of diagnosis of malaria, and is now embedded in local practice.

Facilitating Ambulatory Electronic Health Record System Implementation: Evidence from a Qualitative Study

PubMed Central

Hefner, Jennifer; Robbins, Julie; Huerta, Timothy R.

2013-01-01

Background. Ambulatory care practices have increasing interest in leveraging the capabilities of electronic health record (EHR) systems, but little information is available documenting how organizations have successfully implemented these systems. Objective. To characterize elements of successful electronic health record (EHR) system implementation and to synthesize the key informants' perspectives about successful implementation practices. Methods. Key informant interviews and focus groups were conducted with a purposive sample of individuals from US healthcare organizations identified for their success with ambulatory EHR implementation. Rigorous qualitative data analyses used both deductive and inductive methods. Results. Participants identified personal and system-related barriers, at both the individual and organization levels, including poor computer skills, productivity losses, resistance to change, and EHR system failure. Implementation success was reportedly facilitated by careful planning and consistent communication throughout distinct stages of the implementation process. A significant element of successful implementation was an emphasis on optimization, both during “go-live” and, subsequently, when users had more experience with the system. Conclusion. Successful EHR implementation requires both detailed planning and clear mechanisms to deal with unforeseen or unintended consequences. Focusing on user buy-in early and including plans for optimization can facilitate greater success. PMID:24228257

[Malnutrition and weight loss - nurse assessment of nutritional status and counselling: experiences of patients with newly diagnosed or relapsed cancer].

PubMed

Kröner, A; Stoll, H; Spichiger, E

2012-04-01

Due to the anorexia-cachexia syndrome, cancer patients are already suffering from nutritional problems and weight loss by the time they receive their diagnosis and start chemotherapy. In the oncology outpatient clinic of a Swiss university hospital, patients currently undergo a nutritional assessment and receive individual counselling at the beginning of cancer treatment. This qualitative study explored cancer patients' experiences with weight loss and nutritional problems as well as how they experienced the assessment and the consecutive counselling by nurses. Interviews were conducted with 12 patients and qualitative content analysis was used for data analysis. Results showed that patients barely registered the weight loss and did not interpret it as an early warning signal. Nevertheless, they attempted to improve their nutritional habits soon after diagnosis, prior to receiving any counselling. The patients did not experience the assessment as troublesome. They appreciated the nurses' advice and implemented the suggestions they found appropriate. This study highlights the importance of patient education regarding weight loss and nutritional problems early in the course of an illness. Patients may not be aware of nutritional problems at this early stage and may lack the necessary specialised knowledge. Assessment and counselling provided by nurses offer targeted measures for prevention of malnutrition and weight loss.

Implementing change: staff experiences of changes to prison mental healthcare in England and Wales.

PubMed

Caulfield, Laura S; Twort, Hannah

2012-01-01

Stemming from substantial criticism during the late twentieth and early twenty-first century, the UK government and HM Prison Service developed a number of policies and protocols aimed at improving the state of prison mental healthcare. While it is difficult to fault the purpose of the government's intentions, criticism has continued relating to problems with the implementation of government led change within the prison system. Existing research leads people to question whether policies are being implemented as intended; and if not, why not? The only clear way to answer these questions is to ask those involved in the actual implementation of these recommendations within the prison service. This paper aims to answer these questions. This paper documents findings from a national survey of senior mental healthcare staff working in prisons in England and Wales. Staff were surveyed about their views on the implementation of recommendations from recent key government documents, their perceptions of prison mental healthcare versus community mental healthcare, and their views on the relationship between HM Prison Service and the National Health Service. While many staff report improvements in prison mental healthcare, many have struggled with the implementation of new ways of working and the findings here suggest there is still some way to go towards providing offenders in prison with effective and appropriate care. Where effective ways of implementing change were identified, these are discussed. Listening to the experiences of the staff involved in prison healthcare has helped identify where implementation of changes could be improved and thus highlights where support might best be targeted in future.

Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries

PubMed Central

2014-01-01

Background The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. Methods We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. Results All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. Conclusions The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the versatility and impact of the technology, but also outlines various surmountable barriers to implementation. The study is not representative of all early implementer experiences with MTB/RIF testing but rather provides an overview of the shared issues as well as the many different approaches to programmatic MTB/RIF implementation. PMID:24383553

Vancouver Transcatheter Aortic Valve Replacement Clinical Pathway: Minimalist Approach, Standardized Care, and Discharge Criteria to Reduce Length of Stay.

PubMed

Lauck, Sandra B; Wood, David A; Baumbusch, Jennifer; Kwon, Jae-Yung; Stub, Dion; Achtem, Leslie; Blanke, Philipp; Boone, Robert H; Cheung, Anson; Dvir, Danny; Gibson, Jennifer A; Lee, Bobby; Leipsic, Jonathan; Moss, Robert; Perlman, Gidon; Polderman, Jopie; Ramanathan, Krishnan; Ye, Jian; Webb, John G

2016-05-01

We describe the development, implementation, and evaluation of a standardized clinical pathway to facilitate safe discharge home at the earliest time after transfemoral transcatheter aortic valve replacement. Between May 2012 and October 2014, the Heart Team developed a clinical pathway suited to the unique requirements of transfemoral transcatheter aortic valve replacement in contemporary practice. The components included risk-stratified minimalist periprocedure approach, standardized postprocedure care with early mobilization and reconditioning, and criteria-driven discharge home. Our aim was to reduce variation in care, identify a subgroup of patients suitable for early discharge (≤48 hours), and decrease length of stay for all patients. We addressed barriers related to historical practices, complex multidisciplinary stakeholder engagement, and adoption of length of stay as a quality indicator. We retrospectively reviewed the experiences of 393 consecutive patients; 150 (38.2%) were discharged early. At baseline, early discharge patients had experienced less previous balloon aortic valvuloplasty, had higher left ventricular ejection fraction, better cognitive function, and were less frail than the standard discharge group (>48 hours). Early discharge was associated with the use of local anesthesia, implantation of balloon expandable device, avoidance of urinary catheter, and early removal of temporary pacemaker. Median length of stay was 1 day for early discharge and 3 days for other patients; 97.7% were discharged home. There were no differences in 30-day mortality (1.3%), disabling stroke (0.8%), or readmission (10.7%). The implementation of a transcatheter aortic valve replacement clinical pathway shifted the program's approach to combine standardized processes and individual risk stratification. The Vancouver transcatheter aortic valve replacement clinical pathway requires a rigorous assessment to determine its efficacy, safety, and reproducibility. © 2016 American Heart Association, Inc.

Developing a "toolkit" to measure implementation of concurrent palliative care in rural community cancer centers.

PubMed

Zubkoff, Lisa; Dionne-Odom, J Nicholas; Pisu, Maria; Babu, Dilip; Akyar, Imatullah; Smith, Tasha; Mancarella, Gisella A; Gansauer, Lucy; Sullivan, Margaret Murray; Swetz, Keith M; Azuero, Andres; Bakitas, Marie A

2018-02-01

Despite national guidelines recommending early concurrent palliative care for individuals newly diagnosed with metastatic cancer, few community cancer centers, especially those in underserved rural areas do so. We are implementing an early concurrent palliative care model, ENABLE (Educate, Nurture, Advise, Before Life Ends) in four, rural-serving community cancer centers. Our objective was to develop a "toolkit" to assist community cancer centers that wish to integrate early palliative care for patients with newly diagnosed advanced cancer and their family caregivers. Guided by the RE-AIM (Reach, Effectiveness-Adoption, Implementation, Maintenance) framework, we undertook an instrument-development process based on the literature, expert and site stakeholder review and feedback, and pilot testing during site visits. We developed four instruments to measure ENABLE implementation: (1) the ENABLE RE-AIM Self-Assessment Tool to assess reach, adoption, implementation, and maintenance; (2) the ENABLE General Organizational Index to assess institutional implementation; (3) an Implementation Costs Tool; and (4) an Oncology Clinicians' Perceptions of Early Concurrent Oncology Palliative Care survey. We developed four measures to determine early palliative care implementation. These measures have been pilot-tested, and will be integrated into a comprehensive "toolkit" to assist community cancer centers to measure implementation outcomes. We describe the lessons learned and recommend strategies for promoting long-term program sustainability.

MELCOR/CONTAIN LMR Implementation Report - FY16 Progress.

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

Louie, David; Humphries, Larry L.

2016-11-01

This report describes the progress of the CONTAIN - LMR sodium physics and chemistry models to be implemented in MELCOR 2.1. In the past three years , the implementation included the addition of sodium equations of state and sodium properties from two different sources. The first source is based on the previous work done by Idaho National Laboratory by modifying MELCOR to include liquid lithium equation of state as a working fluid to model the nuclear fusion safety research. The second source uses properties generated for the SIMMER code. The implemented modeling has been tested and results are reported inmore » this document. In addition, the CONTAIN - LMR code was derived from an early version of the CONTAIN code, and many physical models that were developed since this early version of CONTAIN are not available in this early code version. Therefore, CONTAIN 2 has been updated with the sodium models in CONTAIN - LMR as CONTAIN2 - LMR, which may be used to provide code-to-code comparison with CONTAIN - LMR and MELCOR when the sodium chemistry models from CONTAIN - LMR have been completed. Both the spray fire and pool fire chemistry routines from CONTAIN - LMR have been integrated into MELCOR 2.1, and debugging and testing are in progress. Because MELCOR only models the equation of state for liquid and gas phases of the coolant, a modeling gap still exists when dealing with experiments or accident conditions that take place when the ambient temperature is below the freezing point of sodium. An alternative method is under investigation to overcome this gap . We are no longer working on the separate branch from the main branch of MELCOR 2.1 since the major modeling of MELCOR 2.1 has been completed. At the current stage, the newly implemented sodium chemistry models will be a part of the main MELCOR release version (MELCOR 2.2). This report will discuss the accomplishments and issues relating to the implementation. Also, we will report on the planned completion of all remaining tasks in the upcoming FY2017, including the atmospheric chemistry model and sodium - concrete interaction model implementation .« less

Early years neurosurgical training in the era of the European Working Time Directive.

PubMed

Kirkman, Matthew A; Watkins, Laurence D; Kitchen, Neil D; Sethi, Huma

2013-10-01

The past decade has seen significant changes to the face of neurosurgical training in the United Kingdom, driven in part by an increasing focus on patient safety and the introduction of Modernising Medical Careers and the European Working Time Directive (EWTD). Recent reforms to neurosurgical training over the past few years have resulted in creation of an 8-year 'run-through' training programme. In this programme, early years (ST1 and ST2) trainees often lack dedicated time for elective theatre lists and outpatient clinics. Further, any time spent in theatre and clinics is often with different teams. Here we describe a training model for early years trainees at the National Hospital for Neurology and Neurosurgery, who are given the responsibilities traditionally associated with a more senior trainee including dedicated weekly theatre and clinic time under the supervision of a single consultant, in addition to out of hours experience. The advantages and considerations for implementing this model are discussed, including the benefit of guidance under a single consultant in the early stages of training, along with key educational concepts necessary for understanding its utility. We feel that this is an effective model for junior neurosurgical training in the EWTD era, expediting the trainee's development of key technical and non-technical skills, with potentially significant rewards for patient, trainee and trainer. National implementation of this model should be considered.

Roadmap for Early Childhood and K-12 Data Linkages: Key Focus Areas to Ensure Quality Implementation. Quality Implementation Roadmaps

ERIC Educational Resources Information Center

Data Quality Campaign, 2016

2016-01-01

Every state can create secure, robust linkages between early childhood and K-12 data systems, and effectively use the information from these linkages to implement initiatives to support programs and children, answer key policy questions, and be transparent about how the state's early childhood investments prepare students for success in school and…

Getting Ready for School: The Early Childhood Cluster Initiative of Palm Beach County, Florida. Program Implementation and Early Outcomes: Year 3 Report

ERIC Educational Resources Information Center

Spielberger, Julie; Baker, Stephen; Winje, Carolyn; Mayers, Leifa

2009-01-01

Chapin Hall has been conducting an implementation and evaluability study of the ECCI (Early Childhood Cluster Initiative) project since the midway point of its first year. As described in the authors' first report (Spielberger & Goyette, 2006), the initiative made considerable progress in its initial year, particularly in implementing the…

Virtual Observer Controller (VOC) for Small Unit Infantry Laser Simulation Training

DTIC Science & Technology

2007-04-01

per-seat license when deployed. As a result, ViaVoice was abandoned early in development. Next, the SPHINX engine from Carnegie Mellon University was...examined. Sphinx is Java-based software, providing cross-platform functionality, and it is also free, open-source software. Software developers at...IST had experience using SPHINX , so it was initially selected it to be the VOC speech engine. After implementing a small portion of the VOC grammar

Sleep to Implement an Intention

PubMed Central

Diekelmann, Susanne; Wilhelm, Ines; Wagner, Ullrich; Born, Jan

2013-01-01

Study Objectives: Sleep supports the consolidation of new memories. However, this effect has mainly been shown for memories of past events. Here we investigated the role of sleep for the implementation of intentions for the future. Design: Subjects were instructed on a plan that had to be executed after a delay of 2 days. After plan instruction, subjects were either allowed to sleep or stayed awake for one night (Exp. 1) or had a 3-h sleep period either during the early night (SWS-rich sleep) or late night (REM-rich sleep; Exp. 2). In both experiments, retesting took place 2 days later after one recovery night. Setting: Sleep laboratory. Patients or Participants: A total of 56 healthy young adults participated in the study. Interventions: N/A. Measurements and Results: All of the subjects who were allowed to sleep after plan instruction executed the intention 2 days later, whereas only 61% of wake subjects did so (P = 0.004; Exp. 1). Also after early SWS-rich sleep all of the subjects remembered to execute the intention, but only 55% did so after late REM-rich sleep (P = 0.015; Exp. 2). Conclusions: Sleep, especially SWS, plays an important role for the successful implementation of delayed intentions. Citation: Diekelmann S; Wilhelm I; Wagner U; Born J. Sleep to implement an intention. SLEEP 2013;36(1):149-153. PMID:23288982

Using historical perspective in designing discovery learning on Integral for undergraduate students

NASA Astrophysics Data System (ADS)

Abadi; Fiangga, S.

2018-01-01

In the course of Integral Calculus, to be able to calculate an integral of a given function is becoming the main idea in the teaching beside the ability in implementing the application of integral. The students tend to be unable to understand the conceptual idea of what is integration actually. One of the promising perspectives that can be used to invite students to discover the idea of integral is the History and Pedagogy Mathematics (HPM). The method of exhaustion and indivisible appear in the discussion on the early history of area measurement. This paper study will discuss the designed learning activities based on the method of exhaustion and indivisible in providing the undergraduate student’s discovery materials for integral using design research. The designed learning activities were conducted into design experiment that consists of three phases, i.e., preliminary, design experimental, and teaching experiment. The teaching experiment phase was conducted in two cycles for refinement purpose. The finding suggests that the implementation of the method of exhaustion and indivisible enable students to reinvent the idea of integral by using the concept of derivative.

Report of IRPA task group on the impact of the eye lens dose limits.

PubMed

Cantone, Marie Claire; Ginjaume, Merce; Miljanic, Saveta; Martin, Colin J; Akahane, Keiichi; Mpete, Louisa; Michelin, Severino C; Flannery, Cynthia M; Dauer, Lawrence T; Balter, Stephen

2017-06-26

In 2012 IRPA established a task group (TG) to identify key issues in the implementation of the revised eye lens dose limit. The TG reported its conclusions in 2013. In January 2015, IRPA asked the TG to review progress with the implementation of the recommendations from the early report and to collate current practitioner experience. This report presents the results of a survey on the view of the IRPA professionals on the new limit to the lens of the eye and on the wider issue of tissue reactions. Recommendations derived from the survey are presented. This report was approved by IRPA Executive Council on 31 January 2017.

Understanding the unique experiences, perspectives and sexual and reproductive health needs of very young adolescents: Somali refugees in Ethiopia.

PubMed

Ortiz-Echevarria, Luis; Greeley, Meghan; Bawoke, Tenaw; Zimmerman, Linnea; Robinson, Courtland; Schlecht, Jennifer

2017-01-01

Kobe Refugee camp hosts roughly 39,000 refugees displaced from Somalia during the 2011-2012 Horn of Africa Crisis. Sexual and reproductive health, as with the greater issues of health and well-being for adolescents displaced from this crisis remain largely unknown and neglected. In 2013, the Women's Refugee Commission, Johns Hopkins University, and International Medical Corps in Ethiopia, implemented qualitative and quantitative research to explore the factors and risks that impact the health of very young adolescents (VYAs), those 10-14 years of age, in this setting. This paper presents findings from the qualitative effort. Focus group discussions (FGD), incorporating community mapping and photo elicitation activities, were conducted with 10-12 and 13-14 year-olds to obtain information about their own perspectives, experiences and values. FGDs were also implemented with 15-16 year-olds and adults, to consider their perspectives on the sexual and reproductive health needs and risks of VYAs. This research identified several factors that were found to influence the health and well-being of VYAs in Kobe refugee camp, including newfound access to education and security, combined with gender divisions and parental communication around early SRH and puberty that remained intact from traditional Somali culture. Girls were found to face an additional risk of child marriage and early pregnancy exacerbated since displacement, which significantly limited their ability to access education and achieve future aspirations. Findings from this study could help to inform future programs in Kobe and similar contexts involving long-term displacement from conflict, focusing on the health and development needs of VYAs. Future programs should consider the determinants of positive VYA health and development, including access to education, gender equity, and safety.By better understanding the unique experiences, perspectives and needs of VYAs, practitioners, policy makers and donors can invest in the individual and community assets that reinforce positive behaviors established in early adolescence, in order to achieve long-term SRH impacts.

Web-based Tsunami Early Warning System with instant Tsunami Propagation Calculations in the GPU Cloud

NASA Astrophysics Data System (ADS)

Hammitzsch, M.; Spazier, J.; Reißland, S.

2014-12-01

Usually, tsunami early warning and mitigation systems (TWS or TEWS) are based on several software components deployed in a client-server based infrastructure. The vast majority of systems importantly include desktop-based clients with a graphical user interface (GUI) for the operators in early warning centers. However, in times of cloud computing and ubiquitous computing the use of concepts and paradigms, introduced by continuously evolving approaches in information and communications technology (ICT), have to be considered even for early warning systems (EWS). Based on the experiences and the knowledge gained in three research projects - 'German Indonesian Tsunami Early Warning System' (GITEWS), 'Distant Early Warning System' (DEWS), and 'Collaborative, Complex, and Critical Decision-Support in Evolving Crises' (TRIDEC) - new technologies are exploited to implement a cloud-based and web-based prototype to open up new prospects for EWS. This prototype, named 'TRIDEC Cloud', merges several complementary external and in-house cloud-based services into one platform for automated background computation with graphics processing units (GPU), for web-mapping of hazard specific geospatial data, and for serving relevant functionality to handle, share, and communicate threat specific information in a collaborative and distributed environment. The prototype in its current version addresses tsunami early warning and mitigation. The integration of GPU accelerated tsunami simulation computations have been an integral part of this prototype to foster early warning with on-demand tsunami predictions based on actual source parameters. However, the platform is meant for researchers around the world to make use of the cloud-based GPU computation to analyze other types of geohazards and natural hazards and react upon the computed situation picture with a web-based GUI in a web browser at remote sites. The current website is an early alpha version for demonstration purposes to give the concept a whirl and to shape science's future. Further functionality, improvements and possible profound changes have to implemented successively based on the users' evolving needs.

Families’ Experience With Seeking Treatment for Recent-Onset Psychosis

PubMed Central

Gerson, Ruth; Davidson, Larry; Booty, Andrew; Wong, Celine; McGlashan, Thomas; Malespina, Dolores; Pincus, Harold Alan; Corcoran, Cheryl

2013-01-01

Objective Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-onset psychosis; such knowledge can inform services design. Methods The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Results Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma. These data from families are presented in the context of more recent literature as to the efficacy of specialized treatment programs for early stages of psychotic disorder and their involvement of families. Conclusions These qualitative research data support the importance of involving and educating families about psychosis: its recognition, its treatment, and access to services. They also highlight the need to address stigma and implement structural changes in treatment that ensure continuity and coverage of care. Specialized first-episode psychosis services may address these issues, and they may minimize the traumatic experiences of involuntary hospitalization and police involvement early in treatment. PMID:19487352

Families' experience with seeking treatment for recent-onset psychosis.

PubMed

Gerson, Ruth; Davidson, Larry; Booty, Andrew; McGlashan, Thomas; Malespina, Dolores; Pincus, Harold Alan; Corcoran, Cheryl

2009-06-01

Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-onset psychosis; such knowledge can inform services design. The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma. These data from families are presented in the context of more recent literature as to the efficacy of specialized treatment programs for early stages of psychotic disorder and their involvement of families. These qualitative research data support the importance of involving and educating families about psychosis: its recognition, its treatment, and access to services. They also highlight the need to address stigma and implement structural changes in treatment that ensure continuity and coverage of care. Specialized first-episode psychosis services may address these issues, and they may minimize the traumatic experiences of involuntary hospitalization and police involvement early in treatment.

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 enabling factors has the potential to support efforts at implementing national electronic health record implementation endeavors. © The Author(s) 2013.

A community continuity programme: volunteer faculty mentors and continuity learning.

PubMed

McGeehan, John; English, Richard; Shenberger, Keith; Tracy, Gerald; Smego, Raymond

2013-02-01

Longitudinal generalist preceptorship experiences early in medical education can have beneficial effects on how students practise the art and science of medicine, regardless of their eventual career choices. We evaluated the first 2 years of implementation of an integrated, regional campus-based, early clinical experience programme, the Community Continuity Program, at our new community-based medical school that is under the supervision of volunteer primary care faculty members acting as continuity mentors (CMs). Curricular components for years 1 and 2 consisted of three annual 1-week community-based experiences with CMs, extensive physical diagnosis practice, interprofessional learning activities, a multigenerational family care experience, a mandatory Community Health Research Project (CHRP) in year 1 and a mandatory Quality Improvement Project in year 2. Outcome measures included student, faculty member and programme evaluations, student reflective narratives in portal-based e-journals, a Liaison Committee on Medical Education (LCME) self-study student survey and serial level-of-empathy surveys.   Students found all elements of this integrated community experience programme beneficial and worthwhile, especially the CMs and the use of standardised and real-life patients. CMs noted effective and professional student-patient interactions. The number of reflective e-journal postings per student during year1 ranged from 14 to 81 (mean, 47). Serial empathy questionnaires administered over 2 years demonstrated preservation of student empathy, and students believed that the programme had a positive effect on their personal level of empathy.   An integrative, longitudinal, community-based, early clinical experience programme driven by volunteer CMs provides patient-centered instruction for preclinical students in the clinical, social, behavioural, ethical and research foundations of medicine. © Blackwell Publishing Ltd 2013.

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 detailed electronic health record sharing to local health communities. Conclusions Experiences from the early implementation sites, which have received considerable attention, financial investment and support, indicate that delivering improved healthcare through nationwide electronic health records will be a long, complex, and iterative process requiring flexibility and local adaptability both with respect to the systems and the implementation strategy. The more tailored, responsive approach that is emerging is becoming better aligned with NHS organisations’ perceived needs and is, if pursued, likely to deliver clinically useful electronic health record systems. PMID:20813822

Poverty, health and policy: a historical look at the South African experience.

PubMed

Pick, William; Rispel, Laetitia; Naidoo, Shan

2008-07-01

The resurgence of interest in links between health and development raises interesting questions about the process of research, policy-making, and implementation in the field of health and poverty. To learn about the process in South Africa, we examined three commissions of inquiry relating poverty and health -- in 1929, 1942, and the early 1980s. Power relations of the players were a decisive factor and determined the type and nature of the research conducted.

Project EAGLE (Early Academic Gifted Learning Experience): A Program for Gifted and Talented Students (Grades K-3)--Kindergarten Activity Booklets: Xanthus; Zhack; and Activity Pages H-Z.

ERIC Educational Resources Information Center

Merkoski, Kay

Three activity booklets are presented for implementing Project EAGLE, an enrichment program for gifted and talented kindergarten children. The first activity booklet contains a poem by J. D. Evans titled "In Search of the Xanthus," which describes the search for an imaginary beast that leaves an "X" on the spot where it used to be. The second…

Playing with Maths: Implications for Early Childhood Mathematics Teaching from an Implementation Study in Melbourne, Australia

ERIC Educational Resources Information Center

Cohrssen, Caroline; Tayler, Collette; Cloney, Dan

2015-01-01

The Early Years Learning Framework for Australia governs early childhood education in the years before school in Australia. Since this framework is not a curriculum, early childhood educators report uncertainty regarding what mathematical concepts to teach and how to teach them. This implementation study, positioned within the broader E4Kids…

Ocean Acidification Effects on the Early Life-Stages of Commercially Important Flatfish of the Northeast USA

NASA Astrophysics Data System (ADS)

Chambers, R. C.; Habeck, E. A.; Candelmo, A. C.; Poach, M.; Wieczorek, D.; Phelan, B.; Caldarone, E.; Cooper, K. R.

2012-12-01

The limited available evidence about effects on finfish of high CO2 levels and acidification of our oceans suggests that effects will differ across fish species, be subtle, and interact with other stressors. A carefully planned, experimental framework was developed to cast an extensive yet strategic inferential net. Three key elements of our approach are the use of 1) multiple marine finfish species of relevance to the northeastern USA that differ in their ecologies including spawning season and habitat of early life-stages; 2) a wide yet realistic range of environmental conditions (i.e., concurrent manipulation of CO2 levels and water temperatures), and 3) a diverse set of response variables related to fish sensitivity to elevated CO2 levels, water temperatures, and their interactions. The response variable set reflects fish condition, fitness, and likelihood of recruitment, and includes measures of viability, physiology, histopathology, growth, development, and behavior expressed during fish early life-stages (i.e., gametes, embryos, and larvae). Early life-stages were chosen due to the anticipation of their vulnerability to acid-base challenges in their environment. To date, factorial experiments have been implemented on summer flounder (Paralichthys dentatus) and winter flounder (Pseudopleuronectes americanus). Initial results reveal survival of summer flounder embryos is compromised by pH < 7.7 (CO2 > 790 ppm). These results were similar across offspring groups (i.e., embryos from different parents). Winter flounder are larger at hatching when exposed to high CO2 levels in the coolest environment implemented in our experiments (range 4 to 10 ○C). Further responses of advanced larvae of both flounder species are currently being assessed for evidence of other whole body, component organ, and biochemical impairment. This study will aid researchers and resource managers in identifying species types, life-stages, and biotic responses that are most sensitive to the expected future levels of CO2 and water temperature in our oceans.

Early experiences in developing and managing the neuroscience gateway.

PubMed

Sivagnanam, Subhashini; Majumdar, Amit; Yoshimoto, Kenneth; Astakhov, Vadim; Bandrowski, Anita; Martone, MaryAnn; Carnevale, Nicholas T

2015-02-01

The last few decades have seen the emergence of computational neuroscience as a mature field where researchers are interested in modeling complex and large neuronal systems and require access to high performance computing machines and associated cyber infrastructure to manage computational workflow and data. The neuronal simulation tools, used in this research field, are also implemented for parallel computers and suitable for high performance computing machines. But using these tools on complex high performance computing machines remains a challenge because of issues with acquiring computer time on these machines located at national supercomputer centers, dealing with complex user interface of these machines, dealing with data management and retrieval. The Neuroscience Gateway is being developed to alleviate and/or hide these barriers to entry for computational neuroscientists. It hides or eliminates, from the point of view of the users, all the administrative and technical barriers and makes parallel neuronal simulation tools easily available and accessible on complex high performance computing machines. It handles the running of jobs and data management and retrieval. This paper shares the early experiences in bringing up this gateway and describes the software architecture it is based on, how it is implemented, and how users can use this for computational neuroscience research using high performance computing at the back end. We also look at parallel scaling of some publicly available neuronal models and analyze the recent usage data of the neuroscience gateway.

Early experiences in developing and managing the neuroscience gateway

PubMed Central

Sivagnanam, Subhashini; Majumdar, Amit; Yoshimoto, Kenneth; Astakhov, Vadim; Bandrowski, Anita; Martone, MaryAnn; Carnevale, Nicholas. T.

2015-01-01

SUMMARY The last few decades have seen the emergence of computational neuroscience as a mature field where researchers are interested in modeling complex and large neuronal systems and require access to high performance computing machines and associated cyber infrastructure to manage computational workflow and data. The neuronal simulation tools, used in this research field, are also implemented for parallel computers and suitable for high performance computing machines. But using these tools on complex high performance computing machines remains a challenge because of issues with acquiring computer time on these machines located at national supercomputer centers, dealing with complex user interface of these machines, dealing with data management and retrieval. The Neuroscience Gateway is being developed to alleviate and/or hide these barriers to entry for computational neuroscientists. It hides or eliminates, from the point of view of the users, all the administrative and technical barriers and makes parallel neuronal simulation tools easily available and accessible on complex high performance computing machines. It handles the running of jobs and data management and retrieval. This paper shares the early experiences in bringing up this gateway and describes the software architecture it is based on, how it is implemented, and how users can use this for computational neuroscience research using high performance computing at the back end. We also look at parallel scaling of some publicly available neuronal models and analyze the recent usage data of the neuroscience gateway. PMID:26523124

Implementation Challenges for Tier One and Tier Two School-Based Programs for Early Adolescents

ERIC Educational Resources Information Center

LaRusso, Maria D.; Donovan, Suzanne; Snow, Catherine

2016-01-01

This mixed-method study examined the implementation and the challenges to implementation for participants in randomized controlled trials of two school-based programs for early adolescents: the Tier One Word Generation (WG) program, and the Tier Two Strategic Adolescent Reading Intervention (STARI). Levels of implementation for WG and STARI varied…

Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay.

PubMed

Souza Possa, S; Braga Amador, C; Meira Costa, A; Takahama Sakamoto, E; Seiko Kondo, C; Maida Vasconcellos, A L; Moran de Brito, C M; Pereira Yamaguti, W

2014-01-01

The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. A "before and after" study design with historical control was used. The "before" period included consecutive patients who underwent UAS before guideline implementation (intervention). The "after" period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization). There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2±4.1 days) compared to patients in the pre-intervention period (12.1±8.3 days) (p<0.05). The implementation of a physical therapy guideline for patients undergoing UAS resulted in reduced incidence of atelectasis and reduction in length of hospital stay in the postoperative period. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

Coupled auralization and virtual video for immersive multimedia displays

NASA Astrophysics Data System (ADS)

Henderson, Paul D.; Torres, Rendell R.; Shimizu, Yasushi; Radke, Richard; Lonsway, Brian

2003-04-01

The implementation of maximally-immersive interactive multimedia in exhibit spaces requires not only the presentation of realistic visual imagery but also the creation of a perceptually accurate aural experience. While conventional implementations treat audio and video problems as essentially independent, this research seeks to couple the visual sensory information with dynamic auralization in order to enhance perceptual accuracy. An implemented system has been developed for integrating accurate auralizations with virtual video techniques for both interactive presentation and multi-way communication. The current system utilizes a multi-channel loudspeaker array and real-time signal processing techniques for synthesizing the direct sound, early reflections, and reverberant field excited by a moving sound source whose path may be interactively defined in real-time or derived from coupled video tracking data. In this implementation, any virtual acoustic environment may be synthesized and presented in a perceptually-accurate fashion to many participants over a large listening and viewing area. Subject tests support the hypothesis that the cross-modal coupling of aural and visual displays significantly affects perceptual localization accuracy.

Implementation of HIV Palliative Care: Interprofessional Education to Improve Patient Outcomes in Resource-Constrained Settings, 2004-2012.

PubMed

Alexander, Carla S; Pappas, Gregory; Amoroso, Anthony; Lee, Mei Ching; Brown-Henley, Yvonne; Memiah, Peter; O'Neill, Joseph F; Dix, Olivia; Redfield, Robert R

2015-09-01

Palliative care (PC), introduced early in the management of chronic illness, improves patient outcomes. Early integration of a palliative approach for persons with HIV has been documented to be effective in identifying and managing patient-level concerns over the past decade in African settings. The experience of implementing PC in multiple African and other resource-constrained settings (RCSs) emphasizes the need for essential palliative competencies that can be integrated with chronic disease management for patients and their families facing life-limiting illness. This article is an historical description of how basic palliative competencies were observed to be acceptable for health workers providing outpatient HIV care and treatment during eight years of U.S. implementation of "care and support," a term coined to represent PC for persons living with HIV in RCS. The need for team building and interprofessional education is highlighted. The model is currently being tested in one U.S. city and may represent a mechanism for expanding the palliative approach into management of chronic disease. Such competencies may play a role in the development of the patient-centered medical home, a critical component of U.S. health care reform. Copyright © 2015 American Academy of Hospice and Palliative Medicine. All rights reserved.

State of the science on implementation research in early child development and future directions.

PubMed

Aboud, Frances E; Yousafzai, Aisha K; Nores, Milagros

2018-05-01

We summarize the state of the field of implementation research and practice for early child development and propose recommendations. First, conclusions are drawn regarding what is generally known about the implementation of early childhood development programs, based on papers and discussions leading to a published series on the topic. Second, recommendations for short-term activities emphasize the use of newly published guidelines for reporting data collection methods and results for implementation processes; knowledge of the guidelines and a menu of measures allows for planning ahead. Additional recommendations include careful documentation of early-stage implementation, such as adapting a program to a different context and assessing feasibility, as well as the process of sustaining and scaling up a program. Using existing implementation information by building on and improving past programs and translating them into policy are recommended. Longer term goals are to identify implementation characteristics of effective programs and determinants of these characteristics. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

A case study of a team-based, quality-focused compensation model for primary care providers.

PubMed

Greene, Jessica; Hibbard, Judith H; Overton, Valerie

2014-06-01

In 2011, Fairview Health Services began replacing their fee-for-service compensation model for primary care providers (PCPs), which included an annual pay-for-performance bonus, with a team-based model designed to improve quality of care, patient experience, and (eventually) cost containment. In-depth interviews and an online survey of PCPs early after implementation of the new model suggest that it quickly changed the way many PCPs practiced. Most PCPs reported a shift in orientation toward quality of care, working more collaboratively with their colleagues and focusing on their full panel of patients. The majority reported that their quality of care had improved because of the model and that their colleagues' quality had to. The comprehensive change did, however, result in lower fee-for-service billing and reductions in PCP satisfaction. While Fairview's compensation model is still a work in progress, their early experiences can provide lessons for other delivery systems seeking to reform PCP compensation.

influx_s: increasing numerical stability and precision for metabolic flux analysis in isotope labelling experiments.

PubMed

Sokol, Serguei; Millard, Pierre; Portais, Jean-Charles

2012-03-01

The problem of stationary metabolic flux analysis based on isotope labelling experiments first appeared in the early 1950s and was basically solved in early 2000s. Several algorithms and software packages are available for this problem. However, the generic stochastic algorithms (simulated annealing or evolution algorithms) currently used in these software require a lot of time to achieve acceptable precision. For deterministic algorithms, a common drawback is the lack of convergence stability for ill-conditioned systems or when started from a random point. In this article, we present a new deterministic algorithm with significantly increased numerical stability and accuracy of flux estimation compared with commonly used algorithms. It requires relatively short CPU time (from several seconds to several minutes with a standard PC architecture) to estimate fluxes in the central carbon metabolism network of Escherichia coli. The software package influx_s implementing this algorithm is distributed under an OpenSource licence at http://metasys.insa-toulouse.fr/software/influx/. Supplementary data are available at Bioinformatics online.

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

A framework for evaluating the formation, implementation, and performance of accountable care organizations.

PubMed

Fisher, Elliott S; Shortell, Stephen M; Kreindler, Sara A; Van Citters, Aricca D; Larson, Bridget K

2012-11-01

The implementation of accountable care organizations (ACOs), a new health care payment and delivery model designed to improve care and lower costs, is proceeding rapidly. We build on our experience tracking early ACOs to identify the major factors-such as contract characteristics; structure, capabilities, and activities; and local context-that would be likely to influence ACO formation, implementation, and performance. We then propose how an ACO evaluation program could be structured to guide policy makers and payers in improving the design of ACO contracts, while providing insights for providers on approaches to care transformation that are most likely to be successful in different contexts. We also propose key activities to support evaluation of ACOs in the near term, including tracking their formation, developing a set of performance measures across all ACOs and payers, aggregating those performance data, conducting qualitative and quantitative research, and coordinating different evaluation activities.

SMART-1 operations experience and lessons learnt

NASA Astrophysics Data System (ADS)

Camino, Octavio; Alonso, Maria; Gestal, Daniel; de Bruin, Jurriaan; Rathsman, Peter; Kugelberg, Joakim; Bodin, Per; Ricken, Sascha; Blake, Rick; Voss, Pablo Pardo; Stagnaro, Luca

2007-06-01

SMART-1 is the first of a series of ESA Small Missions for Advance Research and Technology where elements of the platform and the payload technology have been conceived as a demonstration for future cornerstone missions and an early opportunity for science. SMART-1 has also been an opportunity to experiment with new ways of conducting ground operations taking advantage of both increased satellite autonomy and ground automation tools. The paper will focus on three areas: The accumulated performance of the technology demonstration components since launch as the electrical propulsion engine, the triple-junction solar cells, the lithium-ion batteries, the 32 bit CPU ERC32 Single Chip, the CAN bus, the DTU Star Trackers and the complex on-board autonomy. The changes implemented on-board and on the ground during the lunar phase to increase the data return. The pros and contras in some of the choices made for SMART-1, the developments and solutions implemented to mitigate the problems, the tools developed to automate the operations and the distribution of data.

Meeting the mental health needs of today's college student: Reinventing services through Stepped Care 2.0.

PubMed

Cornish, Peter A; Berry, Gillian; Benton, Sherry; Barros-Gomes, Patricia; Johnson, Dawn; Ginsburg, Rebecca; Whelan, Beth; Fawcett, Emily; Romano, Vera

2017-11-01

A new stepped care model developed in North America reimagines the original United Kingdom model for the modern university campus environment. It integrates a range of established and emerging online mental health programs systematically along dimensions of treatment intensity and associated student autonomy. Program intensity can be either stepped up or down depending on level of client need. Because monitoring is configured to give both provider and client feedback on progress, the model empowers clients to participate actively in care options, decisions, and delivery. Not only is stepped care designed to be more efficient than traditional counseling services, early observations suggest it improves outcomes and access, including the elimination of service waitlists. This paper describes the new model in detail and outlines implementation experiences at 3 North American universities. While the experiences implementing the model have been positive, there is a need for development of technology that would facilitate more thorough evaluation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Modification, validation and implementation of a protocol for post-thyroidectomy hypocalcaemia.

PubMed

Stedman, T; Chew, P; Truran, P; Lim, C B; Balasubramanian, S P

2018-02-01

Introduction The management of post-thyroidectomy hypocalcaemia should facilitate early discharge, and reduce risks of hypocalcaemia, readmission and treatment related hypercalcaemia. This paper describes the implementation, evaluation and revision a protocol for the optimal management of this condition. Methods Day 1 parathyroid hormone (PTH) measurements in addition to calcium measurements were commenced following review of the unit's outcomes and literature on post-thyroidectomy hypocalcaemia. Outcomes from a three-year cohort of patients undergoing thyroid surgery helped amend this protocol (revision 1) to reduce biochemical tests, stipulate the need, nature and dose of vitamin D/calcium supplements, and encourage early discharge. This was further validated over seven months to assess compliance, episodes of hyper and/or hypocalcaemia after discharge, readmissions and need for treatment changes. Further revisions were made (revision 2) and implemented. Results The temporary and long-term postoperative hypocalcaemia rates were 29.1% and 3.2% respectively. Repeat calcium measurements on the first day altered management in only 1.4% of cases. The revised protocol was adhered to in 90% of cases. One patient had hypocalcaemia (due to non-compliance) and one had hypercalcaemia. Revision 2 involved reducing the dose of calcium. Conclusions This is a good example of a unit protocol for post-thyroidectomy hypocalcaemia being developed and modified on the basis of the literature and local experience. Day 1 PTH and calcium levels determine the need for treatment and frequency of follow-up visits, facilitate early discharge, reduce risk of over and/or undertreatment, and are good indicators of permanent hypocalcaemia.

Building Quality Early Childhood Assessment: What Really Matters?

ERIC Educational Resources Information Center

Bailey, Ann Elise

2017-01-01

This research explored the knowledge, skills, and strategies early childhood teachers possess related to implementing curriculum and authentic assessment. Research suggests that early educators rate their knowledge of curriculum and authentic assessment and their implementation of both as excellent. Despite these self-reported, high levels of…

Stakeholder Engagement in HIV Cure Research: Lessons Learned from Other HIV Interventions and the Way Forward

PubMed Central

Chu, Carissa; Ananworanich, Jintanat; Excler, Jean-Louis; Tucker, Joseph D.

2015-01-01

Abstract Clinical and basic science advances have raised considerable hope for achieving an HIV cure by accelerating research. This research is dominated primarily by issues about the nature and design of current and future clinical trials. Stakeholder engagement for HIV cure remains in its early stages. Our analysis examines timing and mechanisms of historical stakeholder engagement in other HIV research areas for HIV-uninfected individuals [vaccine development and pre-exposure prophylaxis (PrEP)], and HIV-infected individuals (treatment as prevention, prevention of mother-to-child transmission, and treatment of acute HIV infection) and articulate a plan for HIV cure stakeholder engagement. The experience from HIV vaccine development shows that early engagement of stakeholders helped manage expectations, mitigating the failure of several vaccine trials, while paving the way for subsequent trials. The relatively late engagement of HIV stakeholders in PrEP research may partly explain some of the implementation challenges. The treatment-related stakeholder engagement was strong and community-led from the onset and helped translation from research to implementation. We outline five steps to initiate and sustain stakeholder engagement in HIV cure research and conclude that stakeholder engagement represents a key investment in which stakeholders mutually agree to share knowledge, benefits, and risk of failure. Effective stakeholder engagement prevents misconceptions. As HIV cure research advances from early trials involving subjects with generally favorable prognosis to studies involving greater risk and uncertainty, success may depend on early and deliberate engagement of stakeholders. PMID:26061668

Stakeholder Engagement in HIV Cure Research: Lessons Learned from Other HIV Interventions and the Way Forward.

PubMed

Lo, Ying-Ru; Chu, Carissa; Ananworanich, Jintanat; Excler, Jean-Louis; Tucker, Joseph D

2015-07-01

Clinical and basic science advances have raised considerable hope for achieving an HIV cure by accelerating research. This research is dominated primarily by issues about the nature and design of current and future clinical trials. Stakeholder engagement for HIV cure remains in its early stages. Our analysis examines timing and mechanisms of historical stakeholder engagement in other HIV research areas for HIV-uninfected individuals [vaccine development and pre-exposure prophylaxis (PrEP)], and HIV-infected individuals (treatment as prevention, prevention of mother-to-child transmission, and treatment of acute HIV infection) and articulate a plan for HIV cure stakeholder engagement. The experience from HIV vaccine development shows that early engagement of stakeholders helped manage expectations, mitigating the failure of several vaccine trials, while paving the way for subsequent trials. The relatively late engagement of HIV stakeholders in PrEP research may partly explain some of the implementation challenges. The treatment-related stakeholder engagement was strong and community-led from the onset and helped translation from research to implementation. We outline five steps to initiate and sustain stakeholder engagement in HIV cure research and conclude that stakeholder engagement represents a key investment in which stakeholders mutually agree to share knowledge, benefits, and risk of failure. Effective stakeholder engagement prevents misconceptions. As HIV cure research advances from early trials involving subjects with generally favorable prognosis to studies involving greater risk and uncertainty, success may depend on early and deliberate engagement of stakeholders.

Early-Years Teachers' Professional Upgrading in Science: a Long-Term Programme

NASA Astrophysics Data System (ADS)

Kallery, Maria

2017-04-01

In this paper, we present a professional development/upgrading programme in science for early-years teachers and investigate its impact on the teachers' competencies in relation to their knowledge and teaching of science. The basic idea of the programme was to motivate the teachers by making them members of an action research group aimed at developing and implementing curriculum activities to which they would contribute and thus meaningfully engaging them in their own learning. The programme used a `collaborative partnership' model for the development of the activities. In this model, the collaborative notion is defined as an act of `shared creation': partners share a goal and members bring their expertise to the partnership. Within this context, the partners were a researcher in science education with a background in physics, who also served as a facilitator, and six in-service early-years teachers with a background in early-years pedagogy and developmental sciences, who had many years of experience (classroom experts). These teachers participated in the programme as co-designers, but were involved to a significantly lesser degree than the researcher. The programme procedures comprised group work and individual teachers' class work. Data sources included teachers' essays, field-notes, lesson recordings and group-work records. Data were qualitatively analysed. The main results indicate improvement of teachers' `transformed' knowledge of the subject matter, development/improvement of knowledge of instructional strategies, including factors related to quality of implementation of the activities, knowledge of the pupils and improvement of the teachers' efficacy.

Development of environmental education in the Korean kindergarten context

NASA Astrophysics Data System (ADS)

Shin, Keum Ho

Many environmental educators insist that environmental education (EE) should be started from a young age. The Korean Ministry of Education (1999) has also emphasized the importance of environmental education in early childhood by including content and objectives regarding EE in the 1999 National Curriculum of Kindergarten. However, many Korean kindergarten teachers do not sufficiently implement environmental education in their teaching practice. To address this issue, this study aimed at investigating and overcoming barriers to fully implement EE in the Korean kindergarten context. Four experienced Korean kindergarten teachers were involved in a fourteen-week critical action research project that included weekly group meetings. At these group meetings, teachers reflected on the barriers preventing the full implementation of EE in their classrooms and discussed possible environmental education actions to be attempted in the following week. These actions, individually implemented in teachers' classrooms, were reviewed at subsequent group meetings. Data from group meetings and teacher lessons were used to analyze the effectiveness of this critical action research project for developing environmental education. At the beginning stages of this study, Korean kindergarten teachers felt strongly uncomfortable participating in group communication. However, through the continuous encouragement of the researcher and with the involvement of participants who have similar educational backgrounds, age, and working experiences, participants came to actively engage in group communication. Participants in this study identified the following barriers to fully implement EE in kindergartens: insufficient understandings and awareness of EE, reluctant attitudes towards the environment, lack of educational support and resources, low parental involvement, and discomfort about going on a field trip to environments. Teachers came to understand the importance, objectives, potential topics, and teaching methods of early childhood environmental education. While implementing environmental education in their classrooms, teachers recognized possibilities for environmental education through connections with children's daily lives and previous activities conducted in their classrooms. Teachers also identified that critical action research through group communication provided practical and useful knowledge of their educational practices. Teachers' improved pedagogical knowledge and awareness about EE increased their confidence to teach environmental education. To lessen the burden of going on a field trip to environments, teachers provided children direct experiences in the environment surrounding schools and during school picnics. Teachers also actively participated in environmental activities with children. These direct experiences of the environment helped teachers and children appreciate the beauty of the environment and change their reluctant attitudes towards the environment. By providing parents children's products produced during EE, teachers were also able to help parents develop an interest in environmental education. While most educational research in Korean kindergartens is conducted by university-based researchers, this research inquiry revealed that action research by the effective partnership with a university-based researcher can encourage the confidence and passion of Korean kindergarten teachers to reflect and resolve issues arising from their experiences and to change educational practices.

The experiences of districts in implementing a national incentive programme to promote safe delivery in Nepal

PubMed Central

Powell-Jackson, Timothy; Morrison, Joanna; Tiwari, Suresh; Neupane, Basu Dev; Costello, Anthony M

2009-01-01

Background Nepal's Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We explored early implementation of the programme at the district-level to understand the factors that have contributed to its low uptake. Methods We conducted in ten study districts a series of key informant interviews and focus group discussions with staff from health facilities and the district health office and other stakeholders involved in implementation. Manual content analysis was used to categorise data under emerging themes. Results Problems at the central level imposed severe constraints on the ability of district-level actors to implement the programme. These included bureaucratic delays in the disbursement of funds, difficulties in communicating the policy, both to implementers and the wider public and the complexity of the programme's design. However, some district implementers were able to cope with these problems, providing reasons for why uptake of the programme varied considerably between districts. Actions appeared to be influenced by the pressure to meet local needs, as well individual perceptions and acceptance of the programme. The experience also sheds light on some of the adverse effects of the programme on the wider health system. Conclusion The success of conditional cash transfer programmes in Latin America has led to a wave of enthusiasm for their adoption in other parts of the world. However, context matters and proponents of similar programmes in south Asia should give due attention to the challenges to implementation when capacity is weak and health services inadequate. PMID:19508710

78 FR 65767 - Student Assistance General Provisions, Federal Perkins Loan Program, Federal Family Education...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... and the conditions for early implementation. Consistent with the Department's objective to improve...) to designate the following new and amended regulations included in this document for early... Secretary also intends to implement early provisions in 34 CFR 685.205 comparable to the provisions in 34...

Avionics test bed development plan

NASA Technical Reports Server (NTRS)

Harris, L. H.; Parks, J. M.; Murdock, C. R.

1981-01-01

A development plan for a proposed avionics test bed facility for the early investigation and evaluation of new concepts for the control of large space structures, orbiter attached flex body experiments, and orbiter enhancements is presented. A distributed data processing facility that utilizes the current laboratory resources for the test bed development is outlined. Future studies required for implementation, the management system for project control, and the baseline system configuration are defined. A background analysis of the specific hardware system for the preliminary baseline avionics test bed system is included.

Implementation of Early Childhood Development Education Service Standard Guidelines on Physical Facilities in Public and Private Early Childhood Education Centres Kakamega County, Kenya

ERIC Educational Resources Information Center

Sitati, Emmily M.; Ndirangu, Mwangi; Kennedy, Bota; Rapongo, George S.

2016-01-01

In 2006, the Kenyan Ministry of Education (MoE) developed an early childhood development education (ECDE) service standard guidelines to guide the ECDE stakeholders in provision of early childhood education (ECE) programmes. The study sought to investigate the implementation of the ECDE service standard guidelines on provision of physical…

Improving Processual Quality in Early Education and Care: Process Findings from the Evaluation of the Benevolent Society's Partnerships in Early Education Program

ERIC Educational Resources Information Center

Valentine, Kylie; Thomson, Cathy

2009-01-01

This paper describes the facilitators and barriers to implementing an attachment-based intervention in early education and care settings, the Partnerships in Early Childhood program (PIEC), based on findings from the process evaluation of its first year of implementation. The paper focuses on four areas: the nature of the partnership and program…

An Interactive Ambulatory Nephrology Curriculum for Internal Medicine Interns: Design, Implementation, and Participant Feedback.

PubMed

Gomez, Alexis C; Warburton, Karen M; Miller, Rachel K; Negoianu, Dan; Cohen, Jordana B

2017-09-01

While diminishing nephrology fellow recruitment is a known issue, more work is needed to evaluate possible interventions to reverse this trend. We designed and implemented a curriculum to increase exposure to ambulatory nephrology among internal medicine interns. The curriculum focused on key aspects of outpatient nephrology practice, including supervised clinic visits, formal themed didactic content, and an online interactive forum with assigned evidence-based readings and small-group responses to relevant cases. We obtained postcourse surveys from all participating interns. Of the 43 interns who took part in the first year of the ambulatory nephrology curriculum, 100% reported a positive didactic experience and 91% reported a positive interactive online experience. 77% reported an improvement in their familiarity with clinical nephrology practice (median 2-point increase in familiarity score on a 7-point scale, P<0.001 by signed rank testing). Qualitative feedback included praise for the high-yield topics covered by the lectures and energizing teachers. In conclusion, we successfully implemented an ambulatory nephrology curriculum using a framework that integrated formal didactics, interactive online learning, and key clinical components of outpatient nephrology care. Future investigation will evaluate whether early implementation of this curriculum is associated with increased pursuit of nephrology as a career. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Triple Aim in Canada: developing capacity to lead to better health, care and cost

PubMed Central

Farmanova, Elina; Kirvan, Christine; Verma, Jennifer; Mukerji, Geetha; Akunov, Nurdin; Phillips, Kaye; Samis, Stephen

2016-01-01

Abstract Quality problem Many modern health systems strive for ‘Triple Aim’ (TA)—better health for populations, improved experience of care for patients and lower costs of the system, but note challenges in implementation. Outcomes of applying TA as a quality improvement framework (QI) have started to be realized with early lessons as to why some systems make progress while others do not. Initial assessment Limited evidence is available as to how organizations create the capacity and infrastructure required to design, implement, evaluate and sustain TA systems. Choice of solution To support embedding TA across Canada, the Canadian Foundation for Healthcare Improvement supported enrolment of nine Canadian teams to participate in the Institute for Healthcare Improvement's TA Improvement Community. Implementation Structured support for TA design, implementation, evaluation and sustainability was addressed in a collaborative programme of webinars and action periods. Teams were coached to undertake and test small-scale improvements before attempting to scale. Evaluation A summative evaluation of the Canadian cohort was undertaken to assess site progress in building TA infrastructure across various healthcare settings. The evaluation explored the process of change, experiences and challenges and strategies for continuous QI. Lessons learned Delivering TA requires a sustained and coordinated effort supported by strong leadership and governance, continuous QI, engaged interdisciplinary teams and partnering within and beyond the healthcare sector. PMID:28423164

Improving the experience of pregnancy and childbirth for deaf people and their families.

PubMed

Sporek, Paulina

2014-04-01

Deafness is unique in that it crosses barriers of age, gender, economic status and ethnicity. It is particularly complex in the context of the 'disabled/abled binary'. Generalisation is unhelpful since impairment is individualised and manifests itself in emotional, psychological, social and physical dimensions of a person's life. The 'Deaf Nest' project aims to improve deaf users' personal experience, equality of access, choice and control over maternity care. The implementation of clear guidance, an early assessment form, effective referrals, deaf awareness study days and 'Deaf Nest' support packs will result in improved deaf access to information, the ongoing assessment of need, improved health and lifestyle choices and greater family involvement.

Optimization of EGFR high positive cell isolation procedure by design of experiments methodology.

PubMed

Levi, Ofer; Tal, Baruch; Hileli, Sagi; Shapira, Assaf; Benhar, Itai; Grabov, Pavel; Eliaz, Noam

2015-01-01

Circulating tumor cells (CTCs) in blood circulation may play a role in monitoring and even in early detection of metastasis patients. Due to the limited presence of CTCs in blood circulation, viable CTCs isolation technology must supply a very high recovery rate. Here, we implement design of experiments (DOE) methodology in order to optimize the Bio-Ferrography (BF) immunomagnetic isolation (IMI) procedure for the EGFR high positive CTCs application. All consequent DOE phases such as screening design, optimization experiments and validation experiments were used. A significant recovery rate of more than 95% was achieved while isolating 100 EGFR high positive CTCs from 1 mL human whole blood. The recovery achievement in this research positions BF technology as one of the most efficient IMI technologies, which is ready to be challenged with patients' blood samples. © 2015 International Clinical Cytometry Society.

Curriculum reform and evolution: Innovative content and processes at one US medical school.

PubMed

Fischel, Janet E; Olvet, Doreen M; Iuli, Richard J; Lu, Wei-Hsin; Chandran, Latha

2018-03-11

Curriculum reform in medical schools continues to be an ever-present and challenging activity in medical education. This paper describes one school's experiences with specific curricular innovations that were developed or adapted and targeted to meet a clear set of curricular goals during the curriculum reform process. Those goals included: (a) promoting active learning and learner engagement; (b) establishing early professional identity; and (c) developing physician competencies in an integrated and contextual manner while allowing for individualized learning experiences for the millennial student. Six specific innovations championed by the school are described in detail. These included Themes in Medical Education, Translational Pillars, Stony Brook Teaching Families, Transition Courses, Educational Continuous Quality Improvement Processes, and our Career Advising Program. Development of the ideas and design of the innovations were done by faculty and student teams. We discuss successes and ongoing challenges with these innovations which are currently in the fourth year of implementation. Our curriculum reform has emphasized the iterative process of curriculum building. Based on our experience, we discuss general and practical guidelines for curriculum innovation in its three phases: setting the stage, implementation, and monitoring for the achievement of intended goals.

Rapid establishment of the European Bank for induced Pluripotent Stem Cells (EBiSC) - the Hot Start experience.

PubMed

De Sousa, Paul A; Steeg, Rachel; Wachter, Elisabeth; Bruce, Kevin; King, Jason; Hoeve, Marieke; Khadun, Shalinee; McConnachie, George; Holder, Julie; Kurtz, Andreas; Seltmann, Stefanie; Dewender, Johannes; Reimann, Sascha; Stacey, Glyn; O'Shea, Orla; Chapman, Charlotte; Healy, Lyn; Zimmermann, Heiko; Bolton, Bryan; Rawat, Trisha; Atkin, Isobel; Veiga, Anna; Kuebler, Bernd; Serano, Blanca Miranda; Saric, Tomo; Hescheler, Jürgen; Brüstle, Oliver; Peitz, Michael; Thiele, Cornelia; Geijsen, Niels; Holst, Bjørn; Clausen, Christian; Lako, Majlinda; Armstrong, Lyle; Gupta, Shailesh K; Kvist, Alexander J; Hicks, Ryan; Jonebring, Anna; Brolén, Gabriella; Ebneth, Andreas; Cabrera-Socorro, Alfredo; Foerch, Patrik; Geraerts, Martine; Stummann, Tina C; Harmon, Shawn; George, Carol; Streeter, Ian; Clarke, Laura; Parkinson, Helen; Harrison, Peter W; Faulconbridge, Adam; Cherubin, Luca; Burdett, Tony; Trigueros, Cesar; Patel, Minal J; Lucas, Christa; Hardy, Barry; Predan, Rok; Dokler, Joh; Brajnik, Maja; Keminer, Oliver; Pless, Ole; Gribbon, Philip; Claussen, Carsten; Ringwald, Annette; Kreisel, Beate; Courtney, Aidan; Allsopp, Timothy E

2017-04-01

A fast track "Hot Start" process was implemented to launch the European Bank for Induced Pluripotent Stem Cells (EBiSC) to provide early release of a range of established control and disease linked human induced pluripotent stem cell (hiPSC) lines. Established practice amongst consortium members was surveyed to arrive at harmonised and publically accessible Standard Operations Procedures (SOPs) for tissue procurement, bio-sample tracking, iPSC expansion, cryopreservation, qualification and distribution to the research community. These were implemented to create a quality managed foundational collection of lines and associated data made available for distribution. Here we report on the successful outcome of this experience and work flow for banking and facilitating access to an otherwise disparate European resource, with lessons to benefit the international research community. ETOC: The report focuses on the EBiSC experience of rapidly establishing an operational capacity to procure, bank and distribute a foundational collection of established hiPSC lines. It validates the feasibility and defines the challenges of harnessing and integrating the capability and productivity of centres across Europe using commonly available resources currently in the field. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Teaching Practices that Promote Motor Skills in Early Childhood Settings

ERIC Educational Resources Information Center

Robinson, Leah E.; Webster, E. Kipling; Logan, S. Wood; Lucas, W. Amarie; Barber, Laura T.

2012-01-01

Early childhood educators, especially those in preschool centers, are often expected to design and implement movement programs. However, these individuals may not have been taught these skills during their education. The purpose of this study was to determine if early childhood majors could successfully be taught to implement a mastery climate…

Seven Elements Important to Successful Implementation of Early Literacy Intervention

ERIC Educational Resources Information Center

Foorman, Barbara; Dombek, Jennifer; Smith, Kevin

2016-01-01

The objective of this article is to describe seven elements important to successful implementation of early literacy intervention. The seven elements are drawn from research as well as from the authors' recent randomized controlled trial of effective early literacy interventions in kindergarten through second grade in 55 schools across Florida.…

Issues of Implementation of Early Childhood Education and Support Programs.

ERIC Educational Resources Information Center

Prinsen, Bert

This document comprises three papers related to the implementation of early childhood education, health care, and support programs. The first paper is a brief reflection on the nature of implementation, based on the contributions of Boudewijn Bekkers. The second is a proceedings chapter by Marian Hanrahan titled "Community Based Innovative…

We are bitter, but we are better off: case study of the implementation of an electronic health record system into a mental health hospital in England

PubMed Central

2012-01-01

Background In contrast to the acute hospital sector, there have been relatively few implementations of integrated electronic health record (EHR) systems into specialist mental health settings. The National Programme for Information Technology (NPfIT) in England was the most expensive IT-based transformation of public services ever undertaken, which aimed amongst other things, to implement integrated EHR systems into mental health hospitals. This paper describes the arrival, the process of implementation, stakeholders’ experiences and the local consequences of the implementation of an EHR system into a mental health hospital. Methods Longitudinal, real-time, case study-based evaluation of the implementation and adoption of an EHR software (RiO) into an English mental health hospital known here as Beta. We conducted 48 in-depth interviews with a wide range of internal and external stakeholders, undertook 26 hours of on-site observations, and obtained 65 sets of relevant documents from various types relating to Beta. Analysis was both inductive and deductive, the latter being informed by the ‘sociotechnical changing’ theoretical framework. Results Many interviewees perceived the implementation of the EHR system as challenging and cumbersome. During the early stages of the implementation, some clinicians felt that using the software was time-consuming leading to the conclusion that the EHR was not fit for purpose. Most interviewees considered the chain of deployment of the EHR–which was imposed by NPfIT–as bureaucratic and obstructive, which restricted customization and as a result limited adoption and use. The low IT literacy among users at Beta was a further barrier to the implementation of the EHR. This along with inadequate training in using the EHR software led to resistance to the significant cultural and work environment changes initiated by EHR. Despite the many challenges, Beta achieved some early positive results. These included: the ability to check progress notes and monitor staff activities; improving quality of care as a result of real-time, more accurate and shared patient records across the hospital; and potentially improving the safety of care through increasing the legibility of the clinical record. Conclusions Notwithstanding what was seen as a turbulent, painful and troublesome implementation of the EHR system, Beta achieved some early clinical and managerial benefits from implementing EHRs. The ‘sociotechnical changing’ framework helped us go beyond the dichotomy of success versus failure, when conducting the evaluation and interpreting findings. Given the scope for continued development, there are good reasons, we argue, to scale up the intake of EHR systems by mental health care settings. Software customization and appropriate support are essential to work EHR out in such organizations. PMID:23272770

Emotional intensity influences pre-implementation and implementation of distraction and reappraisal

PubMed Central

Shafir, Roni; Schwartz, Naama; Blechert, Jens

2015-01-01

Although emotional intensity powerfully challenges regulatory strategies, its influence remains largely unexplored in affective-neuroscience. Accordingly, the present study addressed the moderating role of emotional intensity in two regulatory stages—implementation (during regulation) and pre-implementation (prior to regulation), of two major cognitive regulatory strategies—distraction and reappraisal. According to our framework, because distraction implementation involves early attentional disengagement from emotional information before it gathers force, in high-intensity it should be more effective in the short-term, relative to reappraisal, which modulates emotional processing only at a late semantic meaning phase. Supporting findings showed that in high (but not low) intensity, distraction implementation resulted in stronger modulation of negative experience, reduced neural emotional processing (centro-parietal late positive potential, LPP), with suggestive evidence for less cognitive effort (frontal-LPP), relative to reappraisal. Related pre-implementation findings confirmed that anticipating regulation of high-intensity stimuli resulted in distraction (over reappraisal) preference. In contrast, anticipating regulation of low-intensity stimuli resulted in reappraisal (over distraction) preference, which is most beneficial for long-term adaptation. Furthermore, anticipating cognitively demanding regulation, either in cases of regulating counter to these preferences or via the more effortful strategy of reappraisal, enhanced neural attentional resource allocation (Stimulus Preceding Negativity). Broad implications are discussed. PMID:25700568

Best practice wound care.

PubMed

O'Brien, Melissa L; Lawton, Joanna E; Conn, Chris R; Ganley, Helen E

2011-04-01

This article describes the barriers, changes and achievements related to implementing one element of a wound care programme being best practice care. With the absence of a coordinated approach to wound care, clinical practice within our Area Health Service (AHS) was diverse, inconsistent and sometimes outdated. This was costly and harmful, leading to overuse of unhelpful care, underuse of effective care and errors in execution. The major aim was to improve the outcomes and quality of life for patients with wound care problems within our community. A collaborative across ten sites/services developed, implemented and evaluated policies and guidelines based on evidence-based bundles of care. Key barriers were local resistance and lack of experience in implementing structural and cultural changes. This was addressed by appointing a wound care programme manager, commissioning of a strategic oversight committee and local wound care committees. The techniques of spread and adoption were used, with early adopters making changes observable and allowing local adaption of guidelines, where appropriate. Deployment and improvement results varied across the sites, ranging from activity but no changes in practice to modest improvement in practice. Evaluating implementation of the leg ulcer guideline as an exemplar, it was demonstrated that there was a statistically significant improvement in overall compliance from 26% to 84%. However, only 7·7% of patients received all interventions to which they were entitled. Compliance with the eight individual interventions of the bundle ranged from 26% to 84%. Generic performance was evaluated against the wound assessment, treatment and evaluation plan with an average compliance of 70%. Early results identified that 20% of wounds were healed within the target of 10 days. As more standardised process are implemented, clinical outcomes should continue to improve and costs decrease. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

The Evolving Purposes of Medical Revalidation in the United Kingdom: A Qualitative Study of Professional and Regulatory Narratives.

PubMed

Tazzyman, Abigail; Ferguson, Jane; Walshe, Kieran; Boyd, Alan; Tredinnick-Rowe, John; Hillier, Charlotte; Regan De Bere, Samantha; Archer, Julian

2017-11-07

Previous research found professionalism and regulation to be competing discourses when plans for medical revalidation in the United Kingdom were being developed in 2011. The purpose of this study was to explore how these competing discourses developed and how the perceived purposes of revalidation evolved as the policy was implemented. Seventy-one interviews with 60 UK policy makers and senior health care leaders were conducted during the development and implementation of revalidation: 31 in 2011, 26 in 2013, and 14 in 2015. Interviewees were selected using purposeful sampling. Across all interviews, questions focused around three areas: individual roles in relation to revalidation; interviewees' understanding of revalidation, its purpose, and aims; and predictions or experiences of revalidation's impact. The first two interview sets also included questions about measurement and evaluation of revalidation. Data were analyzed using the constant comparative method to understand changes and continuities. Two main discourses regarding the purpose of revalidation were present across the implementation period: professionalism and regulation. The nature of the relationship between these two purposes and how they were described changed over time, with the separate discourses converging, and early concerns about actual or potential conflict being replaced by perceptions of coexistence or codependency. The changing nature of the discourse about revalidation suggests that early concerns about adverse consequences were not borne out as organizations and professionals engaged with implementation and experienced the realities of revalidation in practice. Reconciling professional and regulatory narratives was arguably necessary to the effective implementation of revalidation.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

PubMed

Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

2015-01-01

The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project.

PubMed

Herrman, Helen; Humphreys, Cathy; Halperin, Stephen; Monson, Katherine; Harvey, Carol; Mihalopoulos, Cathrine; Cotton, Susan; Mitchell, Penelope; Glynn, Tony; Magnus, Anne; Murray, Lenice; Szwarc, Josef; Davis, Elise; Havighurst, Sophie; McGorry, Patrick; Tyano, Sam; Kaplan, Ida; Rice, Simon; Moeller-Saxone, Kristen

2016-12-07

Out-of-home care (OoHC) refers to young people removed from their families by the state because of abuse, neglect or other adversities. Many of the young people experience poor mental health and social function before, during and after leaving care. Rigorously evaluated interventions are urgently required. This publication describes the protocol for the Ripple project and notes early findings from a controlled trial demonstrating the feasibility of the work. The Ripple project is implementing and evaluating a complex mental health intervention that aims to strengthen the therapeutic capacities of carers and case managers of young people (12-17 years) in OoHC. The study is conducted in partnership with mental health, substance abuse and social services in Melbourne, with young people as participants. It has three parts: 1. Needs assessment and implementation of a complex mental health intervention; 2. A 3-year controlled trial of the mental health, social and economic outcomes; and 3. Nested process evaluation of the intervention. Early findings characterising the young people, their carers and case managers and implementing the intervention are available. The trial Wave 1 includes interviews with 176 young people, 52% of those eligible in the study population, 104 carers and 79 case managers. Implementing and researching an affordable service system intervention appears feasible and likely to be applicable in other places and countries. Success of the intervention will potentially contribute to reducing mental ill-health among these young people, including suicide attempts, self-harm and substance abuse, as well as reducing homelessness, social isolation and contact with the criminal justice system. Australian New Zealand Clinical Trials Registry ACTRN12615000501549 . Retrospectively registered 19 May 2015.

Integrating Early Childhood Mental Health Consultation with the Pyramid Model. Issue Brief

ERIC Educational Resources Information Center

Perry, Deborah F.; Kaufmann, Roxane K.

2009-01-01

A growing number of states and communities are implementing the Pyramid Model in early care and education settings, and in many of these places there are also early childhood mental health consultation (ECMHC) programs operating. This policy brief provides an overview of ECMHC, how it can support the implementation of the Pyramid Model and the…

A Guide for Supervisors and Trainers on Implementing "The Creative Curriculum for Early Childhood, Third Edition."

ERIC Educational Resources Information Center

Dodge, Diane Trister; And Others

This guide is designed for early childhood educators who are helping their staffs implement the Creative Curriculum for Early Childhood, a curriculum that is based on child development theory and is developmentally appropriate for preschool and kindergarten children. A carefully organized and rich environment serves as the focus of this…

Early Childhood Teachers' Professional Learning in Early Algebraic Thinking: A Model that Supports New Knowledge and Pedagogy

ERIC Educational Resources Information Center

Warren, Elizabeth

2009-01-01

The implementation of a new mathematics syllabus in the elementary context is problematic, especially if it contains a new content area. A professional development model, Transformative Teaching in the Early Years Mathematics (TTEYM) was specifically developed to support the implementation of the new Patterns and Algebra strand. The model was…

Making Human Spaceflight Practical and Affordable: Spacecraft Designs and their Degree of Operability

NASA Technical Reports Server (NTRS)

Crocker, Alan R.

2011-01-01

As we push toward new and diverse space transportation capabilities, reduction in operations cost becomes increasingly important. Achieving affordable and safe human spaceflight capabilities will be the mark of success for new programs and new providers. The ability to perceive the operational implications of design decisions is crucial in developing safe yet cost competitive space transportation systems. Any human spaceflight program - government or commercial - must make countless decisions either to implement spacecraft system capabilities or adopt operational constraints or workarounds to account for the lack of such spacecraft capabilities. These decisions can benefit from the collective experience that NASA has accumulated in building and operating crewed spacecraft over the last five decades. This paper reviews NASA s history in developing and operating human rated spacecraft, reviewing the key aspects of spacecraft design and their resultant impacts on operations phase complexity and cost. Specific examples from current and past programs - including the Space Shuttle and International Space Station - are provided to illustrate design traits that either increase or increase cost and complexity associated with spacecraft operations. These examples address factors such as overall design performance margins, levels of redundancy, degree of automated failure response, type and quantity of command and telemetry interfaces, and the definition of reference scenarios for analysis and test. Each example - from early program requirements, design implementation and resulting real-time operations experience - to tell the end-to-end "story" Based on these experiences, specific techniques are recommended to enable earlier and more effective assessment of operations concerns during the design process. A formal method for the assessment of spacecraft operability is defined and results of such operability assessments for recent spacecraft designs are provided. Recent experience in applying these techniques to Orion spacecraft development is reviewed to highlight the direct benefits of early operational assessment and collaborative development efforts.

Patient attitudes towards remote continuous vital signs monitoring on general surgery wards: An interview study.

PubMed

Downey, C L; Brown, J M; Jayne, D G; Randell, R

2018-06-01

Vital signs monitoring is used to identify deteriorating patients in hospital. The most common tool for vital signs monitoring is an early warning score, although emerging technologies allow for remote, continuous patient monitoring. A number of reviews have examined the impact of continuous monitoring on patient outcomes, but little is known about the patient experience. This study aims to discover what patients think of monitoring in hospital, with a particular emphasis on intermittent early warning scores versus remote continuous monitoring, in order to inform future implementations of continuous monitoring technology. Semi-structured interviews were undertaken with 12 surgical inpatients as part of a study testing a remote continuous monitoring device. All patients were monitored with both an early warning score and the new device. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Patients can see the value in remote, continuous monitoring, particularly overnight. However, patients appreciate the face-to-face aspect of early warning score monitoring as it allows for reassurance, social interaction, and gives them further opportunity to ask questions about their medical care. Early warning score systems are widely used to facilitate detection of the deteriorating patient. Continuous monitoring technologies may provide added reassurance. However, patients value personal contact with their healthcare professionals and remote monitoring should not replace this. We suggest that remote monitoring is best introduced in a phased manner, and initially as an adjunct to usual care, with careful consideration of the patient experience throughout. Copyright © 2018 Elsevier B.V. All rights reserved.

Engaging pregnant and parenting teens: early challenges and lessons learned from the Evaluation of Adolescent Pregnancy Prevention Approaches.

PubMed

Asheer, Subuhi; Berger, Amanda; Meckstroth, Alicia; Kisker, Ellen; Keating, Betsy

2014-03-01

This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

CSP Manufacturing Challenges and Assembly Reliability

NASA Technical Reports Server (NTRS)

Ghaffarian, Reza

2000-01-01

Although the expression of CSP is widely used by industry from suppliers to users, its implied definition had evolved as the technology has matured. There are "expert definition"- package that is up to 1.5 time die- or "interim definition". CSPs are miniature new packages that industry is starting to implement and there are many unresolved technical issues associated with their implementation. For example, in early 1997, packages with 1 mm pitch and lower were the dominant CSPs, whereas in early 1998 packages with 0.8 mm and lower became the norm for CSPs. Other changes included the use of flip chip die rather than wire bond in CSP. Nonetheless the emerging CSPs are competing with bare die assemblies and are becoming the package of choice for size reduction applications. These packages provide the benefits of small size and performance of the bare die or flip chip, with the advantage of standard die packages. The JPL-led MicrotypeBGA Consortium of enterprises representing government agencies and private companies have jointed together to pool in-kind resources for developing the quality and reliability of chip scale packages (CSPs) for a variety of projects. This talk will cover specifically the experience of our consortium on technology implementation challenges, including design and build of both standard and microvia boards, assembly of two types of test vehicles, and the most current environmental thermal cycling test results.

Promoters and Barriers to Implementation of Tracheal Intubation Airway Safety Bundle: A Mixed-Method Analysis.

PubMed

Finn Davis, Katherine; Napolitano, Natalie; Li, Simon; Buffman, Hayley; Rehder, Kyle; Pinto, Matthew; Nett, Sholeen; Jarvis, J Dean; Kamat, Pradip; Sanders, Ronald C; Turner, David A; Sullivan, Janice E; Bysani, Kris; Lee, Anthony; Parker, Margaret; Adu-Darko, Michelle; Giuliano, John; Biagas, Katherine; Nadkarni, Vinay; Nishisaki, Akira

2017-10-01

To describe promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. Mixed methods. Thirteen PICUs of the National Emergency Airway Registry for Children network. Remote or on-site focus groups with interdisciplinary ICU staff. Two semistructured interviews with ICU quality improvement leaders with quantitative and qualitative data-based feedbacks. Bundle implementation success (compliance) was defined as greater than or equal to 80% use for tracheal intubations for 3 consecutive months. ICUs were classified as early or late adopters. Focus group discussions concentrated on safety concerns and promoters and barriers to bundle implementation. Initial semistructured quality improvement leader interviews assessed implementation tactics and provided recommendations. Follow-up interviews assessed degree of acceptance and changes made after initial interview. Transcripts were thematically analyzed and contrasted by early versus late adopters. Median duration to achieve success was 502 days (interquartile range, 182-781). Five sites were early (median, 153 d; interquartile range, 146-267) and eight sites were late adopters (median, 783 d; interquartile range, 773-845). Focus groups identified common "promoter" themes-interdisciplinary approach, influential champions, and quality improvement bundle customization-and "barrier" themes-time constraints, competing paperwork and quality improvement activities, and poor engagement. Semistructured interviews with quality improvement leaders identified effective and ineffective tactics implemented by early and late adopters. Effective tactics included interdisciplinary quality improvement team involvement (early adopter: 5/5, 100% vs late adopter: 3/8, 38%; p = 0.08); ineffective tactics included physician-only rollouts, lack of interdisciplinary education, lack of data feedback to frontline clinicians, and misconception of bundle as research instead of quality improvement intervention. Implementation of an airway safety quality improvement bundle with high compliance takes a long time across diverse ICUs. Both early and late adopters identified similar promoter and barrier themes. Early adopter sites customized the quality improvement bundle and had an interdisciplinary quality improvement team approach.

Impact of social preparedness on flood early warning systems

NASA Astrophysics Data System (ADS)

Girons Lopez, M.; Di Baldassarre, G.; Seibert, J.

2017-01-01

Flood early warning systems play a major role in the disaster risk reduction paradigm as cost-effective methods to mitigate flood disaster damage. The connections and feedbacks between the hydrological and social spheres of early warning systems are increasingly being considered as key aspects for successful flood mitigation. The behavior of the public and first responders during flood situations, determined by their preparedness, is heavily influenced by many behavioral traits such as perceived benefits, risk awareness, or even denial. In this study, we use the recency of flood experiences as a proxy for social preparedness to assess its impact on the efficiency of flood early warning systems through a simple stylized model and implemented this model using a simple mathematical description. The main findings, which are based on synthetic data, point to the importance of social preparedness for flood loss mitigation, especially in circumstances where the technical forecasting and warning capabilities are limited. Furthermore, we found that efforts to promote and preserve social preparedness may help to reduce disaster-induced losses by almost one half. The findings provide important insights into the role of social preparedness that may help guide decision-making in the field of flood early warning systems.

Early Career Boot Camp: a novel mechanism for enhancing early career development for psychologists in academic healthcare.

PubMed

Foran-Tuller, Kelly; Robiner, William N; Breland-Noble, Alfiee; Otey-Scott, Stacie; Wryobeck, John; King, Cheryl; Sanders, Kathryn

2012-03-01

The purpose of this article is to describe a pilot mentoring program for Early Career Psychologists (ECPs) working in Academic Health Centers (AHCs) and synthesize the lessons learned to contribute to future ECP and AHC career development training programs. The authors describe an early career development model, named the Early Career Boot Camp. This intensive experience was conducted as a workshop meant to build a supportive network and to provide mentorship and survival tools for working in AHCs. Four major components were addressed: professional effectiveness, clinical supervision, strategic career planning, and academic research. Nineteen attendees who were currently less than 5 years post completion of doctoral graduate programs in psychology participated in the program. The majority of boot camp components were rated as good to excellent, with no component receiving below average ratings. Of the components offered within the boot camp, mentoring and research activities were rated the strongest, followed by educational activities, challenges in AHCS, and promotion and tenure. The article describes the purpose, development, implementation, and assessment of the program in detail in an effort to provide an established outline for future organizations to utilize when mentoring ECPs.

Creating diversity in a baccalaureate nursing program: a case study.

PubMed

Barton, Amanda J; Swider, Susan M

2009-01-01

Minority groups in the United States experience disparity in the health care services they receive and in their health related outcomes. Minority healthcare providers are more likely to serve minority under-served populations, thus addressing this healthcare disparity in an effective culturally competent manner (Robert Wood Johnson 2005; Sullivan, 2004). The purpose of the project was to increase the number of racial and ethnic minority students who are successfully recruited and admitted to the nursing program at Hope College in Holland, Michigan. The project involved the identification of perceived barriers to increased minority participation in nursing at the college, review of the literature to identify evidence-based interventions, and implementation of selected interventions to overcome the identified barriers. Implementation and evaluation are still on-going but showing early success.

Three decades of MSM donor deferral policies. What have we learned?

PubMed

Wilson, Kumanan; Atkinson, Katherine; Keelan, Jennifer

2014-01-01

In the early 1980s, donor deferrals targeting men who have sex with men (MSM) and other high-risk groups were implemented in response to the outbreak of HIV/AIDS. It has now been three decades since the implementation of these deferrals. We review the international experience with developing these policies, which involves combining scientific evidence with ethical and moral concerns and the challenge of moving from precautionary to risk management policies as scientific knowledge and technology evolves. We provide key lessons that can guide blood policymakers as they confront potential new threats to the safety of the blood system and also provide lessons to the wider public health community on how best to incorporate precaution into the policymaking process. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

An Approach Using Parallel Architecture to Storage DICOM Images in Distributed File System

NASA Astrophysics Data System (ADS)

Soares, Tiago S.; Prado, Thiago C.; Dantas, M. A. R.; de Macedo, Douglas D. J.; Bauer, Michael A.

2012-02-01

Telemedicine is a very important area in medical field that is expanding daily motivated by many researchers interested in improving medical applications. In Brazil was started in 2005, in the State of Santa Catarina has a developed server called the CyclopsDCMServer, which the purpose to embrace the HDF for the manipulation of medical images (DICOM) using a distributed file system. Since then, many researches were initiated in order to seek better performance. Our approach for this server represents an additional parallel implementation in I/O operations since HDF version 5 has an essential feature for our work which supports parallel I/O, based upon the MPI paradigm. Early experiments using four parallel nodes, provide good performance when compare to the serial HDF implemented in the CyclopsDCMServer.

Drought Monitoring and Forecasting: Experiences from the US and Africa

NASA Astrophysics Data System (ADS)

Sheffield, Justin; Chaney, Nate; Yuan, Xing; Wood, Eric

2013-04-01

Drought has important but very different consequences regionally due to differences in vulnerability. These differences derive from variations in exposure related to climate variability and change, sensitivity of local populations, and coping capacity at all levels. Managing the risk of drought impacts relies on a variety of measures to reduce vulnerability that includes forewarning of drought development through early-warning systems. Existing systems rely on a variety of observing systems from satellites to local observers, modeling tools, and data dissemination methods. They range from sophisticated state-of-the-art systems to simple ground reports. In some regions, systems are virtually non-existent due to limited national capacity. This talk describes our experiences in developing and implementing drought monitoring and seasonal forecast systems in the US and sub-Saharan Africa as contrasting examples of the scientific challenges and user needs in developing early warning systems. In particular, early warning can help improve livelihoods based on subsistence farming in sub-Saharan Africa; whist reduction of economic impacts is generally foremost in the US. For the US, our national drought monitoring and seasonal forecast system has been operational for over 8 years and provides near real-time updates on hydrological states at ~12km resolution and hydrological forecasts out to 9 months. Output from the system contributes to national assessments such as from the NOAA Climate Prediction Center (CPC) and the US National Drought Monitor (USDM). For sub-Saharan Africa, our experimental drought monitoring system was developed as a translation of the US system but presents generally greater challenges due to, for example, lack of ground data and unique user needs. The system provides near real-time updates based on hydrological modeling and satellite based precipitation estimates, and has recently been augmented by a seasonal forecast component. We discuss the differences in experiences in development and implementation between the two systems in terms of the scientific challenges and the utility of the systems to stakeholders, for whom the information must be relevant to local conditions and needs.

FAA Loran early implementation project

DOT National Transportation Integrated Search

1990-03-01

The Early Implementation Project (EIP), established by FAA Administrator Admiral : Donald C. Engen, was the initial step in the process of Loran integration into the : National Airsace System (NAS). The EIP was designed to give the FAA and the Loran ...

Implementing Competency-Based Medical Education in a Postgraduate Family Medicine Residency Training Program: A Stepwise Approach, Facilitating Factors, and Processes or Steps That Would Have Been Helpful.

PubMed

Schultz, Karen; Griffiths, Jane

2016-05-01

In 2009-2010, the postgraduate residency training program at the Department of Family Medicine, Queen's University, wrestled with the practicalities of competency-based medical education (CBME) implementation when its accrediting body, the College of Family Physicians of Canada, introduced the competency-based Triple C curriculum. The authors used a stepwise approach to implement CMBE; the steps were to (1) identify objectives, (2) identify competencies, (3) map objectives and competencies to learning experiences and assessment processes, (4) plan learning experiences, (5) develop an assessment system, (6) collect and interpret data, (7) adjust individual residents' training programs, and (8) distribute decisions to stakeholders. The authors also note overarching processes, costs, and facil itating factors and processes or steps that would have been helpful for CBME implementation. Early outcomes are encouraging. Residents are being directly observed more often with increased documented feedback about performance based on explicit competency standards (24,000 data points for 150 residents from 2013 to 2015). These multiple observations are being collated in a way that is allowing the identification of patterns of performance, red flags, and competency development trajectory. Outliers are being identified earlier, resulting in earlier individualized modification of their residency training program. The authors will continue to provide and refine faculty development, are developing an entrustable professional activity field note app for handheld devices, and are undertaking research to explore what facilitates learners' competency development, what increases assessors' confidence in making competence decisions, and whether residents are better trained as a result of CBME implementation.

Application of activated barrier hopping theory to viscoplastic modeling of glassy polymers

NASA Astrophysics Data System (ADS)

Sweeney, J.; Spencer, P. E.; Vgenopoulos, D.; Babenko, M.; Boutenel, F.; Caton-Rose, P.; Coates, P. D.

2018-05-01

An established statistical mechanical theory of amorphous polymer deformation has been incorporated as a plastic mechanism into a constitutive model and applied to a range of polymer mechanical deformations. The temperature and rate dependence of the tensile yield of PVC, as reported in early studies, has been modeled to high levels of accuracy. Tensile experiments on PET reported here are analyzed similarly and good accuracy is also achieved. The frequently observed increase in the gradient of the plot of yield stress against logarithm of strain rate is an inherent feature of the constitutive model. The form of temperature dependence of the yield that is predicted by the model is found to give an accurate representation. The constitutive model is developed in two-dimensional form and implemented as a user-defined subroutine in the finite element package ABAQUS. This analysis is applied to the tensile experiments on PET, in some of which strain is localized in the form of shear bands and necks. These deformations are modeled with partial success, though adiabatic heating of the instability causes inaccuracies for this isothermal implementation of the model. The plastic mechanism has advantages over the Eyring process, is equally tractable, and presents no particular difficulties in implementation with finite elements.

Application of activated barrier hopping theory to viscoplastic modeling of glassy polymers

NASA Astrophysics Data System (ADS)

Sweeney, J.; Spencer, P. E.; Vgenopoulos, D.; Babenko, M.; Boutenel, F.; Caton-Rose, P.; Coates, P. D.

2017-10-01

An established statistical mechanical theory of amorphous polymer deformation has been incorporated as a plastic mechanism into a constitutive model and applied to a range of polymer mechanical deformations. The temperature and rate dependence of the tensile yield of PVC, as reported in early studies, has been modeled to high levels of accuracy. Tensile experiments on PET reported here are analyzed similarly and good accuracy is also achieved. The frequently observed increase in the gradient of the plot of yield stress against logarithm of strain rate is an inherent feature of the constitutive model. The form of temperature dependence of the yield that is predicted by the model is found to give an accurate representation. The constitutive model is developed in two-dimensional form and implemented as a user-defined subroutine in the finite element package ABAQUS. This analysis is applied to the tensile experiments on PET, in some of which strain is localized in the form of shear bands and necks. These deformations are modeled with partial success, though adiabatic heating of the instability causes inaccuracies for this isothermal implementation of the model. The plastic mechanism has advantages over the Eyring process, is equally tractable, and presents no particular difficulties in implementation with finite elements.

Implementing National System of Health Research Ethics Regulations: The Nigerian Experience

PubMed Central

Adebamowo, Clement A.

2013-01-01

Efforts by Nigerian authorities to institutionalize health research dates back to the early 70's with the establishment of the Medical Research Council. Subsequently efforts to strengthen a national health research system in line with the concept of Essential National Health Research (ENHR) were made but albeit un-successfully. This may have been as a result of poor political support, and lack of regulations to promote health research in the country. However little is known about health research regulations and their implementation in Nigeria. Health and health research in Nigeria is not regulated via a set of clearly defined legislation. While the country has developed a regulation document for health research ethics, compliance to this document is likely to be affected by the lack of legislation in for the health system as an entity. In this paper we narrate the developments in health, health research, and health regulations; we describe process for, and extent of implementation of the National Code of Health Research Ethics. We conclude that several factors affect the extent of implementation of the ethics code amongst which legislation is an important one. PMID:24324978

Implementing National System of Health Research Ethics Regulations: The Nigerian Experience.

PubMed

Yakubu, Aminu; Adebamowo, Clement A

2012-01-01

Efforts by Nigerian authorities to institutionalize health research dates back to the early 70's with the establishment of the Medical Research Council. Subsequently efforts to strengthen a national health research system in line with the concept of Essential National Health Research (ENHR) were made but albeit un-successfully. This may have been as a result of poor political support, and lack of regulations to promote health research in the country. However little is known about health research regulations and their implementation in Nigeria. Health and health research in Nigeria is not regulated via a set of clearly defined legislation. While the country has developed a regulation document for health research ethics, compliance to this document is likely to be affected by the lack of legislation in for the health system as an entity. In this paper we narrate the developments in health, health research, and health regulations; we describe process for, and extent of implementation of the National Code of Health Research Ethics. We conclude that several factors affect the extent of implementation of the ethics code amongst which legislation is an important one.

Utilizing an Early Childhood Science Curriculum: Factors Influencing Implementation and How Variations Affect Students' Skills and Attitudes

ERIC Educational Resources Information Center

Shamas-Brandt, Ellen

2012-01-01

Early childhood is a ripe time for students to begin learning science, but due to certain constraints, this instruction is not happening as frequently as it should. This mixed-methods, multiple case study examined how two teachers implemented an early childhood science curriculum, the "Young Scientist Series." The teacher participants…

Closing the Gap Early: Implementing a Literacy Intervention for At-Risk Kindergartners in Urban Schools

ERIC Educational Resources Information Center

MacDonald, Colleen; Figueredo, Lauren

2010-01-01

A history of poverty and low academic achievement in four urban schools pointed to the need to implement an early intervention focused on oral language and emergent literacy. The Kindergarten Early Literacy Tutoring (KELT) Program was designed to target senior (5 year old) kindergarten students most at-risk. The intervention consisted of an extra…

Simple mechanisms of early life - simulation model on the origin of semi-cells.

PubMed

Klein, Adrian; Bock, Martin; Alt, Wolfgang

2017-01-01

The development of first cellular structures played an important role in the early evolution of life. Early evolution of life probably took place on a molecular level in a reactive environment. The iron-sulfur theory postulates the formation of cell-like structures on catalytic surfaces. Experiments show that H 2 S together with FeS and other metallic centers drive auto-catalytic surface reactions, in which organic molecules such as pyruvic and amino acids occur. It is questionable which mechanisms are needed to form cell-like structures under these conditions. To address this question, we implemented a model system featuring the fundamentals of molecular dynamics: heat, attraction, repulsion and formation of covalent bonds. Our basic model exhibits a series of essential processes: self-organization of lipid micelles and bilayers, formation of fluid filled cavities, flux of molecules along membranes, transport of energized groups towards sinks and whole colonies of cell-like structures on a larger scale. The results demonstrate that only a few features are sufficient for discovering hitherto non described phenomena of self-assembly and dynamics of cell-like structures as candidates for early evolving proto-cells. Significance statement The quest for a possible origin of life continues to be one of the most fascinating problems in biology. In one theoretical scenario, early life originated from a solution of reactive chemicals in the ancient deep sea, similar to conditions as to be found in thermal vents. Experiments have shown that a variety of organic molecules, the building blocks of life, form under these conditions. Based on such experiments, the iron-sulfur theory postulates the growth of cell-like structures at certain catalytic surfaces. For an explanation and proof of such a process we have developed a computer model simulating molecular assembly of lipid bilayers and formation of semi-cell cavities. The results demonstrate the possibility of cell-like self-organization under appropriate physico-chemical conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Constructions and experiences of motherhood in the context of an early intervention for Aboriginal mothers and their children: mother and healthcare worker perspectives.

PubMed

Ussher, Jane M; Charter, Rosie; Parton, Chloe; Perz, Janette

2016-07-22

The colonisation of Australia has been associated with traumatic consequences for Aboriginal health and wellbeing, including the breakdown of the traditional family unit and negative consequences for the mother/child relationship. Early-intervention programs have been developed to assist families to overcome disadvantage and strengthen mother/child attachment. However, there is no research examining Aboriginal women's subjective experiences and constructions of motherhood in the context of such programs, and no research on the perceived impact of such programs, from the perspective of Aboriginal mothers and healthcare workers (HCWs), with previous research focusing on child outcomes. Researchers conducted participant observation of an early intervention program for Aboriginal mothers and young children over a 6 month period, one-to-one interviews and a focus group with 10 mothers, and interviews with nine HCWs, in order to examine their perspectives on motherhood and the intervention program. Thematic analysis identified 2 major themes under which subthemes were clustered. Constructions of motherhood: 'The resilient mother: Coping with life trauma and social stress' and 'The good mother: Transformation of self through motherhood'; Perspectives on the intervention: '"Mothers come to life": Transformation through therapy'; and '"I know I'm a good mum": The need for connections, skills and time for self'. The mothers constructed themselves as being resilient 'good mothers', whilst also acknowledging their own traumatic life experiences, predominantly valuing the peer support and time-out aspects of the program. HCWs positioned the mothers as 'traumatised', yet also strong, and expressed the view that in order to improve mother/child attachment a therapeutic transformation is required. These results suggest that early interventions for Aboriginal mothers should acknowledge and strengthen constructions of the good and resilient mother. The differing perspectives of mothers and HCWs on the role and impact of the early intervention program reinforces the need for Aboriginal mothers to be involved in the design and implementation of services aimed at assisting their families.

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

PubMed

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

2017-12-01

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

Apollo experience report: Guidance and control systems. Engineering simulation program

NASA Technical Reports Server (NTRS)

Gilbert, D. W.

1973-01-01

The Apollo Program experience from early 1962 to July 1969 with respect to the engineering-simulation support and the problems encountered is summarized in this report. Engineering simulation in support of the Apollo guidance and control system is discussed in terms of design analysis and verification, certification of hardware in closed-loop operation, verification of hardware/software compatibility, and verification of both software and procedures for each mission. The magnitude, time, and cost of the engineering simulations are described with respect to hardware availability, NASA and contractor facilities (for verification of the command module, the lunar module, and the primary guidance, navigation, and control system), and scheduling and planning considerations. Recommendations are made regarding implementation of similar, large-scale simulations for future programs.

Consumer-directed health plans: enrollee views, early employer experience.

PubMed

Frates, Janice; Severoni, Ellen

2005-06-01

Consumer-directed health plans (CDHPs) are a new health insurance product that is of growing interest to employers who are struggling to cope with rising health insurance premium costs and to consumers who are desiring more choice and engagement in their health care. This paper presents the results of a study of California consumer awareness of, and attitudes toward, CDHPs in the context of several national surveys and the experiences of some early-adopting employers. California Health Decisions conducted a telephone survey of 800 insured adult California residents in November 2002. Few respondents had heard of CDHPs. They appealed more to younger, single, less educated, and healthier respondents and those who did not understand them well. The most attractive CDHP features were greater provider choice and health savings accounts' portability and flexibility. Concerns centered on personal financial exposure. While CDHPs' commercial market penetration is increasing, their greatest potential future contributions might be to reduce the number of uninsured Americans by offering an affordable health insurance product and to fund additional health services for retirees. As CDHPs further evolve, more consumer involvement in their refinement, implementation, and evaluation is essential.

Clickers at UMass: a successful program of campus-wide implementation

NASA Astrophysics Data System (ADS)

Schneider, Stephen

2006-12-01

In the early 1990s, the Physics Department of the University of Massachusetts was a testing ground for one of the forerunners of the modern classroom response systems. Today, UMass is one of largest users of the wireless descendants of this system, with “clickers” being used across all disciplines. In Astronomy (and many other departments) we use clickers primarily in our large lecture classrooms. We have found that they can be used to (a) engage students in making predictions about classroom experiments. (b) encourage cooperative work with other students to develop mathematical and reasoning skills. (c) help students explore their own misconceptions. (d) All of the above. [correct answer!] Our early uses of clickers showed that simple testing of student knowledge was often perceived negatively as, in effect, “just taking attendance.” However, when students are challenged with difficult and interesting problems, the classroom response system is a positive addition to classroom teaching. Several successful examples, using demos, experiments, and even horoscopes, are shown, and the process involved in developing a strong campus-wide program at UMass is described.

Implementing the CASPiE course-based research experience at the United States Military Academy: Affective responses and effects on critical thinking

NASA Astrophysics Data System (ADS)

Chase, Anthony Michael

The Center for Authentic Science Practices in Education (CASPiE) pioneered a course-based research experience approach to teaching chemistry laboratory courses. The method had previously been studied in a variety of institutional settings. Recently, the United States Military Academy at West Point decided to develop CASPiE-style modules for the introductory honors chemistry course. This research setting presents clean experimental-control comparisons and a group of faculty who were completely new to the method. Equipping students with authentic research experiences early in their education is important regardless of the institution. However, cadets at a military academy must make decisions relatively early (the outset of their second year) as to what their career trajectory will be as eventual officers. In the new CASPiE-based experience, cadets are given the opportunity to select from one of three different modules (analytical chemistry, toxicology, and chemical engineering) in which to participate during the course. These three modules represent subsections of an overall Army waste-to-energy research project. Cadets generate unique hypotheses, real data, and research posters towards the advancement of the project. Posters are then presented in a session. that includes an audience of project stakeholders, course instructors, and other academy faculty and staff. Here, I will present my research methods, evaluative procedures, and findings in the affective domain, critical thinking, and laboratory content comprehension.

Exploring adverse parent-child relationships from the perspective of convicted child murderers: A South African qualitative study.

PubMed

Dekel, Bianca; Abrahams, Naeemah; Andipatin, Michelle

2018-01-01

Child homicide is the most extreme form of violence against children. Within South Africa, children face the highest risk of homicide by parents/caregivers. It is suggested that prolonged exposure to adverse relationships with one's own parents may be linked to committing child homicide as it may lead to psychological damage and disturb neurological functioning. This paper explores the adverse parent-child relationships of 22 men and women incarcerated for the murder of either a biological child, a stepchild or a child in their care and draws on 49 in-depth interviews with these participants. We illustrate that traumatic parent-child experiences in the form of absent parents, neglect and abuse have a profound impact on establishing unhealthy attachment styles and emphasize the importance of early adverse parent-child bonds in setting the tone for future bonds as adults. The pathway to adopting an adverse attachment with one's own child is argued to be influenced by these early traumatic emotional experiences within the home. This study highlights the need to acknowledge the impact that adverse parent-child experiences have on the formation of violent forms of parental behavior. It is imperative to reduce children's emotional vulnerabilities by implementing strategies to strengthen current parenting practices, to promote the development of less violent parent-child relationships and to work towards resolving parents' experiences of trauma in reducing child homicide.

Transforming Nursing Education With Apple Technology.

PubMed

Clark, Angela; Glazer, Greer; Edwards, Christopher; Pryse, Yvette

The widespread adoption of technology has the potential to redefine nursing education. Currently, there is limited knowledge of how to implement technological advancements in nursing curricula. This article describes 1 college's journey to transform nursing education through leadership, professional development, and innovative learning and teaching. The iPad opens the classroom experience to resources and learning opportunities for students. Facilitating the culture change required to adopt the iPad as a teaching and learning tool required a supportive vision, strong leadership, commitment to provide adequate technological support, early adopters, and planning.

ESTEST: A Framework for the Verification and Validation of Electronic Structure Codes

NASA Astrophysics Data System (ADS)

Yuan, Gary; Gygi, Francois

2011-03-01

ESTEST is a verification and validation (V& V) framework for electronic structure codes that supports Qbox, Quantum Espresso, ABINIT, the Exciting Code and plans support for many more. We discuss various approaches to the electronic structure V& V problem implemented in ESTEST, that are related to parsing, formats, data management, search, comparison and analyses. Additionally, an early experiment in the distribution of V& V ESTEST servers among the electronic structure community will be presented. Supported by NSF-OCI 0749217 and DOE FC02-06ER25777.

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.

Worklife Improvement and Leadership Development study: a learning experience in leadership development and "planned" organizational change.

PubMed

Cummings, Greta G; Spiers, Judith A; Sharlow, Janice; Germann, Paula; Yurtseven, Ozden; Bhatti, Aslam

2013-01-01

In response to increasing recognition of the importance of quality health care work environments, the Alberta Cancer Board initiated a province-wide leadership development program to plan for organizational change through a series of stages. In 2004, the Leadership Development Initiative (LDI) was implemented to facilitate organizational learning using a cohort-based leadership intervention based on a communities of practice framework. The aim of the Worklife Improvement and Leadership Development study was to examine both the outcomes and experiences of participants of the LDI program to better understand leadership development, implementation, and its impact on worklife quality among 5 cohorts of health care managers and staff at the Alberta Cancer Board. This study used both structured survey and interview methods, using a pretest-intervention-posttest quasi-experiment without a control group design, to assess the effects of LDI on worklife of leaders and staff. Surveys included the Leadership Practices Inventory and Areas of Worklife Scale, which looked at meaningfulness of work and organizational engagement. Interviews and focus group data provided a more detailed description of the experience of leadership development and perceptions of organizational worklife. The study revealed layers of information about the complexity of individual and collective leadership in a cohort-based design, perceptions of leadership initiatives, organizational worklife, and planned organizational change. Our findings suggest that early changes in how leaders reflected on their own skills and practices (Leading Self) were positive; however, growing disengagement as the LDI continued was evident in the focus group data, particularly when change in behavior of others was not perceived to be evident. To support the effectiveness and success of a leadership initiative, managers and administrators need to implement strategies designed to help leaders grow and cope with ongoing flux of organizational change and stagnation.

Patient and Family Engagement in Designing and Implementing a Weaning Trial: A Novel Research Paradigm in Critical Care.

PubMed

Burns, Karen E A; Devlin, John W; Hill, Nicholas S

2017-10-01

The call for meaningful patient and family engagement in research has recently gained considerable momentum. This article defines patient and family engagement broadly and specifically in clinical research. Using a multicenter, North American weaning trial as an exemplar, we describe our early experiences as clinical researchers with patient and family engagement. The role of our Patient and Family Advisory Committee in trial design and implementation is illustrated. Through our experiences, we share our insights regarding the perceived opportunities and also highlight some challenges associated with engaging patients and family engagement in critical care research. Although "engagement science" is in its infancy, engaging patients and families in research holds promise as a novel research paradigm that will not only provide new insights into the questions, methods, and outcomes used in ICU research, but it will also make investments in research more accountable and ensure a strong "patient- and family-centered focus" of our research. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

A theory of requirements definition in engineering design

NASA Astrophysics Data System (ADS)

Eodice, Michael Thomas

2000-10-01

Traditional requirements-definition activities begin with the engineer or design team performing a needs-analysis to identify user requirements. Needs-analysis is generally subjective, and varies according to the composition and experience of the design team. Systematic procedures for defining and ranking requirements are necessary to consolidate the foundation on which the design process is predicated, and to enhance its outcome by providing the designer with a consistent, reliable approach to product development. As a first step towards developing such procedures, research was conducted at Stanford University using empirical data from a NASA spaceflight experiment that flew aboard Space Shuttle mission STS-90 (April 1998). This research was accomplished using ex post facto data analysis. This researcher served in the central role of Experiment Manager for the spaceflight experiment, and acted as a participant-observer while conducting formal research. To better understand requirement structure and evolution, individual requirements were decomposed using AND/OR graphs. The AND/OR graph data structure illustrates requirements evolution, and reveals that the original requirement is often met by fulfilling a series of sub-requirements that are easier to implement. Early in the product life cycle, many hundreds of potential needs were identified; however, it was a smaller subset of these initial needs that were realized in the final product. Based on analysis of a large group of requirements, it was observed that two critical components for any individual requirement were: (1) a stated need, and (2) an advocate to implement the need. Identification of need, or needs-analysis, although a necessary condition, is insufficient to ensure that a stated need evolves into a formal requirement. Equally important to the concept of requirements-definition is the notion of advocacy. Early in the product development cycle of the of the NASA experiment, many potential needs were identified; however, it was only through need-advocate pairing that a stated need became a requirement. Empirical data revealed that when needs were accompanied by strong advocates, they became clear requirements. Conversely, needs without advocates did not become requirements. Hence, need-advocate pairing is useful for predicting needs which will become requirements, and more importantly, needs at risk of not becoming requirements.

Design and Implementation of a Community Health Worker HIV Treatment and Prevention Intervention in an HIV Hot Spot Fishing Community in Rakai, Uganda.

PubMed

Long, Amanda; Mbabali, Ismail; Hutton, Heidi E; Thomas, Alvin G; Bugos, Eva; Mulamba, Jeremiah; Amico, Kathy Rivet; Nalugoda, Fred; Gray, Ronald H; Wawer, Maria J; Nakigozi, Gertrude; Chang, Larry W

Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The intervention, utilizing a novel, theory-based approach, trained 10 community residents in an HIV hot spot fishing community to use motivational interviewing strategies and a mobile phone-based counseling application. During the first 3 months, 771 residents (median 82/health scout, range 27-160) were counseled. A directly observed Motivational Interviewing Treatment Integrity scale-based evaluation found adequate performance (median score 20/25, range 11-23). The health scout intervention was feasible to implement in a high HIV-prevalence fishing community, and its impact on HIV care outcomes will be evaluated in an ongoing cluster randomized trial. If found to be effective, it may be an important strategy for responding to HIV in high-burden settings.

The Early Childhood Cluster Initiative of Palm Beach County, Florida. Early Implementation Study and Evaluability Assessment. Executive Summary

ERIC Educational Resources Information Center

Spielberger, Julie; Goyette, Paul

2006-01-01

This report summarizes findings from the first year of an implementation study of the Early Childhood Cluster Initiative (ECCI). ECCI is a prekindergarten program in ten elementary schools and a community child care center in Palm Beach County, based on the design of the High/Scope Perry Preschool model. The initiative is characterized by low…

Using Data to Inform Systems: Assessing Teacher Implementation of Key Features of Program-Wide Positive Behavioral Support in Head Start Classrooms

ERIC Educational Resources Information Center

Stormont, Melissa; Covington, Sandra; Lewis, Timothy J.

2006-01-01

To date, data-based research has not been conducted specifically on the use of systems of schoolwide positive behavioral support (SW-PBS) in early childhood settings; however, several articles have described how the process can be implemented to support children in early childhood settings. Research has also documented early childhood teachers'…

Assessing the Implementation and Cost of High Quality Early Care and Education: A Review of the Literature. OPRE Report 2016-31

ERIC Educational Resources Information Center

Caronongan, Pia; Kirby, Gretchen; Boller, Kimberly; Modlin, Emily; Lyskawa, Julia

2016-01-01

This report summarizes the findings of a literature review conducted as part of the Assessing the Implementation and Cost of High-Quality Early Care and Education (ECE-ICHQ) project. The project's goal is to create a technically sound and feasible instrument that will provide consistent, systematic measures of the implementation and costs of…

The Early Nutrition Programming Project (EARNEST): 5 y of successful multidisciplinary collaborative research.

PubMed

Koletzko, Berthold; Brands, Brigitte; Demmelmair, Hans

2011-12-01

Differences in nutritional experiences during sensitive periods in early life, both before and after birth, can program a person's future development, metabolism, and health. A better scientific understanding of early nutrition programming holds enormous potential for implementing preventive strategies to enhance individuals' long-term health, well-being, and performance. This understanding could reduce costs of health care and social services and may enhance the wealth of societies. The Early Nutrition Programming Project (EARNEST) brought together a multidisciplinary team of international scientists and leaders in key areas of the early nutrition programming field from 40 major research centers across 16 European countries. The project had a total budget of 16.5 million Euros and was funded by the European Communities under the Sixth Framework Program for Research and Technical Development and coordinated by the Children's Hospital at Ludwig-Maximilians-University of Munich. The integrated program of work combined experimental studies in humans, prospective observational studies, and mechanistic animal work, including physiologic studies, cell culture models, and molecular biology techniques. The project lasted from April 2005 to October 2010. After the end of the project, the Early Nutrition Academy (http://www.early-nutrition.org) continues to serve as a platform for the exchange of information, scientific collaboration, and training activities in the area of programming. This article highlights some of the scientific results, achievements, and efforts of EARNEST.

Decision making and action implementation: evidence for an early visually triggered motor activation specific to potential actions.

PubMed

Tandonnet, Christophe; Garry, Michael I; Summers, Jeffery J

2013-07-01

To make a decision may rely on accumulating evidence in favor of one alternative until a threshold is reached. Sequential-sampling models differ by the way of accumulating evidence and the link with action implementation. Here, we tested a model's prediction of an early action implementation specific to potential actions. We assessed the dynamics of action implementation in go/no-go and between-hand choice tasks by transcranial magnetic stimulation of the motor cortex (single- or paired-pulse TMS; 3-ms interstimulus interval). Prior to implementation of the selected action, the amplitude of the motor evoked potential first increased whatever the visual stimulus but only for the hand potentially involved in the to-be-produced action. These findings suggest that visual stimuli can trigger an early motor activation specific to potential actions, consistent with race-like models with continuous transmission between decision making and action implementation. Copyright © 2013 Society for Psychophysiological Research.

She's supporting them; who's supporting her? Preschool center-level social-emotional supports and teacher well-being.

PubMed

Zinsser, Katherine M; Christensen, Claire G; Torres, Luz

2016-12-01

Preschool teachers across the country have been charged to prepare children socially and emotionally for kindergarten. Teachers working in preschool centers are supporting children's social and emotional learning (SEL) within a rich ecology of emotion and social relationships and the present study considers how the supports implemented for children's SEL at the center-level are associated with teachers' psychological health and workplace experiences. Hierarchical linear models were constructed using data from the Head Start Family and Child Experiences Survey 2009 cohort. Results indicate that although teachers work in individual classrooms, they share common perceptions at the center-level of their workplace climate, access to support, and, although to a lesser extent, experience commonalities in psychological health and job satisfaction. Furthermore, in centers that had implemented more supports for children's SEL (including access to mental health consultants, classroom curriculum, and training and resources for teachers) teachers were less depressed, more satisfied with their jobs, felt more supported in managing challenging behavior, and viewed the workplace climate of their center as more positive. Findings are discussed in light of the national efforts to increase and retain a high-quality early childhood workforce. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Using Zebrafish to Implement a Course-Based Undergraduate Research Experience to Study Teratogenesis in Two Biology Laboratory Courses

PubMed Central

Chism, Grady W.; Vaughan, Martin A.; Muralidharan, Pooja; Marrs, Jim A.

2016-01-01

Abstract A course-based undergraduate research experience (CURE) spanning three semesters was introduced into freshman and sophomore biology classes, with the hypothesis that participation in a CURE affects skills in research, communication, and collaboration, which may help students persist in science. Student research projects were centered on the hypothesis that nicotine and caffeine exposure during early development affects gastrulation and heart development in zebrafish. First, freshmen generated original data showing distinct effects of embryonic nicotine and caffeine exposure on zebrafish heart development and function. Next, Cell Biology laboratory students continued the CURE studies and identified novel teratogenic effects of nicotine and caffeine during gastrulation. Finally, new freshmen continued the CURE research, examining additional toxicant effects on development. Students designed new protocols, made measurements, presented results, and generated high-quality preliminary data that were studied in successive semesters. By implementing this project, the CURE extended faculty research and provided a scalable model to address national goals to involve more undergraduates in authentic scientific research. In addition, student survey results support the hypothesis that CUREs provide significant gains in student ability to (1) design experiments, (2) analyze data, and (3) make scientific presentations, translating into high student satisfaction and enhanced learning. PMID:26829498

Using Zebrafish to Implement a Course-Based Undergraduate Research Experience to Study Teratogenesis in Two Biology Laboratory Courses.

PubMed

Sarmah, Swapnalee; Chism, Grady W; Vaughan, Martin A; Muralidharan, Pooja; Marrs, Jim A; Marrs, Kathleen A

2016-08-01

A course-based undergraduate research experience (CURE) spanning three semesters was introduced into freshman and sophomore biology classes, with the hypothesis that participation in a CURE affects skills in research, communication, and collaboration, which may help students persist in science. Student research projects were centered on the hypothesis that nicotine and caffeine exposure during early development affects gastrulation and heart development in zebrafish. First, freshmen generated original data showing distinct effects of embryonic nicotine and caffeine exposure on zebrafish heart development and function. Next, Cell Biology laboratory students continued the CURE studies and identified novel teratogenic effects of nicotine and caffeine during gastrulation. Finally, new freshmen continued the CURE research, examining additional toxicant effects on development. Students designed new protocols, made measurements, presented results, and generated high-quality preliminary data that were studied in successive semesters. By implementing this project, the CURE extended faculty research and provided a scalable model to address national goals to involve more undergraduates in authentic scientific research. In addition, student survey results support the hypothesis that CUREs provide significant gains in student ability to (1) design experiments, (2) analyze data, and (3) make scientific presentations, translating into high student satisfaction and enhanced learning.

Programas de Educacion Inicial en America Latina y los Curriculos Nacionales en el siglo XXI. [Latin American Early Childhood Educational Programs and National Curriculum in the 21st Century.

ERIC Educational Resources Information Center

Peralta, Maria Victoria

2003-01-01

Describes the history of early childhood education in Chile and recent educational reforms. Offers an overview of the Chilean Early Childhood Education program and discusses the new national curriculum and issues arising from its implementation. Describes methods taken to help implement the new curriculum nationwide and to assist teachers in…

The Early Childhood Cluster Initiative of Palm Beach County, Florida. Early Implementation Study And Evaluability Assessment. Final Report. Chapin Hall Working Paper

ERIC Educational Resources Information Center

Spielberger, Julie; Goyette, Paul

2006-01-01

This publication reports findings from the first year of an implementation study of the Early Childhood Cluster Initiative (ECCI). ECCI is a prekindergarten program in ten elementary schools and a community child care center in Palm Beach County, based on the design of the High/Scope Perry Preschool model. The initiative is characterized by low…

Early experiences with big data at an academic medical center.

PubMed

Halamka, John D

2014-07-01

Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

Analysis of In-Space Assembly of Modular Systems

NASA Technical Reports Server (NTRS)

Moses, Robert W.; VanLaak, James; Johnson, Spencer L.; Chytka, Trina M.; Reeves, John D.; Todd, B. Keith; Moe, Rud V.; Stambolian, Damon B.

2005-01-01

Early system-level life cycle assessments facilitate cost effective optimization of system architectures to enable implementation of both modularity and in-space assembly, two key Exploration Systems Research & Technology (ESR&T) Strategic Challenges. Experiences with the International Space Station (ISS) demonstrate that the absence of this rigorous analysis can result in increased cost and operational risk. An effort is underway, called Analysis of In-Space Assembly of Modular Systems, to produce an innovative analytical methodology, including an evolved analysis toolset and proven processes in a collaborative engineering environment, to support the design and evaluation of proposed concepts. The unique aspect of this work is that it will produce the toolset, techniques and initial products to analyze and compare the detailed, life cycle costs and performance of different implementations of modularity for in-space assembly. A multi-Center team consisting of experienced personnel from the Langley Research Center, Johnson Space Center, Kennedy Space Center, and the Goddard Space Flight Center has been formed to bring their resources and experience to this development. At the end of this 30-month effort, the toolset will be ready to support the Exploration Program with an integrated assessment strategy that embodies all life-cycle aspects of the mission from design and manufacturing through operations to enable early and timely selection of an optimum solution among many competing alternatives. Already there are many different designs for crewed missions to the Moon that present competing views of modularity requiring some in-space assembly. The purpose of this paper is to highlight the approach for scoring competing designs.

The opinion of preceptors and students of very early IPPE rotations delivered concurrently with didactic courses.

PubMed

Stanton, Robert B; Kimble, Craig; Butt, Melanie T; Anderson, Stephanie L; Broedel-Zaugg, Kimberly; Anderson, Harold Glenn

The Marshall University School of Pharmacy had the opportunity to create an experiential education program where IPPE education was introduced in their P1 year and was concurrent with didactic coursework. The School begins the delivery of experiential education as soon as the sixth week of the first professional year. To ascertain the opinion of institutional preceptors, community preceptors, and students after the first academic year to discern viewpoints on the effectiveness and value of very early P1 experiential rotations. Institutional and community preceptors and students were assessed by anonymous survey in order to ascertain their respective opinions regarding early P1 experiential education. The results of the preceptors were further divided into institutional and community practice sites. This study was approved by the Marshall University Institutional Review Board. Key findings demonstrated that early rotations were perceived as beneficial to the student by both community and institutional preceptors, as well as, the students themselves. Most, but not all, preceptors felt early rotations were beneficial to their practice and the student. Institutional preceptors were less likely to perceive a benefit to their practice or to the student than were community preceptors. Students were positive about the early experience. The results of these surveys regarding early experiential rotations should help minimize concerns of both preceptors and those assigned responsibility for constructing experiential programs about implementing early experiential rotations in the curriculum. Copyright © 2016 Elsevier Inc. All rights reserved.

Designing Effective Undergraduate Research Experiences

NASA Astrophysics Data System (ADS)

Severson, S.

2010-12-01

I present a model for designing student research internships that is informed by the best practices of the Center for Adaptive Optics (CfAO) Professional Development Program. The dual strands of the CfAO education program include: the preparation of early-career scientists and engineers in effective teaching; and changing the learning experiences of students (e.g., undergraduate interns) through inquiry-based "teaching laboratories." This paper will focus on the carry-over of these ideas into the design of laboratory research internships such as the CfAO Mainland internship program as well as NSF REU (Research Experiences for Undergraduates) and senior-thesis or "capstone" research programs. Key ideas in maximizing student learning outcomes and generating productive research during internships include: defining explicit content, scientific process, and attitudinal goals for the project; assessment of student prior knowledge and experience, then following up with formative assessment throughout the project; setting reasonable goals with timetables and addressing motivation; and giving students ownership of the research by implementing aspects of the inquiry process within the internship.

So you want to share your science…. Connecting to the world of informal science learning.

PubMed

Alpert, Carol Lynn

2018-04-25

Scientists can reap personal rewards through collaborations with science and natural history museums, zoos, botanical gardens, aquaria, parks, and nature preserves, and, while doing so, help to advance science literacy and broaden participation in the natural sciences. Beyond volunteer opportunities, which allow scientists to contribute their knowledge and passion within the context of existing programs and activities, there are also opportunities for scientists to bring their knowledge and resources to the design and implementation of new learning experiences for visitors to these informal science learning organizations (ISLOs). Well-designed education outreach plans that leverage the expertise and broad audiences of ISLOs can also enhance the prospects of research grant proposals made to agencies such as National Science Foundation, which encourage researchers to pay careful attention to the broader impacts of their research as well as its intellectual merit. Few scientists, however, have had the opportunity to become familiar with the pedagogy and design of informal or 'free-choice' science learning, and fewer still know how to go about the process of collaborating with ISLO's in developing and implementing effective programs, exhibits, and other learning experiences. This article, written by an experienced science museum professional, provides guidance for individual scientists and research groups interested in pursuing effective education outreach collaborations with science museums and other ISLOs. When prospective partners begin discussions early in the proposal development process, they increase the likelihood of successful outcomes in funding, implementation, and impact. A strategic planning worksheet is provided, along with a carefully-selected set of further resources to guide the design and planning of informal science learning experiences.

Health in All Policies in South Australia: what has supported early implementation?

PubMed

Delany, Toni; Lawless, Angela; Baum, Frances; Popay, Jennie; Jones, Laura; McDermott, Dennis; Harris, Elizabeth; Broderick, Danny; Marmot, Michael

2016-12-01

Health in All Policies (HiAP) is a policy development approach that facilitates intersectoral responses to addressing the social determinants of health and health equity whilst, at the same time, contributing to policy priorities across the various sectors of government. Given that different models of HiAP have been implemented in at least 16 countries, there is increasing interest in how its effectiveness can be optimized. Much of the existing literature on HiAP remains descriptive, however, and lacks critical, empirically informed analyses of the elements that support implementation. Furthermore, literature on HiAP, and intersectoral action more generally, provides little detail on the practical workings of policy collaborations. This paper contributes empirical findings from a multi-method study of HiAP implementation in South Australia (SA) between 2007 and 2013. It considers the views of public servants and presents analysis of elements that have supported, and impeded, implementation of HiAP in SA. We found that HiAP has been implemented in SA using a combination of interrelated elements. The operation of these elements has provided a strong foundation, which suggests the potential for HiAP to extend beyond being an isolated strategy, to form a more integrated and systemic mechanism of policy-making. We conclude with learnings from the SA experience of HiAP implementation to inform the ongoing development and implementation of HiAP in SA and internationally. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system.

PubMed

Toonstra, Amy L; Nelliot, Archana; Aronson Friedman, Lisa; Zanni, Jennifer M; Hodgson, Carol; Needham, Dale M

2017-06-01

Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs. A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience. An audience response system was incorporated to promote interaction and evaluate knowledge before vs. after the educational session. Up to 175 audience members, of 271 in attendance (129 (48%) physical therapists, 51 (19%) occupational therapists, 31 (11%) nursing, 14 (5%) physician, 46 (17%) other), completed both the pre- and post-test questions for each of the six unique patient cases. In four of six patient cases, there was a significant (p< 0.001) increase in identifying the correct answer regarding initiation of rehabilitation activities. This learning effect was similar irrespective of participants' years of experience and clinical discipline. An interactive, case-based, educational session may be effective for increasing short-term knowledge, and identifying knowledge gaps, regarding clinical decision-making for safe rehabilitation of patients in ICUs. Implications for Rehabilitation Lack of knowledge regarding the safety considerations for early rehabilitation of ICU patients is a barrier to implementing early rehabilitation. Interactive educational formats, such as the use of audience response systems, offer a new method of teaching and instantly assessing learning of clinically important information. In a small study, we have shown that an interactive, case-based educational format may be used to effectively teach clinical decision-making for the safe rehabilitation of ICU patients to a diverse audience of clinicians.

Characteristics of Early Work Experiences and Their Association with Future Employment

ERIC Educational Resources Information Center

McDonnall, Michele Capella; O'Mally, Jamie

2012-01-01

Introduction: Early work experiences are a key predictor of future employment for transition-age youths with visual impairments. We investigated how specific characteristics of early work experiences influence future employment and whether the receipt of Supplemental Security Income (SSI) benefits is associated with early work experiences among…

Enhancing Early Childhood Mental Health Primary Care Services: Evaluation of MA Project LAUNCH.

PubMed

Molnar, Beth E; Lees, Kristin E; Roper, Kate; Byars, Natasha; Méndez-Peñate, Larisa; Moulin, Christy; McMullen, William; Wolfe, Jessica; Allen, Deborah

2018-06-16

Objectives The purpose of this study was to evaluate the efficacy of an innovative early childhood mental health intervention, Massachusetts Project LAUNCH. Early childhood mental health clinicians and family partners (paraprofessionals with lived experience) were embedded within community pediatric medical homes. Methods A longitudinal study design was used to test the hypotheses that (1) children who received services would experience decreased social, emotional and behavioral problems over time and (2) caregivers' stress and depressive symptoms would decrease over time. Families who were enrolled in services and who consented to participate in the evaluation study were included in analyses (N = 225). Individual growth models were used to test longitudinal effects among MA LAUNCH participants (children and caregivers) over three time points using screening tools. Results Analyses showed that LAUNCH children who scored in age-specific clinically significant ranges of social, emotional and behavioral problems at Time 1 scored in the normal range on average by Time 3. Caregivers' stress and depressive symptoms also declined across the three time points. Results support hypotheses that the LAUNCH intervention improved social and emotional health for children and caregivers. Conclusions for Practice This study led to sustainability efforts, an expansion of the model to three additional communities across the state and development of an online toolkit for other communities interested in implementation.

A case study illustrating the use of an attachment video-feedback intervention strategy.

PubMed

Tarabulsy, George M; Dubois-Comtois, Karine; Baudry, Claire; Moss, Ellen; Roberge, Annie; Savage, Laura-Emilie; Cyr, Chantal; St-Laurent, Diane; Bernier, Annie

2018-05-21

Children from high-risk environments are more likely to experience problems in development. Many difficulties are linked to early experiences in the context of the emerging attachment relationship. Over the past 20 years, our group has collaborated with government agencies to develop and implement an attachment-based video-feedback intervention strategy (AVI) that targets parental sensitivity and attachment. This case study presents the manner in which a young mother and her 6-month-old son experienced AVI. The study shows how the absence of maternal sensitivity and responsiveness to infant signals, difficulties in helping the child regulate affect, and problems in autonomy support are addressed via eight semi-structured mentoring visits. Discussion focuses on how AVI may be a helpful addition to primary prevention programs. © 2018 Wiley Periodicals, Inc.

Simulation reduction using the Taguchi method

NASA Technical Reports Server (NTRS)

Mistree, Farrokh; Lautenschlager, Ume; Erikstad, Stein Owe; Allen, Janet K.

1993-01-01

A large amount of engineering effort is consumed in conducting experiments to obtain information needed for making design decisions. Efficiency in generating such information is the key to meeting market windows, keeping development and manufacturing costs low, and having high-quality products. The principal focus of this project is to develop and implement applications of Taguchi's quality engineering techniques. In particular, we show how these techniques are applied to reduce the number of experiments for trajectory simulation of the LifeSat space vehicle. Orthogonal arrays are used to study many parameters simultaneously with a minimum of time and resources. Taguchi's signal to noise ratio is being employed to measure quality. A compromise Decision Support Problem and Robust Design are applied to demonstrate how quality is designed into a product in the early stages of designing.

A Systematic Review of Fidelity of Implementation in Parent-Mediated Early Communication Intervention

ERIC Educational Resources Information Center

Lieberman-Betz, Rebecca G.

2015-01-01

This article examined the reporting of four elements of fidelity of implementation (FOI) in parent-mediated early communication treatment studies. Thirty-five studies were reviewed to extract information regarding reporting of dosage, adherence, quality, and participant responsiveness for both practitioners and parents involved in parent-delivered…

Trade law and alcohol regulation: what role for a global Alcohol Marketing Code?

PubMed

Mitchell, Andrew D; Casben, Jessica

2017-01-01

Following calls for restrictions and bans on alcohol advertising, and in light of the tobacco industry's challenge to Australia's tobacco plain packaging measure, a tobacco control measure finding support in the World Health Organization (WHO) Framework Convention on Tobacco Control, this paper considers what role, if any, an international alcohol marketing code might have in preventing or reducing the risk of challenges to domestic alcohol marketing restrictions under trade rules. Narrative review of international trade and health instruments and international trade court judgements regarding alcohol products and marketing restrictions. The experience of European trade courts in the litigation of similar measures suggests that World Trade Organization rules have sufficient flexibility to support the implementation of alcohol marketing restrictions. However, the experience also highlights the possibility that public health measures have disproportionate and unjustifiable trade effects and that the ability of a public health measure to withstand a challenge under trade rules will turn on its particular design and implementation. Measures implemented pursuant to international public health instruments are not immune to trade law challenges. Close collaboration between health policymakers, trade officials and lawyers, from as early as the research stage in the development of a measure to ensure a robust evidence base, will ensure the best chance of regulatory survival for an international marketing code. © 2016 Society for the Study of Addiction.

Triple Aim in Canada: developing capacity to lead to better health, care and cost.

PubMed

Farmanova, Elina; Kirvan, Christine; Verma, Jennifer; Mukerji, Geetha; Akunov, Nurdin; Phillips, Kaye; Samis, Stephen

2016-12-01

Many modern health systems strive for 'Triple Aim' (TA)-better health for populations, improved experience of care for patients and lower costs of the system, but note challenges in implementation. Outcomes of applying TA as a quality improvement framework (QI) have started to be realized with early lessons as to why some systems make progress while others do not. Limited evidence is available as to how organizations create the capacity and infrastructure required to design, implement, evaluate and sustain TA systems. To support embedding TA across Canada, the Canadian Foundation for Healthcare Improvement supported enrolment of nine Canadian teams to participate in the Institute for Healthcare Improvement's TA Improvement Community. Structured support for TA design, implementation, evaluation and sustainability was addressed in a collaborative programme of webinars and action periods. Teams were coached to undertake and test small-scale improvements before attempting to scale. A summative evaluation of the Canadian cohort was undertaken to assess site progress in building TA infrastructure across various healthcare settings. The evaluation explored the process of change, experiences and challenges and strategies for continuous QI. Delivering TA requires a sustained and coordinated effort supported by strong leadership and governance, continuous QI, engaged interdisciplinary teams and partnering within and beyond the healthcare sector. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice

PubMed Central

Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J

2015-01-01

Background System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children’s service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. Methods We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Results Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Conclusions Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit. PMID:27512239

Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice.

PubMed

Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J

2014-04-01

System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children's service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit.

Patients' views on early sensory relearning following nerve repair-a Q-methodology study.

PubMed

Vikström, Pernilla; Carlsson, Ingela; Rosén, Birgitta; Björkman, Anders

2017-09-26

Descriptive study. Early sensory relearning where the dynamic capacity of the brain is used has been shown to improve sensory outcome after nerve repair. However, no previous studies have examined how patients experience early sensory relearning. To describe patient's views on early sensory relearning. Statements' scores were analyzed by factor analysis. Thirty-seven consecutive adult patients with median and/or ulnar nerve repair who completed early sensory relearning were included. Three factors were identified, explaining 45% of the variance: (1) "Believe sensory relearning is meaningful, manage to get an illusion of touch and complete the sensory relearning"; (2) "Do not get an illusion of touch easily and need support in their sensory relearning" (3) "Are not motivated, manage to get an illusion of touch but do not complete sensory relearning". Many patients succeed in implementing their sensory relearning. However, a substantial part of the patient population need more support, have difficulties to create illusion of touch, and lack motivation to complete the sensory relearning. To enhance motivation and meaningfulness by relating the training clearly to everyday occupations and to the patient's life situation is a suggested way to proceed. The three unique factors indicate motivation and sense of meaningfulness as key components which should be taken into consideration in developing programs for person-centered early sensory relearning. 3. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Video as a technology for interpersonal communications: a new perspective

NASA Astrophysics Data System (ADS)

Whittaker, Steve

1995-03-01

Some of the most challenging multimedia applications have involved real- time conferencing, using audio and video to support interpersonal communication. Here we re-examine assumptions about the role, importance and implementation of video information in such systems. Rather than focussing on novel technologies, we present evaluation data relevant to both the classes of real-time multimedia applications we should develop and their design and implementation. Evaluations of videoconferencing systems show that previous work has overestimated the importance of video at the expense of audio. This has strong implications for the implementation of bandwidth allocation and synchronization. Furthermore our recent studies of workplace interaction show that prior work has neglected another potentially vital function of visual information: in assessing the communication availability of others. In this new class of application, rather than providing a supplement to audio information, visual information is used to promote the opportunistic communications that are prevalent in face-to-face settings. We discuss early experiments with such connection applications and identify outstanding design and implementation issues. Finally we examine a different class of application 'video-as-data', where the video image is used to transmit information about the work objects themselves, rather than information about interactants.

Implementation of a Project Management Office (PMO)--experiences from year 1.

PubMed

Isola, Miriam; Polikaitis, Audrius; Laureto, Rose Ann

2006-01-01

Recognized as an early leader in clinical information systems, the University of Illinois Medical Center was challenged to meet the ever-increasing demand for information systems. Interviews with key stakeholders revealed unfavorable attitudes toward the Information Services department. Reasons given were that projects often are not aligned with business strategy, projects are delayed, IS itself is a barrier to progress, and a lack of proactive planning precipitates crises. Under the leadership of a new CIO, IS began developing a Project Management Office, or PMO, to better meet medical center business objectives and to more effectively manage technology projects. Successes during the first year included comprehensive IT strategic planning. Collaborative relationships were established with departmental leaders for planning, prioritizing, budgeting, and executing projects. A formal Web-based process for requesting IS projects was implemented, project management training was provided, and elements of standard project management methodology were implemented. While a framework for effective project management was created, significant effort is still required to firmly root these new processes within the organizational culture. Project management office goals for the second year include implementing a project portfolio management tool, refining the benefits methodology, and continuing the advancement of the project management methodology.

Detection and Evaluation of Early Breast Cancer via Magnetic Resonance Imaging: Studies of Mouse Models and Clinical Implementation

DTIC Science & Technology

2008-03-01

CONTRACT NUMBER Detection and Evaluation of Early Breast Cancer via Magnetic Resonance Imaging: Studies of Mouse Models and Clinical Implementation...research proposed here can directly lead to clinical improvements in both early breast cancer detection, as well as effective breast cancer therapy. To date... cancer is a major prognostic factor in the management of the disease. In particular, detecting breast cancer in its pre-invasive form as ductal carcinoma

Physician assistant students' views regarding interprofessional education: a focus group study.

PubMed

Lie, Désirée; Walsh, Anne; Segal-Gidan, Freddi; Banzali, Yvonne; Lohenry, Kevin

2013-01-01

The purpose of this study was to identify and report physician assistant (PA) student experiences, learning, and opinions regarding interprofessional education (IPE). A series of open-ended questions was constructed and designed to solicit PA students' opinions about the need for IPE, preferred teaching strategies, and implementation methods, using focus group methodology. We used two sets of questions, one for students who had participated in a formal geriatrics IPE experience (n = 12), the other for students who did not have the experience (n = 10). Focus group sessions were audiotaped and transcripts coded. Key themes were identified and ranked. Twenty-two students participated in four focus groups. Theme saturation was reached and six overlapping themes emerged: (1) PA students learned the most about occupational and physical therapist roles; (2) They were surprised at other professions' lack of knowledge about the PA profession; (3) They strongly expressed that IPE should be required early in training; (4) They expressed preference for direct patient care with other health professions students, with trained faculty oversight; (5) They requested diverse clinical settings; and (6) They identified the optimal number of different students in a single IPE experience as four/five. The group exposed to geriatrics IPE noted the critical importance of faculty training for facilitation, while the nonexposed group emphasized the challenge of limited curricular time. PA students recognize the importance of IPE and request early, required clinical experiences led by well-trained interprofessional faculty with the option to choose clinical sites. Student preferences should be considered in IPE curriculum design.

Concept, Implementation and Testing of PRESTo: Real-time experimentation in Southern Italy and worldwide applications

NASA Astrophysics Data System (ADS)

Zollo, Aldo; Emolo, Antonio; Festa, Gaetano; Picozzi, Matteo; Elia, Luca; Martino, Claudio; Colombelli, Simona; Brondi, Piero; Caruso, Alessandro

2016-04-01

The past two decades have witnessed a huge progress in the development, implementation and testing of Earthquakes Early Warning Systems (EEWS) worldwide, as the result of a joint effort of the seismological and earthquake engineering communities to set up robust and efficient methodologies for the real-time seismic risk mitigation. This work presents an overview of the worldwide applications of the system PRESTo (PRobabilistic and Evolutionary early warning SysTem), which is the highly configurable and easily portable platform for Earthquake Early Warning developed by the RISSCLab group of the University of Naples Federico II. In particular, we first present the results of the real-time experimentation of PRESTo in Suthern Italy on the data streams of the Irpinia Seismic Network (ISNet), in Southern Italy. ISNet is a dense high-dynamic range, earthquake observing system, which operates in true real-time mode, thanks to a mixed data transmission system based on proprietary digital terrestrial links, standard ADSL and UMTS technologies. Using the seedlink protocol data are transferred to the network center unit, running the software platform PRESTo which is devoted to process the real-time data streaming, estimate source parameters and issue the alert. The software platform PRESTo uses a P-wave, network-based approach which has evolved and improved during the time since its first release. In its original version consisted in a series of modules, aimed at the event detection/picking, probabilistic real-time earthquake location and magnitude estimation, prediction of peak ground motion at distant sites through ground motion prediction equations for the area. In the recent years, PRESTo has been also implemented at the accelerometric and broad-band seismic networks in South Korea, Romania, North-East Italy, and Turkey and off-line tested in Iberian Peninsula, Israel, and Japan. Moreover, the feasibility of a PRESTo-based, EEWS at national scale in Italy, has been tested by evaluating its performance for the Italian Accelerometric Network. These testing experiments and the EEWS performance results will be summarized in the near-future perspective of building the next generation of early warning systems.

There is no place like @home!: The value of home consultations in paediatric rehabilitation.

PubMed

van Maren-Suir, I; Ketelaar, M; Brouns, B; van der Sanden, K; Verhoef, M

2018-07-01

Family-centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0-5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations. The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process. In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best. By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre. © 2018 John Wiley & Sons Ltd.

Exploring adverse parent-child relationships from the perspective of convicted child murderers: A South African qualitative study

PubMed Central

Abrahams, Naeemah; Andipatin, Michelle

2018-01-01

Child homicide is the most extreme form of violence against children. Within South Africa, children face the highest risk of homicide by parents/caregivers. It is suggested that prolonged exposure to adverse relationships with one’s own parents may be linked to committing child homicide as it may lead to psychological damage and disturb neurological functioning. This paper explores the adverse parent-child relationships of 22 men and women incarcerated for the murder of either a biological child, a stepchild or a child in their care and draws on 49 in-depth interviews with these participants. We illustrate that traumatic parent-child experiences in the form of absent parents, neglect and abuse have a profound impact on establishing unhealthy attachment styles and emphasize the importance of early adverse parent-child bonds in setting the tone for future bonds as adults. The pathway to adopting an adverse attachment with one’s own child is argued to be influenced by these early traumatic emotional experiences within the home. This study highlights the need to acknowledge the impact that adverse parent-child experiences have on the formation of violent forms of parental behavior. It is imperative to reduce children’s emotional vulnerabilities by implementing strategies to strengthen current parenting practices, to promote the development of less violent parent-child relationships and to work towards resolving parents’ experiences of trauma in reducing child homicide. PMID:29791451

Apollo Spacesuit Modifications for the Apollo-Soyuz Test Project (ASTP) Spacesuit

NASA Technical Reports Server (NTRS)

McBarron, James W., II

2015-01-01

With over 50 years of experience with NASA spacesuit development and operations, as well as for early U.S. Air Force pressure suits, Jim McBarron shared his significant knowledge about modifications to the Apollo spacesuit for use in the Apollo-Soyuz Test Project (ASTP). This included requirements and design changes implemented to establish the ASTP spacesuit design baseline. Additionally, he identified Apollo spacesuit contact details including quantity of spacesuits delivered to support the Apollo and Skylab Programs, and the ASTP. He concluded by identifying a summary of noteworthy lessons learned with recommendations for future spacesuit development.

Report from the School of Experience: Lessons-Learned on NASA's EOS/ICESat Mission

NASA Technical Reports Server (NTRS)

Anselm, William

2003-01-01

Abstract-NASA s Earth Observing System EOS) Ice, Cloud, and Land Elevation Satellite (ICESat) mission was one of the first missions under Goddard Space Flight Center s (then-) new Rapid Spacecraft Development Office. This paper explores the lessons-learned under the ICESat successful implementation and launch, focusing on four areas: Procurement., Management, Technical, and Launch and Early Operations. Each of these areas is explored in a practical perspective of communication, the viewpoint of the players, and the interactions among the organizations. Conclusions and lessons-learned are summarized in the final section.

AID awards 3-year Guatemala contract.

PubMed

1984-01-01

The US Agency for International Development (USAID) has awarded a 3-year US$593,036 grant to the Los Angeles firm of Juarez and Associates, Inc. to help implement a contraceptive social marketing project in Guatemala. The firm will provide marketing assistance to the for-profit organization. Importadora de Productos Farmaceuticos (PROFA), an offshoot of the nonprofit International Planned Parenthood Federation affiliate, Asociacion Pro-Bienestar de la Familia de Guatemala (APROFAM), created specifically to conduct the social marketing project. Juarez and Associates has previous market research experience in family planning in Guatemala. Contraceptive social marketing sales are projected to begin in early 1985.

The Legacy of Early Experiences in Development: Formalizing Alternative Models of How Early Experiences Are Carried Forward over Time

ERIC Educational Resources Information Center

Fraley, R. Chris; Roisman, Glenn I.; Haltigan, John D.

2013-01-01

Psychologists have long debated the role of early experience in social and cognitive development. However, traditional approaches to studying this issue are not well positioned to address this debate. The authors present simulations that indicate that the associations between early experiences and later outcomes should approach different…

Implementing an Early Childhood Professional Development Course across 10 Sites and 15 Sections: Lessons Learned

ERIC Educational Resources Information Center

LoCasale-Crouch, Jennifer; Kraft-Sayre, Marcia; Pianta, Robert C.; Hamre, Bridget K.; Downer, Jason T.; Leach, Allison; Burchinal, Margaret; Howes, Carollee; La Paro, Karen; Scott-Little, Catherine

2011-01-01

In this article we describe the design and implementation of the National Center for Research on Early Childhood Education's (NCRECE's) college-level course and its delivery to teachers across 10 settings and 15 instructional sections. This professional development intervention, found effective in changing teachers' beliefs, knowledge, and actual…

Designing a Measurement Framework for Response to Intervention in Early Childhood Programs

ERIC Educational Resources Information Center

McConnell, Scott R.; Wackerle-Hollman, Alisha K.; Roloff, Tracy A.; Rodriguez, Michael

2014-01-01

The overall architecture and major components of a measurement system designed and evaluated to support Response to Intervention (RTI) in the areas of language and literacy in early childhood programs are described. Efficient and reliable measurement is essential for implementing any viable RTI system, and implementing such a system in early…

An Early Intervention Supporting the Literacy Learning of Children Experiencing Substantial Difficulty.

ERIC Educational Resources Information Center

Jackson, Jane B.; Paratore, Jeanne R.; Chard, David J.; Garnick, Sheila

1999-01-01

A study examined the degree to which eight teachers would faithfully implement an early literacy intervention plan. Teachers implemented the intervention with a high degree of fidelity and benefited from the community approach to intervention for struggling readers. Most children made substantial gains in phonemic blending and segmenting…

Co-Producing Early Years Policy in England under the Coalition Government

ERIC Educational Resources Information Center

Lloyd, Eva

2014-01-01

During the first half of the current Coalition Government, co-production--a form of participatory governance--was implemented widely in the conceptualization, design and implementation of early years policies. Seen as a revolutionary approach to public service reform, resulting in more effective and more cost-effective public services, the joint…

Creating Teacher Capacity in Early Childhood Education and Care Institutions Implementing an Authoritative Adult Style

ERIC Educational Resources Information Center

Omdal, Heidi

2018-01-01

The being together intervention intends to raise teacher capacity in Norwegian Early Childhood Education and Care (ECEC) institutions and promote social and emotional development in preschoolers by implementing an authoritative (warm and predictable) adult style in the institution. An authoritative adult balances between building up high quality…

Preparing Early Interventionists to Implement Family-Centered Practices

ERIC Educational Resources Information Center

Hile, Kimberly A.; Milagros Santos, Rosa; Hughes, Mary-alayne

2016-01-01

The reauthorization of IDEA in 1997 placed greater emphasis on providing early intervention services to the family unit versus solely focusing on children with disabilities or children who are at risk for disabilities. Due to the shift from child-focused services to family-focused services, the need to implement family-centered practices became…

Implementing Guided Pathways: Early Insights from the AACC Pathways Colleges. Executive Summary

ERIC Educational Resources Information Center

Jenkins, Davis; Lahr, Hana; Fink, John

2017-01-01

This summary is a digest of key findings from "Implementing Guided Pathways: Early Insights From the AACC Pathways Colleges," a report based on Community College Research Center's (CCRC's) research on the 30 colleges involved in the American Association of Community Colleges' (AACC) Pathways Project. The research presented in this report…

Implementing the Early Childhood Development Teacher Training Framework in Uganda: Gains and Challenges

ERIC Educational Resources Information Center

Ejuu, Godfrey

2012-01-01

Training of quality early childhood development (ECD) teachers is paramount in ensuring quality ECD service provision. This exploratory study focuses on the gains and challenges met in the implementation of the Uganda ECD teacher training framework. Data were obtained using questionnaires and interviews from principals and tutors of ECD teacher…

Implementing Technology in the Classroom: Paths to Success and Failure.

ERIC Educational Resources Information Center

Harvey, Glen; And Others

This paper discusses the change process experienced by teachers participating in a study of a computer-based language arts instructional program for the early elementary grades--the Apple Learning Series: Early Language (ALS-EL). The study explored ways in which the teachers were implementing ALS-EL in their classrooms before attempting to…

Biological Perspectives on the Effects of Early Psychosocial Experience

ERIC Educational Resources Information Center

Marshall, Peter J.; Kenney, Justin W.

2009-01-01

There is much current interest in how adverse experiences early in life might affect certain elements of physiological, behavioral, and psychological functioning across the lifespan. Recent conceptual frameworks for studying the effects of early experience have involved constructs such as experience-expectant, experience-dependent, and…

Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines.

PubMed

Balas, Michele C; Burke, William J; Gannon, David; Cohen, Marlene Z; Colburn, Lois; Bevil, Catherine; Franz, Doug; Olsen, Keith M; Ely, E Wesley; Vasilevskis, Eduard E

2013-09-01

The awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle is an evidence-based interprofessional multicomponent strategy for minimizing sedative exposure, reducing duration of mechanical ventilation, and managing ICU-acquired delirium and weakness. The purpose of this study was to identify facilitators and barriers to awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle adoption and to evaluate the extent to which bundle implementation was effective, sustainable, and conducive to dissemination. Prospective, before-after, mixed-methods study. Five adult ICUs, one step-down unit, and a special care unit located in a 624-bed academic medical center : Interprofessional ICU team members at participating institution. In collaboration with the participating institution, we developed, implemented, and refined an awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle policy. Over the course of an 18-month period, all ICU team members were offered the opportunity to participate in numerous multimodal educational efforts. Three focus group sessions, three online surveys, and one educational evaluation were administered in an attempt to identify facilitators and barriers to bundle adoption. Factors believed to facilitate bundle implementation included: 1) the performance of daily, interdisciplinary, rounds; 2) engagement of key implementation leaders; 3) sustained and diverse educational efforts; and 4) the bundle's quality and strength. Barriers identified included: 1) intervention-related issues (e.g., timing of trials, fear of adverse events), 2) communication and care coordination challenges, 3) knowledge deficits, 4) workload concerns, and 5) documentation burden. Despite these challenges, participants believed implementation ultimately benefited patients, improved interdisciplinary communication, and empowered nurses and other ICU team members. In this study of the implementation of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle in a tertiary care setting, clear factors were identified that both advanced and impeded adoption of this complex intervention that requires interprofessional education, coordination, and cooperation. Focusing on these factors preemptively should enable a more effective and lasting implementation of the bundle and better care for critically ill patients. Lessons learned from this study will also help healthcare providers optimize implementation of the recent ICU pain, agitation, and delirium guidelines, which has many similarities but also some important differences as compared with the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle.

Post-traumatic Stress Disorder and Cardiovascular Disease.

PubMed

Burg, Matthew M; Soufer, Robert

2016-10-01

Post-traumatic stress disorder (PTSD) is a disabling condition that develops consequent to trauma exposure such as natural disasters, sexual assault, automobile accidents, and combat that independently increases risk for early incident cardiovascular disease (CVD) and cardiovascular (CV) mortality by over 50 % and incident hypertension risk by over 30 %. While the majority of research on PTSD and CVD has concerned initially healthy civilian and military veteran samples, emerging research is also demonstrating that PTSD consequent to the trauma of an acute cardiac event significantly increases risk for early recurrence and mortality and that patient experiences in the clinical pathway that are related to the emergency department environment may provide an opportunity to prevent PTSD onset and thus improve outcomes. Future directions for clinical and implementation science concern broad PTSD and trauma screening in the context of primary care medical environments and the testing of PTSD treatments with CVD-related surrogates and endpoints.

Environmental democracy in action: The Toxics Release Inventory

NASA Astrophysics Data System (ADS)

Lynn, Frances M.; Kartez, Jack D.

1994-07-01

The Toxics Release Inventory (TRI) created by the 1986 Emergency Planning and Community Right-to-Know Act initially received limited attention. During the early years of its implementation, the TRI has become the basis for a national experiment in voluntaristic problem solving among citizens and industry, but that process of environmental democracy hinges on citizens' ability to actually acquire, understand, and apply the new data on industrial toxic emissions. A national study of TRI-using organizations in the public and private sectors reveals that effective citizen access depends in part on the efforts of intermediary public interest groups to bridge individual needs and right-to-know data. Although the TRI has had early success as a supplement to conventional command and control regulation, questions exist about the extent to which state and federal government should or must provide special efforts to make environmental information access work for citizens.

Launching forward: The integration of behavioral health in primary care as a key strategy for promoting young child wellness.

PubMed

Oppenheim, Jennifer; Stewart, Whitney; Zoubak, Ekaterina; Donato, Ingrid; Huang, Larke; Hudock, William

2016-03-01

In 2008, the Substance Abuse and Mental Health Services Administration (SAMHSA) created a national grant program, Project LAUNCH (Linking Actions for Unmet Needs in Children's Health), to improve behavioral health and developmental outcomes for young children through the incorporation of prevention and wellness promotion practices in key early childhood settings. Project LAUNCH supports states, tribal nations, and territories to improve coordination across early childhood systems and implement 5 core strategies of prevention and promotion. This article focuses on the lessons learned from 1 of the 5 core strategies: integration of behavioral health into primary care for young children. This paper analyzes the experiences of a sample of Project LAUNCH grantees, describing 10 common elements of integration approaches and exploring some of the challenges of promoting health and preventing social, emotional, and behavioral problems at a population level. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Adaptation disrupts motion integration in the primate dorsal stream

PubMed Central

Patterson, Carlyn A.; Wissig, Stephanie C.; Kohn, Adam

2014-01-01

Summary Sensory systems adjust continuously to the environment. The effects of recent sensory experience—or adaptation—are typically assayed by recording in a relevant subcortical or cortical network. However, adaptation effects cannot be localized to a single, local network. Adjustments in one circuit or area will alter the input provided to others, with unclear consequences for computations implemented in the downstream circuit. Here we show that prolonged adaptation with drifting gratings, which alters responses in the early visual system, impedes the ability of area MT neurons to integrate motion signals in plaid stimuli. Perceptual experiments reveal a corresponding loss of plaid coherence. A simple computational model shows how the altered representation of motion signals in early cortex can derail integration in MT. Our results suggest that the effects of adaptation cascade through the visual system, derailing the downstream representation of distinct stimulus attributes. PMID:24507198

Minimal ensemble based on subset selection using ECG to diagnose categories of CAN.

PubMed

Abawajy, Jemal; Kelarev, Andrei; Yi, Xun; Jelinek, Herbert F

2018-07-01

Early diagnosis of cardiac autonomic neuropathy (CAN) is critical for reversing or decreasing its progression and prevent complications. Diagnostic accuracy or precision is one of the core requirements of CAN detection. As the standard Ewing battery tests suffer from a number of shortcomings, research in automating and improving the early detection of CAN has recently received serious attention in identifying additional clinical variables and designing advanced ensembles of classifiers to improve the accuracy or precision of CAN diagnostics. Although large ensembles are commonly proposed for the automated diagnosis of CAN, large ensembles are characterized by slow processing speed and computational complexity. This paper applies ECG features and proposes a new ensemble-based approach for diagnosis of CAN progression. We introduce a Minimal Ensemble Based On Subset Selection (MEBOSS) for the diagnosis of all categories of CAN including early, definite and atypical CAN. MEBOSS is based on a novel multi-tier architecture applying classifier subset selection as well as the training subset selection during several steps of its operation. Our experiments determined the diagnostic accuracy or precision obtained in 5 × 2 cross-validation for various options employed in MEBOSS and other classification systems. The experiments demonstrate the operation of the MEBOSS procedure invoking the most effective classifiers available in the open source software environment SageMath. The results of our experiments show that for the large DiabHealth database of CAN related parameters MEBOSS outperformed other classification systems available in SageMath and achieved 94% to 97% precision in 5 × 2 cross-validation correctly distinguishing any two CAN categories to a maximum of five categorizations including control, early, definite, severe and atypical CAN. These results show that MEBOSS architecture is effective and can be recommended for practical implementations in systems for the diagnosis of CAN progression. Copyright © 2018 Elsevier B.V. All rights reserved.

Illinois Early Learning Project Tip Sheets: Parenting and Family Life.

ERIC Educational Resources Information Center

2003

The Illinois Early Learning Project (IEL) is funded by the Illinois State Board of Education to provide information resources on early learning and training related to implementing the Illinois Early Learning Standards for parents and for early childhood personnel in all settings. The IEL tip sheets offer suggestions to parents and early childhood…

Illinois Early Learning Project Tip Sheets: Physical Development and Health.

ERIC Educational Resources Information Center

2003

The Illinois Early Learning Project (IEL) is funded by the Illinois State Board of Education to provide information resources on early learning and training related to implementing the Illinois Early Learning Standards for parents and for early childhood personnel in all settings. The IEL tip sheets offer suggestions to parents and early childhood…

Person-centred services? Rhetoric versus reality.

PubMed

Joyce, Catherine

2017-04-01

National and jurisdictional governments are increasingly using commissioning in health and community services. This includes the devolution of functions such as service planning, resource allocation, and regionalised approaches to intake and service delivery, to non-government organisations. The aims of this paper are to reflect on the experiences of commissioning as a not-for-profit health provider, and to identify some important early lessons. This analysis highlights the importance of a rights-based approach in which consumers, carers and communities actively participate in the design, implementation and evaluation of service systems, not just individual service needs; and that pays special attention to the most disadvantaged and the most vulnerable. The mechanisms and approaches used by cohealth to implement these principles are described. Service users need to be supported to develop advocacy capacity individually and collectively, in order to make informed choices about their own service needs and about the system more broadly, to ensure accessible and appropriate services.

[Training program on cardiopulmonary resuscitation with the use of automated external defibrillator in a university].

PubMed

Boaventura, Ana Paula; Miyadahira, Ana Maria Kazue

2012-03-01

Early defibrillation in cardiopulmonary resuscitation (CPR) receives increasing emphasis on its priority and rapidity. This is an experience report about the implementation of a training program in CPR using a defibrillator in a private university. The training program in basic CPR maneuvers was based on global guidelines, including a theorical course with practical demonstration of CPR maneuvers with the defibrillator, individual practical training and theoretical and practical assessments. About the performance of students in the practical assessment the mean scores obtained by students in the first stage of the course was 26.4 points, while in the second stage the mean was 252.8 points, in the theoretical assessment the mean in the first stage was 3.06 points and in the second 9.0 points. The implementation of programs like this contribute to the effective acquisition of knowledge (theory) and skill (pratice) for the care of CPR victims.

Milestone-specific, Observed data points for evaluating levels of performance (MODEL) assessment strategy for anesthesiology residency programs.

PubMed

Nagy, Christopher J; Fitzgerald, Brian M; Kraus, Gregory P

2014-01-01

Anesthesiology residency programs will be expected to have Milestones-based evaluation systems in place by July 2014 as part of the Next Accreditation System. The San Antonio Uniformed Services Health Education Consortium (SAUSHEC) anesthesiology residency program developed and implemented a Milestones-based feedback and evaluation system a year ahead of schedule. It has been named the Milestone-specific, Observed Data points for Evaluating Levels of performance (MODEL) assessment strategy. The "MODEL Menu" and the "MODEL Blueprint" are tools that other anesthesiology residency programs can use in developing their own Milestones-based feedback and evaluation systems prior to ACGME-required implementation. Data from our early experience with the streamlined MODEL blueprint assessment strategy showed substantially improved faculty compliance with reporting requirements. The MODEL assessment strategy provides programs with a workable assessment method for residents, and important Milestones data points to programs for ACGME reporting.

[Thoughts on optimizing the breast cancer screening strategies and implementation effects].

PubMed

Wu, K J

2018-02-01

Reasonable and effective breast cancer screening can make early diagnosis of breast cancer, improve the cure rate, prolong survival and improve the patients' quality of life. China has made preliminary exploration and attempt in breast cancer screening, however, there are still some problems that have not been solved in terms of the proportion of opportunistic screening, the selection of screening targets, methods and frequency, and the judgment of screening results. Therefore, this article analyzes the above problems in details, and presents some thoughts and recommendations on how to optimize the breast cancer screening strategies and implementation effects in China, from the experience of clinical practice, under the background of constantly emerging new research results and techniques and the rapid development of artificial intelligence, that is, to adjust measures to local conditions, provide personalized strategies, achieve precise screening, preach and educate, ensure health insurance coverage, improve quality control, offer technical support and employ artificial intelligence.

Newborn screening progress in developing countries--overcoming internal barriers.

PubMed

Padilla, Carmencita D; Krotoski, Danuta; Therrell, Bradford L

2010-04-01

Newborn screening is an important public health measure aimed at early identification and management of affected newborns thereby lowering infant morbidity and mortality. It is a comprehensive system of education, screening, follow-up, diagnosis, treatment/management, and evaluation that must be institutionalized and sustained within public health systems often challenged by economic, political, and cultural considerations. As a result, developing countries face unique challenges in implementing and expanding newborn screening that can be grouped into the following categories: (1) planning, (2) leadership, (3) medical support, (4) technical support, (5) logistical support, (6) education, (7) protocol and policy development, (8) administration, (9) evaluation, and (10) sustainability. We review some of the experiences in overcoming implementation challenges in developing newborn screening programs, and discuss recent efforts to encourage increased newborn screening through support networking and information exchange activities in 2 regions-the Asia Pacific and the Middle East/North Africa. Copyright 2010 Elsevier Inc. All rights reserved.

Consonant Acquisition in Young Cochlear Implant Recipients and Their Typically Developing Peers

PubMed Central

Jung, Jongmin; Ertmer, David J.

2017-01-01

Purpose Consonant acquisition was examined in 13 young cochlear implant (CI) recipients and 11 typically developing (TD) children. Method A longitudinal research design was implemented to determine the rate and nature of consonant acquisition during the first 2 years of robust hearing experience. Twenty-minute adult–child (typically a parent) interactions were video and audio recorded at 3-month intervals following implantation until 24 months of robust hearing experience was achieved. TD children were similarly recorded between 6 and 24 months of age. Consonants that were produced twice within a 50-utterance sample were considered “established” within a child's consonant inventory. Results Although the groups showed similar trajectories, the CI group produced larger consonant inventories than the TD group at each interval except for 21 and 24 months. A majority of children with CIs also showed more rapid acquisition of consonants and more diverse consonant inventories than TD children. Conclusions These results suggest that early auditory deprivation does not significantly affect consonant acquisition for most CI recipients. Tracking early consonant development appears to be a useful way to assess the effectiveness of cochlear implantation in young recipients. PMID:28474085

Implementing a Cervical Sentinel Lymph Node Biopsy Program: Quality Improvement in Gynaecologic Oncology.

PubMed

Cusimano, Maria C; Walker, Rachel; Bernardini, Marcus Q; Bouchard-Fortier, Geneviève; Laframboise, Stephane; May, Taymaa; Murphy, Joan; Rosen, Barry; Covens, Al; Clarke, Blaise; Shaw, Patricia; Rouzbahman, Marjan; Mohan, Ravi; Ferguson, Sarah E

2017-08-01

Sentinel lymph node (SLN) biopsy is becoming a reasonable alternative to pelvic lymphadenectomy in early-stage cervical cancer. It is therefore imperative that centres without prior experience are able to successfully implement the procedure. The objectives of the current study were to (1) describe the process of implementing an SLN biopsy program with a novel peer mentorship component and (2) assess post-program quality improvement metrics, including SLN detection rate (DR) and diagnostic parameters. An institutional SLN biopsy protocol was developed collaboratively by gynaecologic oncology, nuclear medicine, and pathology departments at University Health Network, Toronto, Ontario. All decisions were based on the best evidence available. Newly diagnosed, early-stage cervical cancer patients undergoing primary surgery were then recruited prospectively for SLN biopsy with combined technique, followed by pelvic lymphadenectomy to evaluate key quality indicators, including SLN DR, sensitivity, and negative predictive value. Surgeons with previous SLN biopsy experience mentored surgeons unfamiliar with the technique. Interim analyses and multidisciplinary rounds were regularly carried out to identify failures of technique or protocol. Thirty-nine patients (median age 42) were enrolled in the study between August 2010 and February 2014. The median number of SLNs and total pelvic lymph nodes removed per patient were 3 and 19, respectively. SLN DRs were 92% per patient (36/39), 88.5% per hemipelvis (69/78), and 85% bilaterally (33/39). SLN biopsy correctly identified seven of eight hemipelvises with nodal metastases, yielding a sensitivity of 88% (95% CI 0.47 to 1.00) and a false negative rate of 12% (95% CI 0 to 0.53). Surgeons undergoing peer mentorship (n = 3) performed as effectively (DR 100%) as surgeons (n = 2) with prior experience (DR 85%). This study provides a model upon which other centres can adopt and validate cervical SLN biopsy. High SLN DRs and accurate identification of lymph node metastases can be achieved by focusing on multidisciplinary collaboration, knowledge translation with creation of evidence-based protocols, peer mentorship, and ongoing quality control. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Implementing drought early warning systems: policy lessons and future needs

NASA Astrophysics Data System (ADS)

Iglesias, Ana; Werner, Micha; Maia, Rodrigo; Garrote, Luis; Nyabeze, Washington

2014-05-01

Drought forecasting and Warning provides the potential of reducing impacts to society due to drought events. The implementation of effective drought forecasting and warning, however, requires not only science to support reliable forecasting, but also adequate policy and societal response. Here we propose a protocol to develop drought forecasting and early warning based in the international cooperation of African and European institutions in the DEWFORA project (EC, 7th Framework Programme). The protocol includes four major phases that address the scientific knowledge and the social capacity to use the knowledge: (a) What is the science available? Evaluating how signs of impending drought can be detected and predicted, defining risk levels, and analysing of the signs of drought in an integrated vulnerability approach. (b) What are the societal capacities? In this the institutional framework that enables policy development is evaluated. The protocol gathers information on vulnerability and pending hazard in advance so that early warnings can be declared at sufficient lead time and drought mitigation planning can be implemented at an early stage. (c) How can science be translated into policy? Linking science indicators into the actions/interventions that society needs to implement, and evaluating how policy is implemented. Key limitations to planning for drought are the social capacities to implement early warning systems. Vulnerability assessment contributes to identify these limitations and therefore provides crucial information to policy development. Based on the assessment of vulnerability we suggest thresholds for management actions to respond to drought forecasts and link predictive indicators to relevant potential mitigation strategies. Vulnerability assessment is crucial to identify relief, coping and management responses that contribute to a more resilient society. (d) How can society benefit from the forecast? Evaluating how information is provided to potentially affected groups, and how mitigation strategies can be taken in response. This paper presents an outline of the protocol that was developed in the DEWFORA project, outlining the complementary roles of science, policy and societal uptake in effective drought forecasting and warning. A consensus on the need to emphasise the social component of early warning was reached when testing the DEWFORA early warning system protocol among experts from 18 countries.

Mitigation of eutrophication in river basins, lakes, and coastal waters requires and integrated and adaptive approach; experiences from The Netherlands.

NASA Astrophysics Data System (ADS)

Rozemeijer, J.; Jansen, S.; Villars, N.; Grift, B. V. D.

2017-12-01

We propose a guideline for mitigation of eutrophication in river basins, lakes, and coastal waters. The proposed strategy is based on our experiences with implementation of manure legislation and the Water Framework Directive (WFD) in Europe. These regulations led to reduced nutrient losses from highly productive agricultural areas. For example in The Netherlands, the worldwide second largest exporter of agricultural products, nutrient concentrations in agricultural headwaters reduced since the early 1990's. Our guideline builds on three basic principles: (1) a conceptual framework integrating water quality, water quantity, soil, groundwater, and surface water, (2) the `from catchment to coast' approach for up-scaling field-scale pilot results to downstream ecological effects, and (3) a mitigation order of preference from (a) optimizing nutrient uptake efficiency to (b) enhancing nutrient retention and recirculation to (c) nutrient discharge and applying effect oriented measures. The tools needed to mitigate eutrophication are system understanding, smart monitoring, smart modelling, smart measures, and smart governance. Following these principles and using these tools enables an integrated, adaptive approach for selecting, implementing, and evaluating the most cost-effective and sustainable set of mitigation actions.

Shuttle free-flying teleoperator system experiment definition. Volume 3: program development requirements

NASA Technical Reports Server (NTRS)

1972-01-01

The planning data are presented for subsequent phases of free-flying teleoperator program (FFTO) and includes costs, schedules and supporting research and technology activities required to implement the free-flying teleoperator system and associated flight equipment. The purpose of the data presented is to provide NASA with the information needed to continue development of the FFTO and integrate it into the space shuttle program. The planning data describes three major program phases consisting of activities and events scheduled to effect integrated design, development, fabrication and operation of an FFTO system. Phase A, Concept Generation, represents a study effort directed toward generating and evaluating a number of feasible FFTO experiment system concepts. Phase B, Definition, will include preliminary design and supporting analysis of the FFTO, the shuttle based equipment and ground support equipment. Phase C/D, Design, Development and Operations will include detail design of the operational FFTO, its integration into the space shuttle, hardware fabrication and testing, delivery of flight hardware and support of flight operations. Emphasis is placed on the planning for Phases A and B since these studies will be implemented early in the development cycle. Phase C/D planning is more general and subject to refinement during the definition phase.

Implementation and Evaluation of a Life Narrative Interview Program for Medical Inpatients.

PubMed

Rybarczyk, Bruce; Garroway, Andrea Shamaskin-; Lanoye, Autumn; Griffin, Sarah; Bellg, Albert; Stone, Richard; Nelson, Sharon

2018-04-26

Two studies in the early 1990s demonstrated that life narrative interviews conducted by age-peer volunteers strengthened the coping of older patients undergoing invasive medical procedures. The present article reports on the implementation of a similar life narrative interview program for medical inpatients and subsequent evaluation of the mood and coping effects of the intervention. Three volunteers (mean age = 69 years) were trained to administer 45- to 60-minute life narrative interviews. Fifty-three inpatients (mean age = 70 years) on various units of a Mid-Atlantic non-profit hospital agreed to participate. The Positive and Negative Affect Schedule and Coping Self-Efficacy Inventory (CSEI) were administered before and after the interviews. T-tests indicated a significant increase in positive affect and decrease in negative affect following the interview but no changes in the CSEI. Patient satisfaction questions administered after the interview indicated that patients had a high level of satisfaction with the interview experience. The life narrative interview program appeared to improve the overall mood of participants while providing a satisfying activity to engage in while in the hospital. The project demonstrated a cost-effective method for employing volunteers to enhance the experience of patients at healthcare facilities.

Recruitment and retention of rural African Americans in diabetes research: lessons learned.

PubMed

Loftin, Wanda Anderson; Barnett, Steven K; Bunn, Peggy Summers; Sullivan, Patra

2005-01-01

The purpose of this article was to describe lessons learned about recruitment and retention of rural African Americans from published literature, the authors' research, and research experience. Two rural, community-based research studies with African Americans with diabetes are used to illustrate different issues and strategies in recruitment and retention. Relevant MEDLINE articles and clinical studies were reviewed, and the design, implementation, and results of the 2 community-based studies were evaluated. Information from the literature, research results, and sample selection, participation, and attrition experiences were synthesized to determine effective approaches for recruitment and retention. Research funding, design, and implementation; recruitment methods; culturally competent approaches; caring, trusting provider-patient relationships; incentives; follow-up; and factors in the rural environment emerged as important issues influencing recruitment and retention. Recruitment and retention of African Americans in rural diabetes research is a significant challenge, and adequate funding should be sought early in the research process. Culturally competent approaches; caring, trusting relationships; incentives; and follow-up are important concepts in successful recruitment, participation, and retention of African Americans. The lessons learned may be applicable to the more widespread issue of recruitment and retention of rural African Americans in diabetes education programs.

Introducing an enhanced recovery after surgery program in colorectal surgery: A single center experience

PubMed Central

Bona, Stefano; Molteni, Mattia; Rosati, Riccardo; Elmore, Ugo; Bagnoli, Pietro; Monzani, Roberta; Caravaca, Monica; Montorsi, Marco

2014-01-01

AIM: To study the implementation of an enhanced recovery after surgery (ERAS) program at a large University Hospital from “pilot study” to “standard of care”. METHODS: The study was designed as a prospective single centre cohort study. A prospective evaluation of compliance to a protocol based on full application of all ERAS principles, through the progressive steps of its implementation, was performed. Results achieved in the initial pilot study conducted by a dedicated team (n = 47) were compared to those achieved in the shared protocol phase (n = 143) three years later. Outcomes were length of postoperative hospital stay, readmission rate, compliance to the protocol and morbidity. Primary endpoint was the description of the results and the identification of critical issues of large scale implementation of an ERAS program in colorectal surgery emerged in the experience of a single center. Secondary endpoint was the identification of interventions that have been proven to be effective for facilitating the transition from traditional care pathways to a multimodal management protocol according to ERAS principles in colorectal surgery at a single center. RESULTS: During the initial pilot study (March 2009 to December 2010; 47 patients) conducted by a dedicated multidisciplinary team, compliance to the items of ERAS protocol was 93%, with a median length of hospital stay (LOS) of 3 d. Early anastomotic fistulas were observed in 2 cases (4.2%), which required reoperation (Clavien-Dindo grade IIIb). None of the patients had been discharged before the onset of the complication, which could therefore receive prompt treatment. There were also four (8.5%) minor complications (Clavien-Dindo grade II). Thirty days readmission rate was 4%. Perioperative mortality was nil. After implementation of the protocol throughout the Hospital in unselected patients (May 2012 to December 2012; 147 patients) compliance was 74%, with a median LOS of 6 d. Early anastomotic fistulas were observed in 11 cases (7.7%), 5 (3.5%) of which required reoperation (Clavien-Dindo grade IIIb). Two early anastomotic fistulas were treated by radiologic/endoscopic manoeuvres and 4 were treated conservatively. There were also 36 (25.2%) minor complications, 21 (14.7%) of which were Clavien-Dindo grade II and 15 (10.5%) of which were Clavien-Dindo grade I. Only two patients whose course was adversely affected by the development of an anastomotic leak had been discharged before the onset of the complication itself, requiring readmission. Readmission rate within 30 d was 4%. Perioperative mortality was 1%. CONCLUSION: Our results confirm that introduction of an ERAS protocol for colorectal surgery allows quicker postoperative recovery and shortens the length of stay compared to historical series. PMID:25516673

Myths of Childhood.

ERIC Educational Resources Information Center

Paris, Joel

This book calls into question the degree to which early childhood experiences affect psychological development, critiquing three related myths: (1) personality is formed by early childhood experiences; (2) mental disorders are caused by early childhood experiences; and (3) effective psychotherapy depends on reconstructing childhood experiences.…

Creating Environments to Support Breastfeeding: The Challenges and Facilitators of Policy Development in Hospitals, Clinics, Early Care and Education, and Worksites.

PubMed

Bradford, Victoria A; Walkinshaw, Lina P; Steinman, Lesley; Otten, Jennifer J; Fisher, Kari; Ellings, Amy; O'Leary, Jean; Johnson, Donna B

2017-12-01

Objectives Supportive organizational breastfeeding policies can establish enabling environments for breastfeeding. In this qualitative study we identify facilitators and barriers to the development, adoption, and implementation of supportive breastfeeding policies and practices in four influential sectors for breastfeeding women: hospitals, clinics, early care and education settings, and worksites. Methods We interviewed 125 individuals representing 110 organizations in Washington State about their breastfeeding policy development and implementation process between August 2014 and February 2015. Greenhalgh's diffusion of innovations framework guided the interviews and qualitative analysis. Results Breastfeeding policy facilitators across the sectors include national and state laws and regulations, performance tracking requirements, and an increasingly supportive sociopolitical climate; barriers include limited resources and appreciation about the need for breastfeeding policies, and certain organizational characteristics such as workforce age. Despite broad support for breastfeeding, organizations differed on perceptions about the usefulness of written breastfeeding policies. Personal breastfeeding experiences of policy makers and staff affect organizational breastfeeding policies and practices. Conclusions for Practice Supportive organizational systems and environments are built through effective policy development processes; public health can support breastfeeding policy development and assure a coordinated continuum of care by leveraging federal health care policy requirements, building networks to support training and collaboration, and disseminating strategies that reflect the personal nature of breastfeeding.

Implementing Kanban for agile process management within the ALMA Software Operations Group

NASA Astrophysics Data System (ADS)

Reveco, Johnny; Mora, Matias; Shen, Tzu-Chiang; Soto, Ruben; Sepulveda, Jorge; Ibsen, Jorge

2014-07-01

After the inauguration of the Atacama Large Millimeter/submillimeter Array (ALMA), the Software Operations Group in Chile has refocused its objectives to: (1) providing software support to tasks related to System Integration, Scientific Commissioning and Verification, as well as Early Science observations; (2) testing the remaining software features, still under development by the Integrated Computing Team across the world; and (3) designing and developing processes to optimize and increase the level of automation of operational tasks. Due to their different stakeholders, each of these tasks presents a wide diversity of importances, lifespans and complexities. Aiming to provide the proper priority and traceability for every task without stressing our engineers, we introduced the Kanban methodology in our processes in order to balance the demand on the team against the throughput of the delivered work. The aim of this paper is to share experiences gained during the implementation of Kanban in our processes, describing the difficulties we have found, solutions and adaptations that led us to our current but still evolving implementation, which has greatly improved our throughput, prioritization and problem traceability.

Early Practicum Experiences: Preservice Early Childhood Students' Perceptions and Sense of Efficacy

ERIC Educational Resources Information Center

Van Schagen Johnson, Amy; La Paro, Karen M.; Crosby, Danielle A.

2017-01-01

The current study explored early practicum experiences (those occurring before student teaching) in an early childhood birth to kindergarten teacher education program. Undergraduates enrolled in practicum courses completed questionnaires about their overall practicum experience including: socio-emotional components (their perceived fit with their…

Intensive Evaluation of Head Start Implementation in the Tucson Early Education Model.

ERIC Educational Resources Information Center

Rentfrow, Robert K.

As part of the national Head Start Planned Variation Study, this study used a relatively small sample in an intensive evaluation of program implementation in one field community using the Tucson Early Education Model (TEEM). A modified Solomon four-group research design formed the organization framework. Evaluation of six TEEM classrooms and two…

Using e-Coaching to Support an Early Intervention Provider's Implementation of a Functional Assessment-Based Intervention

ERIC Educational Resources Information Center

Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.

2016-01-01

This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…

Improving the Design and Implementation of In-Service Professional Development in Early Childhood Intervention

ERIC Educational Resources Information Center

Dunst, Carl J.

2015-01-01

A model for designing and implementing evidence-­based in­-service professional development in early childhood intervention as well as the key features of the model are described. The key features include professional development specialist (PDS) description and demonstration of an intervention practice, active and authentic job-­embedded…

Children Placed at Risk for Learning and Behavioral Difficulties: Implementing a School-Wide System of Early Identification and Intervention.

ERIC Educational Resources Information Center

O'Shaughnessy, Tam E.; Lane, Kathleen L.; Gresham, Frank M.; Beebe-Frankenberger, Margaret E.

2003-01-01

This article describes a school-wide system of early identification and intervention for children recognized as being at risk for learning and behavior difficulties. Suggested guidelines for implementing such a program include: evaluating existing theory, knowledge, and practice; providing ongoing professional development; creating a school-wide…

A Practitioner's Guide to Implementing Early Warning Systems. REL 2015-056

ERIC Educational Resources Information Center

Frazelle, Sarah; Nagel, Aisling

2015-01-01

To stem the tide of students dropping out, many schools and districts are turning to early warning systems (EWS) that signal whether a student is at risk of not graduating from high school. While some research exists about establishing these systems, there is little information about the actual implementation strategies that are being used across…

[Comparison of red edge parameters of winter wheat canopy under late frost stress].

PubMed

Wu, Yong-feng; Hu, Xin; Lü, Guo-hua; Ren, De-chao; Jiang, Wei-guo; Song, Ji-qing

2014-08-01

In the present study, late frost experiments were implemented under a range of subfreezing temperatures (-1 - -9 degrees C) by using a field movable climate chamber (FMCC) and a cold climate chamber, respectively. Based on the spectra of winter wheat canopy measured at noon on the first day after the frost experiments, red edge parameters REP, Dr, SDr, Dr(min), Dr/Dr(min) and Dr/SDr were extracted using maximum first derivative spectrum method (FD), linear four-point interpolation method (FPI), polynomial fitting method (POLY), inverted Gaussian fitting method (IG) and linear extrapolation technique (LE), respectively. The capacity of the red edge parameters to detect late frost stress was explicated from the aspects of the early, sensitivity and stability through correlation analysis, linear regression modeling and fluctuation analysis. The result indicates that except for REP calculated from FPI and IG method in Experiment 1, REP from the other methods was correlated with frost temperatures (P < 0.05). Thereinto, significant levels (P) of POLY and LE methods all reached 0.01. Except for POLY method in Experiment 2, Dr/SDr from the other methods were all significantly correlated with frost temperatures (P < 0.01). REP showed a trend to shift to short-wave band with decreasing temperatures. The lower the temperature, the more obvious the trend is. Of all the REP, REP calculated by LE method had the highest correlation with frost temperatures which indicated that LE method is the best for REP extraction. In Experiment 1 and 2, only Dr(min) and Dr/Dr(min), calculated by FD method simultaneously achieved the requirements for the early (their correlations with frost temperatures showed a significant level P < 0.01), sensitivity (abso- lute value of the slope of fluctuation coefficient is greater than 2.0) and stability (their correlations with frost temperatures al- ways keep a consistent direction). Dr/SDr calculated from FD and IG methods always had a low sensitivity in Experiment 2. In Experiment 1, the sensitivity of Dr/SDr from FD was moderate and IG was high. REP calculated from LE method had a lowest sensitivity in the two experiments. Totally, Dr(min) and Dr/Dr(min) calculated by FD method have the strongest detection capacity for frost temperature, which will be helpful to conducting the research on early diagnosis of late frost injury to winter wheat.

Barriers and Enablers to Implementation of Dietary Guidelines in Early Childhood Education Centers in Australia: Application of the Theoretical Domains Framework.

PubMed

Grady, Alice; Seward, Kirsty; Finch, Meghan; Fielding, Alison; Stacey, Fiona; Jones, Jannah; Wolfenden, Luke; Yoong, Sze Lin

2018-03-01

To identify perceived barriers and enablers to implementation of dietary guidelines reported by early childhood education center cooks, and barriers and enablers associated with greater implementation based on assessment of center menu compliance. Cross-sectional telephone interview. Early childhood education centers, New South Wales, Australia. A total of 202 cooks responsible for menu planning; 70 centers provided a menu for review of compliance with dietary guidelines. Barriers and enablers to dietary guideline implementation were determined using a tool assessing constructs of the Theoretical Domains Framework (TDF). Higher scores (≥6) for each construct indicated enablers to guideline implementation; lower scores (<6) suggested barriers. Multivariable linear regression identified TDF constructs associated with greater guideline implementation. Scores were lowest for reinforcement (mean, 5.85) and goals (mean, 5.89) domains, and highest for beliefs about consequences (mean, 6.51) and social/professional role and identity (mean, 6.50). The skills domain was positively associated with greater implementation of guidelines based on menu review (P = .01). Cooks perceived social/professional role and identity, and beliefs about consequences to be enablers to dietary guideline implementation; however, only the skills domain was associated with greater implementation. There are opportunities to target the incongruence in perceptions vs reality of the barriers and enablers to implementation. Future research could examine the utility of the TDF to identify barriers and enablers to implementation to inform intervention development and for evaluating interventions to examine intervention mechanisms. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Implementation and execution of military forward resuscitation programs.

PubMed

Hooper, Timothy J; Nadler, Roy; Badloe, John; Butler, Frank K; Glassberg, Elon

2014-05-01

Through necessity, military medicine has been the driver of medical innovation throughout history. The battlefield presents challenges, such as the requirement to provide care while under threat, resource limitation, and prolonged evacuation times, which must be overcome to improve casualty survival. Focus must also be placed on identifying the causes, and timing, of death within the battlefield. By doing so, military medical doctrine can be shaped, appropriate goals set, new concepts adopted, and relevant technologies investigated and implemented. The majority of battlefield casualties still die in the prehospital environment, before reaching a medical treatment facility, and hemorrhage remains the leading cause of potentially survivable death. Many countries have adopted policies that push damage control resuscitation forward into the prehospital setting, while understanding the need for timely medical evacuation. Although these policies vary according to country, the majority share many common principles. These include the need for early catastrophic hemorrhage control at point-of-wounding, judicious use of fluid resuscitation, use of blood products as far forward as possible, and early evacuation to a surgical facility. Some countries place medical providers with the ability, and resources, for advanced resuscitation with the forward fighting units (perhaps at company level), whereas others have established en route resuscitation capabilities. If we are to continue to improve battlefield casualty survival, we must continue to work together and learn from each other. We must also carry on working alongside our civilian colleagues so that the benefits of translational experience are not lost. This review describes several countries current military approaches to prehospital trauma care. These approaches, refined through a decade of experience, merit consideration for integration into civilian prehospital care practice.

Implementation of an Automatic Stop Order and Initial Antibiotic Exposure in Very Low Birth Weight Infants.

PubMed

Tolia, Veeral N; Desai, Sujata; Qin, Huanying; Rayburn, Polli D; Poon, Grace; Murthy, Karna; Ellsbury, Dan L; Chiruvolu, Arpitha

2017-01-01

Objective  To evaluate if an antibiotic automatic stop order (ASO) changed early antibiotic exposure (use in the first 7 days of life) or clinical outcomes in very low birth weight (VLBW) infants. Study Design  We compared birth characteristics, early antibiotic exposure, morbidity, and mortality data in VLBW infants (with birth weight <= 1500 g) born 2 years before (pre-ASO group, n  = 313) to infants born in the 2 years after (post-ASO, n  = 361) implementation of an ASO guideline. Early antibiotic exposure was quantified by days of therapy (DOT) and antibiotic use > 48 hours. Secondary outcomes included mortality, early mortality, early onset sepsis (EOS), and necrotizing enterocolitis. Results  Birth characteristics were similar between the two groups. We observed reduced median antibiotic exposure (pre-ASO: 6.5 DOT vs. Post-ASO: 4 DOT; p  < 0.001), and a lower percentage of infants with antibiotic use > 48 hours (63.4 vs. 41.3%; p  < 0.001). There were no differences in mortality (12.1 vs 10.2%; p  = 0.44), early mortality, or other reported morbidities. EOS accounted for less than 10% of early antibiotic use. Conclusion  Early antibiotic exposure was reduced after the implementation of an ASO without changes in observed outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neuronal Tracing with Magnetic Labels: NMR Imaging Methods, Preliminary Results, and New Optimized Coils.

NASA Astrophysics Data System (ADS)

Ghosh, Pratik

1992-01-01

The investigations focussed on in vivo NMR imaging studies of magnetic particles with and within neural cells. NMR imaging methods, both Fourier transform and projection reconstruction, were implemented and new protocols were developed to perform "Neuronal Tracing with Magnetic Labels" on small animal brains. Having performed the preliminary experiments with neuronal tracing, new optimized coils and experimental set-up were devised. A novel gradient coil technology along with new rf-coils were implemented, and optimized for future use with small animals in them. A new magnetic labelling procedure was developed that allowed labelling of billions of cells with ultra -small magnetite particles in a short time. The relationships among the viability of such cells, the amount of label and the contrast in the images were studied as quantitatively as possible. Intracerebral grafting of magnetite labelled fetal rat brain cells made it possible for the first time to attempt monitoring in vivo the survival, differentiation, and possible migration of both host and grafted cells in the host rat brain. This constituted the early steps toward future experiments that may lead to the monitoring of human brain grafts of fetal brain cells. Preliminary experiments with direct injection of horse radish peroxidase-conjugated magnetite particles into neurons, followed by NMR imaging, revealed a possible non-invasive alternative, allowing serial study of the dynamic transport pattern of tracers in single living animals. New gradient coils were built by using parallel solid-conductor ribbon cables that could be wrapped easily and quickly. Rapid rise times provided by these coils allowed implementation of fast imaging methods. Optimized rf-coil circuit development made it possible to understand better the sample-coil properties and the associated trade -offs in cases of small but conducting samples.

Correlates of Bulimia Nervosa: Early Family Mealtime Experiences.

ERIC Educational Resources Information Center

Miller, Debra A. F.; And Others

1993-01-01

Examined relationship of early mealtime experiences to later bulimia in 128 female college students. Found significant group differences among bulimics, nonbulimics, and repeat dieters on early meal experience questionnaire, with bulimic group reporting most negative and unusual experiences. Found significant differences among groups on depression…

Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study.

PubMed

Wolfenden, Luke; Finch, Meghan; Nathan, Nicole; Weaver, Natasha; Wiggers, John; Yoong, Sze Lin; Jones, Jannah; Dodds, Pennie; Wyse, Rebecca; Sutherland, Rachel; Gillham, Karen

2015-09-01

Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of this study was to assess whether certain theoretically-based factors are associated with implementation of healthy eating and physical activity policies and practices in a sample of ECEC services. A cross-sectional survey was conducted with Service Managers of ECEC services. The survey assessed the operational characteristics, policy, and practice implementation, and 13 factors were suggested by Damschroder's Consolidated Framework for Implementation Research to impede or promote implementation. Logistic regression analyses found a significant association between implementation factor score and full implementation (OR 1.38; 95% CI 1.18-1.61; p = <0.01), indicating that for every one point increase in implementation score, ECEC services were 38 % more likely to be fully implementing the policies and practices. The findings highlight the opportunities for improving implementation of obesity prevention interventions in this setting by developing interventions that address such factors.

How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group.

PubMed

Verrier, J-F; Paget, C; Perlier, F; Demesmay, F

2016-12-01

The traditional model of hospital care has been challenged by the development of a care-management process that allows early patient autonomy (outpatient surgery, Enhanced Recovery after Surgery). Hospitalization has been transformed in response to this development, based on innovative medical and organizational strategies. Within a surgical service, the deployment of these processes requires the creation of a support structure, with re-organization of existing structures, analysis of potential obstacles, implementation of management tools, and ongoing follow-up of organizational function, clinical results, organizational and patient satisfaction. These will ultimately assess adaptation of structures within these new organizations. In this article, we share our insights based on experience gained over the past six years by surgical teams of the CAPIO group. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

An Early Warning System Based on Syndromic Surveillance to Detect Potential Health Emergencies among Migrants: Results of a Two-Year Experience in Italy

PubMed Central

Napoli, Christian; Riccardo, Flavia; Declich, Silvia; Dente, Maria Grazia; Pompa, Maria Grazia; Rizzo, Caterina; Rota, Maria Cristina; Bella, Antonino

2014-01-01

Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability and usefulness of syndromic surveillance in this specific context. PMID:25140999

A synopsis of test results and knowledge gained from the Phase-0 CSI evolutionary model

NASA Technical Reports Server (NTRS)

Belvin, W. Keith; Elliott, Kenny B.; Horta, Lucas G.

1993-01-01

The Phase-0 CSI Evolutionary Model (CEM) is a testbed for the study of space platform global line-of-sight (LOS) pointing. Now that the tests have been completed, a summary of hardware and closed-loop test experiences is necessary to insure a timely dissemination of the knowledge gained. The testbed is described and modeling experiences are presented followed by a summary of the research performed by various investigators. Some early lessons on implementing the closed-loop controllers are described with particular emphasis on real-time computing requirements. A summary of closed-loop studies and a synopsis of test results are presented. Plans for evolving the CEM from phase 0 to phases 1 and 2 are also described. Subsequently, a summary of knowledge gained from the design and testing of the Phase-0 CEM is made.

Middle Term Achievements of Project 5322: Retrieval Of Key Eco-Hydrological Parameters From Remote Sensing In The Watershed Allied Telemetry Experimental Research (Water)

NASA Astrophysics Data System (ADS)

Li, Xin; Menenti, Massimo

2010-10-01

The general objective of project 5322 in the Dragon 2 programme is to quantitatively retrieve some key eco- hydrological parameters by using remote sensed data, especially from ESA, Chinese, and the Third Party Mission (TPM). To achieve this goal, a comprehensive observation experiment, Watershed Allied Telemetry Experimental Research (WATER) was carried out. WARER is a simultaneously airborne, satellite-borne, and ground-based remote sensing experiment took place in the Heihe River Basin, a typical inland river basin in the northwest of China. This paper introduces the background and implementation of WATER. Data have been obtained so far are described in details. After a period of data analysis for two years, numerous results have also been achieved. This paper presents some early results of WATER as well.

Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

PubMed Central

Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

2013-01-01

Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369

Population-wide folic acid fortification and preterm birth: testing the folate depletion hypothesis.

PubMed

Naimi, Ashley I; Auger, Nathalie

2015-04-01

We assess whether population-wide folic acid fortification policies were followed by a reduction of preterm and early-term birth rates in Québec among women with short and optimal interpregnancy intervals. We extracted birth certificate data for 1.3 million births between 1981 and 2010 to compute age-adjusted preterm and early-term birth rates stratified by short and optimal interpregnancy intervals. We used Joinpoint regression to detect changes in the preterm and early term birth rates and assess whether these changes coincide with the implementation of population-wide folic acid fortification. A change in the preterm birth rate occurred in 2000 among women with short (95% confidence interval [CI] = 1994, 2005) and optimal (95% CI = 1995, 2008) interpregnancy intervals. Changes in early term birth rates did not coincide with the implementation of folic acid fortification. Our results do not indicate a link between folic acid fortification and early term birth but suggest an improvement in preterm birth rates after implementation of a nationwide folic acid fortification program.

Adoption of Information and Communication Technologies for Early Detection of Breast and Cervical Cancers in Low- and Middle-Income Countries

PubMed Central

DiCarlo, Jessica M.; Gopakumar, Sricharan; Dhillon, Preet K.

2016-01-01

Purpose In response to the growing burden of breast and cervical cancers, low- and middle-income countries (LMICs) are beginning to implement national cancer prevention programs. We reviewed the literature on information and communication technology (ICT) applications in the prevention of breast and cervical cancers in LMICs to examine their potential to enhance cancer prevention efforts. Methods Ten databases of peer-reviewed and gray literature were searched using an automated strategy for English-language articles on the use of mobile health (mHealth) and telemedicine in breast and cervical cancer prevention (screening and early detection) published between 2005 and 2015. Articles that described the rationale for using these ICTs and/or implementation experiences (successes, challenges, and outcomes) were reviewed. Bibliographies of articles that matched the eligibility criteria were reviewed to identify additional relevant references. Results Of the initial 285 citations identified, eight met the inclusion criteria. Of these, four used primary data, two were overviews of ICT applications, and two were commentaries. Articles described the potential for mHealth and telemedicine to address both demand- and supply-side challenges to cancer prevention, such as awareness, access, and cost, in LMICs. However, there was a dearth of evidence to support these hypotheses. Conclusion This review indicates that there are few publications that reflect specifically on the role of mHealth and telemedicine in cancer prevention and even fewer that describe or evaluate interventions. Although articles suggest that mHealth and telemedicine can enhance the implementation and use of cancer prevention interventions, more evidence is needed. PMID:28717705

Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study.

PubMed

Huang, Keng-Yen; Nakigudde, Janet; Rhule, Dana; Gumikiriza-Onoria, Joy Louise; Abura, Gloria; Kolawole, Bukky; Ndyanabangi, Sheila; Kim, Sharon; Seidman, Edward; Ogedegbe, Gbenga; Brotman, Laurie Miller

2017-11-01

Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions (EBIs) are not available in SSA. This study investigated the implementation quality and effectiveness of one component of an EBI from a developed country (USA) in a SSA country (Uganda). The EBI component, Professional Development, was provided by trained Ugandan mental health professionals to Ugandan primary school teachers. It included large-group experiential training and small-group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. The study was guided by the Consolidated Framework for Implementation Research, the Teacher Training Implementation Model, and the RE-AIM evaluation framework. Effectiveness outcomes were studied using a cluster randomized design, in which 10 schools were randomized to intervention and wait-list control conditions. A total of 79 early childhood teachers participated. Teacher knowledge and the use of EBPs were assessed at baseline and immediately post-intervention (4-5 months later). A sample of 154 parents was randomly selected to report on child behavior at baseline and post-intervention. Linear mixed effect modeling was applied to examine effectiveness outcomes. Findings support the feasibility of training Ugandan mental health professionals to provide Professional Development for Ugandan teachers. Professional Development was delivered with high levels of fidelity and resulted in improved teacher EBP knowledge and the use of EBPs in the classroom, and child social competence.

Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools: study protocol for a cluster randomized controlled trial.

PubMed

Huang, Keng-Yen; Nakigudde, Janet; Calzada, Esther; Boivin, Michael J; Ogedegbe, Gbenga; Brotman, Laurie Miller

2014-12-01

Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students. The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions. The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings. This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.

Studying the Effects of Early Experiences on Women's Career Achievement.

ERIC Educational Resources Information Center

Lykes, M. Brinton; Stewart, Abigail J.

Virtually all psychological theories assume that early life experiences have an impact on later life choices. However, increasing doubts have been expressed about the universality and permanence of the relationship between women's work and family lives. To explore how early family experiences and early adult decisions affect women's later career…

Teaching and Testing Early Reading. Focus On

ERIC Educational Resources Information Center

Mraz, Maryann; Kissel, Brian

2007-01-01

This issue of "Focus On" provides an overview of several key early literacy components: phonemic awareness, alphabet knowledge, concepts of print, oral language development, writing, family literacy, and reading aloud. Suggestions for assessing early literacy development are provided, and examples of implementation of effective early literacy…

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

PubMed

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

2017-12-01

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

Factors influencing speech and language outcomes of children with early identified severe/profound hearing loss: Clinician-identified facilitators and barriers.

PubMed

Fulcher, Anne Nivelles; Purcell, Alison; Baker, Elise; Munro, Natalie

2015-06-01

Early identification of severe/profound childhood hearing loss (HL) gives these children access to hearing devices and early intervention to facilitate improved speech and language outcomes. Predicting which infants will go on to achieve such outcomes remains difficult. This study describes clinician identified malleable and non-malleable factors that may influence speech and language outcomes for children with severe/profound HL. Semi-structured interviews were conducted with six experienced auditory verbal clinicians. A collective case study design was implemented. The interviews were transcribed and coded into themes using constant comparative analysis. Clinicians identified that, for children with severe/profound HL, early identification, early amplification and commencing auditory-verbal intervention under 6 months of age may facilitate child progress. Possible barriers were living in rural/remote areas, the clinicians' lack of experience and confidence in providing intervention for infants under age 6-months and belonging to a family with a culturally and linguistically diverse (CALD) background. The results indicate that multiple factors need to be considered by clinicians working with children with HL and their families to determine how each child functions within their own environment and personal contexts, consistent with the International Classification of Functioning, Disability and Health (ICF) framework. Such an approach is likely to empower clinicians to carefully balance potential barriers to, and facilitators of, optimal speech and language outcomes for all children with HL.

Numerical assessment of bone remodeling around conventionally and early loaded titanium and titanium-zirconium alloy dental implants.

PubMed

Akça, Kıvanç; Eser, Atılım; Çavuşoğlu, Yeliz; Sağırkaya, Elçin; Çehreli, Murat Cavit

2015-05-01

The aim of this study was to investigate conventionally and early loaded titanium and titanium-zirconium alloy implants by three-dimensional finite element stress analysis. Three-dimensional model of a dental implant was created and a thread area was established as a region of interest in trabecular bone to study a localized part of the global model with a refined mesh. The peri-implant tissues around conventionally loaded (model 1) and early loaded (model 2) implants were implemented and were used to explore principal stresses, displacement values, and equivalent strains in the peri-implant region of titanium and titanium-zirconium implants under static load of 300 N with or without 30° inclination applied on top of the abutment surface. Under axial loading, principal stresses in both models were comparable for both implants and models. Under oblique loading, principal stresses around titanium-zirconium implants were slightly higher in both models. Comparable stress magnitudes were observed in both models. The displacement values and equivalent strain amplitudes around both implants and models were similar. Peri-implant bone around titanium and titanium-zirconium implants experiences similar stress magnitudes coupled with intraosseous implant displacement values under conventional loading and early loading simulations. Titanium-zirconium implants have biomechanical outcome comparable to conventional titanium implants under conventional loading and early loading.

Obstacles to early career psychiatrists practicing psychotherapy.

PubMed

Clemens, Norman A; Plakun, Eric M; Lazar, Susan G; Mellman, Lisa

2014-09-01

Though psychiatric residents are expected to be competent psychotherapists on graduation, further growth in skill and versatility requires continued experience in their ongoing career. Maturity as a psychotherapist is essential because a psychiatrist is the only mental health provider who, as a physician, can assume full responsibility for biopsychosocial patient care and roles as supervisor, consultant, and team leader. Graduating residents face an environment in which surveys show a steady and alarming decline in practice of psychotherapy by psychiatrists, along with a decline in job satisfaction. High educational debts, practice structures, intrusive management, and reimbursement policies that devalue psychotherapy discourage early career psychiatrists from a practice style that enables providing it. For the early-career psychiatrist there is thus the serious risk of being unable to develop a critical mass of experience or a secure identity as a psychiatric psychotherapist. Implementation of parity laws and the Affordable Care Act (ACA) will affect the situation in unpredictable ways that call for vigilance and active response. Additional service and administrative demands may result from the ACA, creating ethical dilemmas about meeting urgent patient needs versus biopsychosocial standards of care. The authors recommend 1) vigorous advocacy for better payment levels for psychotherapy and freedom from disruptive management; 2) aggressive action against violations of the parity act, 3) active preparation of psychiatric residents for dealing with career choices and the environment for providing psychotherapy in their practice, and 4) post-graduate training in psychotherapy through supervision/consultation, continuing education courses, computer instruction, and distance learning.

A Year-Long Research Experience Program in Solar and Atmospheric Physics at the Queensborough Community College of the City University of New York (CUNY)

NASA Astrophysics Data System (ADS)

Damas, M. C.; Cheung, T. D.; Ngwira, C.; Mohamed, A.; Knipp, D. J.; Johnson, L. P.; Zheng, Y.; Paglione, T.

2015-12-01

The Queensborough Community College (QCC) of the City University of New York (CUNY), a Hispanic and minority-serving institution, is the recipient of a 2-year NSF EAGER (Early Concept Grants for Exploratory Research) grant to design and implement a high-impact practice integrated research and education program in solar and atmospheric physics. Through a strong collaboration with CUNY/City College of New York and NASA Goddard Space Flight Center's Community Coordinated Modeling Center (CCMC), the project engages underrepresented community college students in geosciences-related STEM fields through a year-long research experience with two components: 1) during the academic year, students are enrolled in a course-based introductory research (CURE) where they conduct research on real-world problems; and 2) during the summer, students are placed in research internships at partner institutions. We will present the results of the first year-long research experience, including successes and challenges.

Identifying patients with depression who require a change in treatment and implementing that change.

PubMed

Papakostas, George I

2016-02-01

Creating an effective treatment regimen for patients diagnosed with major depressive disorder (MDD) can be a challenge for clinicians. With each treatment trial, only 20% to 30% of patients achieve remission, and many of those who do reach remission experience residual symptoms. Patients with treatment-resistant depression or with residual symptoms are candidates for a change in treatment. Other patients requiring treatment changes are those who experience intolerable adverse effects and those who experience an illness recurrence. Because early detection can lead to improved outcomes, clinicians must be vigilant about assessing patients to identify when one or more of these situations occur. Clinicians must also communicate effectively with their patients to ensure that they understand the treatment strategies, goals, and potential adverse effects; have realistic expectations of treatment; and express their treatment preferences. Timely and appropriate treatment adjustment is necessary to help patients with MDD achieve recovery. © Copyright 2016 Physicians Postgraduate Press, Inc.

Obesity Prevention in Early Child Care Settings: A Bistate (Minnesota and Wisconsin) Assessment of Best Practices, Implementation Difficulty, and Barriers

ERIC Educational Resources Information Center

Nanney, Marilyn S.; LaRowe, Tara L.; Davey, Cynthia; Frost, Natasha; Arcan, Chrisa; O'Meara, Joyce

2017-01-01

Background: Long-term evaluation studies reveal that high-quality early care and education (ECE) programs that include a lifestyle component predict later adult health outcomes. The purpose of this article is to characterize the nutrition and physical activity (PA) practices, including implementation difficulty and barriers, of licensed center-…

The Challenges Facing the Implementation of Early Childhood Development and Education Policy in Bungoma County, Kenya

ERIC Educational Resources Information Center

Wangila, Violet Muyoka

2017-01-01

This paper scrutinises the challenges facing the implementation of Early Childhood Development and Education policy in Bungoma County, Kenya. The study used a mixed research design and study population comprised of the QASOs, the Head teachers, ECDE teachers and the non-teaching staff in respective ECDCs. The sample size of the study comprised of…

Building Capacity to Enact Change for Classroom Quality Improvement in New Jersey. CEELO Policy Brief

ERIC Educational Resources Information Center

Riley-Ayers, Shannon; Ryan, Sharon; Figueras-Daniel, Alexandra; Costanza, Vincent; Northey, Kaitlin

2018-01-01

The Center on Enhancing Early Learning Outcomes partnered with the New Jersey Department of Education from 2013 to 2017 to implement a peer learning community in selected districts. The goal of the PLC was to support effective implementation of key early childhood policies and improve the quality of instruction preschool through grade 3. This…

Measuring Implementation of Evidence-Based Programs Targeting Young Children at Risk for Emotional/Behavioral Disorders: Conceptual Issues and Recommendations

ERIC Educational Resources Information Center

Sutherland, Kevin S.; McLeod, Bryce D.; Conroy, Maureen A.; Cox, Julia R.

2013-01-01

Young children with and at risk for emotional/behavioral disorders (EBD) present challenges for early childhood teachers. Evidence-based programs designed to address these young children's behavior problems exist, but there are a number of barriers to implementing these programs in early childhood settings. Advancing the science of treatment…

Scaling the Pyramid Model across Complex Systems Providing Early Care for Preschoolers: Exploring How Models for Decision Making May Enhance Implementation Science

ERIC Educational Resources Information Center

Johnson, LeAnne D.

2017-01-01

Bringing effective practices to scale across large systems requires attending to how information and belief systems come together in decisions to adopt, implement, and sustain those practices. Statewide scaling of the Pyramid Model, a framework for positive behavior intervention and support, across different types of early childhood programs…

Listening to the Voices of Education Professionals Involved in Implementing an Oral Language and Early Literacy Program in the Classroom

ERIC Educational Resources Information Center

Lennox, Maria; Garvis, Susanne; Westerveld, Marleen

2017-01-01

This paper explores teachers' and teacher assistants' self-efficacy of delivering PrepSTART, a classroom based, oral language and early literacy program for five-year-old students. In the current study, speech pathologists developed, provided training and monitored program implementation. Teachers and teacher assistants (n = 17) shared their…

Implementing College and Career Standards in Math Methods Course for Early Childhood and Elementary Education Teacher Candidates

ERIC Educational Resources Information Center

Lee, Joohi

2016-01-01

This study is purposed to measure the efficacy of implementing College and Career Readiness Standards (CCRS) math standards into math methods courses for early childhood and elementary education teacher candidates at an urban university located in the Dallas and Fort Worth metroplex area. A total of 161 college seniors (teacher candidates)…

Challenges Pre-School Teachers Face in the Implementation of the Early Childhood Curriculum in the Cape Coast Metropolis

ERIC Educational Resources Information Center

Ntumi, Simon

2016-01-01

The study examined the challenges that pre-school teachers encounter in the implementation of the early childhood curriculum; exploring teaching methods employed by pre-schools teachers in the Cape Coast Metropolis. The study employed descriptive survey as the research design. A convenient sample of 62 pre-school teachers were selected from a…

The Supporting Healthy Marriage Evaluation: Early Lessons from the Implementation of a Relationship and Marriage Skills Program for Low-Income Married Couples

ERIC Educational Resources Information Center

Gaubert, Jennifer Miller; Knox, Virginia; Alderson, Desiree Principe; Dalton, Christopher; Fletcher, Kate; McCormick, Meghan

2010-01-01

This report presents early implementation and operational lessons from the Supporting Healthy Marriage (SHM) evaluation. Funded by the Administration for Children and Families, SHM uses a rigorous research design to test the effectiveness of a new approach to improving outcomes for low-income children: strengthening the marriages and relationships…

Design Principles for resilient cyber-physical Early Warning Systems - Challenges, Experiences, Design Patterns, and Best Practices

NASA Astrophysics Data System (ADS)

Gensch, S.; Wächter, J.; Schnor, B.

2014-12-01

Early warning systems (EWS) are safety-critical IT-infrastructures that serve the purpose of potentially saving lives or assets by observing real-world phenomena and issuing timely warning products to authorities and communities. An EWS consists of sensors, communication networks, data centers, simulation platforms, and dissemination channels. The components of this cyber-physical system may all be affected by both natural hazards and malfunctions of components alike. Resilience engineering so far has mostly been applied to safety-critical systems and processes in transportation (aviation, automobile), construction and medicine. Early warning systems need equivalent techniques to compensate for failures, and furthermore means to adapt to changing threats, emerging technology and research findings. We present threats and pitfalls from our experiences with the German and Indonesian tsunami early warning system, as well as architectural, technological and organizational concepts employed that can enhance an EWS' resilience. The current EWS is comprised of a multi-type sensor data upstream part, different processing and analysis engines, a decision support system, and various warning dissemination channels. Each subsystem requires a set of approaches towards ensuring stable functionality across system layer boundaries, including also institutional borders. Not only must services be available, but also produce correct results. Most sensors are distributed components with restricted resources, communication channels and power supply. An example for successful resilience engineering is the power capacity based functional management for buoy and tide gauge stations. We discuss various fault-models like cause and effect models on linear pathways, interaction of multiple events, complex and non-linear interaction of assumedly reliable subsystems and fault tolerance means implemented to tackle these threats.

Experiences integrating autonomous components and legacy systems into tsunami early warning systems

NASA Astrophysics Data System (ADS)

Reißland, S.; Herrnkind, S.; Guenther, M.; Babeyko, A.; Comoglu, M.; Hammitzsch, M.

2012-04-01

Fostered by and embedded in the general development of Information and Communication Technology (ICT) the evolution of Tsunami Early Warning Systems (TEWS) shows a significant development from seismic-centred to multi-sensor system architectures using additional sensors, e.g. sea level stations for the detection of tsunami waves and GPS stations for the detection of ground displacements. Furthermore, the design and implementation of a robust and scalable service infrastructure supporting the integration and utilisation of existing resources serving near real-time data not only includes sensors but also other components and systems offering services such as the delivery of feasible simulations used for forecasting in an imminent tsunami threat. In the context of the development of the German Indonesian Tsunami Early Warning System (GITEWS) and the project Distant Early Warning System (DEWS) a service platform for both sensor integration and warning dissemination has been newly developed and demonstrated. In particular, standards of the Open Geospatial Consortium (OGC) and the Organization for the Advancement of Structured Information Standards (OASIS) have been successfully incorporated. In the project Collaborative, Complex, and Critical Decision-Support in Evolving Crises (TRIDEC) new developments are used to extend the existing platform to realise a component-based technology framework for building distributed TEWS. This talk will describe experiences made in GITEWS, DEWS and TRIDEC while integrating legacy stand-alone systems and newly developed special-purpose software components into TEWS using different software adapters and communication strategies to make the systems work together in a corporate infrastructure. The talk will also cover task management and data conversion between the different systems. Practical approaches and software solutions for the integration of sensors, e.g. providing seismic and sea level data, and utilisation of special-purpose components, such as simulation systems, in TEWS will be presented.

Survey of Academic Field Experiences (SAFE): Trainees Report Harassment and Assault

PubMed Central

Clancy, Kathryn B. H.; Nelson, Robin G.; Rutherford, Julienne N.; Hinde, Katie

2014-01-01

Little is known about the climate of the scientific fieldwork setting as it relates to gendered experiences, sexual harassment, and sexual assault. We conducted an internet-based survey of field scientists (N = 666) to characterize these experiences. Codes of conduct and sexual harassment policies were not regularly encountered by respondents, while harassment and assault were commonly experienced by respondents during trainee career stages. Women trainees were the primary targets; their perpetrators were predominantly senior to them professionally within the research team. Male trainees were more often targeted by their peers at the research site. Few respondents were aware of mechanisms to report incidents; most who did report were unsatisfied with the outcome. These findings suggest that policies emphasizing safety, inclusivity, and collegiality have the potential to improve field experiences of a diversity of researchers, especially during early career stages. These include better awareness of mechanisms for direct and oblique reporting of harassment and assault and, the implementation of productive response mechanisms when such behaviors are reported. Principal investigators are particularly well positioned to influence workplace culture at their field sites. PMID:25028932

Survey of academic field experiences (SAFE): trainees report harassment and assault.

PubMed

Clancy, Kathryn B H; Nelson, Robin G; Rutherford, Julienne N; Hinde, Katie

2014-01-01

Little is known about the climate of the scientific fieldwork setting as it relates to gendered experiences, sexual harassment, and sexual assault. We conducted an internet-based survey of field scientists (N = 666) to characterize these experiences. Codes of conduct and sexual harassment policies were not regularly encountered by respondents, while harassment and assault were commonly experienced by respondents during trainee career stages. Women trainees were the primary targets; their perpetrators were predominantly senior to them professionally within the research team. Male trainees were more often targeted by their peers at the research site. Few respondents were aware of mechanisms to report incidents; most who did report were unsatisfied with the outcome. These findings suggest that policies emphasizing safety, inclusivity, and collegiality have the potential to improve field experiences of a diversity of researchers, especially during early career stages. These include better awareness of mechanisms for direct and oblique reporting of harassment and assault and, the implementation of productive response mechanisms when such behaviors are reported. Principal investigators are particularly well positioned to influence workplace culture at their field sites.

Situational theory of leadership.

PubMed

Waller, D J; Smith, S R; Warnock, J T

1989-11-01

The situational theory of leadership and the LEAD instruments for determining leadership style are explained, and the application of the situational leadership theory to the process of planning for and implementing organizational change is described. Early studies of leadership style identified two basic leadership styles: the task-oriented autocratic style and the relationship-oriented democratic style. Subsequent research found that most leaders exhibited one of four combinations of task and relationship behaviors. The situational leadership theory holds that the difference between the effectiveness and ineffectiveness of the four leadership styles is the appropriateness of the leader's behavior to the particular situation in which it is used. The task maturity of the individual or group being led must also be accounted for; follower readiness is defined in terms of the capacity to set high but attainable goals, willingness or ability to accept responsibility, and possession of the necessary education or experience for a specific task. A person's leadership style, range, and adaptability can be determined from the LEADSelf and LEADOther questionnaires. By applying the principles of the situational leadership theory and adapting their managerial styles to specific tasks and levels of follower maturity, the authors were successful in implementing 24-hour pharmacokinetic dosing services provided by staff pharmacists with little previous experience in clinical services. The situational leadership model enables a leader to identify a task, set goals, determine the task maturity of the individual or group, select an appropriate leadership style, and modify the style as change occurs. Pharmacy managers can use this model when implementing clinical pharmacy services.

Reasons for Implementing Movement in Kinetic Architecture

NASA Astrophysics Data System (ADS)

Cudzik, Jan; Nyka, Lucyna

2017-10-01

The paper gives insights into different forms of movement in contemporary architecture and examines them based on the reasons for their implementation. The main objective of the paper is to determine: the degree to which the complexity of kinematic architecture results from functional and spatial needs and what other motivations there are. The method adopted to investigate these questions involves theoretical studies and comparative analyses of architectural objects with different forms of movement imbedded in their structure. Using both methods allowed delving into reasons that lie behind the implementation of movement in contemporary kinetic architecture. As research shows, there is a constantly growing range of applications with kinematic solutions inserted in buildings’ structures. The reasons for their implementation are manifold and encompass pursuits of functional qualities, environmental performance, spatial effects, social interactions and new aesthetics. In those early projects based on simple mechanisms, the main motives were focused on functional values and in later experiments - on improving buildings’ environmental performance. Additionally, in recent proposals, a significant quest could be detected toward kinematic solutions that are focused on factors related to alternative aesthetics and innovative spatial effects. Research reveals that the more complicated form of movement, the more often the reason for its implementation goes beyond the traditionally understood “function”. However, research also shows that the effects resulting from investigations on spatial qualities of architecture and new aesthetics often appear to provide creative insights into new functionalities in architecture.

Learning the Landscape: Implementation Challenges of Primary Care Innovators around Cancer Survivorship Care

PubMed Central

O’Malley, Denalee; Hudson, Shawna V.; Nekhlyudov, Larissa; Howard, Jenna; Rubinstein, Ellen; Lee, Heather S.; Overholser, Linda S.; Shaw, Amy; Givens, Sarah; Burton, Jay S.; Grunfeld, Eva; Parry, Carly; Crabtree, Benjamin F.

2016-01-01

PURPOSE This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models. METHODS Snowball sampling was used to identify innovators. Twelve participants (five cancer survivorship primary care innovators and seven content experts) attended a working conference focused on cancer survivorship population strategies and primary care transformation. Data included meeting discussion transcripts/field notes, transcribed in-depth innovator interviews, and innovators’ summaries of care models. We used a multi-step immersion/crystallization analytic approach, guided by a primary care organizational change model. RESULTS Innovative practice models included: 1) a consultative model in a primary care setting; 2) a primary care physician (PCP)-led, blended consultative/panel-based model in an oncology setting; 3) an oncology nurse navigator in a primary care practice; and 4) two sub-specialty models where PCPs in a general medical practice dedicated part of their patient panel to cancer survivors. Implementation challenges included: (1) lack of key stakeholder buy-in; (2) practice resources allocated to competing (non-survivorship) change efforts; and (3) competition with higher priority initiatives incentivized by payers. CONCLUSIONS Cancer survivorship delivery models are potentially feasible in primary care; however, significant barriers to widespread implementation exist. Implementation efforts would benefit from increasing the awareness and potential value-add of primary care-focused strategies to address survivors’ needs. PMID:27277895

The Impact of Specific and Complex Trauma on the Mental Health of Homeless Youth.

PubMed

Wong, Carolyn F; Clark, Leslie F; Marlotte, Lauren

2016-03-01

This study investigates the relative impact of trauma experiences that occurred prior to and since becoming homeless on depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and self-injurious behaviors among a sample of homeless youth (N = 389). Youth (aged 13 to 25) who had been homeless or precariously housed in the past year completed a survey about housing history, experiences of violence and victimization, mental health, and service utilization. In addition to examining the impact associated with specific trauma types, we also considered the effect of "early-on" poly-victimization (i.e., cumulative number of reported traumas prior to homelessness) and the influence of a compound sexual trauma variable created to represent earlier complex trauma. This created-variable has values ranging from no reported trauma, single trauma, multiple non-sexual traumas, and multiple traumas that co-occurred with sexual abuse. Multivariate analyses revealed that specific traumatic experiences prior to homelessness, including sexual abuse, emotional abuse/neglect, and adverse home environment, predicted greater mental health symptoms. Poly-victimization did not add to the prediction of mental health symptoms after the inclusion of specific traumas. Results with early compound sexual trauma revealed significant differences between lower-order trauma exposures and multiple-trauma exposures. Specifically, experience of multiple traumas that co-occurred with sexual trauma was significantly more detrimental in predicting PTSD symptoms than multiple traumas of non-sexual nature. Findings support the utility of an alternate/novel conceptualization of complex trauma, and support the need to carefully evaluate complex traumatic experiences that occurred prior to homelessness, which can impact the design and implementation of mental health care and services for homeless youth. © The Author(s) 2014.

How the Timing and Quality of Early Experiences Influence the Development of Brain Architecture

PubMed Central

Fox, Sharon E.; Levitt, Pat; Nelson, Charles A.

2009-01-01

Early life events can exert a powerful influence on both the pattern of brain architecture and behavioral development. In this paper a conceptual framework is provided for considering how the structure of early experience gets “under the skin.” The paper begins with a description of the genetic framework that lays the foundation for brain development, and then to the ways experience interacts with and modifies the structures and functions of the developing brain. Much of the attention is focused on early experience and sensitive periods, although it is made clear that later experience also plays an important role in maintaining and elaborating this early wiring diagram, which is critical to establishing a solid footing for development beyond the early years. PMID:20331653

Critical early mission design considerations for lunar data systems architecture

NASA Technical Reports Server (NTRS)

Hei, Donald J., Jr.; Stephens, Elaine

1992-01-01

This paper outlines recent early mission design activites for a lunar data systems architecture. Each major functional element is shown to be strikingly similar when viewed in a common reference system. While this similarity probably deviates with lower levels of decomposition, the sub-functions can always be arranged into similar and dissimilar categories. Similar functions can be implemented as objects - implemented once and reused several times like today's advanced integrated circuits. This approach to mission data systems, applied to other NASA programs, may result in substantial agency implementation and maintenance savings. In today's zero-sum-game budgetary environment, this approach could help to enable a lunar exploration program in the next decade. Several early mission studies leading to such an object-oriented data systems design are recommended.

Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.

PubMed

Garg, Sachin K; Lyles, Courtney R; Ackerman, Sara; Handley, Margaret A; Schillinger, Dean; Gourley, Gato; Aulakh, Veenu; Sarkar, Urmimala

2016-02-06

Text messaging is an affordable, ubiquitous, and expanding mobile communication technology. However, safety net health systems in the United States that provide more care to uninsured and low-income patients may face additional financial and infrastructural challenges in utilizing this technology. Formative evaluations of texting implementation experiences are limited. We interviewed safety net health systems piloting texting initiatives to study facilitators and barriers to real-world implementation. We conducted telephone interviews with various stakeholders who volunteered from each of the eight California-based safety net systems that received external funding to pilot a texting-based program of their choosing to serve a primary care need. We developed a semi-structured interview guide based partly on the Consolidated Framework for Implementation Research (CFIR), which encompasses several domains: the intervention, individuals involved, contextual factors, and implementation process. We inductively and deductively (using CFIR) coded transcripts, and categorized themes into facilitators and barriers. We performed eight interviews (one interview per pilot site). Five sites had no prior texting experience. Sites applied texting for programs related to medication adherence and monitoring, appointment reminders, care coordination, and health education and promotion. No site texted patient-identifying health information, and most sites manually obtained informed consent from each participating patient. Facilitators of implementation included perceived enthusiasm from patients, staff and management belief that texting is patient-centered, and the early identification of potential barriers through peer collaboration among grantees. Navigating government regulations that protect patient privacy and guide the handling of protected health information emerged as a crucial barrier. A related technical challenge in five sites was the labor-intensive tracking and documenting of texting communications due to an inability to integrate texting platforms with electronic health records. Despite enthusiasm for the texting programs from the involved individuals and organizations, inadequate data management capabilities and unclear privacy and security regulations for mobile health technology slowed the initial implementation and limited the clinical use of texting in the safety net and scope of pilots. Future implementation work and research should investigate how different texting platform and intervention designs affect efficacy, as well as explore issues that may affect sustainability and the scalability.

A Context-Aware EEG Headset System for Early Detection of Driver Drowsiness.

PubMed

Li, Gang; Chung, Wan-Young

2015-08-21

Driver drowsiness is a major cause of mortality in traffic accidents worldwide. Electroencephalographic (EEG) signal, which reflects the brain activities, is more directly related to drowsiness. Thus, many Brain-Machine-Interface (BMI) systems have been proposed to detect driver drowsiness. However, detecting driver drowsiness at its early stage poses a major practical hurdle when using existing BMI systems. This study proposes a context-aware BMI system aimed to detect driver drowsiness at its early stage by enriching the EEG data with the intensity of head-movements. The proposed system is carefully designed for low-power consumption with on-chip feature extraction and low energy Bluetooth connection. Also, the proposed system is implemented using JAVA programming language as a mobile application for on-line analysis. In total, 266 datasets obtained from six subjects who participated in a one-hour monotonous driving simulation experiment were used to evaluate this system. According to a video-based reference, the proposed system obtained an overall detection accuracy of 82.71% for classifying alert and slightly drowsy events by using EEG data alone and 96.24% by using the hybrid data of head-movement and EEG. These results indicate that the combination of EEG data and head-movement contextual information constitutes a robust solution for the early detection of driver drowsiness.

A Context-Aware EEG Headset System for Early Detection of Driver Drowsiness

PubMed Central

Li, Gang; Chung, Wan-Young

2015-01-01

Driver drowsiness is a major cause of mortality in traffic accidents worldwide. Electroencephalographic (EEG) signal, which reflects the brain activities, is more directly related to drowsiness. Thus, many Brain-Machine-Interface (BMI) systems have been proposed to detect driver drowsiness. However, detecting driver drowsiness at its early stage poses a major practical hurdle when using existing BMI systems. This study proposes a context-aware BMI system aimed to detect driver drowsiness at its early stage by enriching the EEG data with the intensity of head-movements. The proposed system is carefully designed for low-power consumption with on-chip feature extraction and low energy Bluetooth connection. Also, the proposed system is implemented using JAVA programming language as a mobile application for on-line analysis. In total, 266 datasets obtained from six subjects who participated in a one-hour monotonous driving simulation experiment were used to evaluate this system. According to a video-based reference, the proposed system obtained an overall detection accuracy of 82.71% for classifying alert and slightly drowsy events by using EEG data alone and 96.24% by using the hybrid data of head-movement and EEG. These results indicate that the combination of EEG data and head-movement contextual information constitutes a robust solution for the early detection of driver drowsiness. PMID:26308002

Extending the benefits of early mobility to critically ill patients undergoing continuous renal replacement therapy: the Michigan experience.

PubMed

Talley, Cheryl L; Wonnacott, Robert O; Schuette, Janice K; Jamieson, Jill; Heung, Michael

2013-01-01

Evidence to support improved outcomes with early ambulation is strong in medical literature. Yet, critically ill continuous renal replacement therapy (CRRT) patients remain tethered to their beds by devices delivering supportive therapy. The University of Michigan Adult CRRT Committee identified this deficiency and sought to change it. There was no guidance in the literature to support mobilizing this population; therefore, we reviewed literature from devices with similar technological profiles. Revision of our institutional mobility protocol for the CRRT population included a simple safety acronym, ASK. The acronym addresses appropriate candidacy; secured, appropriate access; and potential device and patient complications as a memorable aid to help nursing staff determine whether their CRRT patients are candidates for early mobility. After implementing our CRRT mobility standard, a preliminary study of 109 CRRT patients and a review of incident reports related to CRRT demonstrated no significant adverse patient events or falls and no access complications related to mobility. This deliberate intervention allows CRRT patients to safely engage in mobility activities to improve this population's outcomes. A simple mobility protocol and safety acronym partnered with strong clinical leadership has permitted the University of Michigan to add CRRT patients to the body of early mobility literature.

Anticipatory scene representation in preschool children's recall and recognition memory.

PubMed

Kreindel, Erica; Intraub, Helene

2017-09-01

Behavioral and neuroscience research on boundary extension (false memory beyond the edges of a view of a scene) has provided new insights into the constructive nature of scene representation, and motivates questions about development. Early research with children (as young as 6-7 years) was consistent with boundary extension, but relied on an analysis of spatial errors in drawings which are open to alternative explanations (e.g. drawing ability). Experiment 1 replicated and extended prior drawing results with 4-5-year-olds and adults. In Experiment 2, a new, forced-choice immediate recognition memory test was implemented with the same children. On each trial, a card (photograph of a simple scene) was immediately replaced by a test card (identical view and either a closer or more wide-angle view) and participants indicated which one matched the original view. Error patterns supported boundary extension; identical photographs were more frequently rejected when the closer view was the original view, than vice versa. This asymmetry was not attributable to a selection bias (guessing tasks; Experiments 3-5). In Experiment 4, working memory load was increased by presenting more expansive views of more complex scenes. Again, children exhibited boundary extension, but now adults did not, unless stimulus duration was reduced to 5 s (limiting time to implement strategies; Experiment 5). We propose that like adults, children interpret photographs as views of places in the world; they extrapolate the anticipated continuation of the scene beyond the view and misattribute it to having been seen. Developmental differences in source attribution decision processes provide an explanation for the age-related differences observed. © 2016 John Wiley & Sons Ltd.

Early access programs: Benefits, challenges, and key considerations for successful implementation

PubMed Central

Patil, Sanjaykumar

2016-01-01

Early access programs, (EAPs) are adopted by an increasing number of pharma companies due to several benefits offered by these programs. EAPs offer ethical, compliant, and controlled mechanisms of access to investigational drugs outside of the clinical trial space and before the commercial launch of the drug, to patients with life-threatening diseases having no treatment options available. In addition to the development of positive relationships with key opinion leaders (KOL), patients, advocacy groups and regulators, the data captured from the implementation of EAPs supports in the formulation of global commercialization strategies. This white paper outlines various circumstances to be considered for the implementation of EAPs named patient programs, the regulatory landscape, the benefits and challenges associated with implementing these programs and the key considerations for their successful implementation. PMID:26955570

Changing the S and MA [Safety and Mission Assurance] Paradigm

NASA Technical Reports Server (NTRS)

Malone, Roy W., Jr.

2010-01-01

Objectives: 1) Optimize S&MA organization to best facilitate Shuttle transition in 2010, successfully support Ares developmental responsibilities, and minimize the impacts of the gap between last Shuttle flight and start of Ares V Project. 2) Improve leveraging of critical skills and experience between Shuttle and Ares. 3) Split technical and supervisory functions to facilitate technical penetration. 4) Create Chief Safety and Mission Assurance Officer (CSO) stand-alone position for successfully implementation of S&MA Technical Authority. 5) Minimize disruption to customers. 6) Provide early involvement of S&MA leadership team and frequent/open communications with S&MA team members and steak-holders.

First Results with TIGRESS and Accelerated Radioactive Ion Beams from ISAC: Coulomb Excitation of 20,21,29Na

NASA Astrophysics Data System (ADS)

Schumaker, M. A.; Hurst, A. M.; Svensson, C. E.; Wu, C. Y.; Becker, J. A.; Cline, D.; Hackman, G.; Pearson, C. J.; Stoyer, M. A.; Andreyev, A.; Austin, R. A. E.; Ball, G. C.; Bandyopadhyay, D.; Barton, C. J.; Boston, A. J.; Boston, H. C.; Buchmann, L.; Churchman, R.; Cifarelli, F.; Colosimo, S. J.; Cooper, R. J.; Cross, D. S.; Dashdorj, D.; Demand, G. A.; Dimmock, M. R.; Djongolov, M.; Drake, T. E.; Finlay, P.; Gallant, A. T.; Garrett, P. E.; Gray-Jones, C.; Green, K. L.; Grint, A. N.; Grinyer, G. F.; Harkness, L. J.; Hayes, A. B.; Kanungo, R.; Leach, K. G.; Kulp, W. D.; Lisetskiy, A. F.; Lee, G.; Lloyd, S.; Maharaj, R.; Martin, J.-P.; Millar, B. A.; Moisan, F.; Morton, A. C.; Mythili, S.; Nelson, L.; Newman, O.; Nolan, P. J.; Orce, J. N.; Oxley, D. C.; Padilla-Rodal, E.; Phillips, A. A.; Porter-Peden, M.; Ressler, J. J.; Rigby, S. V.; Roy, R.; Ruiz, C.; Sarazin, F.; Scraggs, D. P.; Sumithrarachchi, C. S.; Triambak, S.; Waddington, J. C.; Walker, P. M.; Wan, J.; Whitbeck, A.; Williams, S. J.; Wong, J.; Wood, J. L.

2009-03-01

The TRIUMF-ISAC Gamma-Ray Escape Suppressed Spectrometer (TIGRESS) is a state-of-the-art γ-ray spectrometer being constructed at the ISAC-II radioactive ion beam facility at TRIUMF. TIGRESS will be comprised of twelve 32-fold segmented high-purity germanium (HPGe) clover-type γ-ray detectors, with BGO/CsI(Tl) Compton-suppression shields, and is currently operational at ISAC-II in an early-implementation configuration of six detectors. Results have been obtained for the first experiments performed using TIGRESS, which examined the A = 20, 21, and 29 isotopes of Na by Coulomb excitation.

The Fermi Unix Environment - Dealing with Adolescence

NASA Astrophysics Data System (ADS)

Pordes, Ruth; Nicholls, Judy; Wicks, Matt

Fermilab's Computing Division started early in the definition implemention and promulgation of a common environment for Users across the Laboratory's UNIX platforms and installations. Based on our experience over nearly five years, we discuss the status of the effort ongoing developments and needs, some analysis of where we could have done better, and identify future directions to allow us to provide better and more complete service to our customers. In particular, with the power of the new PCs making enthusiastic converts of physicists to the pc world, we are faced with the challenge of expanding the paradigm to non-UNIX platforms in a uniform and consistent way.

NeuPAT: an intranet database supporting translational research in neuroblastic tumors.

PubMed

Villamón, Eva; Piqueras, Marta; Meseguer, Javier; Blanquer, Ignacio; Berbegall, Ana P; Tadeo, Irene; Hernández, Vicente; Navarro, Samuel; Noguera, Rosa

2013-03-01

Translational research in oncology is directed mainly towards establishing a better risk stratification and searching for appropriate therapeutic targets. This research generates a tremendous amount of complex clinical and biological data needing speedy and effective management. The authors describe the design, implementation and early experiences of a computer-aided system for the integration and management of data for neuroblastoma patients. NeuPAT facilitates clinical and translational research, minimizes the workload in consolidating the information, reduces errors and increases correlation of data through extensive coding. This design can also be applied to other tumor types. Copyright © 2012 Elsevier Ltd. All rights reserved.

Early experience with a new model of employer group purchasing in Minnesota.

PubMed

Christianson, J; Feldman, R; Weiner, J P; Drury, P

1999-01-01

The Buyers Health Care Action Group (BHCAG) in the Twin Cities has implemented a new purchasing initiative that offers employees a choice among care systems with nonoverlapping networks of primary care providers. These systems offer a standardized benefit package, submit annual bids, and are paid on a risk-adjusted basis. Employees are provided with information on quality and other differences among systems, and most have financial incentives to choose lower-cost systems. Generally, providers have responded favorably to direct contracting and to risk-adjusted payments but have concerns about the risk-adjustment mechanism used and, more importantly, the strength of employers' commitment to the purchasing model.

Survey of UK radiology trainees in the aftermath of ‘Modernising Medical Careers’

PubMed Central

2012-01-01

Background Following implementation of Modernising Medical Careers (MMC) in the UK, potential radiology trainees must decide on their career and apply sooner than ever before. We aimed to determine whether current trainees were sufficiently informed to make an earlier career decision by comparing the early radiology experiences of Traditional and Foundation Trainees. Methods 344 radiology trainees were appointed through MMC in 2007/08. This cohort was surveyed online. Results Response rate was 174/344 (51%). Traditional Trainees made their career decision 2.6 years after graduation compared with 1.2 years for Foundation Trainees (57/167, 34%). Nearly half of responders (79/169, 47%) experienced no formal radiology teaching as undergraduates. Most trainees regularly attended radiology meetings, spent time in a radiology department and/or performed radiology research. Many trainees received no career advice specific to radiology (69/163, 42%) at any point prior to entering the specialty; this includes both formal and informal advice. Junior doctor experiences were more frequently cited as influencing career choice (98/164, 60%). An earlier career decision was associated with; undergraduate radiology projects (-0.72 years, p = 0.018), career advice (-0.63 years, p = 0.009) and regular attendance at radiology meetings (-0.65 years, p = 0.014). Conclusion Early experience of radiology enables trainees to make an earlier career decision, however current radiology trainees were not always afforded relevant experiences prior to entering training. Radiologists need to be more proactive in encouraging the next generation of trainees. PMID:23031228

Developing and Conducting a Dissertation Study through the Community-Based Participatory Research Approach.

PubMed

Nadimpalli, S B; Van Devanter, N; Kavathe, R; Islam, N

2016-06-01

The community-based participatory research (CBPR) approach has been shown to be innovative and effective in conducting research with communities experiencing health disparities. Doctoral nursing students, and other doctoral students in the health sciences, who are interested in this approach can benefit through structured CBPR training experiences in learning how to engage with communities, build community capacity, share resources, implement CBPR study plans, and disseminate results of CBPR-focused studies. The objectives of this case-study are to demonstrate ways in which one doctoral student aligned with academic mentors and a funded CBPR project to build a relationship with the Sikh Asian Indian (AI) community of New York City to develop and implement a CBPR-focused doctoral dissertation study. The purpose of the research was to examine the relationship between the experience of perceived discrimination and health outcomes in this community. CBPR methods utilized in developing the study entailed the author partaking in formal and informal CBPR learning experiences, building relationships with community and academic partners early on through volunteering, developing a research plan in collaboration with members of the community and academic partners, identifying an appropriate setting and methods for recruitment and data collection, increasing capacity and resources for all partners (the author, community, and academic), and presenting dissertation study findings to the community. In conclusion, CBPR-focused doctoral experiences are novel pedagogical and professional approaches for nursing and health science students which can lead to mutual benefits for all involved, and ultimately successful and effective community-based health research.

A Reduced Duty Hours Model for Senior Internal Medicine Residents: A Qualitative Analysis of Residents' Experiences and Perceptions.

PubMed

Mathew, Rebecca; Gundy, Serena; Ulic, Diana; Haider, Shariq; Wasi, Parveen

2016-09-01

To assess senior internal medicine residents' experience of the implementation of a reduced duty hours model with night float, the transition from the prior 26-hour call system, and the new model's effects on resident quality of life and perceived patient safety in the emergency department and clinical teaching unit at McMaster University. Qualitative data were collected during May 2013-July 2014, through resident focus groups held prior to implementation of a reduced duty hours model and 10 to 12 months postimplementation. Data analysis was guided by a constructivist grounded theory based in a relativist paradigm. Transcripts were coded; codes were collapsed into themes. Thematic analysis revealed five themes. Residents described reduced fatigue in the early morning, counterbalanced with worsened long-term fatigue on night float blocks; anticipation of negative impacts of the loss of distributed on-call experience and on-call shift volume; an urgency to sleep postcall in anticipation of consecutive night float shifts accompanied by conflicting role demands to stay postcall for care continuity; increased handover frequency accompanied by inaccurate/incomplete communication of patients' issues; and improvement in the senior resident experience on the clinical teaching unit, with increased ownership over patient care and improved relationships with junior housestaff. A reduced duty hours model with night float has potential to improve residents' perceived fatigue on call and care continuity on the clinical teaching unit. This must be weighed against increased handover frequency and loss of the postcall day, which may negatively affect patient care and resident quality of life.

Early Childhood Educator and Administrator Surveys on the Use of Assessments and Standards in Early Childhood Settings. REL 2014-019

ERIC Educational Resources Information Center

Irwin, Clare W.; O'Dwyer, Laura; Cook, Kyle DeMeo

2014-01-01

The Early Childhood Educator Survey and the Early Childhood Administrator Survey allow users to collect consistent data on the use of child assessments and learning standards in early childhood learning settings. Each survey includes modules on educator/administrator background information, assessment use, and learning standards implementation.…

A Mastery Learning Experiment.

ERIC Educational Resources Information Center

Anderson, Stephen A.; And Others

Yale Public Schools (Yale, Michigan) conducted a field experiment in implementing mastery learning. The purpose of the experiment was to provide a hands-on experience for teachers in the implementation of mastery learning and to use students as their own controls in order to compare the results of the implementation of mastery learning both in…

34 CFR 300.711 - Early intervening services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Early intervening services. 300.711 Section 300.711... Secretary of the Interior § 300.711 Early intervening services. (a) The Secretary of the Interior may allow... funds), to develop and implement coordinated, early intervening services, which may include interagency...

Early Interventions: Keys to Successful Readers.

ERIC Educational Resources Information Center

Jeffreys, JoAnn; Spang, Joan

This action research outlines an early reading intervention project for improving students' reading skills and promoting the implementation of early reading intervention programs. The targeted population includes first and second grade students in one school located in the suburbs of a major city in Illinois. The problem of early reading…

Effect of implementation of the mass breast cancer screening programme in older women in the Netherlands: population based study.

PubMed

de Glas, Nienke A; de Craen, Anton J M; Bastiaannet, Esther; Op 't Land, Ester G; Kiderlen, Mandy; van de Water, Willemien; Siesling, Sabine; Portielje, Johanneke E A; Schuttevaer, Herman M; de Bock, Geertruida Truuske H; van de Velde, Cornelis J H; Liefers, Gerrit-Jan

2014-09-14

To assess the incidence of early stage and advanced stage breast cancer before and after the implementation of mass screening in women aged 70-75 years in the Netherlands in 1998. Prospective nationwide population based study. National cancer registry, the Netherlands. Patients aged 70-75 years with a diagnosis of invasive or ductal carcinoma in situ breast cancer between 1995 and 2011 (n=25,414). Incidence rates were calculated using population data from Statistics Netherlands. Incidence rates of early stage (I, II, or ductal carcinoma in situ) and advanced stage (III and IV) breast cancer before and after implementation of screening. Hypotheses were formulated before data collection. The incidence of early stage tumours significantly increased after the extension for implementation of screening (248.7 cases per 100,000 women before screening up to 362.9 cases per 100,000 women after implementation of screening, incidence rate ratio 1.46, 95% confidence interval 1.40 to 1.52, P<0.001). However, the incidence of advanced stage breast cancers decreased to a far lesser extent (58.6 cases per 100,000 women before screening to 51.8 cases per 100,000 women after implementation of screening, incidence rate ratio 0.88, 0.81 to 0.97, P<0.001). The extension of the upper age limit to 75 years has only led to a small decrease in incidence of advanced stage breast cancer, while that of early stage tumours has strongly increased. © de Glas et al 2014.

ICU team composition and its association with ABCDE implementation in a quality collaborative.

PubMed

Costa, Deena Kelly; Valley, Thomas S; Miller, Melissa A; Manojlovich, Milisa; Watson, Sam R; McLellan, Phyllis; Pope, Corine; Hyzy, Robert C; Iwashyna, Theodore J

2018-04-01

Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. We administered a survey at MHA Keystone Center ICU 2015 workshop. We measured team composition by the frequency of nurse, respiratory therapist, physician, physical therapist, nurse practitioner/physician assistant or nursing assistant involvement in 1) spontaneous awakening trials (SATs), 2) spontaneous breathing trials, 3) delirium and 4) early mobility. We assessed ABCDE implementation using a 5-point Likert ("routine part of every patient's care" - "no plans to implement"). We used ordinal logistic regression to examine team composition and ABCDE implementation, adjusting for confounders and clustering. From 293 surveys (75% response rate), we found that frequent nurse [OR 6.1 (1.1-34.9)] and physician involvement [OR 4.2 (1.3-13.4)] in SATs, nurse [OR 4.7 (1.6-13.4)] and nursing assistant's involvement [OR 3.9 (1.2-13.5)] in delirium and nurse [OR 2.8 (1.2-6.7)], physician [OR (3.6 (1.2-10.3)], and nursing assistants' involvement [OR 2.3 (1.1-4.8)] in early mobility were significantly associated with higher odds of routine ABCDE implementation. ABCDE implementation was associated with frequent involvement of team members, suggesting a need for role articulation and coordination. Copyright © 2017 Elsevier Inc. All rights reserved.

Trauma-Focused CBT for Youth who Experience Ongoing Traumas

PubMed Central

Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura A.

2011-01-01

Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will this in some way impair their responding to current or ongoing trauma? The paper addresses practical strategies for implementing one evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with ongoing traumas. Collaboration with local therapists and families participating in TF-CBT community and international programs elucidated effective strategies for applying TF-CBT with these youth. These strategies included: 1) enhancing safety early in treatment; 2) effectively engaging parents who experience personal ongoing trauma; and 3) during the trauma narrative and processing component focusing on a) increasing parental awareness and acceptance of the extent of the youths’ ongoing trauma experiences; b) addressing youths’ maladaptive cognitions about ongoing traumas; and c) helping youth differentiate between real danger and generalized trauma reminders. Case examples illustrate how to use these strategies in diverse clinical situations. Through these strategies TF-CBT clinicians can effectively improve outcomes for youth experiencing ongoing traumas. PMID:21855140

Reengaging New York City's Disconnected Youth through Work: Implementation and Early Impacts of the Young Adult Internship Program. OPRE Report 2017-22

ERIC Educational Resources Information Center

Skemer, Melanie; Sherman, Arielle; Williams, Sonya; Cummings, Danielle

2017-01-01

This report presents implementation and early impact results from a random assignment evaluation of the Young Adult Internship Program (YAIP), a subsidized employment program for young people in New York City who have become disconnected from school and work. Operated by various provider agencies, YAIP offers disconnected youth between the ages of…

The Implementation and Effects of the Literacy Design Collaborative (LDC): Early Findings in Sixth-Grade Advanced Reading Courses. CRESST Report 846

ERIC Educational Resources Information Center

Herman, Joan L.; Epstein, Scott; Leon, Seth; Dai, Yunyun; La Torre Matrundola, Deborah; Reber, Sarah; Choi, Kilchan

2015-01-01

The Bill and Melinda Gates Foundation invested in the Literacy Design Collaborative (LDC) as one strategy to support teachers' and students' transition to the Common Core State Standards (CCSS) in English language arts. This report provides an early look at the implementation of LDC in sixth-grade Advanced Reading classes in a large Florida…

Stakeholders' views of the introduction of assistive technology in the classroom: How family-centred is Australian practice for students with cerebral palsy?

PubMed

Karlsson, P; Johnston, C; Barker, K

2017-07-01

With family-centred care widely recognized as a cornerstone for effective assistive technology service provision, the current study was undertaken to investigate to what extent such approaches were used by schools when assistive technology assessments and implementation occurred in the classroom. In this cross-sectional study, we compare survey results from parents (n = 76), school staff (n = 33) and allied health professionals (n = 65) with experience in the use of high-tech assistive technology. Demographic characteristics and the stakeholders' perceived helpfulness and frequency attending assessment and set-up sessions were captured. To evaluate how family-centred the assistive technology services were perceived to be, the parents filled out the Measure of Processes of Care for Caregivers, and the professionals completed the Measure of Processes of Care for Service Providers. Descriptive statistics and one-way analysis of variance were used to conduct the data analysis. Findings show that parents are more involved during the assessment stage than during the implementation and that classroom teachers are often not involved in the initial stage. Speech pathologists in particular are seen to be to a great extent helpful when implementing assistive technology in the classroom. This study found that family-centred service is not yet fully achieved in schools despite being endorsed in early intervention and disability services for over 20 years. No statistically significant differences were found with respect to school staff and allied health professionals' roles, their years of experience working with students with cerebral palsy and the scales in the Measure of Processes of Care for Service Providers. To enhance the way technology is matched to the student and successfully implemented, classroom teachers need to be fully involved in the whole assistive technology process. The findings also point to the significance of parents' involvement, with the support of allied health professionals, in the process of selecting and implementing assistive technology in the classroom. © 2017 John Wiley & Sons Ltd.

Menstruation across time: menarche, menstrual attitudes, experiences, and behaviors.

PubMed

McPherson, Marianne E; Korfine, Lauren

2004-01-01

This study explored the relationship between early and current menstrual experiences. The primary hypothesis was that women who reported positive menarcheal experiences (including menstrual education and menarche) would tend to report positive current menstrual attitudes, experiences, and/or behaviors, and vice versa for women who reported negative menarcheal experiences. In this survey-based study, college-aged women (n = 327) were screened by completing a questionnaire concerning their menarcheal experiences. Women who had extremely negative ("negative group," n = 46) or extremely positive ("positive group," n = 38) early menstrual experiences returned to complete questionnaires concerning current menstrual attitudes, experiences, and behaviors. Early and current menstrual experiences were most strongly associated in the domain of menstrual attitudes. Women in the negative group reported more negative menstrual attitudes than did women in the positive group. There were additional associations between early menstrual experiences and measures of body image and health behaviors. Positive group participants reported more positive body image and better general health behaviors. Results suggest that early menstrual experiences may be related to menstrual experiences later in life. This study invites further investigation of the psychology of menstruation and suggests connecting menstruation with other women's health issues.

[PROtocol-based MObilizaTION on intensive care units : Design of a cluster randomized pilot study].

PubMed

Nydahl, P; Diers, A; Günther, U; Haastert, B; Hesse, S; Kerschensteiner, C; Klarmann, S; Köpke, S

2017-10-12

Despite convincing evidence for early mobilization of patients on intensive care units (ICU), implementation in practice is limited. Protocols for early mobilization, including in- and exclusion criteria, assessments, safety criteria, and step schemes may increase the rate of implementation and mobilization. Patients (population) on ICUs with a protocol for early mobilization (intervention), compared to patients on ICUs without protocol (control), will be more frequently mobilized (outcome). A multicenter, stepped-wedge, cluster-randomized pilot study is presented. Five ICUs will receive an adapted, interprofessional protocol for early mobilization in randomized order. Before and after implementation, mobilization of ICU patients will be evaluated by randomized monthly one-day point prevalence surveys. Primary outcome is the percentage of patients mobilized out of bed, operationalized as a score of ≥3 on the ICU Mobility Scale. Secondary outcome parameters will be presence and/or length of mechanical ventilation, delirium, stay on ICU and in hospital, barriers to early mobilization, adverse events, and process parameters as identified barriers, used strategies, and adaptions to local conditions. Exploratory evaluation of study feasibility and estimation of effect sizes as the basis for a future explanatory study.

Challenges in treating post-traumatic stress disorder and attachment trauma.

PubMed

Allen, Jon G

2003-06-01

Treating women suffering from trauma poses significant challenges. The diagnostic prototype of post-traumatic stress disorder (PTSD) is based on single-event trauma, such as sexual assault in adulthood. Several effective cognitive- behavioral treatments for such traumas have been developed, although many treated patients continue to experience residual symptoms. Even more problematic is the complex developmental psychopathology stemming from a lifetime history of multiple traumas, often beginning with maltreatment in early attachment relationships. A history of attachment trauma undermines the development of capacities to regulate emotional distress and thereby complicates the treatment of acute trauma in adulthood. Such complex trauma requires a multifaceted treatment approach that must balance processing of traumatic memories with strategies to contain the intense emotions this processing evokes. Moreover, conducting such treatment places therapists at risk for secondary trauma such that trauma therapists also must process this stressful experience and implement strategies to regulate their own distress.

Bundled Payments for Care Improvement

PubMed Central

Hardin, Lauran; Kilian, Adam; Murphy, Elizabeth

2017-01-01

BACKGROUND The Centers for Medicare and Medicaid Services Innovation Center introduced the Bundled Payments for Care Improvement (BPCI) initiative in 2011 as 1 strategy to encourage healthcare organizations and clinicians to improve healthcare delivery for patients, both when they are in the hospital and after they are discharged. Mercy Health Saint Mary’s, a large urban academic medical center, engaged in BPCI primarily with a group of medical diagnosis-related groups (DRGs). OBJECTIVES In this article, we describe our experience creating a system of response for the diverse people and diagnoses that fall into the medical DRG bundles and specifically identify organizational factors for enabling successful implementation of bundled payments. RESULTS Our experience suggests that interprofessional collaboration enabled program success. CONCLUSIONS Although still in its early phases, observations from our program’s strategies and tactics may provide potential insights for organizations considering engagement in the BPCI initiative. PMID:28509721

The Adam and Eve Robot Scientists for the Automated Discovery of Scientific Knowledge

NASA Astrophysics Data System (ADS)

King, Ross

A Robot Scientist is a physically implemented robotic system that applies techniques from artificial intelligence to execute cycles of automated scientific experimentation. A Robot Scientist can automatically execute cycles of hypothesis formation, selection of efficient experiments to discriminate between hypotheses, execution of experiments using laboratory automation equipment, and analysis of results. The motivation for developing Robot Scientists is to better understand science, and to make scientific research more efficient. The Robot Scientist `Adam' was the first machine to autonomously discover scientific knowledge: both form and experimentally confirm novel hypotheses. Adam worked in the domain of yeast functional genomics. The Robot Scientist `Eve' was originally developed to automate early-stage drug development, with specific application to neglected tropical disease such as malaria, African sleeping sickness, etc. We are now adapting Eve to work with on cancer. We are also teaching Eve to autonomously extract information from the scientific literature.

Modeling of Dense Plasma Effects in Short-Pulse Laser Experiments

NASA Astrophysics Data System (ADS)

Walton, Timothy; Golovkin, Igor; Macfarlane, Joseph; Prism Computational Sciences, Madison, WI Team

2016-10-01

Warm and Hot Dense Matter produced in short-pulse laser experiments can be studied with new high resolving power x-ray spectrometers. Data interpretation implies accurate modeling of the early-time heating dynamics and the radiation conditions that are generated. Producing synthetic spectra requires a model that describes the major physical processes that occur inside the target, including the hot-electron generation and relaxation phases and the effect of target heating. An important issue concerns the sensitivity of the predicted K-line shifts to the continuum lowering model that is used. We will present a set of PrismSPECT spectroscopic simulations using various continuum lowering models: Hummer/Mihalas, Stewart-Pyatt, and Ecker-Kroll and discuss their effect on the formation of K-shell features. We will also discuss recently implemented models for dense plasma shifts for H-like, He-like and neutral systems.

Transactional processes in the development of adult personality disorder symptoms.

PubMed

Carlson, Elizabeth A; Ruiz, Sarah K

2016-08-01

The development of adult personality disorder symptoms, including transactional processes of relationship representational and behavioral experience from infancy to early adolescence, was examined using longitudinal data from a risk sample (N = 162). Significant preliminary correlations were found between early caregiving experience and adult personality disorder symptoms and between representational and behavioral indices across time and adult symptomatology. Significant correlations were also found among diverse representational assessments (e.g., interview, drawing, and projective narrative) and between concurrent representational and observational measures of relationship functioning. Path models were analyzed to investigate the combined relations of caregiving experience in infancy; relationship representation and experience in early childhood, middle childhood, and early adolescence; and personality disorder symptoms in adulthood. The hypothesized model representing interactive contributions of representational and behavioral experience represented the data significantly better than competing models representing noninteractive contributions. Representational and behavioral indicators mediated the link between early caregiving quality and personality disorder symptoms. The findings extend previous studies of normative development and support an organizational developmental view that early relationship experiences contribute to socioemotional maladaptation as well as adaptation through the progressive transaction of mutually informing expectations and experience.

Developing and Implementing an Early Retirement Incentive Program for Marin County School Districts. Vol. 1 and 2.

ERIC Educational Resources Information Center

Mauzy, Byron W.

In creating an early retirement incentive program for the Marin County (California) schools, the author examined the early retirement ethic, other early retirement plans in the public and private sectors, the impact of early retirement on Social Security benefits, opposition to such programs, and the factors in the California school districts that…

Computer order entry systems in the emergency department significantly reduce the time to medication delivery for high acuity patients.

PubMed

Syed, Shahbaz; Wang, Dongmei; Goulard, Debbie; Rich, Tom; Innes, Grant; Lang, Eddy

2013-07-05

Computerized physician order entry (CPOE) systems are designed to increase safety and improve quality of care; however, their impact on efficiency in the ED has not yet been validated. This study examined the impact of CPOE on process times for medication delivery, laboratory utilization and diagnostic imaging in the early, late and control phases of a regional ED-CPOE implementation. Three tertiary care hospitals serving a population in excess of 1 million inhabitants that initiated the same CPOE system during the same 3-week time window. Patients were stratified into three groupings: Control, Early CPOE and Late CPOE (n = 200 patients per group/hospital site). Eligible patients consisted of a stratified (40% CTAS 2 and 60% CTAS 3) random sample of all patients seen 30 days preceding CPOE implementation (Control), 30 days immediately after CPOE implementation (Early CPOE) and 5-6 months after CPOE implementation (Late CPOE). Primary outcomes were time to (TT) from physician assignment (MD-sign) up to MD-order completion. An ANOVA and t-test were employed for statistical analysis. In comparison with control, TT 1st MD-Ordered Medication decreased in both the Early and Late CPOE groups (102.6 min control, 62.8 Early and 65.7 late, p < 0.001). TT 1st MD-ordered laboratory results increased in both the Early and Late CPOE groups compared to Control (76.4, 85.3 and 73.8 min, respectively, p < 0.001). TT 1st X-Ray also significantly increased in both the Early and Late CPOE groups (80.4, 84.8 min, respectively, compared to 68.1, p < 0.001). Given that CT and ultrasound imaging inherently takes increased time, these imaging studies were not included, and only X-ray was examined. There was no statistical difference found between TT discharge and consult request. Regional implementation of CPOE afforded important efficiencies in time to medication delivery for high acuity ED patients. Increased times observed for laboratory and radiology results may reflect system issues outside of the emergency department and as a result of potential confounding may not be a reflection of CPOE impact.

Final Report to the Clean Air Act Advisory Committee, Title V Implementation Experience

EPA Pesticide Factsheets

In 2004, the Clean Air Act Advisory Committee established the Task Force on Title V Implementation Experience to report on stakeholder experience with implementation of the Title V operating permit program. This report details their recommendations.

Assessing Teacher Beliefs about Early Literacy Curriculum Implementation

ERIC Educational Resources Information Center

McKenney, Susan; Bradley, Barbara

2016-01-01

Against the backdrop of growing international concern for a narrowing view of early literacy, this study was initiated to determine how teachers of four-year-olds view their task of fostering early literacy. This paper reports on the first steps to design and validate an instrument which captures teachers' perceptions of early literacy content…

Promoting Resilience: Breaking the Intergenerational Cycle of Adverse Childhood Experiences.

PubMed

Woods-Jaeger, Briana A; Cho, Bridget; Sexton, Chris C; Slagel, Lauren; Goggin, Kathy

2018-02-01

Adverse childhood experiences (ACEs), including trauma exposure, parent mental health problems, and family dysfunction, put children at risk for disrupted brain development and increased risk for later health problems and mortality. These negative effects may be prevented by resilience promoting environments that include protective caregiving relationships. We sought to understand (1) parents' experiences of ACEs, (2) the perceived impact on parenting, (3) protective factors that buffer ACEs potential negative impact, and (4) supports and services that can reduce the number and severity of ACEs and promote resilience among children exposed to early adversity. We conducted in-depth qualitative interviews with 11 low-income, urban parents of young children who had experienced ACEs. Interviews were analyzed for emergent themes and shared with parents from the community to ensure relevance and proper interpretation. Themes from these interviews describe the potential intergenerational cycle of ACEs and key factors that can break that cycle, including parent aspirations to make children's lives better and parent nurturance and support. Parents' suggestions for intervention are also presented. Our findings illuminate protective factors and family strengths that are important to build upon when developing and implementing interventions to promote resilience among parents and children exposed to early adversity. This study benefits from highly ecologically valid data obtained from low-socioeconomic status, racial/ethnic minority parents through one-on-one in-depth interviews and interpreted with the aid of community stakeholders through a community-based participatory research approach.

Developments in early intervention for psychosis in Hong Kong.

PubMed

Wong, G H Y; Hui, C L M; Wong, D Y; Tang, J Y M; Chang, W C; Chan, S K W; Lee, E H M; Xu, J Q; Lin, J J X; Lai, D C; Tam, W; Kok, J; Chung, D W S; Hung, S F; Chen, E Y H

2012-09-01

The year 2011 marked the 10-year milestone of early intervention for psychosis in Hong Kong. Since 2001, the landscape of early psychosis services has changed markedly in Hong Kong. Substantial progress has been made in the areas of early intervention service implementation, knowledge generation, and public awareness promotion. Favourable outcomes attributable to the early intervention service are supported by solid evidence from local clinical research studies; early intervention service users showed improved functioning, ameliorated symptoms, and decreased hospitalisation and suicide rates. Continued development of early intervention in Hong Kong over the decade includes the introduction and maturation of several key platforms, such as the Hospital Authority Early Assessment Service for Young People with Psychosis programme, the Psychosis Studies and Intervention Unit by the University of Hong Kong, the Hong Kong Early Psychosis Intervention Society, the Jockey Club Early Psychosis Project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. In this paper, we reviewed some of the major milestones in local service development with reference to features of the Hong Kong mental health system. We describe chronologically the implementation and consolidation of public early intervention services as well as recent progresses in public awareness work that are tied in with knowledge generation and transfer, and outline the prospects for early intervention in the next decade and those that follow.

Early experience with influenza A H1N109 in an Australian intensive care unit.

PubMed

Leen, Tim; Williams, Teresa A; Campbell, Lorraine; Chamberlain, Jenny; Gould, Andree; McEntaggart, Geraldine; Leslie, Gavin D

2010-08-01

Influenza is a common seasonal viral infection that affects large numbers of people. In early 2009, many people were admitted to hospitals in Mexico with severe respiratory failure following an influenza-like illness, subtyped as H1N1. An increased mortality rate was observed. By June 2009, H1N1 was upgraded to pandemic status. In June-July, Australian ICUs were experiencing increased activity due to the influenza pandemic. While hospitals implemented plans for the pandemic, the particularly heavy demand to provide critical care facilities to accommodate an influx of people with severe respiratory failure became evident and placed a great burden on provision of these services. This paper describes the initial experience (June to mid September) of the pandemic from the nursing perspective in a single Australian ICU. Patients were noted to be younger with a higher proportion of women, two of whom were pregnant. Two patients had APACHE III comorbidity. Of the 31 patients admitted during this period, three patients died in ICU and one patient died in hospital. Aerosol precautions were initiated for all patients. The requirement for single room accommodation placed enormous demands for bed management in ICU. Specific infection control procedures were developed to deal with this new pandemic influenza. Copyright 2010 Elsevier Ltd. All rights reserved.

The shift to early palliative care: a typology of illness journeys and the role of nursing.

PubMed

Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ragan, Sandra

2011-06-01

For the current study, clinical observations of communication between patients, families, and clinicians during chronic, serious, or terminal illness in a cancer care trajectory were examined for patterns and trends. Five communication characteristics were concluded, which informed a typology of illness journeys experienced by patients with cancer and their families. The isolated journey characterizes an illness path in which communication about terminal prognosis and end-of-life care options are not present; communication is restricted by a curative-only approach to diagnosis as well as the structure of medical care. The rescued journey signifies a transition between curative care (hospital narrative) to noncurative care (hospice narrative), challenging patients and their families with an awareness of dying. The rescued journey allows communication about prognosis and care options, establishes productive experiences through open awareness, and affords patients and families opportunities to experience end-of-life care preferences. Finally, palliative care prior to hospice provides patients and families with an illness journey more readily characterized by open awareness and community, which facilitates a comforted journey. Nurses play a pivotal role in communicating about disease progression and plans of care. The typology presented can inform a structured communication curriculum for nurses and assist in the implementation of early palliative care.

Learning from parents' stories about what works in early intervention.

PubMed

Pighini, Maria J; Goelman, Hillel; Buchanan, Marla; Schonert-Reichl, Kimberly; Brynelsen, Dana

2014-08-01

Using a multiple case study approach, this ethnography examined the experiences of parents of children deemed at risk for developmental delays or disabilities who had received early intervention (EI) services (birth to age 3 years) in a large urban location in Western Canada. Participants (11 adult parents and 7 children) were drawn from six families. Methods of data collection included focus groups (FG), face-to-face interviews and file reviews. Member check and expert reviews were conducted throughout data collection and data analyses as part of the validation process in this ethnography. Qualitative content analyses followed by thematic analyses highlighted the implementation of family-centred practices (FCP) as a main theme. Parents identified how EI professionals using FCP embraced collaborative practices. FCP resulted in parents leading the EI process for their children. More specifically, EI professionals shared strategies and information to support parents in gaining a deeper understanding of their children's individual developmental characteristics. Parents expressed how empowering this level of understanding was for them as they learned to articulate what were their children's needs for developmental, health and educational services. Recommendations for future research include inquiring about parents' experiences for families of diverse constellations and/or residing in smaller urban or rural communities. © 2013 International Union of Psychological Science.

Making Sense, Making Do: Local District Implementation of a New State Induction Policy

ERIC Educational Resources Information Center

Ellis, Chad D.

2016-01-01

Connecticut's Teacher Education and Mentoring (TEAM) program is in its early stages of implementation. This study examined how local school districts implemented TEAM and identified factors that affected implementation. It was based on interviews with twenty-two participants at the state, district, and local school levels. The intentions of the…

Implementing the World Report on Disability in Malaysia: a student-led service to promote knowledge and innovation.

PubMed

Van Dort, Sandra; Coyle, Julia; Wilson, Linda; Ibrahim, Hasherah Mohd

2013-02-01

The lead article by Wylie, McAllister, Davidson, and Marshall (2013) puts forward pertinent issues facing the speech-language pathology profession raised by the World Report on Disability. This paper continues the discussion by reporting on a capacity building action research study on the development, implementation, and evaluation of a new approach to early intervention speech-language pathology through clinical education in Malaysia. This research evaluated a student-led service in community-based rehabilitation that supplemented existing and more typical institution-based services. A Malaysian community-based rehabilitation project was chosen due to its emphasis on increasing the equitability and accessibility of services for people with disabilities which was a catalyst for this research. Also, expanding awareness-building, education, and training activities about communication disability was important. The intention was to provide students with experience of working in such settings, and facilitate their development as advocates for broadening the scope of practice of speech-language pathology services in Malaysia. This article focuses on the findings pertaining to the collaborative process and the learning experiences of the adult participants. Through reflection on the positive achievements, as well as some failures, it aims to provide deeper understanding of the use of such a model.

[Implementation of the EndoCert system for certification of arthroplasty centers. Experiences from the pilot phase].

PubMed

Haas, H; Mittelmeier, W

2014-06-01

EndoCert is an initiative of the Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC, German Society for Orthopedics and Orthopedic Surgery) which has been available since October 2012 and is the first system worldwide for certification of specialized arthroplasty centers. Before implementation of this certification concept two sequential pilot phases were carried out with representative treatment institutions. The results from these pilot clinics are presented with respect to quality improvement effects. Early effects on the quality of treatment have been achieved by rectification of nonconformities determined in the audit with respect to structural and process quality. A total of 172 nonconformities found in the 23 participating pilot clinics could be rectified. Long-term effects on the quality of results will in future be analyzed in cooperation with the German endoprosthesis register (EPRD) and by accompanying evaluations. A close feedback of the collated experiences and results to the certification committee, which is responsible for the procedure together with the DGOOC, allows continuous further development of the system EndoCert represents a substantial step towards a nationwide safety and improvement of the quality in arthroplasty treatment within the preoperative, perioperative and postoperative framework and can in future represent a decisive tool together with the EPRD in quality management.

Access with evidence development: the US experience.

PubMed

Mohr, Penny E; Tunis, Sean R

2010-01-01

The concept of access with evidence development (AED), also known as 'coverage with evidence development' in the Medicare programme, has long been discussed as a policy option for ensuring more appropriate use of new technologies in the US. This article provides a comprehensive overview of more than 10 years of US experience with AED, both in the public and private healthcare sectors. Beginning with a discussion of the successes of private plans' conditional coverage for high-density chemotherapy for autologous bone marrow transplants for metastatic breast cancer and Medicare's conditional coverage of lung-volume-reduction surgery in the 1990s, the article moves on to describe how Medicare worked to codify AED as one of its coverage policy options in the early part of this decade. More recent private and public sector initiatives are also discussed, including an overview of barriers to implementing AED. Despite the complexity of political, financial and ethical issues faced in implementation, AED is now a permanent fixture of US coverage policy. Future initiatives within the Medicare programme and with private payers in the US are much more likely to succeed by relying upon the simple but consequential principles laid out at a Summit convened in Banff, Alberta, Canada in 2009 and presented in another article in this issue.

Risk and Outbreak Communication: Lessons from Taiwan's Experiences in the Post-SARS Era.

PubMed

Hsu, Yu-Chen; Chen, Yu-Ling; Wei, Han-Ning; Yang, Yu-Wen; Chen, Ying-Hwei

In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of "One World, One Health."

Risk and Outbreak Communication: Lessons from Taiwan's Experiences in the Post-SARS Era

PubMed Central

Chen, Yu-Ling; Wei, Han-Ning; Yang, Yu-Wen; Chen, Ying-Hwei

2017-01-01

In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of “One World, One Health.” PMID:28418746

A decade of aquatic invasive species (AIS) early detection ...

EPA Pesticide Factsheets

As an invasion prone location, the St. Louis River Estuary (SLRE) has been a case study for ongoing research to develop the framework for a practical Great Lakes monitoring network for early detection of aquatic invasive species (AIS). Early detection, however, necessitates finding new invaders before they are common. Here we outline our research (2005 present) approach and findings, including strategies to increase detection efficiency by optimizing specimen collection and identification methods. Initial surveys were designed to over-sample to amass data as the basis for numerical experiments to investigate to the effort required for a given detection probability. Later surveys tested the outcome of implementing these strategies, examined the potential benefits of sampling larval fish instead of adults and explored the prospect of using advanced DNA based methods as an alternative to traditional taxonomy. To date we have identified several previously undetected invertebrate invaders, developed survey design and gear recommendations and have refined the search strategy for systems beyond the SLRE. In addition, because we’ve accumulated such a large body of data we now have the basis to show spatial-temporal trends for native and non-native species in the SLRE. not applicable

Recovery from stunting and cognitive outcomes in young children: evidence from the South African Birth to Twenty Cohort Study.

PubMed

Casale, D; Desmond, C

2016-04-01

In this study we analyse the implications for cognitive function of recovery from stunting in early childhood. More specifically, we test whether children who met the definition for stunted at age 2, but not at age 5, perform better in cognitive tests than children who remain stunted over this period. The sample is drawn from the Birth to Twenty Cohort Study, a prospective data set of children born in 1990 in urban South Africa. The measure of cognitive function that we use is based on the Revised Denver Prescreening Developmental Questionnaire implemented when the children were age 5. We employ multivariate regression in the analysis to control for child-specific characteristics, socio-economic status, the home environment and caregiver inputs. We find that recovery from stunting is not uncommon among young children in our sample. However, children who recover from stunting by age 5 still perform significantly worse on cognitive tests than children who do not experience early malnutrition, and almost as poorly as children who remain stunted. These findings suggest that the timing of nutritional inputs in the early years is key in a child's cognitive development, with implications for school readiness and achievement.

Implementing and evaluating early intervention for children with autism: Where are the gaps and what should we do?

PubMed

Vivanti, Giacomo; Kasari, Connie; Green, Jonathan; Mandell, David; Maye, Melissa; Hudry, Kristelle

2018-01-01

Despite recent advances, the evidence base supporting early intervention for young children with autism spectrum disorder (ASD) remains relatively sparse. The International Society for Autism Research (INSAR) recently sponsored a Special Interest Group (SIG) on Implementing and Evaluating Community-Based Early Intervention. Across three meetings, in 2015, 2016, and 2017, conveners of this SIG engaged >200 members to identify knowledge gaps and research priorities for moving the field forward. Here, we summarize the perspectives that emerged from group discussion at the SIG meetings as represented by scholars working actively in the field. Despite encouraging progress, critical gaps and research priorities were identified across all the stages of intervention development and testing from conceptualization to community implementation. Key issues include the need for (a) formal theories to guide early intervention development, evaluation, and implementation; and alignment of intervention goals with scientific knowledge and societal changes that have occurred in the decades since interventions were originally developed; (b) increased focus on feasibility of treatment procedures and alignment with stakeholder values during pilot evaluations; (c) use of research designs that allow for comparisons of different interventions and formats, analyses of active ingredients of treatment, and identification of moderators and mediators of outcome; (d) use of community-partnered participatory research to guide adaptation of intervention models to community settings; (e) inclusion of constructs related to implementation processes and outcomes in treatment trials and; (f) an iterative approach to the progression of knowledge from intervention development to implementation. Autism Res 2018, 11: 16-23. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. In this article, we summarize the themes discussed at the INSAR Special Interest Group (SIG) on Implementing and Evaluating Community-Based Early Intervention. Priorities for moving the field forward identified in the SIG included the need for (a) formal theories to guide the development and evaluation of interventions, (b) pilot evaluations that investigate feasibility and acceptability of interventions, (c) methodologies that allow us to determine for whom different interventions bring most benefit and why this is so, (d) strategies to include community members and other stakeholders in the process of developing and evaluating interventions, and (e) understanding of factors that make interventions more likely to be adopted and successfully implemented in the real world. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

The Influence of Technology-Rich Early Childhood Field Experiences on Preservice Teachers

ERIC Educational Resources Information Center

Lux, Nicholas; Lux, Christine

2015-01-01

Despite a comprehensive body of research on field experiences in teacher education, technology-rich early field experiences in early childhood environments is one particular area of inquiry lacking substantive current research. Therefore, this study was conducted to better understand how preservice teachers' perceptions of global concepts related…

'Lessons learned': A comparative case study analysis of an emergency department response to two burns disasters.

PubMed

Little, Mark; Cooper, Jim; Gope, Monica; Hahn, Kelly A; Kibar, Cem; McCoubrie, David; Ng, Conrad; Robinson, Annie; Soderstrom, Jessamine; Leclercq, Muriel

2012-08-01

The Royal Perth Hospital (RPH; Perth, Australia) has been the receiving facility for burns patients in two separate disasters. In 2002, RPH received 28 severely injured burns patients after the Bali bombing, and in 2009 RPH received 23 significantly burnt patients as a result of an explosion on board a foreign vessel in the remote Ashmore Reef Islands (840 km west of Darwin). The aim of this paper is to identify the interventions developed following the Bali bombing in 2002 and review their effectiveness of their implementation in the subsequent burns disaster. A comparative case study analysis using a standardised approach was used to describe context with debrief reports and ED photographs from both disasters used for evaluation. The implementation of regular ED disaster response planning and training, early Code Brown notification of the entire hospital with regular updates, early clearing of inpatient beds, use of Short Message Service to communicate regularly with ED staff, control of the public and media access to the ED, visual identification of staff within the ED, early panendoscopy to ascertain intubation needs, and senior clinical decision makers in all areas of the ED were all acknowledged as effective based on the debrief reports. There was a reduction in ED length of stay (150 to 55 min) and no deaths occurred; however, quantitative analysis can only be suggestive rather than a direct measure of improvement given the likelihood of other system changes. There were a number of lessons observed from the Bali experience in 2002 that have led to improvements in practice and lessons learned. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Chronic social isolation and chronic variable stress during early development induce later elevated ethanol intake in adult C57BL/6J mice.

PubMed

Lopez, Marcelo F; Doremus-Fitzwater, Tamara L; Becker, Howard C

2011-06-01

Experience with stress situations during early development can have long-lasting effects on stress- and anxiety-related behaviors. Importantly, this can also favor drug self-administration. These studies examined the effects of chronic social isolation and/or variable stress experiences during early development on subsequent voluntary ethanol intake in adult male and female C57BL/6J mice. The experiments were conducted to evaluate the effect of chronic isolation between weaning and adulthood (Experiment 1), chronic isolation during adulthood (Experiment 2), and chronic variable stress (CVS) alone or in combination with chronic social isolation between weaning and adulthood (Experiment 3) on subsequent voluntary ethanol intake. Mice were born in our facility and were separated into two housing conditions: isolate housed (one mouse/cage) or group housed (four mice/cage) according to sex. Separate groups were isolated for 40 days starting either at time of weaning postnatal day 21 (PD 21) (early isolation, Experiments 1 and 3) or at adulthood (PD 60: late isolation, Experiment 2). The effects of housing condition on subsequent ethanol intake were assessed starting at around PD 65 in Experiments 1 and 3 or PD 105 days in Experiment 2. In Experiment 3, starting at PD 32, isolate-housed and group-housed mice were either subjected to CVS or left undisturbed. CVS groups experienced random presentations of mild stressors for 14 days, including exposure to an unfamiliar open field, restraint, physical shaking, and forced swim, among others. All mice were tested for ethanol intake for 14 days using a two-bottle choice (ethanol 15% vol/vol vs. water) for a 2-h limited access procedure. Early social isolation resulted in greater ethanol intake compared with the corresponding group-housed mice (Experiment 1). In contrast, social isolation during adulthood (late isolation) did not increase subsequent ethanol intake compared with the corresponding group-housed mice (Experiment 2). For mice that did not experience CVS, early social isolation resulted in greater ethanol intake compared with group-housed mice (Experiment 3). CVS subsequently resulted in a significant increase in ethanol intake in group-housed mice, but CVS failed to further increase ethanol intake in mice that experienced chronic social isolation early in life (Experiment 3). Overall, female mice consumed more ethanol than males, whether isolated (early or late) or group housed. These results indicate that early but not late social isolation can subsequently influence ethanol consumption in C57BL/6J mice. Thus, the developmental timing of chronic social isolation appears to be an important factor in defining later effects on ethanol self-administration behavior. In addition, experience with CVS early in life results in elevated ethanol intake later in adulthood. Taken together, these results emphasize the important role of early stress experiences that modulate later voluntary ethanol intake during adulthood. Copyright © 2011 Elsevier Inc. All rights reserved.

An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol

PubMed Central

Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

2014-01-01

Background Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. Methods A descriptive, comparative (6 months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Results Over the 12 -month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS–EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6 min from 35 to 29 min), admission rate (decreased 6% from 14.5% to 8.5%), increase in β-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). Conclusions The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. PMID:24136123

Early rigorous control interventions can largely reduce dengue outbreak magnitude: experience from Chaozhou, China.

PubMed

Liu, Tao; Zhu, Guanghu; He, Jianfeng; Song, Tie; Zhang, Meng; Lin, Hualiang; Xiao, Jianpeng; Zeng, Weilin; Li, Xing; Li, Zhihao; Xie, Runsheng; Zhong, Haojie; Wu, Xiaocheng; Hu, Wenbiao; Zhang, Yonghui; Ma, Wenjun

2017-08-02

Dengue fever is a severe public heath challenge in south China. A dengue outbreak was reported in Chaozhou city, China in 2015. Intensified interventions were implemented by the government to control the epidemic. However, it is still unknown the degree to which intensified control measures reduced the size of the epidemics, and when should such measures be initiated to reduce the risk of large dengue outbreaks developing? We selected Xiangqiao district as study setting because the majority of the indigenous cases (90.6%) in Chaozhou city were from this district. The numbers of daily indigenous dengue cases in 2015 were collected through the national infectious diseases and vectors surveillance system, and daily Breteau Index (BI) data were reported by local public health department. We used a compartmental dynamic SEIR (Susceptible, Exposed, Infected and Removed) model to assess the effectiveness of control interventions, and evaluate the control effect of intervention timing on dengue epidemic. A total of 1250 indigenous dengue cases was reported from Xiangqiao district. The results of SEIR modeling using BI as an indicator of actual control interventions showed a total of 1255 dengue cases, which is close to the reported number (n = 1250). The size and duration of the outbreak were highly sensitive to the intensity and timing of interventions. The more rigorous and earlier the control interventions implemented, the more effective it yielded. Even if the interventions were initiated several weeks after the onset of the dengue outbreak, the interventions were shown to greatly impact the prevalence and duration of dengue outbreak. This study suggests that early implementation of rigorous dengue interventions can effectively reduce the epidemic size and shorten the epidemic duration.

Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

PubMed

Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

2016-03-01

This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P < 0.05) per TBSA burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P < 0.05). The authors report their promising experience with a newly implemented protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

Feasibility of a Team Approach to Complex Congenital Heart Defect Neurodevelopmental Follow-Up: Early Experience of a Combined Cardiology/Neonatal Intensive Care Unit Follow-Up Program.

PubMed

Chorna, Olena; Baldwin, H Scott; Neumaier, Jamie; Gogliotti, Shirley; Powers, Deborah; Mouvery, Amanda; Bichell, David; Maitre, Nathalie L

2016-07-01

Infants with complex congenital heart disease are at high risk for poor neurodevelopmental outcomes. However, implementation of dedicated congenital heart disease follow-up programs presents important infrastructure, personnel, and resource challenges. We present the development, implementation, and retrospective review of 1- and 2-year outcomes of a Complex Congenital Heart Defect Neurodevelopmental Follow-Up program. This program was a synergistic approach between the Pediatric Cardiology, Cardiothoracic Surgery, Pediatric Intensive Care, and Neonatal Intensive Care Unit Follow-Up teams to provide a feasible and responsible utilization of existing infrastructure and personnel, to develop and implement a program dedicated to children with congenital heart disease. Trained developmental testers administered the Ages and Stages Questionnaire-3 over the phone to the parents of all referred children at least once between 6 and 12 months' corrected age. At 18 months' corrected age, all children were scheduled in the Neonatal Intensive-Care Unit Follow-Up Clinic for a visit with standardized neurological exams, Bayley III, multidisciplinary therapy evaluations and continued follow-up. Of the 132 patients identified in the Cardiothoracic Surgery database and at discharge from the hospital, a total number of 106 infants were reviewed. A genetic syndrome was identified in 23.4% of the population. Neuroimaging abnormalities were identified in 21.7% of the cohort with 12.8% having visibly severe insults. As a result, 23 (26.7%) received first-time referrals for early intervention services, 16 (13.8%) received referrals for new services in addition to their existing ones. We concluded that utilization of existing resources in collaboration with established programs can ensure targeted neurodevelopmental follow-up for all children with complex congenital heart disease. © 2016 American Heart Association, Inc.

Linking mathematics with engineering applications at an early stage - implementation, experimental set-up and evaluation of a pilot project

NASA Astrophysics Data System (ADS)

Rooch, Aeneas; Junker, Philipp; Härterich, Jörg; Hackl, Klaus

2016-03-01

Too difficult, too abstract, too theoretical - many first-year engineering students complain about their mathematics courses. The project MathePraxis aims to resolve this disaffection. It links mathematical methods as they are taught in the first semesters with practical problems from engineering applications - and thereby shall give first-year engineering students a vivid and convincing impression of where they will need mathematics in their later working life. But since real applications usually require more than basic mathematics and first-year engineering students typically are not experienced with construction, mensuration and the use of engineering software, such an approach is hard to realise. In this article, we show that it is possible. We report on the implementation of MathePraxis at Ruhr-Universität Bochum. We describe the set-up and the implementation of a course on designing a mass damper which combines basic mathematical techniques with an impressive experiment. In an accompanying evaluation, we have examined the students' motivation relating to mathematics. This opens up new perspectives how to address the need for a more practically oriented mathematical education in engineering sciences.

Radio-frequency tracking of respiratory equipment: rationale and early experience at the Cleveland Clinic.

PubMed

Stoller, James K; Roberts, Vincent; Matt, David; Chom, Leslie; Sasidhar, Madhu; Chatburn, Robert L

2013-12-01

When respiratory therapists (RTs) seek respiratory care equipment, finding it quickly is desirable, both to expedite patient care and to avert RTs wasting time. To optimize RTs' ability to quickly locate ventilators, we developed and implemented a radio-frequency identification (RFID) tagging system called eTrak. The Clinical Engineering and Information Technology groups at Cleveland Clinic collaboratively developed a Wi-Fi-based RFID program that used active RFID tags. Altogether, 218 ventilators, 82 noninvasive ventilators, and various non-respiratory equipment were tagged, beginning in March 2010. We calculated the difference in time required to locate equipment before versus after implementation. The eTrak system had a mean 145 log-ons per week over the first year of use, and was associated with a decreased time required for RTs to locate ventilators: median 18 min (range 1-45 min) versus 3 min (range 1-6 min) (P < .001). Surveys of RTs regarding whether equipment was hard to find before versus after implementing eTrak showed a non-significant trend toward improvement. An RFID tracking system for respiratory equipment shortened the time to locate ventilators and non-significantly improved RT satisfaction with finding equipment. RFID tagging of equipment warrants further investigation.

[The importance of an early accompanying evaluation of new care forms for the development of indicators for quality assurance in outpatient psychiatric integrated care].

PubMed

Hausen, A; Glaeske, G

2015-05-01

Aim of this contribution is to illustrate the imp-ortance of an early accompanying evaluation of new care forms for the development of indicators. The illustration uses the experience of the accompanying evaluation of the integrated care model for optimisation of outpatient psychiatric care. For the integrated care model we could develop potential indicators by using medical-psychiatric and insured-related routine data, but all potential indicators need further development to enable reliable statements about achieved quality targets. It is shown that the development of indicators in the outpatient psychiatric integrated care is affected by many different factors such as vague target agreements in the contract and missing contractual agreements for the data. As a result it is illustrated that in this project the evaluation was introduced after implementation of this new form of care and the already established contract and the data management impeded the development of indicators. © Georg Thieme Verlag KG Stuttgart · New York.

Exploring Coaching Strategies in a Parent-Implemented Intervention for Toddlers

ERIC Educational Resources Information Center

Brown, Jennifer A.

2012-01-01

Purpose: This study examined the triadic relationships between the early interventionist, the parent and the child in a parent-implemented communication intervention for toddlers. Specifically, relationships between coaching strategies used by interventionists, parents' implementation of communication intervention strategies, child…

Implementation of an Automated System.

ERIC Educational Resources Information Center

Epstein, Susan Baerg

1983-01-01

Discussion of care and planning given to the implementation of an automated library system highlights informing the staff in the early stages, project management, involvement of the entire staff, the control log, time and money, where and when to go online, and implementation consultants. (EJS)

The impact of electronic medical record systems on outpatient workflows: a longitudinal evaluation of its workflow effects.

PubMed

Vishwanath, Arun; Singh, Sandeep Rajan; Winkelstein, Peter

2010-11-01

The promise of the electronic medical record (EMR) lies in its ability to reduce the costs of health care delivery and improve the overall quality of care--a promise that is realized through major changes in workflows within the health care organization. Yet little systematic information exists about the workflow effects of EMRs. Moreover, some of the research to-date points to reduced satisfaction among physicians after implementation of the EMR and increased time, i.e., negative workflow effects. A better understanding of the impact of the EMR on workflows is, hence, vital to understanding what the technology really does offer that is new and unique. (i) To empirically develop a physician centric conceptual model of the workflow effects of EMRs; (ii) To use the model to understand the antecedents to the physicians' workflow expectation from the new EMR; (iii) To track physicians' satisfaction overtime, 3 months and 20 months after implementation of the EMR; (iv) To explore the impact of technology learning curves on physicians' reported satisfaction levels. The current research uses the mixed-method technique of concept mapping to empirically develop the conceptual model of an EMR's workflow effects. The model is then used within a controlled study to track physician expectations from a new EMR system as well as their assessments of the EMR's performance 3 months and 20 months after implementation. The research tracks the actual implementation of a new EMR within the outpatient clinics of a large northeastern research hospital. The pre-implementation survey netted 20 physician responses; post-implementation Time 1 survey netted 22 responses, and Time 2 survey netted 26 physician responses. The implementation of the actual EMR served as the intervention. Since the study was conducted within the same setting and tracked a homogenous group of respondents, the overall study design ensured against extraneous influences on the results. Outcome measures were derived empirically from the conceptual model. They included 85 items that measured physician perceptions of the EMR's workflow effect on the following eight issues: (1) administration, (2) efficiency in patient processing, (3) basic clinical processes, (4) documentation of patient encounter, (5) economic challenges and reimbursement, (6) technical issues, (7) patient safety and care, and (8) communication and confidentiality. The items were used to track expectations prior to implementation and they served as retrospective measures of satisfaction with the EMR in post-implementation Time 1 and Time 2. The findings suggest that physicians conceptualize EMRs as an incremental extension of older computerized provider order entries (CPOEs) rather than as a new innovation. The EMRs major functional advantages are seen to be very similar to, if not the same as, those of CPOEs. Technology learning curves play a statistically significant though minor role in shaping physician perceptions. The physicians' expectations from the EMR are based on their prior beliefs rather than on a rational evaluation of the EMR's fit, functionality, or performance. Their decision regarding the usefulness of the EMR is made very early, within the first few months of use of the EMR. These early perceptions then remain stable and become the lens through which subsequent experience with the EMR is interpreted. The findings suggest a need for communication based interventions aimed at explaining the value, fit, and usefulness of EMRs to physicians early in the pre- and immediate post-EMR implementation stages. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The Vector, Signal, and Image Processing Library (VSIPL): an Open Standard for Astronomical Data Processing

NASA Astrophysics Data System (ADS)

Kepner, J. V.; Janka, R. S.; Lebak, J.; Richards, M. A.

1999-12-01

The Vector/Signal/Image Processing Library (VSIPL) is a DARPA initiated effort made up of industry, government and academic representatives who have defined an industry standard API for vector, signal, and image processing primitives for real-time signal processing on high performance systems. VSIPL supports a wide range of data types (int, float, complex, ...) and layouts (vectors, matrices and tensors) and is ideal for astronomical data processing. The VSIPL API is intended to serve as an open, vendor-neutral, industry standard interface. The object-based VSIPL API abstracts the memory architecture of the underlying machine by using the concept of memory blocks and views. Early experiments with VSIPL code conversions have been carried out by the High Performance Computing Program team at the UCSD. Commercially, several major vendors of signal processors are actively developing implementations. VSIPL has also been explicitly required as part of a recent Rome Labs teraflop procurement. This poster presents the VSIPL API, its functionality and the status of various implementations.

Understanding the Early Transition Needs of Diverse Commencing University Students in a Health Faculty: Informing Effective Intervention Practices

ERIC Educational Resources Information Center

Wilson, Keithia L.; Murphy, Karen A.; Pearson, Andrew G.; Wallace, Barbara M.; Reher, Vanessa G. S.; Buys, Nicholas

2016-01-01

The engagement and retention of commencing students is a longstanding issue in higher education, particularly with the implementation of the widening student participation agenda. The early weeks of the first semester are especially critical to student engagement and early attrition. This study investigated the perceived early transition needs of…

Examining the Impacts of Systematic and Engaging Early Literacy (SEEL): Attention to Teacher Practices and Classroom Effects across the Kindergarten Year

ERIC Educational Resources Information Center

Bingham, Gary E.; Culatta, Barbara; Hall-Kenyon, Kendra M.

2016-01-01

This study examined teachers' implementation of an early literacy intervention, Systematic and Engaging Early Literacy (SEEL), on kindergarten children's development of early literacy skills. One hundred forty-nine kindergarten children (102 treatment) across six classrooms participated in this study. Results reveal that children who received SEEL…

12 CFR 408.4 - Early involvement in foreign activities for which Eximbank financing may be requested.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Early involvement in foreign activities for... Implementing Procedures § 408.4 Early involvement in foreign activities for which Eximbank financing may be requested. (a) Section 1501.2(d) of the NEPA Regulations requires agencies to provide for early involvement...

From Early Starters to Late Finishers? A Longitudinal Study of Early Foreign Language Learning in School

ERIC Educational Resources Information Center

Jaekel, Nils; Schurig, Michael; Florian, Merle; Ritter, Markus

2017-01-01

Foreign language education has now been implemented at the elementary school level across Europe, and early foreign language education has gained traction following language policies set by the European Commission. The long-term effects of an early start, however, have not received ample scientific scrutiny. The present study assessed early…

40 CFR 93.165 - Early emission reduction credit programs at Federal facilities and installation subject to...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Early emission reduction credit... Federal Actions to State or Federal Implementation Plans § 93.165 Early emission reduction credit programs... the SIP or TIP in that area, create an early emissions reductions credit program. The Federal agency...

40 CFR 93.165 - Early emission reduction credit programs at Federal facilities and installation subject to...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Early emission reduction credit... Federal Actions to State or Federal Implementation Plans § 93.165 Early emission reduction credit programs... the SIP or TIP in that area, create an early emissions reductions credit program. The Federal agency...

"Let's Count": Evaluation of a Pilot Early Mathematics Program in Low Socioeconomic Locations in Australia

ERIC Educational Resources Information Center

Perry, Bob; Gervasoni, Ann; Dockett, Sue

2012-01-01

The "Let's Count" pilot early mathematics program was implemented in five early childhood educational contexts across Australia during 2011. The program used specifically formulated materials and workshops to enlist the assistance of early childhood educators to work with parents and other family members of children in their settings to…

75 FR 12221 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-15

... Outcomes: Early Childhood Language Development (ECLD). Frequency: One time. Affected Public: State, Local... Implementation and Outcomes: Early Childhood Language Development (ECLD). Once school districts have been...

75 FR 70931 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-19

... Information Collection Activity; Comment Request Title: Evaluation of Head Start Early Learning Mentor Coach... implementation evaluation of the Head Start Early Learning Mentor-Coach Initiative. The study will collect... awarded funds under the American Recovery and Reinvestment Act of 2009--Early Learning Mentor Coach...

34 CFR 303.501 - Permissive use of funds by the lead agency.

Code of Federal Regulations, 2014 CFR

2014-07-01

... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR... and necessary for implementing the State's early intervention program for infants and toddlers with disabilities including funds— (a) For direct early intervention services for infants and toddlers with...

34 CFR 303.501 - Permissive use of funds by the lead agency.

Code of Federal Regulations, 2013 CFR

2013-07-01

... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR... and necessary for implementing the State's early intervention program for infants and toddlers with disabilities including funds— (a) For direct early intervention services for infants and toddlers with...

34 CFR 303.501 - Permissive use of funds by the lead agency.

Code of Federal Regulations, 2012 CFR

2012-07-01

... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR... and necessary for implementing the State's early intervention program for infants and toddlers with disabilities including funds— (a) For direct early intervention services for infants and toddlers with...

"A palliative end-stage COPD patient does not exist": a qualitative study of barriers to and facilitators for early integration of palliative home care for end-stage COPD.

PubMed

Scheerens, Charlotte; Deliens, Luc; Van Belle, Simon; Joos, Guy; Pype, Peter; Chambaere, Kenneth

2018-06-20

Early integration of palliative home care (PHC) might positively affect people with chronic obstructive pulmonary disease (COPD). However, PHC as a holistic approach is not well integrated in clinical practice at the end-stage COPD. General practitioners (GPs) and community nurses (CNs) are highly involved in primary and home care and could provide valuable perspectives about barriers to and facilitators for early integrated PHC in end-stage COPD. Three focus groups were organised with GPs (n = 28) and four with CNs (n = 28), transcribed verbatim and comparatively analysed. Barriers were related to the unpredictability of COPD, a lack of disease insight and resistance towards care of the patient, lack of cooperation and experience with PHC for professional caregivers, lack of education about early integrated PHC, insufficient continuity of care from hospital to home, and lack of communication about PHC between professional caregivers and with end-stage COPD patients. Facilitators were the use of trigger moments for early integrating PHC, such as after a hospital admission or when an end-stage COPD patient becomes oxygen-dependent or housebound, positive attitudes towards PHC in informal caregivers, more focus on early integration of PHC in professional caregivers' education, implementing advance care planning in healthcare and PHC systems, and enhancing communication about care and PHC. The results provide insights for clinical practice and the development of key components for successful practice in a phase 0-2 Early Integration of PHC for end-stage COPD (EPIC) trial, such as improving care integration, patients' disease insight and training PHC nurses in care for end-stage COPD.

The impact of Early Warning Score and Rapid Response Systems on nurses' competence: An integrative literature review and synthesis.

PubMed

Jensen, Jørghild Karlotte; Skår, Randi; Tveit, Bodil

2018-04-01

To describe, interpret and synthesise the current research findings on the impact of the Early Warning Score and Rapid Response Systems on nurses' competence in identifying and managing deteriorating patients in general hospital wards. As patient safety initiatives designed to ensure the early identification and management of deteriorating patients, the Early Warning Score and Rapid Response Systems have broad appeal. However, it is still unclear how these systems impact nurses' competence when these systems are used in general hospital wards. CINAHL, PubMed, Cochrane, EMBASE and Ovid MEDLINE databases were systematically searched for relevant articles. Articles were appraised, a thematic analysis was conducted, and similar and divergent perspectives on emergent themes and subthemes were extracted by a team of researchers. Thirty-six studies met the inclusion criteria. The analysis of findings showed how the Early Warning Score and Rapid Response Systems impacted three competence areas: (i) Nurses' competence in assessing and caring for patients related to the subthemes: (a) sensing clinical deterioration and (b) the development of skills and knowledge. (ii). Nurses' competence in referring patients, related to the subthemes: (a) deciding whether to summon help and (b) the language and communication lines in the referral process. (ii) Nurses' coping and mastery experiences. The impact of the Early Warning Score and Rapid Response Systems on nurses' competence in identifying and managing deteriorating patients is beneficial but also somewhat contradictory. A greater understanding of nurses' development of competence when using the Early Warning Score and Rapid Response Systems will facilitate the design of implementation strategies and the use of these systems to improve practice. © 2017 John Wiley & Sons Ltd.

Operational Earthquake Forecasting and Earthquake Early Warning: The Challenges of Introducing Scientific Innovations for Public Safety

NASA Astrophysics Data System (ADS)

Goltz, J. D.

2016-12-01

Although variants of both earthquake early warning and short-term operational earthquake forecasting systems have been implemented or are now being implemented in some regions and nations, they have been slow to gain acceptance within the disciplines that produced them as well as among those for whom they were intended to assist. To accelerate the development and implementation of these technologies will require the cooperation and collaboration of multiple disciplines, some inside and others outside of academia. Seismologists, social scientists, emergency managers, elected officials and key opinion leaders from the media and public must be the participants in this process. Representatives of these groups come from both inside and outside of academia and represent very different organizational cultures, backgrounds and expectations for these systems, sometimes leading to serious disagreements and impediments to further development and implementation. This presentation will focus on examples of the emergence of earthquake early warning and operational earthquake forecasting systems in California, Japan and other regions and document the challenges confronted in the ongoing effort to improve seismic safety.

Geriatric hip fracture management: keys to providing a successful program.

PubMed

Basu, N; Natour, M; Mounasamy, V; Kates, S L

2016-10-01

Hip fractures are a common event in older adults and are associated with significant morbidity, mortality and costs. This review examines the necessary elements required to implement a successful geriatric fracture program and identifies some of the barriers faced when implementing a successful program. The Geriatric Fracture Center (GFC) is a treatment model that standardizes the approach to the geriatric fracture patient. It is based on five principles: surgical fracture management; early operative intervention; medical co-management with geriatricians; patient-centered, standard order sets to employ best practices; and early discharge planning with a focus on early functional rehabilitation. Implementing a geriatric fracture program begins with an assessment of the hospital's data on hip fractures and standard care metrics such as length of stay, complications, time to surgery, readmission rates and costs. Business planning is essential along with the medical planning process. To successfully develop and implement such a program, strong physician leadership is necessary to articulate both a short- and long-term plan for implementation. Good communication is essential-those organizing a geriatric fracture program must be able to implement standardized plans of care working with all members of the healthcare team and must also be able to foster relationships both within the hospital and with other institutions in the community. Finally, a program of continual quality improvement must be undertaken to ensure that performance outcomes are improving patient care.

Concerns of Teacher Candidates in an Early Field Experience

ERIC Educational Resources Information Center

Chang, Sau Hou

2009-01-01

The present study examined the concerns of teacher candidates in an early field experience. Thirty-five teacher candidates completed the Teacher Concerns Checklist (TCC, Fuller & Borich, 2000) at the beginning, middle and end of their early field experiences. Results showed that teacher candidates ranked impact as the highest concern, self as…

Examining the Content of Preservice Teachers' Reflections of Early Field Experiences

ERIC Educational Resources Information Center

Subramaniam, Karthigeyan

2013-01-01

This paper describes an exploratory study that examined the content of preservice elementary teachers' reflections of their documented early field experiences of science teaching in authentic contexts. The study used an early field experience model that was focused on the objective of profiling an elementary science teacher as the practical…

ZERO TO THREE Critical Competencies for Infant-Toddler Educators™ ... in Brief

ERIC Educational Resources Information Center

ZERO TO THREE, 2016

2016-01-01

Early experiences matter. The quality of the early care and education provided to young children not only impacts their experiences now, but directly contributes to their future success in school and in life. High-quality early learning experiences require effective educators but attainment and application of these critical knowledge and skills is…

The Importance of Early Experiences: Clinical, Research, and Policy Perspectives

ERIC Educational Resources Information Center

Zeanah, Charles H.

2009-01-01

The degree to which early adverse experiences exert long term effects on development and how much early adversity may be overcome through subsequent experiences are important mental health questions. The clinical, research and policy perspectives on these questions lead to different answers. From a clinical perspective, change is always possible,…

Early Workplace Learning Experiences: What Are the Pedagogical Possibilities beyond Retention and Employability?

ERIC Educational Resources Information Center

Trede, Franziska; McEwen, Celina

2015-01-01

With this paper, we explore early placement experiences and their pedagogical potential, including ways of keeping students enrolled and persisting with their studies. Few university courses offer early placements because traditionally placement experiences have a focus on employability and work readiness of graduates, hence occur towards the end…

Developing a Phonological Awareness Curriculum: Reflections on an Implementation Science Framework

ERIC Educational Resources Information Center

Goldstein, Howard; Olszewski, Arnold

2015-01-01

Purpose: This article describes the process of developing and implementing a supplemental early literacy curriculum designed for preschoolers demonstrating delays in literacy development. Method: Intervention research and implementation research have traditionally been viewed as sequential processes. This article illustrates a process of…

Active Implementation Frameworks for Program Success: How to Use Implementation Science to Improve Outcomes for Children

ERIC Educational Resources Information Center

Metz, Allison; Bartley, Leah

2012-01-01

Over the past decade the science related to developing and identifying evidence-based programs and practices for children and families has improved significantly. However, the science related to implementing these programs in early childhood settings has lagged far behind. In this article, the authors outline how the science of implementation and…

Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery.

PubMed

Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.

Time-Motion Analysis of Clinical Nursing Documentation During Implementation of an Electronic Operating Room Management System for Ophthalmic Surgery

PubMed Central

Read-Brown, Sarah; Sanders, David S.; Brown, Anna S.; Yackel, Thomas R.; Choi, Dongseok; Tu, Daniel C.; Chiang, Michael F.

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design. PMID:24551402

The early effects of Medicare's mandatory hospital pay-for-performance program.

PubMed

Ryan, Andrew M; Burgess, James F; Pesko, Michael F; Borden, William B; Dimick, Justin B

2015-02-01

To evaluate the impact of hospital value-based purchasing (HVBP) on clinical quality and patient experience during its initial implementation period (July 2011-March 2012). Hospital-level clinical quality and patient experience data from Hospital Compare from up to 5 years before and three quarters after HVBP was initiated. Acute care hospitals were exposed to HVBP by mandate while critical access hospitals and hospitals located in Maryland were not exposed. We performed a difference-in-differences analysis, comparing performance on 12 incentivized clinical process and 8 incentivized patient experience measures between hospitals exposed to the program and a matched comparison group of nonexposed hospitals. We also evaluated whether hospitals that were ultimately exposed to HVBP may have anticipated the program by improving quality in advance of its introduction. Difference-in-differences estimates indicated that hospitals that were exposed to HVBP did not show greater improvement for either the clinical process or patient experience measures during the program's first implementation period. Estimates from our preferred specification showed that HVBP was associated with a 0.51 percentage point reduction in composite quality for the clinical process measures (p > .10, 95 percent CI: -1.37, 0.34) and a 0.30 percentage point reduction in composite quality for the patient experience measures (p > .10, 95 percent CI: -0.79, 0.19). We found some evidence that hospitals improved performance on clinical process measures prior to the start of HVBP, but no evidence of this phenomenon for the patient experience measures. The timing of the financial incentives in HVBP was not associated with improved quality of care. It is unclear whether improvement for the clinical process measures prior to the start of HVBP was driven by the expectation of the program or was the result of other factors. © Health Research and Educational Trust.

Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care.

PubMed

O'Malley, Denalee; Hudson, Shawna V; Nekhlyudov, Larissa; Howard, Jenna; Rubinstein, Ellen; Lee, Heather S; Overholser, Linda S; Shaw, Amy; Givens, Sarah; Burton, Jay S; Grunfeld, Eva; Parry, Carly; Crabtree, Benjamin F

2017-02-01

This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models. Snowball sampling was used to identify innovators. Twelve participants (five cancer survivorship primary care innovators and seven content experts) attended a working conference focused on cancer survivorship population strategies and primary care transformation. Data included meeting discussion transcripts/field notes, transcribed in-depth innovator interviews, and innovators' summaries of care models. We used a multistep immersion/crystallization analytic approach, guided by a primary care organizational change model. Innovative practice models included: (1) a consultative model in a primary care setting; (2) a primary care physician (PCP)-led, blended consultative/panel-based model in an oncology setting; (3) an oncology nurse navigator in a primary care practice; and (4) two subspecialty models where PCPs in a general medical practice dedicated part of their patient panel to cancer survivors. Implementation challenges included (1) lack of key stakeholder buy-in; (2) practice resources allocated to competing (non-survivorship) change efforts; and (3) competition with higher priority initiatives incentivized by payers. Cancer survivorship delivery models are potentially feasible in primary care; however, significant barriers to widespread implementation exist. Implementation efforts would benefit from increasing the awareness and potential value-add of primary care-focused strategies to address survivors' needs. Current models of primary care-based cancer survivorship care may not be sustainable. Innovative strategies to provide quality care to this growing population of survivors need to be developed and integrated into primary care settings.

Implementing online quantitative support modules in an intermediate-level course

NASA Astrophysics Data System (ADS)

Daly, J.

2011-12-01

While instructors typically anticipate that students in introductory geology courses enter a class with a wide range of quantitative ability, we often overlook the fact that this may also be true in upper-level courses. Some students are drawn to the subject and experience success in early courses with an emphasis on descriptive geology, then experience frustration and disappointment in mid- and upper-level courses that are more quantitative. To bolster student confidence in quantitative skills and enhance their performance in an upper-level course, I implemented several modules from The Math You Need (TMYN) online resource with a 200-level geomorphology class. Student facility with basic quantitative skills (rearranging equations, manipulating units, and graphing) was assessed with an online pre- and post-test. During the semester, modules were assigned to complement existing course activities (for example, the module on manipulating units was assigned prior to a lab on measurement of channel area and water velocity, then calculation of discharge). The implementation was designed to be a concise review of relevant skills for students with higher confidence in their quantitative abilities, and to provide a self-paced opportunity for students with less quantitative facility to build skills. This course already includes a strong emphasis on quantitative data collection, analysis, and presentation; in the past, student performance in the course has been strongly influenced by their individual quantitative ability. I anticipate that giving students the opportunity to improve mastery of fundamental quantitative skills will improve their performance on higher-stakes assignments and exams, and will enhance their sense of accomplishment in the course.

The evolution of an academic-community partnership in the design, implementation, and evaluation of experience corps® Baltimore city: a courtship model.

PubMed

Tan, Erwin J; McGill, Sylvia; Tanner, Elizabeth K; Carlson, Michelle C; Rebok, George W; Seeman, Teresa E; Fried, Linda P

2014-04-01

Experience Corps Baltimore City (EC) is a product of a partnership between the Greater Homewood Community Corporation (GHCC) and the Johns Hopkins Center on Aging and Health (COAH) that began in 1998. EC recruits volunteers aged 55 and older into high-impact mentoring and tutoring roles in public elementary schools that are designed to also benefit the volunteers. We describe the evolution of the GHCC-COAH partnership through the "Courtship Model." We describe how community-based participatory research principals, such as shared governance, were applied at the following stages: (1) partner selection, (2) getting serious, (3) commitment, and (4) leaving a legacy. EC could not have achieved its current level of success without academic-community partnership. In early stages of the "Courtship Model," GHCC and COAH were able to rely on the trust developed between the leadership of the partner organizations. Competing missions from different community and academic funders led to tension in later stages of the "Courtship Model" and necessitated a formal Memorandum of Understanding between the partners as they embarked on a randomized controlled trial. The GHCC-COAH partnership demonstrates how academic-community partnerships can serve as an engine for social innovation. The partnership could serve as a model for other communities seeking multiple funding sources to implement similar public health interventions that are based on national service models. Unified funding mechanisms would assist the formation of academic-community partnerships that could support the design, implementation, and the evaluation of community-based public health interventions.

Design and Outcomes of a Comprehensive Care Experience Level System to Evaluate and Monitor Dental Students' Clinical Progress.

PubMed

Teich, Sorin T; Roperto, Renato; Alonso, Aurelio A; Lang, Lisa A

2016-06-01

A Comprehensive Care Experience Level (CCEL) system that is aligned with Commission on Dental Accreditation (CODA) standards, promotes comprehensive care and prevention, and addresses flaws observed in previous Relative Value Units (RVU)-based programs has been implemented at the School of Dental Medicine, Case Western Reserve University since 2011. The purpose of this article is to report on the design, implementation, and preliminary outcomes of this novel clinical evaluation system. With the development of the CCEL concept, it was decided not to award points for procedures performed on competency exams. The reason behind this decision was that exams are not learning opportunities and are evaluated with summative tools. To determine reasonable alternative requirements, production data from previous classes were gathered and translated into CCEL points. These RVU points had been granted selectively only for restorative procedures completed after the initial preparation stage of the treatment plan, and achievement of the required levels was checked at multiple points during the clinical curriculum. Results of the CCEL system showed that low performing students increased their productivity, overall production at graduation increased significantly, and fluoride utilization to prevent caries rose by an order of magnitude over the RVU system. The CCEL program also allowed early identification and remediation of students having difficulty in the clinic. This successful implementation suggests that the CCEL concept has the potential for widespread adoption by dental schools. This method also can be used as a behavior modification tool to achieve specific patient care or clinical educational goals as illustrated by the way caries prevention was promoted through the program.

Users' experiences of trauma-focused cognitive behavioural therapy for children and adolescents: a systematic review and metasynthesis of qualitative research.

PubMed

Neelakantan, Lakshmi; Hetrick, Sarah; Michelson, Daniel

2018-05-25

Trauma-focused cognitive behavioural therapy (TF-CBT) is an effective intervention for post-traumatic stress disorder, yet implementation may be hindered by practitioners' concerns about how treatment is experienced by users. This metasynthesis systematically reviews qualitative evidence on youth and caregivers' experiences of TF-CBT to better understand user perspectives on process and outcomes of treatment. A systematic review and metasynthesis were undertaken for qualitative studies of treatment experience related to TF-CBT. Data were extracted according to Evidence for Policy and Practice Information and Coordinating Centre guidelines, and studies were critically appraised using Critical Appraisal Skills Programme checklists. Findings from included studies were coded and synthesized using thematic synthesis methodology. Eight studies were selected after a full-text review of 39 papers. Findings were organised around nine sub-themes, under three broad thematic categories: 'engagement in TF-CBT'; 'experience of treatment components'; and 'therapeutic outcomes'. Youth were often unclear about what to expect from treatment and concerned about (in)compatibility with their therapist. Youth reports indicated how such misgivings can be addressed through early psychoeducation and efforts to strengthen the therapeutic alliance. Once underway, treatment was viewed as a place of refuge and validation, aided by therapist competence and confidentiality. Youth and caregivers felt that constructing a trauma narrative was instrumental for recovery. Cognitive-behavioural coping techniques were useful during treatment and in the long-term. While participants in TF-CBT may begin treatment with unclear expectancies, careful attention to early engagement and other process issues can optimise process and outcomes. Implications for clinical practice and further research are discussed.

Volunteering in dementia care – a Norwegian phenomenological study

PubMed Central

Söderhamn, Ulrika; Landmark, Bjørg; Aasgaard, Live; Eide, Hilde; Söderhamn, Olle

2012-01-01

Introduction The number of people suffering from dementia will increase dramatically in the future, and this will be a great challenge and concern for health care services. It is assumed that volunteers will strengthen community health care services more in the future than they do today. Aim The aim of this study was to elucidate lived experiences of working as a volunteer in an activity center with adapted activities for home-dwelling people with early stage dementia. Methods Qualitative interviews were implemented in a group of nine female volunteers from an activity center in southern Norway. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Results Volunteering in an activity center for home-dwelling people with early stage dementia was reported to provide experiences of being useful and feeling satisfied with performing a good job. It was an advantage for the volunteers to have had experiences from life in general, but also as a health professional or as being the next of kin of a dementia sufferer. It was important for the volunteers to focus on the dementia sufferer and show caring behavior, and interaction with and the appreciation of the health care professionals were also important. The volunteers were motivated by being able to have influence and participate in the planning of the work, to be a part of the social setting, and to learn. However, for some volunteers it was difficult to adjust to an appropriate role. Conclusion In order to promote volunteering in a caring context, mutual trust and freedom should be emphasized. Being conscious of important volunteer characteristics like their experiences, knowledge, and caring behavior, as well as a focus on the staff showing appreciation and providing feedback, may be the difference between success and failure. PMID:22396627

Model-Based Systems Engineering Pilot Program at NASA Langley

NASA Technical Reports Server (NTRS)

Vipavetz, Kevin G.; Murphy, Douglas G.; Infeld, Samatha I.

2012-01-01

NASA Langley Research Center conducted a pilot program to evaluate the benefits of using a Model-Based Systems Engineering (MBSE) approach during the early phase of the Materials International Space Station Experiment-X (MISSE-X) project. The goal of the pilot was to leverage MBSE tools and methods, including the Systems Modeling Language (SysML), to understand the net gain of utilizing this approach on a moderate size flight project. The System Requirements Review (SRR) success criteria were used to guide the work products desired from the pilot. This paper discusses the pilot project implementation, provides SysML model examples, identifies lessons learned, and describes plans for further use on MBSE on MISSE-X.

The Fermi Unix environment -- Dealing with adolescence

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

Pordes, R.; Nicholls, J.; Wicks, M.

1995-10-01

Fermilab`s Computing Division started early in the definition implementation and promulgation of a common environment for Users across the Laboratory`s UNIX platforms and installations. Based on the authors experience over nearly five years, they discuss the status of the effort, ongoing developments and needs, some analysis of where they could have done better, and identify future directions to allow them to provide better and more complete service to their customers. In particular, with the power of the new PCs making enthusiastic converts of physicists to the pc world, they are faced with the challenge of expanding the paradigm to non-UNIXmore » platforms in a uniform and consistent way.« less

Leadership in Undergraduate Medical Education: Training Future Physician Leaders.

PubMed

Clyne, Brian; Rapoza, Brenda; George, Paul

2015-09-01

To confront the challenges facing modern health care, experts and organizations are calling for an increase in physician leadership capabilities. In response to this need, physician leadership programs are proliferating, targeting all levels of experience at all levels of training. Many academic medical centers, major universities, and specialty societies now sponsor physician leadership training programs. To meet this need, The Warren Alpert Medical School of Brown University, as part of its Primary Care-Population Medicine (PC-PM) Program, designed a four-year integrated curriculum, Leadership in Health Care, to engage with leadership topics starting early in the preclinical stages of training. This paper describes the design and implementation of this leadership curriculum for PC-PM students.

Linked symptom monitoring and depression treatment programmes for specialist cancer services: protocol for a mixed-methods implementation study

PubMed Central

Walker, Jane; Burke, Katy; Sevdalis, Nick; Richardson, Alison; Mulick, Amy; Frost, Chris; Sharpe, Michael

2017-01-01

Introduction There is growing awareness that cancer services need to address patients’ well-being as well as treating their cancer. We developed systematic approaches to (1) monitoring patients’ symptoms including depression using a ‘Symptom Monitoring Service’ and (2) providing treatment for those with major depression using a programme called ‘Depression Care for People with Cancer’. Used together, these two programmes were found to be highly effective and cost-effective in clinical trials. The overall aims of this project are to: (1) study the process of introducing these programmes into routine clinical care in a large cancer service, (2) identify the challenges associated with implementation and how these are overcome, (3) determine their effectiveness in a routine non-research setting and (4) describe patients’ and clinicians’ experience of the programmes. Methods and analysis This is a mixed-methods longitudinal implementation study. We will study the process of implementation in three phases (April 2016–December 2018): ‘Pre-implementation’ (setting up of the new programmes), ‘Early Implementation’ (implementation of the programmes in a small number of clinics) and ‘Implementation and Maintenance’ (implementation in the majority of clinics). We will use the following methods of data collection: (1) contemporaneous logs of the implementation process, (2) interviews with healthcare professionals and managers, (3) interviews with patients and (4) routinely collected clinical data. Ethics and dissemination The study has been reviewed by a joint committee of Oxford University Hospitals National Health Service Foundation Trust Research and Development Department and the University of Oxford’s Clinical Trials and Research Governance Department and judged to be service evaluation, not requiring ethics committee approval. The findings of this study will guide the scaling up implementation of the programmes across the UK and will enable us to construct an implementation toolkit. We will disseminate our findings in publications and at relevant national and international conferences. PMID:28674143

Evidence-Based Practices: Providing Guidance for Early Childhood Practitioners

ERIC Educational Resources Information Center

Farley, Kristin S.; Brock, Matthew E.; Winterbottom, Christian

2018-01-01

Early childhood education represents a pivotal opportunity to improve the developmental trajectories of young children, and evidence-based practices (EBPs) are scientifically proven to improve these outcomes. Furthermore, federal law mandates that early childhood practitioners implement EBPs. However, because EBP has not been clearly defined in…

Entitled to What? Public Policy and the Responsibilities of Early Intervention.

ERIC Educational Resources Information Center

Brown, Wesley; Conroy, Maureen

1999-01-01

Examines early-intervention entitlements currently extended by all states. Perspectives from the legislative process, federal and state implementation, judicial interpretation, and professional views are included. Distinctions among the key provisions for differing early intervention service systems are presented, legal cases are reviewed, and…

Collaboration: Putting the Puzzle Pieces Together.

ERIC Educational Resources Information Center

Bruder, Mary Beth

These training materials derive from a personnel preparation special project that developed, implemented, and evaluated a teaching model on collaborations necessary for effective delivery of early intervention. Module 1 provides an overview of the history of early intervention and the legal statutes that define early intervention. Module 2…

Behavioral and neural plasticity caused by early social experiences: the case of the honeybee

PubMed Central

Arenas, Andrés; Ramírez, Gabriela P.; Balbuena, María Sol; Farina, Walter M.

2013-01-01

Cognitive experiences during the early stages of life play an important role in shaping future behavior. Behavioral and neural long-term changes after early sensory and associative experiences have been recently reported in the honeybee. This invertebrate is an excellent model for assessing the role of precocious experiences on later behavior due to its extraordinarily tuned division of labor based on age polyethism. These studies are mainly focused on the role and importance of experiences occurred during the first days of the adult lifespan, their impact on foraging decisions, and their contribution to coordinate food gathering. Odor-rewarded experiences during the first days of honeybee adulthood alter the responsiveness to sucrose, making young hive bees more sensitive to assess gustatory features about the nectar brought back to the hive and affecting the dynamic of the food transfers and the propagation of food-related information within the colony. Early olfactory experiences lead to stable and long-term associative memories that can be successfully recalled after many days, even at foraging ages. Also they improve memorizing of new associative learning events later in life. The establishment of early memories promotes stable reorganization of the olfactory circuits inducing structural and functional changes in the antennal lobe (AL). Early rewarded experiences have relevant consequences at the social level too, biasing dance and trophallaxis partner choice and affecting recruitment. Here, we revised recent results in bees' physiology, behavior, and sociobiology to depict how the early experiences affect their cognition abilities and neural-related circuits. PMID:23986708

Training Early Career Scientists in Flight Instrument Design Through Experiential Learning: NASA Goddard's Planetary Science Winter School.

NASA Technical Reports Server (NTRS)

Bleacher, L. V.; Lakew, B.; Bracken, J.; Brown, T.; Rivera, R.

2017-01-01

The NASA Goddard Planetary Science Winter School (PSWS) is a Goddard Space Flight Center-sponsored training program, managed by Goddard's Solar System Exploration Division (SSED), for Goddard-based postdoctoral fellows and early career planetary scientists. Currently in its third year, the PSWS is an experiential training program for scientists interested in participating on future planetary science instrument teams. Inspired by the NASA Planetary Science Summer School, Goddard's PSWS is unique in that participants learn the flight instrument lifecycle by designing a planetary flight instrument under actual consideration by Goddard for proposal and development. They work alongside the instrument Principal Investigator (PI) and engineers in Goddard's Instrument Design Laboratory (IDL; idc.nasa.gov), to develop a science traceability matrix and design the instrument, culminating in a conceptual design and presentation to the PI, the IDL team and Goddard management. By shadowing and working alongside IDL discipline engineers, participants experience firsthand the science and cost constraints, trade-offs, and teamwork that are required for optimal instrument design. Each PSWS is collaboratively designed with representatives from SSED, IDL, and the instrument PI, to ensure value added for all stakeholders. The pilot PSWS was held in early 2015, with a second implementation in early 2016. Feedback from past participants was used to design the 2017 PSWS, which is underway as of the writing of this abstract.

Integrated community case management in Malawi: an analysis of innovation and institutional characteristics for policy adoption.

PubMed

Rodríguez, Daniela C; Banda, Hastings; Namakhoma, Ireen

2015-12-01

In 2007, Malawi became an early adopter of integrated community case management for childhood illnesses (iCCM), a policy aimed at community-level treatment for malaria, diarrhoea and pneumonia for children below 5 years. Through a retrospective case study, this article explores critical issues in implementation that arose during policy formulation through the lens of the innovation (i.e. iCCM) and of the institutions involved in the policy process. Data analysis is founded on a documentary review and 21 in-depth stakeholder interviews across institutions in Malawi. Findings indicate that the characteristics of iCCM made it a suitable policy to address persistent challenges in child mortality, namely that ill children were not interacting with health workers on a timely basis and consequently were dying in their communities. Further, iCCM was compatible with the Malawian health system due to the ability to build on an existing community health worker cadre of health surveillance assistants (HSAs) and previous experiences with treatment provision at the community level. In terms of institutions, the Ministry of Health (MoH) demonstrated leadership in the overall policy process despite early challenges of co-ordination within the MoH. WHO, United Nations Children's Fund (UNICEF) and implementing organizations played a supportive role in their position as knowledge brokers. Greater challenges were faced in the organizational capacity of the MoH. Regulatory issues around HSA training as well as concerns around supervision and overburdening of HSAs were discussed, though not fully addressed during policy development. Similarly, the financial sustainability of iCCM, including the mechanisms for channelling funding flows, also remains an unresolved issue. This analysis highlights the role of implementation questions during policy development. Despite several outstanding concerns, the compatibility between iCCM as a policy alternative and the local context laid the foundation for Malawi's road to early adoption of iCCM. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Prospects for Interdisciplinary Science Aboard the International Space Station

NASA Technical Reports Server (NTRS)

Robinson, Julie A.

2011-01-01

The assembly of the International Space Station was completed in early 2011, and is now embarking on its first year of the coming decade of use as a laboratory. Two key types of physical science research are enabled by ISS: studies of processes that are normally masked by gravity, and instruments that take advantage of its position as a powerful platform in orbit. The absence of buoyancy-driven convection enables experiments in diverse areas such as fluids near the critical point, Marangoni convection, combustion, and coarsening of metal alloys. The positioning of such a powerful platform in orbit with robotic transfer and instrument support also provides a unique alternative platform for astronomy and physics instruments. Some of the operating or planned instruments related to fundamental physics on the International Space Station include MAXI (Monitoring all-sky X-ray Instrument for ISS), the Alpha Magnetic Spectrometer, CALET (Calorimetric Electron Telescope), and ACES (Atomic Clock Experiment in Space). The presentation will conclude with an overview of pathways for funding different types of experiments from NASA funding to the ISS National Laboratory, and highlights of the streamlining of services to help scientists implement their experiments on ISS.

Experiences and preferences of users with major mental disorders regarding helpful care in situations of mental crisis.

PubMed

Gudde, Camilla Buch; Olsø, Turid Møller; Antonsen, Dag Øivind; Rø, Marit; Eriksen, Lasse; Vatne, Solfrid

2013-03-01

To examine the experiences of and preferences for helpful care in situations of mental crisis from the perspective of people with major mental disorders. Qualitative individual interviews with 19 users with major mental disorder, 13 men and six women, aged 22-60 years. Analysis was conducted with systematic text condensation. The main tendencies among a majority of the users are a clear understanding of their own problems and ways of handling these, and the desire for early help from providers whom they know well and who are open to dialogue and reflection. A clear majority perceived a high threshold for contacting the mental health system due to negative experiences and lack of user involvement in treatment planning and implementation. The findings challenge traditional views of professionalism and describe important implications for mental health services from the user's perspective. Our study provides a clear indication of the importance of becoming an active participant in one's own life, and the need for deeper understanding among the professionals in relation to user experiences and preferences for helpful care in periods of mental health crisis in order to optimize the care.

Parent-Implemented Communication Intervention: Sequential Analysis of Triadic Relationships

ERIC Educational Resources Information Center

Brown, Jennifer A.; Woods, Juliann J.

2016-01-01

Collaboration with parents and caregivers to support young children's communication development is an important component to early intervention services. Coaching parents to implement communication support strategies is increasingly common in parent-implemented interventions, but few studies examine the process as well as the outcomes. We explored…

Implementation of Pediatric Early Warning Score; Adherence to Guidelines and Influence of Context.

PubMed

Almblad, Ann-Charlotte; Siltberg, Petra; Engvall, Gunn; Målqvist, Mats

To describe data of Pediatric Early Warning Score (PEWS) registrations and to evaluate the implementation of PEWS by examining adherence to clinical guidelines based on measured PEWS, and to relate findings to work context. PEWS, as a part of a concept called Early Detection and Treatment-Children (EDT-C) was implemented at three wards at a Children's Hospital in Sweden. Data were collected from the Electronic Patient Record (EPR) retrospectively to assess adherence to guidelines. The Alberta Context Tool (ACT) was used to assess work context among healthcare professionals (n=109) before implementation of EDT-C. The majority of PEWS registrations in EPR were low whereas 10% were moderate to high. Adherences to ward-specific guidelines at admission and for saturation in respiratory distress were high whereas adherence to pain assessment was low. There were significant differences in documented recommended actions between wards. Some differences in leadership and evaluation between wards were identified. Evaluation of PEWS implementation indicated frequent use of the tool despite most scores being low. High scores (5-9) occurred 28 times, which may indicate that patients with a high risk of clinical deterioration were identified. Documentation of the consequent recommended actions was however incomplete and there was a large variation in adherence to guidelines. Contextual factors may have an impact on adherence. EDT-C can lead to increased knowledge about early detection of deterioration, strengthen nurses as professionals, optimize treatment and teamwork and thereby increase patient safety for children treated in hospitals. Copyright © 2017 Elsevier Inc. All rights reserved.

Barriers and facilitators to implementing family support and education in Early Psychosis Intervention programmes: A systematic review.

PubMed

Selick, Avra; Durbin, Janet; Vu, Nhi; O'Connor, Karen; Volpe, Tiziana; Lin, Elizabeth

2017-10-01

Family support is a core component of the Early Psychosis Intervention (EPI) model, yet it continues to have relatively low rates of implementation in practice. This paper reports results of a literature review on facilitators and barriers to delivering family interventions in EPI programmes. A search was conducted of 4 electronic databases, Medline, EMBASE, PsycINFO and Joanna Briggs, from 2000 to 2015 using terms related to early onset psychosis, family work and implementation. Four thousand four hundred and two unique studies were identified, 7 of which met inclusion criteria. Barriers and facilitators were coded and aggregated to higher-level themes using a consensus approach. Five of 7 studies examined structured multifamily psychoeducation. Uptake by families was affected by: family/client interest and readiness to participate; ability to access supports; and support needs/preferences. Implementation by programmes was affected by staff access to training and resources to provide family support. A key finding across the identified studies was that families have different needs and preferences regarding the timing, length, intensity and content of the intervention. One size does not fit all and many families do not require the intensive psychoeducational programmes typically provided. The reviewed literature suggests that flexible, tiered approaches to care may better meet family needs and increase rates of uptake of family support. However, more research is needed on the effectiveness of different models of family support in early psychosis and how they can be successfully implemented. © 2017 John Wiley & Sons Australia, Ltd.

Starting Smart: How Early Experiences Affect Brain Development. An Ounce of Prevention Fund Paper.

ERIC Educational Resources Information Center

Ounce of Prevention Fund.

Recent research has provided great insight into the impact of early experience on brain development. It is now believed that brain growth is highly dependent upon early experiences. Neurons allow communication and coordinated functioning among various brain areas. Brain development after birth consists of an ongoing process of wiring and rewiring…