Virtual worlds as a tool to facilitate weight management for young people

PubMed Central

Taylor, Michael; Taylor, Dave; Kulendran, Myutan; Gately, Paul; Darzi, Ara

2016-01-01

Childhood obesity is a serious problem in the UK, with around 20% of children aged 10-11 being overweight or obese. Lifestyle interventions can be effective, but there is limited evidence of their effectiveness in delivering sustained weight loss. The present research explored potential of web-based, 3-dimensional virtual worlds (VWs) for facilitation of weight-management, well-being and patient and public involvement (PPI) for young people. Attendees of a weight management camp took part in induction sessions for use of the VW of Second Life. All participants successfully learned how to interact with one another and navigate the virtual environment. Participant appraisals of Second Life were varied. Some found it complicated and difficult to use, and some found it fun and the majority stated that they would choose to use VWs again. There is considerable potential for use of VWs to promote weight management, and Second Life or a similar VW could be used to deliver this. Potential barriers include members of the target sample having limited access to computers with necessary system requirements for running VWs, and that some may find VW-based educational experiences unappealing or challenging to navigate. For some however, VWs may provide a useful mode for provision of education, PPI and support relating to weight management. PMID:27540446

Engaging Watershed Stakeholders for Cost-Effective Environmental Management Planning with "Watershed Manager"

ERIC Educational Resources Information Center

Williams, Jeffery R.; Smith, Craig M.; Roe, Josh D.; Leatherman, John C.; Wilson, Robert M.

2012-01-01

"Watershed Manager" is a spreadsheet-based model that is used in extension education programs for learning about and selecting cost-effective watershed management practices to reduce soil, nitrogen, and phosphorus losses from cropland. It can facilitate Watershed Restoration and Protection Strategy (WRAPS) stakeholder groups' development…

Facilitating an L2 Book Club: A Conversation-Analytic Study of Task Management

ERIC Educational Resources Information Center

Ro, Eunseok

2018-01-01

This study employs conversation analysis to examine a facilitator's interactional practices in the post-expansion phase of students' presentations in the context of a book club for second language learning. The analysis shows how the facilitator establishes intersubjectivity with regard to the ongoing task and manages students' task performance.…

Development of a Tool to Measure Youths' Food Allergy Management Facilitators and Barriers.

PubMed

Herbert, Linda Jones; Lin, Adora; Matsui, Elizabeth; Wood, Robert A; Sharma, Hemant

2016-04-01

This study's aims are to identify factors related to allergen avoidance and epinephrine carriage among youth with food allergy, develop a tool to measure food allergy management facilitators and barriers, and investigate its initial reliability and validity.  The Food Allergy Management Perceptions Questionnaire (FAMPQ) was developed based on focus groups with 19 adolescents and young adults with food allergy. Additional youth with food allergy (N = 92; ages: 13-21 years) completed food allergy clinical history and management questionnaires and the FAMPQ.  Internal reliability estimates for the FAMPQ Facilitators and Barriers subscales were acceptable to good. Youth who were adherent to allergen avoidance and epinephrine carriage had higher Facilitator scores. Poor adherence was more likely among youth with higher Barrier scores.  Initial FAMPQ reliability and validity is promising. Additional research is needed to develop FAMPQ clinical guidelines. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Barriers and facilitators to diabetes self-management: perspectives of older community dwellers and health professionals in China.

PubMed

Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wei, Juan

2013-12-01

Little is known about self-management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self-management. The aim of this study was to explore perceived barriers and facilitators to diabetes self-management for both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self-management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstances. © 2013 Wiley Publishing Asia Pty Ltd.

Using multisensory cues to facilitate air traffic management.

PubMed

Ngo, Mary K; Pierce, Russell S; Spence, Charles

2012-12-01

In the present study, we sought to investigate whether auditory and tactile cuing could be used to facilitate a complex, real-world air traffic management scenario. Auditory and tactile cuing provides an effective means of improving both the speed and accuracy of participants' performance in a variety of laboratory-based visual target detection and identification tasks. A low-fidelity air traffic simulation task was used in which participants monitored and controlled aircraft.The participants had to ensure that the aircraft landed or exited at the correct altitude, speed, and direction and that they maintained a safe separation from all other aircraft and boundaries. The performance measures recorded included en route time, handoff delay, and conflict resolution delay (the performance measure of interest). In a baseline condition, the aircraft in conflict was highlighted in red (visual cue), and in the experimental conditions, this standard visual cue was accompanied by a simultaneously presented auditory, vibrotactile, or audiotactile cue. Participants responded significantly more rapidly, but no less accurately, to conflicts when presented with an additional auditory or audiotactile cue than with either a vibrotactile or visual cue alone. Auditory and audiotactile cues have the potential for improving operator performance by reducing the time it takes to detect and respond to potential visual target events. These results have important implications for the design and use of multisensory cues in air traffic management.

Managers' social support: Facilitators and hindrances for seeking support at work.

PubMed

Lundqvist, Daniel; Fogelberg Eriksson, Anna; Ekberg, Kerstin

2018-01-01

Previous research has shown that social support is important for health and performance at work, but there is a lack of research regarding managers' social support at work, and if it needs to be improvedOBJECTIVE:To investigate managers' perception of work-related social support, and facilitators and hindrances that influence their seeking of social support at work. Semi-structured interviews with sixty-two managers in two Swedish organizations. Work-related support, which strengthened their managerial image of being competent, was sought from sources within the workplace. Sensitive and personal support, where there was a risk of jeopardizing their image of being competent, was sought from sources outside the workplace. Access to arenas for support (location of the workplace, meetings, and vocational courses) and the managerial role could facilitate their support-seeking, but could also act as hindrances. Because attending different arenas for support were demanding, they refrained from seeking support if the demands were perceived as too high. Different supportive sources are distinguished based on what supportive function they have and in which arenas they are found, in order to preserve the confidence of the closest organization and to maintain the image of being a competent and performing manager.

Facilitating Sound, Cost-Effective Federal Energy Management

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

FEMP

2016-07-01

Fact sheet offers an overview of the Federal Energy Management Program (FEMP), which provides agencies and organizations with the information, tools, and assistance they need to achieve their energy-related requirements and goals through specialized initiatives.

Technology-facilitated depression care management among predominantly Latino diabetes patients within a public safety net care system: comparative effectiveness trial design.

PubMed

Wu, Shinyi; Ell, Kathleen; Gross-Schulman, Sandra G; Sklaroff, Laura Myerchin; Katon, Wayne J; Nezu, Art M; Lee, Pey-Jiuan; Vidyanti, Irene; Chou, Chih-Ping; Guterman, Jeffrey J

2014-03-01

Health disparities in minority populations are well recognized. Hispanics and Latinos constitute the largest ethnic minority group in the United States; a significant proportion receives their care via a safety net. The prevalence of diabetes mellitus and comorbid depression is high among this group, but the uptake of evidence-based collaborative depression care management has been suboptimal. The study design and baseline characteristics of the enrolled sample in the Diabetes-Depression Care-management Adoption Trial (DCAT) establishes a quasi-experimental comparative effectiveness research clinical trial aimed at accelerating the adoption of collaborative depression care in safety net clinics. The study was conducted in collaboration with the Los Angeles County Department of Health Services at eight county-operated clinics. DCAT has enrolled 1406 low-income, predominantly Hispanic/Latino patients with diabetes to test a translational model of depression care management. This three-group study compares usual care with a collaborative care team support model and a technology-facilitated depression care model that provides automated telephonic depression screening and monitoring tailored to patient conditions and preferences. Call results are integrated into a diabetes disease management registry that delivers provider notifications, generates tasks, and issues critical alerts. All subjects receive comprehensive assessments at baseline, 6, 12, and 18 months by independent English-Spanish bilingual interviewers. Study outcomes include depression outcomes, treatment adherence, satisfaction, acceptance of assessment and monitoring technology, social and economic stress reduction, diabetes self-care management, health care utilization, and care management model cost and cost-effectiveness comparisons. DCAT's goal is to optimize depression screening, treatment, follow-up, outcomes, and cost savings to reduce health disparities. Copyright © 2013 Elsevier Inc. All rights

Facilitators and Barriers to Implementing Clinical Governance: A Qualitative Study among Senior Managers in Iran.

PubMed

Ravaghi, Hamid; Rafiei, Sima; Heidarpour, Peigham; Mohseni, Maryam

2014-09-01

Health care systems should assign quality improvement as their main mission. Clinical governance (CG) is a key strategy to improve quality of health care services. The Iranian Ministry of Health and Medical Education (MOHME) has promoted CG as a framework for safeguarding quality and safety in all hospitals since 2009. The purpose of this study was to explore perceived facilitators and barriers to implementing CG by deputies for curative affairs of Iranian medical universities. A qualitative study was conducted using face to face interviews with a purposeful sample of 43 deputies for curative affairs of Iranian Medical Universities and documents review. Thematic analysis was used to analyze the data. Five themes were explored including: knowledge and attitude toward CG, culture, organizational factors, managerial factors and barriers. The main perceived facilitating factors were adequate knowledge and positive attitude toward CG, supporting culture, managers' commitment, effective communication and well designed incentives. Pe rceived barriers were the reverse of facilitators noted above in addition to insufficient resources, legal challenges, workload and parallel quality programs. Successful implementation of CG in Iran will require identifying barriers and challenges existing in the way of CG implementation and try to mitigate them by using appropriate facilitators.

Exploring the experience of facilitating self-management with minority ethnic stroke survivors: a qualitative study of therapists' perceptions

PubMed Central

Jones, Fiona; Kilbride, Cherry; Victor, Christina

2014-01-01

Purpose: The utility of self-management with people from minority ethnic backgrounds has been questioned, resulting in the development of culturally specific tools. Yet, the use of stroke specific self-management programmes is underexplored in these high risk groups. This article presents the experience of stroke therapists in using a stroke specific self-management programme with stroke survivors from minority ethnic backgrounds. Methods: 26 stroke therapists with experience of using the self-management programme with stroke survivors from minority ethnic backgrounds participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Results: Three themes were identified. One questioned perceived differences in stroke survivors interaction with self-management based on ethnicity. The other themes contrasted with this view demonstrating two areas in which ethnic and cultural attributes were deemed to influence the self-management process both positively and negatively. Aspects of knowledge of health, illness and recovery, religion, family and the professionals themselves are highlighted. Conclusions: This study indicates that ethnicity should not be considered a limitation to the use of an individualized stroke specific self-management programme. However, it highlights potential facilitators and barriers, many of which relate to the capacity of the professional to effectively navigate cultural and ethnic differences. Implications for Rehabilitation Stroke therapists suggest that ethnicity should not be considered a barrier to successful engagement with a stroke specific self-management programme. Health, illness and recovery beliefs along with religion and the specific role of the family do however need to be considered to maximize the effectiveness of the programme. A number of the facilitators and barriers identified are not unique to stroke survivors from ethnic minority communities, nor shared by all. The

Barriers and facilitators to epilepsy self-management for patients with physical and psychological co-morbidity.

PubMed

Perzynski, Adam T; Ramsey, Riane K; Colón-Zimmermann, Kari; Cage, Jamie; Welter, Elisabeth; Sajatovic, Martha

2017-09-01

Objectives This exploratory study identifies barriers and facilitators to self-management to inform future epilepsy self-management interventions for persons who have epilepsy complicated by co-morbid mental health conditions and serious medical events. Methods Focus group methods were used in a series of community advisory board meetings. Analysis was conducted using a thematic, constant comparative approach aiming to describe the range of barriers and facilitators salient to participants. There were a total of 22 participants, including 8 health professionals, 9 patients with epilepsy, and 5 care partners. Mean age was 49.1 (SD = 11.0, range 32-69), 11 (50%) were female, and 11 (50%) were male. For those with epilepsy, mean years having epilepsy was 24.7 (SD = 19.9, range 1-58 years). Results Individual psychological barriers (mental illness, fatigue, and psychological distress) prominently interfered with health behaviors. Community and family barriers included stigma, lack of epilepsy knowledge, and poor social support. Facilitators included planning for seizures, learning about medications, stress management, socializing with others, and talking with other epilepsy patients. Discussion Qualitative evidence in this study suggests a linkage between social integration and positive health behaviors. Future efforts to embed patients with epilepsy and their caregivers into clinical care processes could offset barriers and enhance facilitators.

Managed Hearts? Emotional Labour and the Applied Theatre Facilitator in Urban Settings

ERIC Educational Resources Information Center

Prestona, Sheila

2013-01-01

This paper reflects on Arlie Hochschild's concept of "Emotional Labour" to investigate the emotion work undertaken by artists facilitating participatory arts in urban community settings. The discussion seeks to capture the emotional cost of "managing" feelings to understand the resilient practitioner in wider political…

Facilitating small groups: how to encourage student learning.

PubMed

Kitchen, Mark

2012-02-01

Many clinicians are involved in medical education, with small group teaching (SGT) forming a significant part of their work. Most facilitate these sessions by experience and common sense: less than one-third of them have received formal training in SGT. Evidence suggests small group productivity depends on good facilitation rather than on topic knowledge. Applying the fundamental concepts of SGT will lead to improvements in the quality of clinicians' teaching and in student learning. Good SGT creates the perfect environment for learning and discussion, without the need for didactic teaching. SGT emphasises the role of students in sharing and discussing their ideas in a safe learning environment, without domination by the tutor. This article provides clinicians with basic requirements for effective session design and planning, explains how to encourage student participation, how to manage students as a group, how to manage student learning, and how to recognise and deal with problems. Active facilitation and group management is the key to success in SGT, and consequently better learning outcomes. Improving the facilitation skills of clinical teachers makes teaching more effective, stimulating, and enjoyable for both tutors and students. © Blackwell Publishing Ltd 2012.

The barriers and facilitators people with diabetes from a nonEnglish speaking background experience when managing their medications: a qualitative study.

PubMed

Claydon-Platt, Kate; Manias, Elizabeth; Dunning, Trisha

2014-08-01

To explore the barriers to and facilitators of effective medication management from the perspectives of people with diabetes from a nonEnglish speaking background, carers and health professionals. The barriers that people with diabetes experience managing their medications can adversely impact on health outcomes. People from nonEnglish speaking backgrounds are at risk of medication-related problems, although there is a paucity of research in this area. A qualitative research design using a purposive sampling approach. People with type 1 or type 2 diabetes from a nonEnglish speaking background, their carers, and health professionals who assisted these people and their carers to manage their medications were recruited from the diabetes outpatient clinic at an adult teaching public hospital in Melbourne, Australia. Participants were interviewed using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim and analysed using a thematic framework method. Eleven people with diabetes, 10 carers and 10 health professionals were interviewed, and four key issues were identified: diabetes knowledge, diabetes impact, medication knowledge and medication management. The cost of medications, language barriers that hinder communication, forgetfulness, and poor knowledge and understanding emerged as barriers to effective medication management. Facilitators included the use of dose administration aids to manage medications, but current medication lists were not used. Findings revealed people with diabetes experienced a multitude of barriers when managing their medications, and, despite the problems people experienced, there appeared to be poor use of support aids to assist people to effectively manage their medications. The findings can be used to develop strategies aiming at improving how people from nonEnglish speaking backgrounds manage their medicines. © 2013 John Wiley & Sons Ltd.

Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers

PubMed Central

2011-01-01

Background Chronic diseases are a leading contributor to work disability and job loss in Europe. Recent EU policies aim to improve job retention among chronically ill employees. Disability and occupational health researchers argue that this requires a coordinated and pro-active approach at the workplace by occupational health professionals, line managers (LMs) and human resource managers (HRM). Little is known about the perspectives of LMs an HRM on what is needed to facilitate job retention among chronically ill employees. The aim of this qualitative study was to explore and compare the perspectives of Dutch LMs and HRM on this issue. Methods Concept mapping methodology was used to elicit and map statements (ideas) from 10 LMs and 17 HRM about what is needed to ensure continued employment for chronically ill employees. Study participants were recruited through a higher education and an occupational health services organization. Results Participants generated 35 statements. Each group (LMs and HRM) sorted these statements into six thematic clusters. LMs and HRM identified four similar clusters: LMs and HRM must be knowledgeable about the impact of chronic disease on the employee; employees must accept responsibility for work retention; work adaptations must be implemented; and clear company policy. Thematic clusters identified only by LMs were: good manager/employee cooperation and knowledge transfer within the company. Unique clusters identified by HRM were: company culture and organizational support. Conclusions There were both similarities and differences between the views of LMs and HRM on what may facilitate job retention for chronically ill employees. LMs perceived manager/employee cooperation as the most important mechanism for enabling continued employment for these employees. HRM perceived organizational policy and culture as the most important mechanism. The findings provide information about topics that occupational health researchers and planners should

Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers.

PubMed

Haafkens, Joke A; Kopnina, Helen; Meerman, Martha G M; van Dijk, Frank J H

2011-05-17

Chronic diseases are a leading contributor to work disability and job loss in Europe. Recent EU policies aim to improve job retention among chronically ill employees. Disability and occupational health researchers argue that this requires a coordinated and pro-active approach at the workplace by occupational health professionals, line managers (LMs) and human resource managers (HRM). Little is known about the perspectives of LMs an HRM on what is needed to facilitate job retention among chronically ill employees. The aim of this qualitative study was to explore and compare the perspectives of Dutch LMs and HRM on this issue. Concept mapping methodology was used to elicit and map statements (ideas) from 10 LMs and 17 HRM about what is needed to ensure continued employment for chronically ill employees. Study participants were recruited through a higher education and an occupational health services organization. Participants generated 35 statements. Each group (LMs and HRM) sorted these statements into six thematic clusters. LMs and HRM identified four similar clusters: LMs and HRM must be knowledgeable about the impact of chronic disease on the employee; employees must accept responsibility for work retention; work adaptations must be implemented; and clear company policy. Thematic clusters identified only by LMs were: good manager/employee cooperation and knowledge transfer within the company. Unique clusters identified by HRM were: company culture and organizational support. There were both similarities and differences between the views of LMs and HRM on what may facilitate job retention for chronically ill employees. LMs perceived manager/employee cooperation as the most important mechanism for enabling continued employment for these employees. HRM perceived organizational policy and culture as the most important mechanism. The findings provide information about topics that occupational health researchers and planners should address in developing job retention

Reciprocal Benefits, Legacy and Risk: Applying Ellinger and Bostrom's Model of Line Manager Role Identity as Facilitators of Learning

ERIC Educational Resources Information Center

Campbell, Paul; Evans, Peter

2016-01-01

Purpose: The purpose of this paper is to explore the beliefs held by managers about their roles as facilitators of learning with their employees in a public utilities organisation. Design/methodology/approach: The research was based on Ellinger and Bostrom's (2002) study on managers' beliefs on their role as facilitators of learning in…

A framework for responding to coral disease outbreaks that facilitates adaptive management.

PubMed

Beeden, Roger; Maynard, Jeffrey A; Marshall, Paul A; Heron, Scott F; Willis, Bette L

2012-01-01

Predicted increases in coral disease outbreaks associated with climate change have implications for coral reef ecosystems and the people and industries that depend on them. It is critical that coral reef managers understand these implications and have the ability to assess and reduce risk, detect and contain outbreaks, and monitor and minimise impacts. Here, we present a coral disease response framework that has four core components: (1) an early warning system, (2) a tiered impact assessment program, (3) scaled management actions and (4) a communication plan. The early warning system combines predictive tools that monitor the risk of outbreaks of temperature-dependent coral diseases with in situ observations provided by a network of observers who regularly report on coral health and reef state. Verified reports of an increase in disease prevalence trigger a tiered response of more detailed impact assessment, targeted research and/or management actions. The response is scaled to the risk posed by the outbreak, which is a function of the severity and spatial extent of the impacts. We review potential management actions to mitigate coral disease impacts and facilitate recovery, considering emerging strategies unique to coral disease and more established strategies to support reef resilience. We also describe approaches to communicating about coral disease outbreaks that will address common misperceptions and raise awareness of the coral disease threat. By adopting this framework, managers and researchers can establish a community of practice and can develop response plans for the management of coral disease outbreaks based on local needs. The collaborations between managers and researchers we suggest will enable adaptive management of disease impacts following evaluating the cost-effectiveness of emerging response actions and incrementally improving our understanding of outbreak causation.

A Framework for Responding to Coral Disease Outbreaks that Facilitates Adaptive Management

NASA Astrophysics Data System (ADS)

Beeden, Roger; Maynard, Jeffrey A.; Marshall, Paul A.; Heron, Scott F.; Willis, Bette L.

2012-01-01

Predicted increases in coral disease outbreaks associated with climate change have implications for coral reef ecosystems and the people and industries that depend on them. It is critical that coral reef managers understand these implications and have the ability to assess and reduce risk, detect and contain outbreaks, and monitor and minimise impacts. Here, we present a coral disease response framework that has four core components: (1) an early warning system, (2) a tiered impact assessment program, (3) scaled management actions and (4) a communication plan. The early warning system combines predictive tools that monitor the risk of outbreaks of temperature-dependent coral diseases with in situ observations provided by a network of observers who regularly report on coral health and reef state. Verified reports of an increase in disease prevalence trigger a tiered response of more detailed impact assessment, targeted research and/or management actions. The response is scaled to the risk posed by the outbreak, which is a function of the severity and spatial extent of the impacts. We review potential management actions to mitigate coral disease impacts and facilitate recovery, considering emerging strategies unique to coral disease and more established strategies to support reef resilience. We also describe approaches to communicating about coral disease outbreaks that will address common misperceptions and raise awareness of the coral disease threat. By adopting this framework, managers and researchers can establish a community of practice and can develop response plans for the management of coral disease outbreaks based on local needs. The collaborations between managers and researchers we suggest will enable adaptive management of disease impacts following evaluating the cost-effectiveness of emerging response actions and incrementally improving our understanding of outbreak causation.

The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis.

PubMed

Hughes, Stephen; Lewis, Sophie; Willis, Karen; Rogers, Anne; Wyke, Sally; Smith, Lorraine

2017-12-01

Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

Effective team management by district nurses.

PubMed

Bliss, Julie

2004-12-01

This article considers the key role played by the district nurse in managing the district nursing team in order to provide high quality health care. It considers how the district nurse can use key managerial roles (interpersonal, informational and decision-making) in order to ensure unity within the team. The importance of shared goals and trust to achieve unity is explored and a strategy for managing conflict is discussed. Finally, the article suggests a set of ground rules which could be used to facilitate effective team working.

Understanding Facilitation: Theory and Principles.

ERIC Educational Resources Information Center

Hogan, Christine

This book introduces newcomers to the concept of facilitation, and it presents a critical analysis of established and current theory on facilitation for existing practitioners. The following are among the topics discussed: (1) emergence of the field of facilitation; (2) development of facilitation in management; (3) development of facilitation in…

Interactions among resource partitioning, sampling effect, and facilitation on the biodiversity effect: a modeling approach.

PubMed

Flombaum, Pedro; Sala, Osvaldo E; Rastetter, Edward B

2014-02-01

Resource partitioning, facilitation, and sampling effect are the three mechanisms behind the biodiversity effect, which is depicted usually as the effect of plant-species richness on aboveground net primary production. These mechanisms operate simultaneously but their relative importance and interactions are difficult to unravel experimentally. Thus, niche differentiation and facilitation have been lumped together and separated from the sampling effect. Here, we propose three hypotheses about interactions among the three mechanisms and test them using a simulation model. The model simulated water movement through soil and vegetation, and net primary production mimicking the Patagonian steppe. Using the model, we created grass and shrub monocultures and mixtures, controlled root overlap and grass water-use efficiency (WUE) to simulate gradients of biodiversity, resource partitioning and facilitation. The presence of shrubs facilitated grass growth by increasing its WUE and in turn increased the sampling effect, whereas root overlap (resource partitioning) had, on average, no effect on sampling effect. Interestingly, resource partitioning and facilitation interacted so the effect of facilitation on sampling effect decreased as resource partitioning increased. Sampling effect was enhanced by the difference between the two functional groups in their efficiency in using resources. Morphological and physiological differences make one group outperform the other; once these differences were established further differences did not enhance the sampling effect. In addition, grass WUE and root overlap positively influence the biodiversity effect but showed no interactions.

Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial

PubMed Central

Ell, Kathleen; Jin, Haomiao; Vidyanti, Irene; Chou, Chih-Ping; Lee, Pey-Jiuan; Gross-Schulman, Sandra; Sklaroff, Laura Myerchin; Belson, David; Nezu, Arthur M; Hay, Joel; Wang, Chien-Ju; Scheib, Geoffrey; Di Capua, Paul; Hawkins, Caitlin; Liu, Pai; Ramirez, Magaly; Wu, Brian W; Richman, Mark; Myers, Caitlin; Agustines, Davin; Dasher, Robert; Kopelowicz, Alex; Allevato, Joseph; Roybal, Mike; Ipp, Eli; Haider, Uzma; Graham, Sharon; Mahabadi, Vahid; Guterman, Jeffrey

2018-01-01

Background Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers. Objective The aim of this study was to compare 6-month outcomes of a technology-facilitated care model with a usual care model and a supported care model that involved team-based collaborative depression care for safety-net primary care adult patients with type 2 diabetes. Methods DCAT is a translational study in collaboration with Los Angeles County Department of Health Services, the second largest safety-net care system in the United States. A comparative effectiveness study with quasi-experimental design was conducted in three groups of adult patients with type 2 diabetes to compare three delivery models: usual care, supported care, and technology-facilitated care. Six-month outcomes included depression and diabetes care measures and patient-reported outcomes. Comparative treatment effects were estimated by linear or logistic regression models that used generalized propensity scores to adjust for sampling bias inherent in the nonrandomized design. Results DCAT enrolled 1406 patients (484 in usual care, 480 in supported care, and 442 in technology-facilitated care), most of whom were Hispanic or Latino and female. Compared with usual care, both the supported care and technology-facilitated care groups were associated with significant reduction in depressive symptoms measured by scores on the 9-item Patient Health Questionnaire (least squares estimate, LSE: usual care=6.35, supported

Medical undergraduates’ use of behaviour change talk: the example of facilitating weight management

PubMed Central

2013-01-01

Background Obesity, an increasing problem worldwide, is a leading cause of morbidity and mortality. Management principally requires lifestyle (i.e. behavioural) changes. An evidence-base exists of behaviour change techniques for weight loss; however, in routine practice doctors are often unsure about effective treatments and commonly use theoretically-unfounded communication strategies (e.g. information-giving). It is not known if communication skills teaching during undergraduate training adequately prepares future doctors to engage in effective behaviour change talk with patients. The aim of the study was to examine which behaviour change techniques medical undergraduates use to facilitate lifestyle adjustments in obese patients. Methods Forty-eight medical trainees in their clinical years of a UK medical school conducted two simulated consultations each. Both consultations involved an obese patient scenario where weight loss was indicated. Use of simulated patients (SPs) ensured standardisation of key variables (e.g. barriers to behaviour change). Presentation of scenario order was counterbalanced. Following each consultation, students assessed the techniques they perceived themselves to have used. SPs rated the extent to which they intended to make behavioural changes and why. Anonymised transcripts of the audiotaped consultations were coded by independent assessors, blind to student and SP ratings, using a validated behaviour change taxonomy. Results Students reported using a wide range of evidence-based techniques. In contrast, codings of observed communication behaviours were limited. SPs behavioural intention varied and a range of helpful elements of student’s communication were revealed. Conclusions Current skills-based communication programmes do not adequately prepare future doctors for the growing task of facilitating weight management. Students are able to generalise some communication skills to these encounters, but are over confident and have

The Relationship of Facilitative Functioning to Effective Peer Supervision

ERIC Educational Resources Information Center

Seligman, Linda

1978-01-01

This study investigates peer supervision. The criterion used was counselor trainees' growth in facilitative functioning. The study sought to ascertain whether the facilitative counselor trainee was also the effective peer supervisor, to provide information on evaluating peer-supervisory experience, and to shed light on the most effective…

The New England School Effectiveness Project: A Facilitator's Sourcebook.

ERIC Educational Resources Information Center

Northeast Regional Exchange, Inc., Chelmsford, MA.

The School Team Facilitator assists participating New England secondary schools in planning and implementing improvement efforts based on school effectiveness research. This publication, distributed at a team training conference, begins with the conference schedule, a list of facilitators, instructions on choosing a school team, and letters to…

Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management.

PubMed

Samuel, Cleo A; Turner, Kea; Donovan, Heidi A S; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J

2017-12-01

Adjuvant endocrine therapy (AET) utilization is linked to improved clinical outcomes among breast cancer survivors (BCS); yet, AET adherence rates remain suboptimal. Little is known about provider perspectives regarding barriers and facilitators to AET-related symptom management (SM). In this study, we examined provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. We conducted three focus groups (FGs) with a multidisciplinary group of healthcare providers (n = 13) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM. FGs were audiotaped, transcribed, and analyzed using qualitative software to identify key themes. Providers described patient-, provider-, and system-level barriers and facilitators to AET-related SM. At the patient-level, barriers included competing demands, limited time/resources, and possible misattribution of some symptoms to AET, while family/social relationships and insurance emerged as important facilitators. Discomfort with SM, limited time, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Provider-level facilitators included routine symptom documentation and strong provider relationships. Care fragmentation and complexity of the cancer care delivery system were described as system-level barriers; however, survivor clinics were endorsed by providers. Provider perspectives on AET-related SM can shed light on SM barriers and facilitators spanning multiple levels of the cancer care delivery system. Strategies for improving AET-related SM in BCS include increasing patients' knowledge and engagement in SM, equipping providers with efficient SM strategies, and improving coordination of symptom-related services through survivorship programs.

AMModels: An R package for storing models, data, and metadata to facilitate adaptive management

PubMed Central

Katz, Jonathan E.

2018-01-01

Agencies are increasingly called upon to implement their natural resource management programs within an adaptive management (AM) framework. This article provides the background and motivation for the R package, AMModels. AMModels was developed under R version 3.2.2. The overall goal of AMModels is simple: To codify knowledge in the form of models and to store it, along with models generated from numerous analyses and datasets that may come our way, so that it can be used or recalled in the future. AMModels facilitates this process by storing all models and datasets in a single object that can be saved to an .RData file and routinely augmented to track changes in knowledge through time. Through this process, AMModels allows the capture, development, sharing, and use of knowledge that may help organizations achieve their mission. While AMModels was designed to facilitate adaptive management, its utility is far more general. Many R packages exist for creating and summarizing models, but to our knowledge, AMModels is the only package dedicated not to the mechanics of analysis but to organizing analysis inputs, analysis outputs, and preserving descriptive metadata. We anticipate that this package will assist users hoping to preserve the key elements of an analysis so they may be more confidently revisited at a later date. PMID:29489825

AMModels: An R package for storing models, data, and metadata to facilitate adaptive management.

PubMed

Donovan, Therese M; Katz, Jonathan E

2018-01-01

Agencies are increasingly called upon to implement their natural resource management programs within an adaptive management (AM) framework. This article provides the background and motivation for the R package, AMModels. AMModels was developed under R version 3.2.2. The overall goal of AMModels is simple: To codify knowledge in the form of models and to store it, along with models generated from numerous analyses and datasets that may come our way, so that it can be used or recalled in the future. AMModels facilitates this process by storing all models and datasets in a single object that can be saved to an .RData file and routinely augmented to track changes in knowledge through time. Through this process, AMModels allows the capture, development, sharing, and use of knowledge that may help organizations achieve their mission. While AMModels was designed to facilitate adaptive management, its utility is far more general. Many R packages exist for creating and summarizing models, but to our knowledge, AMModels is the only package dedicated not to the mechanics of analysis but to organizing analysis inputs, analysis outputs, and preserving descriptive metadata. We anticipate that this package will assist users hoping to preserve the key elements of an analysis so they may be more confidently revisited at a later date.

Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.

PubMed

Taylor, Erin Fries; Machta, Rachel M; Meyers, David S; Genevro, Janice; Peikes, Deborah N

2013-01-01

Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating their quality improvement activities and help build capacity for those activities-reflecting a systems-level approach to improving quality, safety, and implementation of evidence-based practices. Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care.

Designing and delivering facilitated storytelling interventions for chronic disease self-management: a scoping review.

PubMed

Gucciardi, Enza; Jean-Pierre, Nicole; Karam, Grace; Sidani, Souraya

2016-07-11

Little is known about how to develop and deliver storytelling as an intervention to support those managing chronic illnesses. This scoping review aims to describe the core elements of storytelling interventions in order to help facilitate its implementation. A scoping review was conducted in seven databases for articles published up to May 2014 to identify interventions that describe in detail how storytelling was used to support people in disease self-management interventions. Ten articles met all inclusion criteria. Core elements consistently observed across the storytelling interventions were: reflection and interactive meaning-making of experiences; principles of informality and spontaneity; non-directional and non-hierarchical facilitation; development of group norms and conduct to create a community among participants; and both an individual and collective role for participants. Differences were also observed across interventions, such as: the conceptual frameworks that directed the design of the intervention; the type and training of facilitators; intervention duration; and how session topics were selected and stories delivered. Furthermore, evaluation of the intervention and outcome assessment varied greatly across studies. The use of storytelling can be a novel intervention to enhance chronic disease self-management. The core elements identified in the review inform the development of the intervention to be more patient-centred by guiding participants to take ownership of and lead the intervention, which differs significantly from traditional support groups. Storytelling has the potential to provide patients with a more active role in their health care by identifying their specific needs as well as gaps in knowledge and skills, while allowing them to form strong bonds with peers who share similar disease-related experiences. However, measures of impact differed across interventions given the variation in chronic conditions. Our findings can guide future

Facilitating Facilitators: Enhancing PBL through a Structured Facilitator Development Program

ERIC Educational Resources Information Center

Salinitri, Francine D.; Wilhelm, Sheila M.; Crabtree, Brian L.

2015-01-01

With increasing adoption of the problem-based learning (PBL) model, creative approaches to enhancing facilitator training and optimizing resources to maintain effective learning in small groups is essential. We describe a theoretical framework for the development of a PBL facilitator training program that uses the constructivist approach as the…

Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial.

PubMed

Wu, Shinyi; Ell, Kathleen; Jin, Haomiao; Vidyanti, Irene; Chou, Chih-Ping; Lee, Pey-Jiuan; Gross-Schulman, Sandra; Sklaroff, Laura Myerchin; Belson, David; Nezu, Arthur M; Hay, Joel; Wang, Chien-Ju; Scheib, Geoffrey; Di Capua, Paul; Hawkins, Caitlin; Liu, Pai; Ramirez, Magaly; Wu, Brian W; Richman, Mark; Myers, Caitlin; Agustines, Davin; Dasher, Robert; Kopelowicz, Alex; Allevato, Joseph; Roybal, Mike; Ipp, Eli; Haider, Uzma; Graham, Sharon; Mahabadi, Vahid; Guterman, Jeffrey

2018-04-23

Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers. The aim of this study was to compare 6-month outcomes of a technology-facilitated care model with a usual care model and a supported care model that involved team-based collaborative depression care for safety-net primary care adult patients with type 2 diabetes. DCAT is a translational study in collaboration with Los Angeles County Department of Health Services, the second largest safety-net care system in the United States. A comparative effectiveness study with quasi-experimental design was conducted in three groups of adult patients with type 2 diabetes to compare three delivery models: usual care, supported care, and technology-facilitated care. Six-month outcomes included depression and diabetes care measures and patient-reported outcomes. Comparative treatment effects were estimated by linear or logistic regression models that used generalized propensity scores to adjust for sampling bias inherent in the nonrandomized design. DCAT enrolled 1406 patients (484 in usual care, 480 in supported care, and 442 in technology-facilitated care), most of whom were Hispanic or Latino and female. Compared with usual care, both the supported care and technology-facilitated care groups were associated with significant reduction in depressive symptoms measured by scores on the 9-item Patient Health Questionnaire (least squares estimate, LSE: usual care=6.35, supported care=5.05, technology-facilitated care=5

Facilitating adaptive management in a government program: A household energy efficiency case study.

PubMed

Curtis, Jim; Graham, Alex; Ghafoori, Eraj; Pyke, Susan; Kaufman, Stefan; Boulet, Mark

2017-02-01

Interim evaluations of government programs can sometimes reveal lower than expected outcomes, leading to the question of how adjustments can be made while the program is still underway. Although adaptive management frameworks can provide a practical roadmap to address this question, a lack of successful learnings and poor implementation have hampered the progress and wider application of adaptive management. Using a case study involving an energy efficiency government program targeting low-income households, this article provides supporting evidence on how adaptive management can be facilitated and applied. Factors such as proactive and responsive leadership, establishing a research-practice interface, and recognizing the skills, expertise, and contributions of multiple stakeholders guided adjustments to the program, and later paved the way for longer-term organizational learning that impacted how other programs are delivered. Implications for knowledge and practice, and a discussion of the challenges faced in the program, advance current thinking in adaptive management. Copyright © 2016 Elsevier Ltd. All rights reserved.

Chronic care model for the management of depression: synthesis of barriers to, and facilitators of, success.

PubMed

Holm, Anne Lise; Severinsson, Elisabeth

2012-12-01

Depression is a socially- and physically-disabling condition. The Chronic Care Model (CCM) was developed to promote better management of long-term conditions, such as depression, in primary care settings. The aim of the study was to identify barriers to, and facilitators of, success when implementing the CCM for the management of depression in primary care. A systematic search was conducted in electronic databases from January 2005 to December 2011. Thirteen articles met the inclusion criteria and were reviewed by means of a thematic analysis. The barriers were categorized under two themes: lack of organizational, administrative, and professional ability to change and implement the components of the CCM; and lack of clarity pertaining to the responsibility inherent in the role of care manager (often a nurse) when it comes to promoting the patient's self-management ability. In terms of the facilitators of success, two themes emerged: leadership support and vision, and redesigning the delivery system. When shaping an environment for organizational change, leadership and professionals must work towards a common goal and vision. Such processes require a care manager with a clear role and responsibilities in order for the health-care system to meet the needs of the person with depression. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Event-related potentials dissociate facilitation and interference effects in the numerical Stroop paradigm.

PubMed

Szucs, Dénes; Soltész, Fruzsina

2007-11-05

In the numerical Stroop paradigm (NSP) participants compare simultaneously presented Arabic digits based on either their numerical or on their physical size dimension. Responses are faster when the numerical and size dimensions are congruent with each other (facilitation), and responses are slower when the numerical and size dimensions are incongruent with each other (interference). We aimed to find out whether facilitation and interference appears during the course of perceptual or response processing. To this end, facilitation and interference effects in the amplitude of event-related brain potentials (ERPs) were examined. The onset of motor preparation was determined by monitoring the lateralized readiness potential. In numerical comparison one facilitation effect was related to perceptual processing at the level of the magnitude representation. A second facilitation effect and interference effects appeared during response processing. In size comparison facilitation and interference appeared exclusively during response processing. In both tasks, ERP interference effects were probably related to contextual analysis and to the conflict monitoring and selection for action activity of the anterior cingulate cortex. The results demonstrate that facilitation and interference effects in the NSP appear during multiple stages of processing, and that they are related to different cognitive processes. Therefore these effects should be clearly separated in studies of the NSP. A model of the processes involved in the NSP is provided and implications for studies of the NSP are drawn.

AMModels: An R package for storing models, data, and metadata to facilitate adaptive management

USGS Publications Warehouse

Donovan, Therese M.; Katz, Jonathan

2018-01-01

Agencies are increasingly called upon to implement their natural resource management programs within an adaptive management (AM) framework. This article provides the background and motivation for the R package, AMModels. AMModels was developed under R version 3.2.2. The overall goal of AMModels is simple: To codify knowledge in the form of models and to store it, along with models generated from numerous analyses and datasets that may come our way, so that it can be used or recalled in the future. AMModels facilitates this process by storing all models and datasets in a single object that can be saved to an .RData file and routinely augmented to track changes in knowledge through time. Through this process, AMModels allows the capture, development, sharing, and use of knowledge that may help organizations achieve their mission. While AMModels was designed to facilitate adaptive management, its utility is far more general. Many R packages exist for creating and summarizing models, but to our knowledge, AMModels is the only package dedicated not to the mechanics of analysis but to organizing analysis inputs, analysis outputs, and preserving descriptive metadata. We anticipate that this package will assist users hoping to preserve the key elements of an analysis so they may be more confidently revisited at a later date.

Facilitators and Barriers to the Achievement of Healthy Lifestyle Goals: Qualitative Findings From Australian Parents Enrolled in the PEACH Child Weight Management Program.

PubMed

Perry, Rebecca Anne; Daniels, Lynne Anne; Bell, Lucinda; Magarey, Anthea Margaret

2017-01-01

To describe the qualitative research methods used in the Parenting Eating and Activity for Child Health (PEACH) randomized controlled trial and to examine parent-reported facilitators and barriers to the achievement of program goals. Qualitative study using semistructured interviews. Parents enrolled in the Australian PEACH randomized controlled trial, a family-focused child weight management program conducted blinded for review. A total of 95 parents of overweight children aged 5-10 years participated in face-to-face semistructured interviews. Factors external to the PEACH intervention that facilitated or inhibited their success. Interviews were recorded, transcribed, and analyzed using thematic analysis techniques. Three facilitator themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors. Six barrier themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors; (4) maintenance and managing special occasions; (5) time management challenges; and (6) inconsistencies or lack of support. The social and environmental barriers and time pressures identified by parents are a common feature of Western family life such that many parents are raising families in stressful situations. Insights provided by this qualitative research provide an important understanding of these experiences. Consideration of such issues in the design and implementation of future child weight management interventions may help to increase the acceptability and effectiveness of such programs. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Community-Based Solid Waste Management: A Training Facilitator's Guide.

ERIC Educational Resources Information Center

Peace Corps, Washington, DC. Information Collection and Exchange Div.

Urban environmental management and environmental health issues are of increasing concern worldwide. The need for urban environmental management work at the local level where the Peace Corps works most effectively is significant, but training materials dedicated specifically to community-based solid waste management work in urban areas are lacking.…

Mobilizing and Managing Social Capital: On Roles and Responsibilities of Local Facilitators in Territorial Development

ERIC Educational Resources Information Center

Schermer, Markus; Kirchengast, Christoph; Petit, Sandrine; Magnani, Natalia; Mieville-Ott, Valerie

2010-01-01

The paper explores the difficulties and challenges in mobilizing and managing social capital in concrete local and territorial directed rural development project activities. The main focus is put on the roles of local facilitators working with farmers and other local stakeholders during project implementation. The EU 5th framework project IMALP…

Implementing a Lean Management System in Primary Care: Facilitators and Barriers From the Front Lines.

PubMed

Hung, Dorothy; Martinez, Meghan; Yakir, Maayan; Gray, Caroline

2015-01-01

Although Lean management techniques are increasingly used in health care to improve quality and reduce costs, lessons about how to successfully implement this approach on the front lines of care delivery are not well documented. In this study, we highlight key facilitators and barriers to implementing Lean among frontline primary care providers. This case study took place at a large, ambulatory care delivery system serving nearly 1 million patients. In-depth interviews were conducted with primary care physicians, staff, and administrators to identify key factors impacting Lean redesigns in primary care. Overall, staff engagement and performance management, sensitivity to the professional values and culture of medicine, and perceived adequacy of organizational resources were critical when introducing Lean changes. Specific drivers of change included empowerment of staff at all levels, visual display of performance metrics, and a culture of innovation and collaboration. Barriers included physician resistance to standardized work, difficulty transferring management responsibilities to non-physician staff, and time and staffing required for participating in improvement efforts. Although Lean offers a new approach to delivering care, the implementation process itself is both complex and crucial to success. Understanding early facilitators and barriers can maximize Lean's, potential to improve health care delivery.

Facilitated family presence at resuscitation: effectiveness of a nursing student toolkit.

PubMed

Kantrowitz-Gordon, Ira; Bennett, Deborah; Wise Stauffer, Debra; Champ-Gibson, Erla; Fitzgerald, Cynthia; Corbett, Cynthia

2013-10-01

Facilitated family presence at resuscitation is endorsed by multiple nursing and specialty practice organizations. Implementation of this practice is not universal so there is a need to increase familiarity and competence with facilitated family presence at resuscitation during this significant life event. One strategy to promote this practice is to use a nursing student toolkit for pre-licensure and graduate nursing students. The toolkit includes short video simulations of facilitated family presence at resuscitation, a PowerPoint presentation of evidence-based practice, and questions to facilitate guided discussion. This study tested the effectiveness of this toolkit in increasing nursing students' knowledge, perceptions, and confidence in facilitated family presence at resuscitation. Nursing students from five universities in the United States completed the Family Presence Risk-Benefit Scale, Family Presence Self-Confidence Scale, and a knowledge test before and after the intervention. Implementing the facilitated family presence at resuscitation toolkit significantly increased nursing students' knowledge, perceptions, and confidence related to facilitated family presence at resuscitation (p<.001). The effect size was large for knowledge (d=.90) and perceptions (d=1.04) and moderate for confidence (d=.51). The facilitated family presence at resuscitation toolkit used in this study had a positive impact on students' knowledge, perception of benefits and risks, and self-confidence in facilitated family presence at resuscitation. The toolkit provides students a structured opportunity to consider the presence of family members at resuscitation prior to encountering this situation in clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Text messaging to support off-campus clinical nursing facilitators: a descriptive survey.

PubMed

Howard, Christine; Fox, Amanda R; Coyer, Fiona

2014-06-01

Managing large student cohorts can be a challenge for university academics, coordinating these units. Bachelor of Nursing programmes have the added challenge of managing multiple groups of students and clinical facilitators whilst completing clinical placement. Clear, time efficient and effective communication between coordinating academics and clinical facilitators is needed to ensure consistency between student and teaching groups and prompt management of emerging issues. This study used a descriptive survey to explore the use of text messaging via a mobile phone, sent from coordinating academics to off-campus clinical facilitators, as an approach to providing direction and support. The response rate was 47.8% (n=22). Correlations were found between the approachability of the coordinating academic and clinical facilitator perception that, a) the coordinating academic understood issues on clinical placement (r=0.785, p<0.001), and b) being part of the teaching team (r=0.768, p<0.001). Analysis of responses to qualitative questions revealed three themes: connection, approachability and collaboration. This study demonstrates that use of regular text messages improves communication between coordinating academics and clinical facilitators. Findings suggest improved connection, approachability and collaboration between the coordinating academic and clinical facilitation staff. Copyright © 2014 Elsevier Ltd. All rights reserved.

The facilitating effect of positive emotions during an emotional Stroop task.

PubMed

Liu, Xingyu; Yang, Yisheng; Jiang, Songxiu; Li, Jie

2018-05-08

Prior research has shown that negative emotions, even though task irrelevant, are capable of delaying a participant's response to the color in which a negative emotional word is presented, a phenomenon known as the 'emotional Stroop effect'. However, relatively little is known about whether positive emotions have a similar or an opposite effect. The current study sets out to confirm the facilitating effect of positive emotions on color naming, which is predicted by Barbara Fredrickson's 'broaden and build' theory. Our results indicate that positive emotions did facilitate such processing in both of the study's experiments. We also found a significant difference in early posterior negativity amplitudes between positive and neutral stimuli, which was related to the 'fast effect'. Overall, the study's findings suggest that positive emotions can be detected quickly and automatically, and that this kind of prioritizing facilitates the ongoing cognitive processing.

A proposal for amending administrative law to facilitate adaptive management

USGS Publications Warehouse

Craig, Robin K.; Ruhl, J.B.; Brown, Eleanor D.; Williams, Byron K.

2017-01-01

In this article we examine how federal agencies use adaptive management. In order for federal agencies to implement adaptive management more successfully, administrative law must adapt to adaptive management, and we propose changes in administrative law that will help to steer the current process out of a dead end. Adaptive management is a form of structured decision making that is widely used in natural resources management. It involves specific steps integrated in an iterative process for adjusting management actions as new information becomes available. Theoretical requirements for adaptive management notwithstanding, federal agency decision making is subject to the requirements of the federal Administrative Procedure Act, and state agencies are subject to the states' parallel statutes. We argue that conventional administrative law has unnecessarily shackled effective use of adaptive management. We show that through a specialized 'adaptive management track' of administrative procedures, the core values of administrative law—especially public participation, judicial review, and finality— can be implemented in ways that allow for more effective adaptive management. We present and explain draft model legislation (the Model Adaptive Management Procedure Act) that would create such a track for the specific types of agency decision making that could benefit from adaptive management.

Older adults are mobile too!Identifying the barriers and facilitators to older adults' use of mHealth for pain management.

PubMed

Parker, Samantha J; Jessel, Sonal; Richardson, Joshua E; Reid, M Cary

2013-05-06

Mobile health (mHealth) is a rapidly emerging field with the potential to assist older adults in the management of chronic pain (CP) through enhanced communication with providers, monitoring treatment-related side effects and pain levels, and increased access to pain care resources. Little is currently known, however, about older adults' attitudes and perceptions of mHealth or perceived barriers and facilitators to using mHealth tools to improve pain management. We conducted six focus groups comprised of 41 diverse older adults (≥60 years of age) with CP. Participants were recruited from one primary care practice and two multiservice senior community day-visit centers located in New York City that serve older adults in their surrounding neighborhoods. Focus group discussions were recorded and transcribed, and transcriptions were analyzed using direct content analysis to identify and quantify themes. Focus group discussions generated 38 individual themes pertaining to the use of mHealth to help manage pain and pain medications. Participants had low prior use of mHealth (5% of participants), but the vast majority (85%) were highly willing to try the devices. Participants reported that mHealth devices might help them reach their healthcare provider more expeditiously (27%), as well as help to monitor for falls and other adverse events in the home (15%). Barriers to device use included concerns about the cost (42%) and a lack of familiarity with the technology (32%). Facilitators to device use included training prior to device use (61%) and tailoring devices to the functional needs of older adults (34%). This study suggests that older adults with CP are interested and willing to use mHealth to assist in the management of pain. Participants in our study reported important barriers that medical professionals, researchers, and mHealth developers should address to help facilitate the development and evaluation of age-appropriate, and function-appropriate, m

Virtual OD: Facilitating Groups Online

ERIC Educational Resources Information Center

Milton, Judy; Watkins, Karen E.; Daley, Barbara J.

2005-01-01

This study examined the role of facilitators in nine virtual action learning groups. A qualitative analysis of the facilitators' interventions across all groups resulted in a typology that included group management, group process, and support interventions. A model showing the relationship among these categories proposes that effective…

Effectiveness of participatory planning for community management of fisheries in Bangladesh.

PubMed

Sultana, Parvin; Abeyasekera, Savitri

2008-01-01

This study provides statistical evidence that support for community-based management of resources was more effective when initiated through a process known as participatory action plan development (PAPD). Thirty-six sites were studied where community management of fisheries was facilitated by NGOs. All involved community participation and establishing local fisheries management institutions. However, communities were able to take up more conservation-related interventions and faced fewer conflicts in the 18 sites where a PAPD was the basis for collective action and institution development. This indicates the value and effectiveness of adopting good practice in participatory planning, such as PAPD, which helps diverse stakeholders find common problems and solutions for natural resource management.

A qualitative study of a primary-care based intervention to improve the management of patients with heart failure: the dynamic relationship between facilitation and context.

PubMed

Tierney, Stephanie; Kislov, Roman; Deaton, Christi

2014-09-18

There is currently a growing emphasis in primary care on upscaling the provision of evidence-based services for specific conditions, such as heart failure (HF), which have traditionally been seen as part of a specialist's domain. While contextual challenges associated with improvement in primary care have been documented previously, we still know relatively little about how the intentional, theory-informed facilitation of evidence-based change is shaped by contextual factors within this healthcare setting. Hence, a qualitative study was conducted to address the question: How is the process of facilitating evidence-based practice affected by the context of primary care? Data collection took place across general practices in northwest England as part of a process evaluation of the Greater Manchester HF Investigation Tool (GM-HFIT) - a programme of work aiming to improve the management of HF in primary care. Semi-structured interviews, with purposefully selected GM-HFIT team members (n = 9) and primary care practitioners (n = 7), were supplemented by observational data and a three-month diary reflecting on facilitation activities. Framework analysis was used to manage and interpret data. We describe a complex and dynamic interplay between facilitation and context, focusing on three major themes: (1) Addressing macro and micro agendas; (2) Forming a facilitative unit; (3) Maintaining momentum. We show that HF specialist nurses (HFSNs) have a high level of professional credibility, which allows them to play a key role in making recommendations to practices for improving patient care. At the same time, we argue that contextual factors, such as top-level endorsement, the necessity to comply with a performance measurement system, and the varying involvement of practice nurses produce tensions that can have both an enabling and constraining effect on the process of facilitation. When facilitating the transfer of evidence, context is an important aspect to consider

Increasing engagement with, and effectiveness of, an online CBT-based stress management intervention for employees through the use of an online facilitated bulletin board: study protocol for a pilot randomised controlled trial.

PubMed

Carolan, Stephany; Harris, Peter R; Greenwood, Kathryn; Cavanagh, Kate

2016-12-15

The evidence for the benefits of online cognitive behaviour therapy (CBT)-based programmes delivered in a clinical context is clear, but this evidence does not translate to online CBT-based stress management programmes delivered within a workplace context. One of the challenges to the delivery of online interventions is programme engagement; this challenge is even more acute for interventions delivered in real-world settings such as the workplace. The purpose of this pilot study is to explore the effect of an online facilitated discussion group on engagement, and to estimate the potential effectiveness of an online CBT-based stress management programme. This study is a three-arm randomised controlled trial (RCT) comparing a minimally guided, online, CBT-based stress management intervention delivered with and without an online facilitated bulletin board, and a wait list control group. Up to 90 employees from six UK-based organisations will be recruited to the study. Inclusion criteria will include age 18 years or over, elevated levels of stress (as measured on the PSS-10 scale), access to a computer or a tablet and the Internet. The primary outcome measure will be engagement, as defined by the number of logins to the site; secondary outcome measures will include further measures of engagement (the number of pages visited, the number of modules completed and self-report engagement) and measures of effectiveness (psychological distress and subjective wellbeing). Possible moderators will include measures of intervention quality (satisfaction, acceptability, credibility, system usability), time pressure, goal conflict, levels of distress at baseline and job autonomy. Measures will be taken at baseline, 2 weeks (credibility and expectancy measures only), 8 weeks (completion of intervention) and 16 weeks (follow-up). Primary analysis will be conducted on intention-to-treat principles. To our knowledge this is the first study to explore the effect of an online

A proposal for amending administrative law to facilitate adaptive management

NASA Astrophysics Data System (ADS)

Craig, Robin K.; Ruhl, J. B.; Brown, Eleanor D.; Williams, Byron K.

2017-07-01

In this article we examine how federal agencies use adaptive management. In order for federal agencies to implement adaptive management more successfully, administrative law must adapt to adaptive management, and we propose changes in administrative law that will help to steer the current process out of a dead end. Adaptive management is a form of structured decision making that is widely used in natural resources management. It involves specific steps integrated in an iterative process for adjusting management actions as new information becomes available. Theoretical requirements for adaptive management notwithstanding, federal agency decision making is subject to the requirements of the federal Administrative Procedure Act, and state agencies are subject to the states’ parallel statutes. We argue that conventional administrative law has unnecessarily shackled effective use of adaptive management. We show that through a specialized ‘adaptive management track’ of administrative procedures, the core values of administrative law—especially public participation, judicial review, and finality— can be implemented in ways that allow for more effective adaptive management. We present and explain draft model legislation (the Model Adaptive Management Procedure Act) that would create such a track for the specific types of agency decision making that could benefit from adaptive management.

Online Chemistry Modules: Interaction and Effective Faculty Facilitation

ERIC Educational Resources Information Center

Slocum, Laura E.; Towns Marcy Hamby; Zielinski, Theresa Julia

2004-01-01

Computer supported collaborative learning, cooperative learning combined with electronic communication, physical chemistry online modules, use of discussion boards, its advantages and limitations are experimented and discussed. The most important finding is the example of effective online faculty facilitation and interaction.

Determining the barriers and facilitators to adopting best practices in the management of poststroke unilateral spatial neglect: results of a qualitative study.

PubMed

Petzold, Anita; Korner-Bitensky, Nicol; Salbach, Nancy M; Ahmed, Sara; Menon, Anita; Ogourtsova, Tatiana

2014-01-01

A gap exists between best and actual management of poststroke unilateral spatial neglect (USN). Given the negative impact of USN on poststroke recovery, knowledge translation efforts are needed to optimize USN management. To date, no study has investigated the specific barriers and facilitators affecting USN management during the acute care process. To identify the facilitators and barriers that affect evidence-based practice use by occupational therapists (the primary discipline managing USN) when treating individuals with acute poststroke USN. Focus group methodology elicited information from 9 acute care occupational therapists. Key barriers identified included lack of basic evidence-based practice skills specific to USN treatment and personal motivation to change current practices and engrained habits. Key facilitators included the presence of a multidisciplinary stroke team, recent graduation, and an environment with access to learning time and resources. Synthesized Web-based learning was also seen as important to uptake of best practices. It is estimated that upwards of 40% of patients experience poststroke USN in the acute phase, and we have evidence of poor early management. This study identified several modifiable factors that prepare the ground for the creation and testing of a multimodal knowledge translation intervention aimed at improving clinicians' best practice management of poststroke USN.

Effective Group Facilitation in Education: How to Energize Meetings and Manage Difficult Groups

ERIC Educational Resources Information Center

Eller, John F.

2004-01-01

At their worst, meetings can waste time, lack focus, foster a combative spirit, or be just plain boring. At their best, meetings can be a positive, dynamic experience that nurtures individual strengths while inspiring teamwork to successfully accomplish an established task. The fate of a meeting lies in the skill of the facilitator, and this…

Perceived Barriers and Facilitators of Exercise and Healthy Dietary Choices: A Study of Employees and Managers within a Large Transport Organisation

ERIC Educational Resources Information Center

Donaldson-Feilder, Emma; Lewis, Rachel; Pavey, Louisa; Jones, Bethan; Green, Melanie; Webster, Angela

2017-01-01

Objective: The objective of this study was to examine employees' perceived barriers and facilitators of physical activity and healthy dietary choices, and managers' perceptions of how best to facilitate physical activity and healthy dietary choices among their team members. Design: Single time-point survey with categorical and open-ended…

Facilitating superior chronic disease management through a knowledge-based systems development model.

PubMed

Wickramasinghe, Nilmini S; Goldberg, Steve

2008-01-01

To date, the adoption and diffusion of technology-enabled solutions to deliver better healthcare has been slow. There are many reasons for this. One of the most significant is that the existing methodologies that are normally used in general for Information and Communications Technology (ICT) implementations tend to be less successful in a healthcare context. This paper describes a knowledge-based adaptive mapping to realisation methodology to traverse successfully from idea to realisation rapidly and without compromising rigour so that success ensues. It is discussed in connection with trying to implement superior ICT-enabled approaches to facilitate superior Chronic Disease Management (CDM).

Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.

PubMed

McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D

2018-04-01

Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.

Facilitating Decision Making, Re-Use and Collaboration: A Knowledge Management Approach for System Self-Awareness

DTIC Science & Technology

2009-10-01

FACILITATING DECISION MAKING, RE-USE AND COLLABORATION: A KNOWLEDGE MANAGEMENT APPROACH FOR SYSTEM SELF- AWARENESS Shelley P. Gallup, Douglas J... Information Systems Experimentation (DISE) Group Naval Postgraduate School, Monterey, CA 93943 Keywords: Program self- awareness , decision making...decision makers express in obtaining constant awareness of what is going on in their domains of decision making because information that is needed

Facilitators and barriers to self-management of nursing home residents: perspectives of health-care professionals in Korean nursing homes.

PubMed

Park, Yeon-Hwan; Bang, Hwal Lan; Kim, Ga Hye; Ha, Ji Yeon

2015-01-01

To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. A qualitative content analysis was done using the focus group interview method. A total of 23 health-care professionals (16 registered nurses and 7 social workers) were interviewed from three urban NHs, each with more than 100 beds. Five facilitators were identified: grouping the residents; the resident's awareness of his/her current health status; the willingness of residents to engage in self-management; residence in the facility; and support from the staff. Additionally, seven barriers were identified: deterioration of the resident's health; the dependency expectations of the resident; hesitation in asking for help; difference in expectations between the staff and the resident's family; insufficient staffing and time; lack of standardized guidelines; and conservative tendencies of the staff due to rigid policies. The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents.

Interdisciplinary and participatory approaches: the key to effective groundwater management

NASA Astrophysics Data System (ADS)

Barthel, Roland; Foster, Stephen; Villholth, Karen G.

2017-11-01

The challenges of a changing world, which are progressively threatening sustainable use of groundwater resources, can only be rationally and effectively addressed through close collaboration between experts and practitioners from different disciplines. Furthermore, science and management need to build on stakeholder opinions and processes in order to generate useful knowledge and positive outcomes in terms of sustainable and equitable groundwater management. This essay provides a discussion of the status of and vision for participatory and inter-disciplinary approaches to groundwater evaluation and management as well as a conceptual framework and relevant research questions that will facilitate such approaches.

Effects of Student-Facilitated Learning on Instructional Facilitators

ERIC Educational Resources Information Center

Bonner, Sarah M.; Somers, Jennifer A.; Rivera, Gwendelyn J.; Keiler, Leslie S.

2017-01-01

We investigated perceptions about learning strategy use and instructional roles among a sample of high needs adolescents (n = 230) who acted as near-peer instructional facilitators. The sample was drawn from science and mathematics classes in nonselective public secondary schools in New York City. Students participated in an inschool intervention…

The Effectiveness of Remote Facilitation in Simulation-Based Pediatric Resuscitation Training for Medical Students.

PubMed

Ohta, Kunio; Kurosawa, Hiroshi; Shiima, Yuko; Ikeyama, Takanari; Scott, James; Hayes, Scott; Gould, Michael; Buchanan, Newton; Nadkarni, Vinay; Nishisaki, Akira

2017-08-01

To assess the effectiveness of pediatric simulation by remote facilitation. We hypothesized that simulation by remote facilitation is more effective compared to simulation by an on-site facilitator. We defined remote facilitation as a facilitator remotely (1) introduces simulation-based learning and simulation environment, (2) runs scenarios, and (3) performs debriefing with an on-site facilitator. A remote simulation program for medical students during pediatric rotation was implemented. Groups were allocated to either remote or on-site facilitation depending on the availability of telemedicine technology. Both groups had identical 1-hour simulation sessions with 2 scenarios and debriefing. Their team performance was assessed with behavioral assessment tool by a trained rater. Perception by students was evaluated with Likert scale (1-7). Fifteen groups with 89 students participated in a simulation by remote facilitation, and 8 groups with 47 students participated in a simulation by on-site facilitation. Participant demographics and previous simulation experience were similar. Both groups improved their performance from first to second scenario: groups by remote simulation (first [8.5 ± 4.2] vs second [13.2 ± 6.2], P = 0.003), and groups by on-site simulation (first [6.9 ± 4.1] vs second [12.4 ± 6.4], P = 0.056). The performance improvement was not significantly different between the 2 groups (P = 0.94). Faculty evaluation by students was equally high in both groups (7 vs 7; P = 0.65). A pediatric acute care simulation by remote facilitation significantly improved students' performance. In this pilot study, remote facilitation seems as effective as a traditional, locally facilitated simulation. The remote simulation can be a strong alternative method, especially where experienced facilitators are limited.

Improving Voluntary Environmental Management Programs: Facilitating Learning and Adaptation

NASA Astrophysics Data System (ADS)

Genskow, Kenneth D.; Wood, Danielle M.

2011-05-01

Environmental planners and managers face unique challenges understanding and documenting the effectiveness of programs that rely on voluntary actions by private landowners. Programs, such as those aimed at reducing nonpoint source pollution or improving habitat, intend to reach those goals by persuading landowners to adopt behaviors and management practices consistent with environmental restoration and protection. Our purpose with this paper is to identify barriers for improving voluntary environmental management programs and ways to overcome them. We first draw upon insights regarding data, learning, and adaptation from the adaptive management and performance management literatures, describing three key issues: overcoming information constraints, structural limitations, and organizational culture. Although these lessons are applicable to a variety of voluntary environmental management programs, we then present the issues in the context of on-going research for nonpoint source water quality pollution. We end the discussion by highlighting important elements for advancing voluntary program efforts.

Facilitative Orthographic Neighborhood Effects: The SERIOL Model Account

ERIC Educational Resources Information Center

Whitney, Carol; Lavidor, Michal

2005-01-01

A large orthographic neighborhood (N) facilitates lexical decision for central and left visual field/right hemisphere (LVF/RH) presentation, but not for right visual field/left hemisphere (RVF/LH) presentation. Based on the SERIOL model of letter-position encoding, this asymmetric N effect is explained by differential activation patterns at the…

Facilitating Stroke Management using Modern Information Technology.

PubMed

Nam, Hyo Suk; Park, Eunjeong; Heo, Ji Hoe

2013-09-01

Information technology and mobile devices may be beneficial and useful in many aspects of stroke management, including recognition of stroke, transport and triage of patients, emergent stroke evaluation at the hospital, and rehabilitation. In this review, we address the contributions of information technology and mobile health to stroke management. Rapid detection and triage are essential for effective thrombolytic treatment. Awareness of stroke warning signs and responses to stroke could be enhanced by using mobile applications. Furthermore, prehospital assessment and notification could be streamlined for use in telemedicine and teleradiology. A mobile telemedicine system for assessing the National Institutes of Health Stroke Scale scores has shown higher correlation and fast assessment comparing with face-to-face method. Because the benefits of thrombolytic treatment are time-dependent, treatment should be initiated as quickly as possible. In-hospital communication between multidisciplinary team members can be enhanced using information technology. A computerized in-hospital alert system using computerized physician-order entry was shown to be effective in reducing the time intervals from hospital arrival to medical evaluations and thrombolytic treatment. Mobile devices can also be used as supplementary tools for neurologic examination and clinical decision-making. In post-stroke rehabilitation, virtual reality and telerehabilitation are helpful. Mobile applications might be useful for public awareness, lifestyle modification, and education/training of healthcare professionals. Information technology and mobile health are useful tools for management of stroke patients from the acute period to rehabilitation. Further improvement of technology will change and enhance stroke prevention and treatment.

Effect of Facilitation on Practice Outcomes in the National Demonstration Project Model of the Patient-Centered Medical Home

PubMed Central

Nutting, Paul A.; Crabtree, Benjamin F.; Stewart, Elizabeth E.; Miller, William L.; Palmer, Raymond F.; Stange, Kurt C.; Jaén, Carlos Roberto

2010-01-01

PURPOSE The objective of this study was to elucidate the effect of facilitation on practice outcomes in the 2-year patient-centered medical home (PCMH) National Demonstration Project (NDP) intervention, and to describe practices’ experience in implementing different components of the NDP model of the PCMH. METHODS Thirty-six family practices were randomized to a facilitated intervention group or a self-directed intervention group. We measured 3 practice-level outcomes: (1) the proportion of 39 components of the NDP model that practices implemented, (2) the aggregate patient rating of the practices’ PCMH attributes, and (3) the practices’ ability to make and sustain change, which we term adaptive reserve. We used a repeated-measures analysis of variance to test the intervention effects. RESULTS By the end of the 2 years of the NDP, practices in both facilitated and self-directed groups had at least 70% of the NDP model components in place. Implementation was relatively harder if the model component affected multiple roles and processes, required coordination across work units, necessitated additional resources and expertise, or challenged the traditional model of primary care. Electronic visits, group visits, team-based care, wellness promotion, and proactive population management presented the greatest challenges. Controlling for baseline differences and practice size, facilitated practices had greater increases in adaptive reserve (group difference by time, P = .005) and the proportion of NDP model components implemented (group difference by time, P=.02); the latter increased from 42% to 72% in the facilitated group and from 54% to 70% in the self-directed group. Patient ratings of the practices’ PCMH attributes did not differ between groups and, in fact, diminished in both of them. CONCLUSIONS Highly motivated practices can implement many components of the PCMH in 2 years, but apparently at a cost of diminishing the patient’s experience of care. Intense

Multidisciplinary Teaming To Promote Effective Management of Type 1 Diabetes for Adolescents.

ERIC Educational Resources Information Center

Strawhacker, MaryAnn Tapper

2001-01-01

By facilitating active participation in treatment, coordinating services, and maximizing community resources, schools can help adolescents build a strong foundation for lifelong diabetes management. This paper presents an overview of intensive diabetes therapy, psychosocial implications of chronic illness in adolescence, the effects of chronic…

Implementation of Environmental Flows for Intermittent River Systems: Adaptive Management and Stakeholder Participation Facilitate Implementation

NASA Astrophysics Data System (ADS)

Conallin, John; Wilson, Emma; Campbell, Josh

2018-03-01

Anthropogenic pressure on freshwater ecosystems is increasing, and often leading to unacceptable social-ecological outcomes. This is even more prevalent in intermittent river systems where many are already heavily modified, or human encroachment is increasing. Although adaptive management approaches have the potential to aid in providing the framework to consider the complexities of intermittent river systems and improve utility within the management of these systems, success has been variable. This paper looks at the application of an adaptive management pilot project within an environmental flows program in an intermittent stream (Tuppal Creek) in the Murray Darling Basin, Australia. The program focused on stakeholder involvement, participatory decision-making, and simple monitoring as the basis of an adaptive management approach. The approach found that by building trust and ownership through concentrating on inclusiveness and transparency, partnerships between government agencies and landholders were developed. This facilitated a willingness to accept greater risks and unintended consequences allowing implementation to occur.

Barriers and facilitators influencing self-management among COPD patients: a mixed methods exploration in primary and affiliated specialist care.

PubMed

Hillebregt, Chantal F; Vlonk, Auke J; Bruijnzeels, Marc A; van Schayck, Onno Cp; Chavannes, Niels H

2017-01-01

Self-management is becoming increasingly important in COPD health care although it remains difficult to embed self-management into routine clinical care. The implementation of self-management is understood as a complex interaction at the level of patient, health care provider (HCP), and health system. Nonetheless there is still a poor understanding of the barriers and effective facilitators. Comprehension of these determinants can have significant implications in optimizing self-management implementation and give further directions for the development of self-management interventions. Data were collected among COPD patients (N=46) and their HCPs (N=11) in three general practices and their collaborating affiliated hospitals. Mixed methods exploration of the data was conducted and collected by interviews, video-recorded consultations (N=50), and questionnaires on consultation skills. Influencing determinants were monitored by 1) interaction and communication between the patient and HCP, 2) visible and invisible competencies of both the patient and the HCP, and 3) degree of embedding self-management into the health care system. Video observations showed little emphasis on effective behavioral change and follow-up of given lifestyle advice during consultation. A strong presence of COPD assessment and monitoring negatively affects the patient-centered communication. Both patients and HCPs experience difficulties in defining personalized goals. The satisfaction of both patients and HCPs concerning patient centeredness during consultation was measured by the patient feedback questionnaire on consultation skills. The patients scored high (84.3% maximum score) and differed from the HCPs (26.5% maximum score). Although the patient-centered approach accentuating self-management is one of the dominant paradigms in modern medicine, our observations show several influencing determinants causing difficulties in daily practice implementation. This research is a first step

Facilitators and barriers to self-management of nursing home residents: perspectives of health-care professionals in Korean nursing homes

PubMed Central

Park, Yeon-Hwan; Bang, Hwal Lan; Kim, Ga Hye; Ha, Ji Yeon

2015-01-01

Purpose To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. Patients and methods A qualitative content analysis was done using the focus group interview method. A total of 23 health-care professionals (16 registered nurses and 7 social workers) were interviewed from three urban NHs, each with more than 100 beds. Results Five facilitators were identified: grouping the residents; the resident’s awareness of his/her current health status; the willingness of residents to engage in self-management; residence in the facility; and support from the staff. Additionally, seven barriers were identified: deterioration of the resident’s health; the dependency expectations of the resident; hesitation in asking for help; difference in expectations between the staff and the resident’s family; insufficient staffing and time; lack of standardized guidelines; and conservative tendencies of the staff due to rigid policies. Conclusion The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents. PMID:26491277

Look at me, I'm happy and creative: The effect of impression management on behavior in social presence.

PubMed

Uziel, Liad

2010-12-01

The present research tested competing approaches to individual differences in impression management (as measured with social desirability scales) and their implication for behavior in social contexts. A defensiveness approach argues that impression management is a source of defensive self-presentation, which causes performance impairment in public social settings. The competing adjustment approach argues that impression management measures friendliness and self-control, which should bring about performance facilitation in public social settings. To decide between these approaches, two experiments utilized a social facilitation paradigm, whereby task performance was compared between an alone and a public condition. The results supported the predictions of the adjustment approach. Across different tasks, a high impression management score was associated with performance facilitation in social presence, expressed in greater creativity, positive implicit affect, and high self-control. The results reveal previously unnoticed constructive effects of impression management, supporting the reframing of the trait as reflecting interpersonally oriented self-control.

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness.

PubMed

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-04-11

Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers' leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention's potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers' behaviors or clinical practice at the units. Future interventions directed towards managers should have a

Implementation of pregnancy weight management and obesity guidelines: a meta-synthesis of healthcare professionals' barriers and facilitators using the Theoretical Domains Framework.

PubMed

Heslehurst, N; Newham, J; Maniatopoulos, G; Fleetwood, C; Robalino, S; Rankin, J

2014-06-01

Obesity in pregnancy is rising and is associated with severe health consequences for both the mother and the child. There is an increasing international focus on guidelines to manage the clinical risks of maternal obesity, and for pregnancy weight management. However, passive dissemination of guidelines is not effective and more active strategies are required for effective guideline implementation into practice. Implementation of guidelines is a form of healthcare professional behaviour change, and therefore implementation strategies should be based on appropriate behaviour change theory. This systematic review aimed to identify the determinants of healthcare professionals' behaviours in relation to maternal obesity and weight management. Twenty-five studies were included. Data synthesis of the existing international qualitative and quantitative evidence base used the Theoretical Domains Framework to identify the barriers and facilitators to healthcare professionals' maternal obesity and weight management practice. The domains most frequently identified included 'knowledge', 'beliefs about consequences' and 'environmental context and resources'. Healthcare professionals' weight management practice had the most barriers compared with any other area of maternal obesity practice. The results of this review will be used to inform the development of an intervention to support healthcare professional behaviour change. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

Patient information, education and self-management in bronchiectasis: facilitating improvements to optimise health outcomes.

PubMed

Hester, Katy L M; Newton, Julia; Rapley, Tim; De Soyza, Anthony

2018-05-22

Bronchiectasis is an incurable lung disease characterised by irreversible airway dilatation. It causes symptoms including chronic productive cough, dyspnoea, and recurrent respiratory infections often requiring hospital admission. Fatigue and reductions in quality of life are also reported in bronchiectasis. Patients often require multi-modal treatments that can be burdensome, leading to issues with adherence. In this article we review the provision of, and requirement for, education and information in bronchiectasis. To date, little research has been undertaken to improve self-management in bronchiectasis in comparison to other chronic conditions, such as COPD, for which there has been a wealth of recent developments. Qualitative work has begun to establish that information deficit is one of the potential barriers to self-management, and that patients feel having credible information is fundamental when learning to live with and manage bronchiectasis. Emerging research offers some insights into ways of improving treatment adherence and approaches to self-management education; highlighting ways of addressing the specific unmet information needs of patients and their families who are living with bronchiectasis. We propose non-pharmacological recommendations to optimise patient self-management and symptom recognition; with the aim of facilitating measurable improvements in health outcomes for patients with bronchiectasis.

Facilitation techniques as predictors of crew participation in LOFT debriefings

NASA Technical Reports Server (NTRS)

McDonnell, L. K.

1996-01-01

Based on theories of adult learning and airline industry guidelines for Crew Resource Management (CRM), the stated objective during Line Oriented Flight Training (LOFT) debriefings is for instructor pilots (IP's) to facilitate crew self-analysis of performance. This study reviews 19 LOFT debriefings from two major U.S. airlines to examine the relationship between IP efforts at facilitation and associated characteristics of crew participation. A subjective rating scale called the Debriefing Assessment Battery was developed and utilized to evaluate the effectiveness of IP facilitation and the quality of crew participation. The results indicate that IP content, encouragement, and questioning techniques are highly and significantly correlated with, and can therefore predict, the degree and depth of crew participation.

Implementation of a mental health medication management intervention in Australian community pharmacies: Facilitators and challenges.

PubMed

Hattingh, H Laetitia; Kelly, Fiona; Fowler, Jane; Wheeler, Amanda J

explored their experiences of intervention implementation and delivery. Twenty-nine staff members from completer pharmacies returned exit surveys and interviews were conducted with 30 staff from completer and non-completer pharmacies. Descriptive analyses of quantitative data and thematic analyses of qualitative data were used to compare completers and non-completers. Baseline similarities included numbers of general and mental health prescriptions dispensed and established professional services. However, there was greater prevalence of diabetes management, opioid substitution services, and relationships with mental health services in completer pharmacies. Key facilitators for completers included pharmacy owner/manager support, staff buy-in and involvement, intervention flexibility, recruitment immediately following training, integration of intervention with existing services, changes to workflow, and regular consumer contact. Key barriers for both groups included lack of pharmacy owner/manager support or staff buy-in, time constraints, privacy limitations and pilot project associated paperwork. Insights into factors that underpinned successful intervention implementation and delivery should inform effective strategies for similar future studies and allocation of pharmacy mental health service delivery resources. Copyright © 2017 Elsevier Inc. All rights reserved.

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

PubMed Central

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B.; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-01-01

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future

Effects of facilitated family case conferencing for advanced dementia: A cluster randomised clinical trial

PubMed Central

2017-01-01

Background Palliative care planning for nursing home residents with advanced dementia is often suboptimal. This study compared effects of facilitated case conferencing (FCC) with usual care (UC) on end-of-life care. Methods A two arm parallel cluster randomised controlled trial was conducted. The sample included people with advanced dementia from 20 Australian nursing homes and their families and professional caregivers. In each intervention nursing home (n = 10), Palliative Care Planning Coordinators (PCPCs) facilitated family case conferences and trained staff in person-centred palliative care for 16 hours per week over 18 months. The primary outcome was family-rated quality of end-of-life care (End-of-Life Dementia [EOLD] Scales). Secondary outcomes included nurse-rated EOLD scales, resident quality of life (Quality of Life in Late-stage Dementia [QUALID]) and quality of care over the last month of life (pharmacological/non-pharmacological palliative strategies, hospitalization or inappropriate interventions). Results Two-hundred-eighty-six people with advanced dementia took part but only 131 died (64 in UC and 67 in FCC which was fewer than anticipated), rendering the primary analysis under-powered with no group effect seen in EOLD scales. Significant differences in pharmacological (P < 0.01) and non-pharmacological (P < 0.05) palliative management in last month of life were seen. Intercurrent illness was associated with lower family-rated EOLD Satisfaction with Care (coefficient 2.97, P < 0.05) and lower staff-rated EOLD Comfort Assessment with Dying (coefficient 4.37, P < 0.01). Per protocol analyses showed positive relationships between EOLD and staff hours to bed ratios, proportion of residents with dementia and staff attitudes. Conclusion FCC facilitates a palliative approach to care. Future trials of case conferencing should consider outcomes and processes regarding decision making and planning for anticipated events and acute illness. Trial registration

Solid waste management in primary healthcare centers: application of a facilitation tool 1

PubMed Central

Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

2016-01-01

Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. PMID:27556874

Neural substrates of social facilitation effects on incentive-based performance

PubMed Central

Chib, Vikram S; Adachi, Ryo; O’Doherty, John P

2018-01-01

Abstract Throughout our lives we must perform tasks while being observed by others. Previous studies have shown that the presence of an audience can cause increases in an individual’s performance as compared to when they are not being observed—a phenomenon called ‘social facilitation’. However, the neural mechanisms underlying this effect, in the context of skilled-task performance for monetary incentives, are not well understood. We used functional magnetic resonance imaging to monitor brain activity while healthy human participants performed a skilled-task during conditions in which they were paid based on their performance and observed and not observed by an audience. We found that during social facilitation, social signals represented in the dorsomedial prefrontal cortex (dmPFC) enhanced reward value computations in ventromedial prefrontal cortex (vmPFC). We also found that functional connectivity between dmPFC and ventral striatum was enhanced when participants exhibited social facilitation effects, indicative of a means by which social signals serve to modulate brain regions involved in regulating behavioral motivation. These findings illustrate how neural processing of social judgments gives rise to the enhanced motivational state that results in social facilitation of incentive-based performance. PMID:29648653

The effects of facilitation and competition on group foraging in patches

PubMed Central

Laguë, Marysa; Tania, Nessy; Heath, Joel; Edelstein-Keshet, Leah

2012-01-01

Significant progress has been made towards understanding the social behaviour of animal groups, but the patch model, a foundation of foraging theory, has received little attention in a social context. The effect of competition on the optimal time to leave a foraging patch was considered as early as the original formulation of the marginal value theorem, but surprisingly, the role of facilitation (where foraging in groups decreases the time to find food in patches), has not been incorporated. Here we adapt the classic patch model to consider how the trade-off between facilitation and competition influence optimal group size. Using simple assumptions about the effect of group size on the food-finding time and the sharing of resources, we find conditions for existence of optima in patch residence time and in group size. When patches are close together (low travel times), larger group sizes are optimal. Groups are predicted to exploit patches differently than individual foragers and the degree of patch depletion at departure depends on the details of the trade-off between competition and facilitation. A variety of currencies and group-size effects are also considered and compared. Using our simple formulation, we also study the effects of social foraging on patch exploitation which to date have received little empirical study. PMID:22743132

Mobile phone messaging for facilitating self-management of long-term illnesses.

PubMed

de Jongh, Thyra; Gurol-Urganci, Ipek; Vodopivec-Jamsek, Vlasta; Car, Josip; Atun, Rifat

2012-12-12

Long-term illnesses affect a significant proportion of the population in developed and developing countries. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), may present convenient, cost-effective ways of supporting self-management and improving patients' self-efficacy skills through, for instance, medication reminders, therapy adjustments or supportive messages. To assess the effects of mobile phone messaging applications designed to facilitate self-management of long-term illnesses, in terms of impact on health outcomes and patients' capacity to self-manage their condition. Secondary objectives include assessment of: user evaluation of the intervention; health service utilisation and costs; and possible risks and harms associated with the intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009).We also reviewed grey literature (including trial registers) and reference lists of articles. We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, or interrupted time series (ITS) studies with at least three time points before and after the intervention. We selected only studies where it was possible to assess the effects of mobile phone messaging independent of other technologies or interventions. Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by

A systematic review of explanatory factors of barriers and facilitators to improving asthma management in South Asian children

PubMed Central

2014-01-01

Background South Asian children with asthma are less likely to receive prescriptions and more likely to suffer uncontrolled symptoms and acute asthma admissions compared with White British children. Understanding barriers are therefore vital in addressing health inequalities. We undertook a systematic review identifying explanatory factors for barriers and facilitators to asthma management in South Asian children. South Asians were defined as individuals of Indian, Pakistani or Bangladeshi descent. Methods Data Sources - Medline, HMIC, EMBASE, ASSIA, Web of Science, BNI, CINAHL, PsycINFO, OpenSIGLE, CRD, Scopus, NHS Evidence, Cochrane Library, Campbell Collaboration, RCPCH, ATS, ERS, Asthma UK, Google Scholar & Asthma Guidelines (BTS, GINA, ATS, Monash, NAEPP, Singapore & New Zealand) to August 2013. Inclusion Criteria – Qualitative, quantitative or mixed methods research with primary focus on identifying explanations for barriers and/or facilitators to asthma management in South Asian children aged 0–18 years with diagnosed/suspected asthma and/or carers and/or healthcare professionals. Data Extraction – Three authors independently reviewed, selected & extracted eligible articles with disagreements resolved by research team discussion. Results 15 studies encompassing 25,755 children, 18,483 parents/carers and 239 healthcare professionals were included. Barriers and explanatory factors identified were: 1. Lack of asthma knowledge in families and healthcare professionals. 2. Under-use of preventer medications. 3. Non-acceptance/denial of asthma. 4. Over-reliance on Emergency Department management. 5. Communication problems. 6. Non-adherence to medication. 7. Use of complementary therapies. Little facilitators regarding asthma management were identified. Conclusions Several key issues were identified as likely to be ethnic-specific to South Asian families, rather than a reflection of minority status: impact of parental and professional knowledge and beliefs

Astronomical large projects managed with MANATEE: management tool for effective engineering

NASA Astrophysics Data System (ADS)

García-Vargas, M. L.; Mujica-Alvarez, E.; Pérez-Calpena, A.

2012-09-01

This paper describes MANATEE, which is the Management project web tool developed by FRACTAL, specifically designed for managing large astronomical projects. MANATEE facilitates the management by providing an overall view of the project and the capabilities to control the three main projects parameters: scope, schedule and budget. MANATEE is one of the three tools of the FRACTAL System & Project Suite, which is composed also by GECO (System Engineering Tool) and DOCMA (Documentation Management Tool). These tools are especially suited for those Consortia and teams collaborating in a multi-discipline, complex project in a geographically distributed environment. Our Management view has been applied successfully in several projects and currently is being used for Managing MEGARA, the next instrument for the GTC 10m telescope.

The Relationship between Stroop Interference and Facilitation Effects: Statistical Artifacts, Baselines, and a Reassessment

ERIC Educational Resources Information Center

Brown, Tracy L.

2011-01-01

The relationship between interference and facilitation effects in the Stroop task is poorly understood yet central to its implications. At question is the modal view that they arise from a single mechanism--the congruency of color and word. Two developments have challenged that view: (a) the belief that facilitation effects are fractionally small…

Effect of Visualization (Job Aids) in Facilitating Cognitive Development.

ERIC Educational Resources Information Center

Spaulding, Karen L.; Dwyer, Francis

This study examined the instructional effectiveness with which different job aid types facilitated learner achievement of different types of learning objectives and identified the degree to which low and high prior knowledge individuals profit from different job aid types. The instructional content used in the study was an instructional module on…

Successfully Automating Library Consortia: Procedures To Facilitate Governance, Management and Cooperation. DataResearch Automation Guide Series, Number Three.

ERIC Educational Resources Information Center

Data Research Associates, Inc., St. Louis, MO.

Sharing a local automated library system will generally reduce the costs of automation for each participating library and will facilitate the sharing of resources. To set up a consortium, libraries must first identify and agree on governance issues and methods for dealing with these issues. Issues range from ownership, management, and location of…

An Overview of Practice Facilitation Programs in Canada: Current Perspectives and Future Directions

PubMed Central

Liddy, Clare; Laferriere, Dianne; Baskerville, Bruce; Dahrouge, Simone; Knox, Lyndee; Hogg, William

2013-01-01

Practice facilitation has proven to be effective in improving the quality of primary care. A practice facilitator is a health professional, usually external to the practice, who regularly visits the practice to provide support in change management that targets improvements in the delivery of care. Our environmental scan shows that several initiatives across Canada utilize practice facilitation as a quality improvement method; however, many are conducted in isolation as there is a lack of coordinated effort, knowledge translation and dissemination in this field across the country. We recommend that investments be made in capacity building, knowledge exchange and facilitator training, and that partnership building be considered a priority in this field. PMID:23968627

The effects of facilitation and competition on group foraging in patches.

PubMed

Laguë, Marysa; Tania, Nessy; Heath, Joel; Edelstein-Keshet, Leah

2012-10-07

Significant progress has been made towards understanding the social behaviour of animal groups, but the patch model, a foundation of foraging theory, has received little attention in a social context. The effect of competition on the optimal time to leave a foraging patch was considered as early as the original formulation of the marginal value theorem, but surprisingly, the role of facilitation (where foraging in groups decreases the time to find food in patches), has not been incorporated. Here we adapt the classic patch model to consider how the trade-off between facilitation and competition influences optimal group size. Using simple assumptions about the effect of group size on the food-finding time and the sharing of resources, we find conditions for existence of optima in patch residence time and in group size. When patches are close together (low travel times), larger group sizes are optimal. Groups are predicted to exploit patches differently than individual foragers and the degree of patch depletion at departure depends on the details of the trade-off between competition and facilitation. A variety of currencies and group-size effects are also considered and compared. Using our simple formulation, we also study the effects of social foraging on patch exploitation which to date have received little empirical study. Copyright © 2012 Elsevier Ltd. All rights reserved.

PERSPECTIVES ON MULTIDISCIPLINARY TEAM PROCESSES AMONG HEALTHCARE EXECUTIVES: PROCESSES THAT FACILITATE TEAM EFFECTIVENESS.

PubMed

Landry, Amy; Erwin, Cathleen

2015-01-01

Multidisciplinary teams (MDTs) are used in healthcare organizations to address both clinical and managerial functions. Despite their prevalence, little is known about how team processes work to facilitate effectiveness among MDT leadership teams. This study explores perceptions of MDT participation experienced by organizational leaders in healthcare organizations in the United States. A survey of American College of Healthcare Executives members was conducted to assess involvement and perceptions of MDTs among health care management professionals. Descriptive statistics, independent T-Tests and Chi-square analyses were used to examine participation in MDTs, perception of MDT processes, and the association of participation and perceived processes with employee and organizational characteristics. The survey yielded a sample comprised of 492 healthcare executive or executive-track employees. An overwhelming majority indicated participation in MDTs. The study identified team processes that could use improvement including communication, cooperation, and conflict resolution. The study provides evidence that can help guide the development of training programs that focus on providing managerial leaders with strategies aimed at improving communication, coordination, and conflict resolution that will improve the effectiveness of MDT functioning in healthcare organizations.

Chronic disease management: a qualitative study investigating the barriers, facilitators and incentives perceived by Swiss healthcare stakeholders.

PubMed

Lauvergeon, Stéphanie; Burnand, Bernard; Peytremann-Bridevaux, Isabelle

2012-06-22

Chronic disease management has been implemented for some time in several countries to tackle the increasing burden of chronic diseases. While Switzerland faces the same challenge, such initiatives have only emerged recently in this country. The aim of this study is to assess their feasibility, in terms of barriers, facilitators and incentives to participation. To meet our aim, we used qualitative methods involving the collection of opinions of various healthcare stakeholders, by means of 5 focus groups and 33 individual interviews. All the data were recorded and transcribed verbatim. Thematic analysis was then performed and five levels were determined to categorize the data: political, financial, organisational/ structural, professionals and patients. Our results show that, at each level, stakeholders share common opinions towards the feasibility of chronic disease management in Switzerland. They mainly mention barriers linked to the federalist political organization as well as to financing such programs. They also envision difficulties to motivate both patients and healthcare professionals to participate. Nevertheless, their favourable attitudes towards chronic disease management as well as the fact that they are convinced that Switzerland possesses all the resources (financial, structural and human) to develop such programs constitute important facilitators. The implementation of quality and financial incentives could also foster the participation of the actors. Even if healthcare stakeholders do not have the same role and interest regarding chronic diseases, they express similar opinions on the development of chronic disease management in Switzerland. Their overall positive attitude shows that it could be further implemented if political, financial and organisational barriers are overcome and if incentives are found to face the scepticism and non-motivation of some stakeholders.

Chronic disease management: a qualitative study investigating the barriers, facilitators and incentives perceived by Swiss healthcare stakeholders

PubMed Central

2012-01-01

Background Chronic disease management has been implemented for some time in several countries to tackle the increasing burden of chronic diseases. While Switzerland faces the same challenge, such initiatives have only emerged recently in this country. The aim of this study is to assess their feasibility, in terms of barriers, facilitators and incentives to participation. Methods To meet our aim, we used qualitative methods involving the collection of opinions of various healthcare stakeholders, by means of 5 focus groups and 33 individual interviews. All the data were recorded and transcribed verbatim. Thematic analysis was then performed and five levels were determined to categorize the data: political, financial, organisational/ structural, professionals and patients. Results Our results show that, at each level, stakeholders share common opinions towards the feasibility of chronic disease management in Switzerland. They mainly mention barriers linked to the federalist political organization as well as to financing such programs. They also envision difficulties to motivate both patients and healthcare professionals to participate. Nevertheless, their favourable attitudes towards chronic disease management as well as the fact that they are convinced that Switzerland possesses all the resources (financial, structural and human) to develop such programs constitute important facilitators. The implementation of quality and financial incentives could also foster the participation of the actors. Conclusions Even if healthcare stakeholders do not have the same role and interest regarding chronic diseases, they express similar opinions on the development of chronic disease management in Switzerland. Their overall positive attitude shows that it could be further implemented if political, financial and organisational barriers are overcome and if incentives are found to face the scepticism and non-motivation of some stakeholders. PMID:22726820

Suppressive and Facilitative Effects of Shock Intensity and Interresponse Times Followed by Shock

ERIC Educational Resources Information Center

Everly, Jessica B.; Perone, Michael

2012-01-01

Although response-dependent shock often suppresses responding, response facilitation can occur. In two experiments, we examined the suppressive and facilitative effects of shock by manipulating shock intensity and the interresponse times that produced shock. Rats' lever presses were reinforced on a variable-interval 40-s schedule of food…

Changing office practice and health care systems to facilitate diabetes self-management.

PubMed

Funnell, Martha M; Anderson, Robert M

2003-04-01

Diabetes is a self-managed disease for which patients provide 99% of their own care. For patients to succeed as diabetes self-managers, they need office practices and health care systems that can prepare and support them in their diabetes self-management efforts over the long term. In order to provide effective diabetes education and ongoing support, office practices and health care systems will have to fundamentally redefine the roles of health professionals and patients with diabetes, and redesign practices and systems to allow for effective long-term self-management education and support. Although it is difficult for both people and systems to change, change is essential if we are going to provide self-management support for the majority of patients suffering from this serious chronic disease.

Quality Management Tools: Facilitating Clinical Research Data Integrity by Utilizing Specialized Reports with Electronic Case Report Forms

PubMed Central

Trocky, NM; Fontinha, M

2005-01-01

Data collected throughout the course of a clinical research trial must be reviewed for accuracy and completeness continually. The Oracle Clinical® (OC) data management application utilized to capture clinical data facilitates data integrity through pre-programmed validations, edit and range checks, and discrepancy management modules. These functions were not enough. Coupled with the use of specially created reports in Oracle Discoverer® and Integrated Review TM, both ad-hoc query and reporting tools, research staff have enhanced their ability to clean, analyze and report more accurate data captured within and among Case Report Forms (eCRFs) by individual study or across multiple studies. PMID:16779428

Teaching Adult Learner Characteristics and Facilitation Strategies through Simulation-Based Practice

ERIC Educational Resources Information Center

Speed, Sally A.; Bradley, Elizabeth; Garland, Krista Vince

2015-01-01

This article relates a project in which a curriculum module was developed to help graduate students more effectively manage behaviors of adults in facilitation sessions. The module was piloted in the project and later included in a graduate level course in the Creative Studies Department of SUNY Buffalo State. The curriculum identified…

Effective Stress Management: A Model of Emotional Intelligence, Self-Leadership, and Student Stress Coping

ERIC Educational Resources Information Center

Houghton, Jeffery D.; Wu, Jinpei; Godwin, Jeffrey L.; Neck, Christopher P.; Manz, Charles C.

2012-01-01

This article develops and presents a model of the relationships among emotional intelligence, self-leadership, and stress coping among management students. In short, the authors' model suggests that effective emotion regulation and self-leadership, as mediated through positive affect and self-efficacy, has the potential to facilitate stress coping…

JXTA: A Technology Facilitating Mobile P2P Health Management System

PubMed Central

Rajkumar, Rajasekaran; Nallani Chackravatula Sriman, Narayana Iyengar

2012-01-01

Objectives Mobile JXTA (Juxtapose) gaining momentum and has attracted the interest of doctors and patients through P2P service that transmits messages. Audio and video can also be transmitted through JXTA. The use of mobile streaming mechanism with the support of mobile hospital management and healthcare system would enable better interaction between doctors, nurses, and the hospital. Experimental results demonstrate good performance in comparison with conventional systems. This study evaluates P2P JXTA/JXME (JXTA functionality to MIDP devices.) which facilitates peer-to-peer application+ using mobile-constraint devices. Also a proven learning algorithm was used to automatically send and process sorted patient data to nurses. Methods From December 2010 to December 2011, a total of 500 patients were referred to our hospital due to minor health problems and were monitored. We selected all of the peer groups and the control server, which controlled the BMO (Block Medical Officer) peer groups and BMO through the doctor peer groups, and prescriptions were delivered to the patient’s mobile phones through the JXTA/ JXME network. Results All 500 patients were registered in the JXTA network. Among these, 300 patient histories were referred to the record peer group by the doctors, 100 patients were referred to the external doctor peer group, and 100 patients were registered as new users in the JXTA/JXME network. Conclusion This system was developed for mobile streaming applications and was designed to support the mobile health management system using JXTA/ JXME. The simulated results show that this system can carry out streaming audio and video applications. Controlling and monitoring by the doctor peer group makes the system more flexible and structured. Enhanced studies are needed to improve knowledge mining and cloud-based M health management technology in comparison with the traditional system. PMID:24159509

Cost-effectiveness of a nurse facilitated, cognitive behavioural self-management programme compared with usual care using a CBT manual alone for patients with heart failure: secondary analysis of data from the SEMAPHFOR trial.

PubMed

Mejía, Aurelio; Richardson, Gerry; Pattenden, Jill; Cockayne, Sarah; Lewin, Robert

2014-09-01

To assess the cost-effectiveness of a nurse facilitated, cognitive behavioural self-management programme for patients with heart failure compared with usual care including the un-facilitated access to the same manual, from the perspective of the NHS. Data were obtained from a pragmatic, multi-centre, randomized controlled 'open' trial conducted in seven centres in the UK between 2006 and 2008. Effectiveness was estimated as Quality-Adjusted Life Years. Resource use was measured prospectively on all patients using information provided by patients in postal questionnaires, case-note review, electronic record review and interviews with patients. Unit costs were obtained from the literature and applied to the relevant resource use to estimate total costs. Multiple imputation was used to handle missing data. There were no substantial differences in the utility scores between treatment groups in all follow-up assessments, in the use of medication or outpatient visits and both groups report a similar frequency of contact with health care professionals. After controlling for baseline utility and using imputed dataset, treatment was associated with a reduction in QALY of 0.004 and a additional cost of £69.49. The probability that the intervention is cost-effective for thresholds between £20,000 and £30,000 is around 45%. There is little evidence that the addition of the intervention had any effect on costs or outcomes. The uncertainty around both estimates of cost and effectiveness mean that it is not reasonable to make recommendations based on cost-effectiveness alone. Copyright © 2014 Elsevier Ltd. All rights reserved.

Determining Barriers and Facilitators Associated With Willingness to Use a Personal Health Information Management System to Support Worksite Wellness Programs.

PubMed

Neyens, David M; Childers, Ashley Kay

2017-07-01

To determine the barriers and facilitators associated with willingness to use personal health information management (PHIM) systems to support an existing worksite wellness program (WWP). The study design involved a Web-based survey. The study setting was a regional hospital. Hospital employees comprised the study subjects. Willingness, barriers, and facilitators associated with PHIM were measured. Bivariate logit models were used to model two binary dependent variables. One model predicted the likelihood of believing PHIM systems would positively affect overall health and willingness to use. Another predicted the likelihood of worrying about online security and not believing PHIM systems would benefit health goals. Based on 333 responses, believing PHIM systems would positively affect health was highly associated with willingness to use PHIM systems (p < .01). Those comfortable online were 7.22 times more willing to use PHIM systems. Participants in exercise-based components of WWPs were 3.03 times more likely to be willing to use PHIM systems. Those who worried about online security were 5.03 times more likely to believe PHIM systems would not help obtain health goals. Comfort with personal health information online and exercise-based WWP experience was associated with willingness to use PHIM systems. However, nutrition-based WWPs did not have similar effects. Implementation barriers relate to technology anxiety and trust in security, as well as experience with specific WWP activities. Identifying differences between WWP components and addressing technology concerns before implementation of PHIM systems into WWPs may facilitate improved adoption and usage.

Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

PubMed

Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

Facilitating Learner Autonomy: Reading and Effective Dictionary Use for Lexical Development

ERIC Educational Resources Information Center

Lin, Debbita Tan Ai; Pandian, Ambigapathy; Jaganathan, Paramaswari

2017-01-01

Effective dictionary use facilitates reading and subsequently, vocabulary knowledge development. Reading, especially extensive reading, has time and again been proven to be highly effective for both receptive and productive lexical development. Possessing control over a large vocabulary is essential for language competence--be it L1, L2, or L3.…

In Support of Coaching Models of Management and Leadership: A Comparative Study of Empirically Derived Managerial Coaching/Facilitating Learning Behaviors

ERIC Educational Resources Information Center

Hamlin, Bob; Ellinger, Andrea D.; Beattie, Rona S.

2004-01-01

The concept of managers assuming developmental roles such as coaches and learning facilitators has gained considerable attention in recent years as organizations seek to leverage learning by creating infrastructures that foster employee learning and development. Despite the increased focus on coaching, the literature base remains atheoretical.…

The socioeconomic factors that facilitate or constrain restoration management: Watershed rehabilitation and wet meadow (bofedal) restoration in the Bolivian Andes.

PubMed

Hartman, Brett D; Cleveland, David A

2018-03-01

Restoration ecology holds promise for addressing land degradation in impoverished rural environments, provided the approach is adapted to rural development settings. While there is a need for increased integration of social dynamics in land restoration, few systematic studies exist. We explored the socioeconomic factors that influence restoration management, including local motives and perceived benefits, incentives, land tenancy, institutional factors, conflict resolution, accessibility, off-farm labor, and outmigration. The study area is a successful watershed rehabilitation and wet meadow restoration project in the Bolivian Andes that began in 1992. We used household survey methods (n = 237) to compare the communities that had conducted the most restoration management with those that had conducted the least. Results suggest that several factors facilitate investments in land restoration, including aligning restoration objectives with local motives and perceived benefits, ensuring incentives are in place to stimulate long-term investments, conflict resolution, private land tenancy, and accessibility. However, higher levels of organization and active leadership can facilitate land restoration on communal lands. Increased livelihood benefits from land restoration helped slow the rate of rural to urban migration, with 24.5% outmigration in the highest restoration management communities compared to 62.1% in the lowest restoration management communities. Results suggest that land restoration projects that integrate community development into project planning and implementation will achieve greater success. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using learning theory, interprofessional facilitation competencies, and behavioral indicators to evaluate facilitator training.

PubMed

LeGros, Theresa A; Amerongen, Helen M; Cooley, Janet H; Schloss, Ernest P

2015-01-01

Despite the increasing need for faculty and preceptors skilled in interprofessional facilitation (IPF), the relative novelty of the field poses a challenge to the development and evaluation of IPF programs. We use learning theory and IPF competencies with associated behavioral indicators to develop and evaluate six key messages in IPF training and experience. Our mixed methods approach included two phases: quantitative data collection with embedded qualitative data, followed by qualitative data collection in explanatory sequential fashion. This enabled triangulated analyses of both data types and of facilitation behaviors from facilitator and student perspectives. Results indicate the competency-based training was effective. Facilitators felt comfortable performing behaviors associated with IPF competencies; student observations of those behaviors supported facilitator self-reported performance. Overall, students perceived more facilitation opportunities than facilitators. Findings corroborate the importance of recruiting seasoned facilitators and establishing IPF guidelines that acknowledge variable team dynamics and help facilitators recognize teachable moments.

Facilitation of Adult Development

ERIC Educational Resources Information Center

Boydell, Tom

2016-01-01

Taking an autobiographical approach, I tell the story of my experiences facilitating adult development, in a polytechnic and as a management consultant. I relate these to a developmental framework of Modes of Being and Learning that I created and elaborated with colleagues. I connect this picture with a number of related models, theories,…

Facilitating Collaborative Efforts to Redesign Community Managed Water Systems

ERIC Educational Resources Information Center

Tyson, Ben; Edgar, Nick; Robertson, Gretchen

2011-01-01

The Upper Taieri River catchment is an arid area in the Otago region of the South Island of New Zealand faced with intensifying agriculture production. This article describes an assessment of the education/communication processes of a water resource management project and the effects on farmer beliefs/attitudes and targeted outcomes. Lessons…

The Relationship between Subject Matter Knowledge and Teaching Effectiveness of Undergraduate Chemistry Peer Facilitators

ERIC Educational Resources Information Center

Boothe, J. R.; Barnard, R. A.; Peterson, L. J.; Coppola, B. P.

2018-01-01

Use of peer instruction and facilitation has surged in undergraduate education at large colleges and universities in recent years. Studies on peer instruction have been directed primarily at student learning gains and affective outcomes among the facilitators. For peer instructors, the relationship between their teaching effectiveness and their…

Natural frequencies facilitate diagnostic inferences of managers

PubMed Central

Hoffrage, Ulrich; Hafenbrädl, Sebastian; Bouquet, Cyril

2015-01-01

In Bayesian inference tasks, information about base rates as well as hit rate and false-alarm rate needs to be integrated according to Bayes’ rule after the result of a diagnostic test became known. Numerous studies have found that presenting information in a Bayesian inference task in terms of natural frequencies leads to better performance compared to variants with information presented in terms of probabilities or percentages. Natural frequencies are the tallies in a natural sample in which hit rate and false-alarm rate are not normalized with respect to base rates. The present research replicates the beneficial effect of natural frequencies with four tasks from the domain of management, and with management students as well as experienced executives as participants. The percentage of Bayesian responses was almost twice as high when information was presented in natural frequencies compared to a presentation in terms of percentages. In contrast to most tasks previously studied, the majority of numerical responses were lower than the Bayesian solutions. Having heard of Bayes’ rule prior to the study did not affect Bayesian performance. An implication of our work is that textbooks explaining Bayes’ rule should teach how to represent information in terms of natural frequencies instead of how to plug probabilities or percentages into a formula. PMID:26157397

Group Facilitation: Functions and Skills.

ERIC Educational Resources Information Center

Anderson, L. Frances; Robertson, Sharon E.

1985-01-01

Discusses a model based on a specific set of assumptions about causality and effectiveness in interactional groups. Discusses personal qualities of group facilitators and proposes five major functions and seven skill clusters central to effective group facilitation. (Author/BH)

Competence to Complete Psychiatric Advance Directives: Effects of Facilitated Decision Making

PubMed Central

Swanson, Jeffrey W.; Appelbaum, Paul S.; Swartz, Marvin S.; Ferron, Joelle; Van Dorn, Richard A.; Wagner, H. Ryan

2013-01-01

Psychiatric advance directives (PADs) statutes presume competence to complete these documents, but the range and dimensions of decisional competence among people who actually complete PADs is unknown. This study examines clinical and neuropsychological correlates of performance on a measure to assess competence to complete PADs and investigates the effects of a facilitated PAD intervention on decisional capacity. N = 469 adults with psychotic disorders were interviewed at baseline and then randomly assigned to either a control group in which they received written materials about PADs or to an intervention group in which they were offered an opportunity to meet individually with a trained facilitator to create a PAD. At baseline, domains on the Decisional Competence Assessment Tool for PADs (DCAT-PAD) were most strongly associated with IQ, verbal memory, abstract thinking, and psychiatric symptoms. At one-month follow-up, participants in the intervention group showed more improvement on the DCAT-PAD than controls, particularly among participants with pre-morbid IQ estimates below the median of 100. The results suggest that PAD facilitation is an effective method to boost competence of cognitively-impaired clients to write PADs and make treatment decisions within PADs, thereby maximizing the chances their advance directives will be valid. PMID:17294136

Management competencies: intrinsic or acquired? What competencies are required to move into speech pathology management and beyond?

PubMed

Pilling, Samantha; Slattery, Justine

2004-01-01

Speech pathology managers frequently move into careers beyond their clinical discipline. As practicing speech pathology managers and students of business leadership, we were curious about the nature of career transitions out of speech pathology management. We conducted an exploratory descriptive study investigating the perceived competencies that facilitate such career transitions and when further education is required to effectively equip one for such transition. The perceived skills related to a speech pathology background are identified along with the gaps in competence for moving into general management positions. Career management practices that facilitate this type of career transition are provided as recommendations for career planning.

Using Gemba Boards to Facilitate Evidence-Based Practice in Critical Care.

PubMed

Bourgault, Annette M; Upvall, Michele J; Graham, Alison

2018-06-01

Tradition-based practices lack supporting research evidence and may be harmful or ineffective. Engagement of key stakeholders is a critical step toward facilitating evidence-based practice change. Gemba , derived from Japanese, refers to the real place where work is done. Gemba boards (visual management tools) appear to be an innovative method to engage stakeholders and facilitate evidence-based practice. To explore the use of gemba boards and gemba huddles to facilitate practice change. Twenty-two critical care nurses participated in interviews in this qualitative, descriptive study. Thematic analysis was used to code and categorize interview data. Two researchers reached consensus on coding and derived themes. Data were managed with qualitative analysis software. The code gemba occurred most frequently; a secondary analysis was performed to explore its impact on practice change. Four themes were derived from the gemba code: (1) facilitation of staff, leadership, and interdisciplinary communication, (2) transparency of outcome data, (3) solicitation of staff ideas and feedback, and (4) dissemination of practice changes. Gemba boards and gemba huddles became part of the organizational culture for promoting and disseminating evidence-based practices. Unit-based, publicly located gemba boards and huddles have become key components of evidence-based practice culture. Gemba is both a tool and a process to engage team members and the public to generate clinical questions and to plan, implement, and evaluate practice changes. Future research on the effectiveness of gemba boards to facilitate evidence-based practice is warranted. ©2018 American Association of Critical-Care Nurses.

Managing human resources for successful strategy execution.

PubMed

Arnold, Edwin

2010-01-01

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

[Implementation and (cost-)effectiveness of case management for people with dementia and their informal caregivers: results of the COMPAS study].

PubMed

van Mierlo, Lisa D; MacNeil-Vroomen, Janet; Meiland, Franka J M; Joling, Karlijn J; Bosmans, Judith E; Dröes, Rose Marie; Moll van Charante, Eric P; de Rooij, Sophia E J A; van Hout, Hein P J

2016-12-01

Different forms of case management for dementia have emerged over the past few years. In the COMPAS study (Collaborative dementia care for patients and caregivers study), two prominent Dutch case management forms were studied: the linkage and the integrated care form. Evaluation of the (cost)effectiveness of two dementia case management forms compared to usual care as well as factors that facilitated or impeded their implementation. A mixed methods design with a) a prospective, observational controlled cohort study with 2 years follow-up among 521 dyads of people with dementia and their primary informal caregiver with and without case management; b) interviews with 22 stakeholders on facilitating and impeding factors of the implementation and continuity of the two case management models. Outcome measures were severity and frequency of behavioural problems (NPI) for the person with dementia and mental health complaints (GHQ-12) for the informal caregiver, total met and unmet care needs (CANE) and quality adjusted life years (QALYs). Outcomes showed a better quality of life of informal caregivers in the integrated model compared to the linkage model. Caregivers in the control group reported more care needs than those in both case management groups. The independence of the case management provider in the integrated model facilitated the implementation, while the rivalry between multiple providers in the linkage model impeded the implementation. The costs of care were lower in the linkage model (minus 22 %) and integrated care model (minus 33 %) compared to the control group. The integrated care form was (very) cost-effective in comparison with the linkage form or no case management. The integrated care form is easy to implement.

How nursing leadership and management interventions could facilitate the effective use of ICT by student nurses.

PubMed

Willmer, Marian

2007-03-01

This article makes the case for how evidence-based nursing leadership and management activities could promote, implement and sustain quality patient care by student nurses using Information and Communications Technology. It is on aspects of the findings of a professional doctorate inquiry into Information and Communications Technology use and skills development by student nurses. The 21st century is both an information and knowledge age. Nursing and medical professions are facing the increasing usage of information technology in day-to-day operations with the overall aim of improving the quality of patient care. The quality of the future of the nursing profession is dependent on the calibre of those who are currently socialized to become professional nurses. The new United Kingdom Labour Government, in power since 1997, has placed increasing focus on the effectiveness of the National Health Service and using computers as one way to assist in achieving greater effectiveness. This has implications for nurse education and the future preparation of future nurses to acquire skills in Information and Communications Technology. This is a case study approach using multiple triangulation methodology. This includes: semi-structured interview of six student nurses and four of their mentors; one unstructured meeting with the Research and Development Manager; observational visit to a medical admission ward and a renal unit; one semi-structured meeting with the Information Manager; Review of Documentation - the National Health Service Trust Nursing Strategy; and Review, Application and Development of relevant theory. The overall findings are that student nurses are not using Information and Communications Technology in nursing practice in a structured and systematic way. The reasons for this are very many and very complex but are interrelated. They include strategic resource-based issues, what Jumaa referred to as Time, Human, Equipment, Information, Material and Money resources

Facilitating the improved management of waste in South Africa through a national waste information system

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

Godfrey, Linda

2008-07-01

Developing a waste information system (WIS) for a country is more than just about collecting routine data on waste; it is about facilitating the improved management of waste by providing timely, reliable information to the relevant role-players. It is a means of supporting the waste governance challenges facing South Africa - challenges ranging from strategic waste management issues at national government to basic operational challenges at local government. The paper addresses two hypotheses. The first is that the identified needs of government can provide a platform from which to design a national WIS framework for a developing country such asmore » South Africa, and the second is that the needs for waste information reflect greater, currently unfulfilled challenges in the sustainable management of waste. Through a participatory needs analysis process, it is shown that waste information is needed by the three spheres of government, to support amongst others, informed planning and decision-making, compliance monitoring and enforcement, community participation through public access to information, human, infrastructure and financial resource management and policy development. These needs for waste information correspond closely with key waste management challenges currently facing the country. A shift in governments approach to waste, in line with national and international policy, is evident from identified current and future waste information needs. However, the need for information on landfilling remains entrenched within government, possibly due to the poor compliance of landfill sites in South Africa and the problems around the illegal disposal of both general and hazardous waste.« less

Management type affects composition and facilitative processes in altoandine dry grassland

NASA Astrophysics Data System (ADS)

Catorci, Andrea; Cesaretti, Sabrina; Velasquez, Jose Luis; Burrascano, Sabina; Zeballos, Horacio

2013-10-01

We performed our study in the Dry Puna of the southern Peruvian Andes. Through a comparative approach we aimed to assess the effects of the two management systems, low grazing pressure by wild camelids vs. high grazing pressure by domestic livestock and periodic burning. Our general hypothesis was that the traditional high disturbance regime affects the dry Puna species diversity and composition through modifications of the magnitude of plant-plant-interactions and changes of the community structure due to shifts in species dominance. In 40 plots of 10 × 10 m, the cover value of each species was recorded and the species richness, floristic diversity, and community similarity of each treatment were compared. For each disturbance regime, differences of soil features (organic matter, carbon/nitrogen ratio, and potassium content) were tested. To evaluate plant-plant interactions, 4 linear transect divided into 500 plots of 10 × 10 cm were laid out and co-occurrence analysis was performed. We found that different disturbance regimes were associated with differences in the floristic composition, and that the high disturbance condition had lower species diversity and evenness. A decrease of tall species such as Festuca orthophylla and increase of dwarf and spiny Tetraglochin cristatum shrubs was observed as well. In addition, different disturbance intensities caused differences in the functional composition of the plant communities, since species with avoidance strategies are selected by high grazing pressure. High disturbance intensity was also associated to differences of soil features and to different clumped spatial structure of the dry Puna. Our results indicate also that: positive interactions are often species-specific mainly depending on the features of nurse and beneficiary species; the importance of positive interaction is higher at low grazing pressure than at high disturbance intensity; the magnitude and direction of the herbivory-mediated facilitation

Facilitators and Barriers to Implementing Clinical Governance: A Qualitative Study among Senior Managers in Iran

PubMed Central

RAVAGHI, Hamid; RAFIEI, Sima; HEIDARPOUR, Peigham; MOHSENI, Maryam

2014-01-01

Abstract Background Health care systems should assign quality improvement as their main mission. Clinical governance (CG) is a key strategy to improve quality of health care services. The Iranian Ministry of Health and Medical Education (MOHME) has promoted CG as a framework for safeguarding quality and safety in all hospitals since 2009. The purpose of this study was to explore perceived facilitators and barriers to implementing CG by deputies for curative affairs of Iranian medical universities. Methods A qualitative study was conducted using face to face interviews with a purposeful sample of 43 deputies for curative affairs of Iranian Medical Universities and documents review. Thematic analysis was used to analyze the data Results Five themes were explored including: knowledge and attitude toward CG, culture, organizational factors, managerial factors and barriers. The main perceived facilitating factors were adequate knowledge and positive attitude toward CG, supporting culture, managers’ commitment, effective communication and well designed incentives. Pe rceived barriers were the reverse of facilitators noted above in addition to insufficient resources, legal challenges, workload and parallel quality programs. Conclusions Successful implementation of CG in Iran will require identifying barriers and challenges existing in the way of CG implementation and try to mitigate them by using appropriate facilitators. PMID:26175981

Proprioceptive Neuromuscular Facilitation Flexibility Techniques: Acute Effects on Arterial Blood Pressure.

ERIC Educational Resources Information Center

Cornelius, William L.; Craft-Hamm, Kelley

1988-01-01

The effects of stretching techniques on arterial blood pressure (ABP) were studied in three groups of 20 men each. Each group performed one of three proprioceptive neuromuscular facilitation (PNF) techniques. Results are presented. The study indicates that the benefits of stretching may outweigh the risk of elevated ABP. (JL)

What does it mean to manage sky survey data? A model to facilitate stakeholder conversations

NASA Astrophysics Data System (ADS)

Sands, Ashley E.; Darch, Peter T.

2016-06-01

Astronomy sky surveys, while of great scientific value independently, can be deployed even more effectively when multiple sources of data are combined. Integrating discrete datasets is a non-trivial exercise despite investments in standard data formats and tools. Creating and maintaining data and associated infrastructures requires investments in technology and expertise. Combining data from multiple sources necessitates a common understanding of data, structures, and goals amongst relevant stakeholders.We present a model of Astronomy Stakeholder Perspectives on Data. The model is based on 80 semi-structured interviews with astronomers, computational astronomers, computer scientists, and others involved in the building or use of the Sloan Digital Sky Survey (SDSS) and Large Synoptic Survey Telescope (LSST). Interviewees were selected to ensure a range of roles, institutional affiliations, career stages, and level of astronomy education. Interviewee explanations of data were analyzed to understand how perspectives on astronomy data varied by stakeholder.Interviewees described sky survey data either intrinsically or extrinsically. “Intrinsic” descriptions of data refer to data as an object in and of itself. Respondents with intrinsic perspectives view data management in one of three ways: (1) “Medium” - securing the zeros and ones from bit rot; (2) “Scale” - assuring that changes in state are documented; or (3) “Content” - ensuring the scientific validity of the images, spectra, and catalogs.“Extrinsic” definitions, in contrast, define data in relation to other forms of information. Respondents with extrinsic perspectives view data management in one of three ways: (1) “Source” - supporting the integrity of the instruments and documentation; (2) “Relationship” - retaining relationships between data and their analytical byproducts; or (3) “Use” - ensuring that data remain scientifically usable.This model shows how data management can

Managing frame diversity in environmental participatory processes - Example from the Fogera woreda in Ethiopia.

PubMed

Hassenforder, Emeline; Brugnach, Marcela; Cullen, Beth; Ferrand, Nils; Barreteau, Olivier; Daniell, Katherine Anne; Pittock, Jamie

2016-07-15

Many participatory processes fail to generate social change and collaborative outcomes. This failure can partly be explained by how divergent stakeholders' frames are handled. This paper builds on the framing and participation literature to explain how facilitators can manage frame diversity and foster collaborative outcomes. It suggests two pragmatic steps: identifying frames and managing frames. The two steps are applied to a participatory process for natural resource management in Fogera, Ethiopia. Effectiveness of facilitators' strategies to manage frame diversity in the Fogera case is discussed. Two main elements challenging effectiveness are identified: counter-strategies used by facilitators and most-powerful stakeholders, and the constraining factors knowledge, champions and frame sponsorship. We argue that these elements need to be taken into account by participatory process facilitators when managing frame diversity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Orthographic Facilitation of First Graders' Vocabulary Learning: Does Directing Attention to Print Enhance the Effect?

ERIC Educational Resources Information Center

Chambré, Susan J.; Ehri, Linnea C.; Ness, Molly

2017-01-01

Orthographic facilitation refers to the boost in vocabulary learning that is provided when spellings are shown during study periods, but not during testing. The current study examined orthographic facilitation in beginning readers and whether directing their attention to print enhances the effect. In an experiment, first graders (N = 45) were…

Watershed Management Optimization Support Tool v3

EPA Science Inventory

The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that facilitates integrated water management at the local or small watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed context that is, accou...

Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO) protocol: testing the effectiveness of a facilitation intervention in a pragmatic, cluster-randomised trial with an embedded process evaluation and cost analysis.

PubMed

Bucknall, Tracey K; Harvey, Gill; Considine, Julie; Mitchell, Imogen; Rycroft-Malone, Jo; Graham, Ian D; Mohebbi, Mohammadreza; Watts, Jennifer; Hutchinson, Alison M

2017-07-11

Vital signs are the primary indicator of physiological status and for determining the need for urgent clinical treatment. Yet, if physiological signs of deterioration are missed, misinterpreted or mismanaged, then critical illness, unplanned intensive care admissions, cardiac arrest and death may ensue. Although evidence demonstrates the benefit of early recognition and management of deteriorating patients, failure to escalate care and manage deteriorating patients remains a relatively frequent occurrence in hospitals. A pragmatic cluster-randomised controlled trial design will be used to measure clinical effectiveness and cost of a facilitation intervention to improve nurses' vital sign measurement, interpretation, treatment and escalation of care for patients with abnormal vital signs. A cost consequence analysis will evaluate the intervention cost and effectiveness, and a process evaluation will determine how the implementation of the intervention contributes to outcomes. We will compare clinical outcomes and costs from standard implementation of clinical practice guidelines (CPGs) to facilitated implementation of CPGs. The primary outcome will be adherence to the CPGs by nurses, as measured by escalation of care as per organisational policy. The study will be conducted in four Australian major metropolitan teaching hospitals. In each hospital, eight to ten wards will be randomly allocated to intervention and control groups. Control wards will receive standard implementation of CPGs, while intervention wards will receive standard CPG implementation plus facilitation, using facilitation methods and processes tailored to the ward context. The intervention will be administered to all nursing staff at the ward level for 6 months. At each hospital, two types of facilitators will be provided: a hospital-level facilitator as the lead; and two ward-level facilitators for each ward. This study uses an innovative, networked approach to facilitation to enable uptake of

Facilitating social support: member-leader communication in a breast cancer support group.

PubMed

Beck, Stephenson J; Keyton, Joann

2014-01-01

Early detection and treatment have resulted in more women surviving breast cancer; increased survivorship has also increased the need for breast cancer support groups (BCSG). The ostensible goal of such groups is to provide support for the physical and emotional stressors that cancer survivors face, as well as provide information on coping and treatment options. Although scholars have examined the effects of support groups on their group members, the examination of group facilitator messages has been largely neglected. The goal of this study was to extend theory on group leader behavior, specifically investigating how member-leader messages create social support in support groups. The transcribed conversations of weekly meetings of a BCSG were examined using Interaction Process Analysis to discover how the member-leader facilitated the group's enactment and management of social support. Across the meetings, task talk dominated (primarily statements of orientation or information). Furthermore, analysis of interaction sequences between the support group facilitator and other members revealed 2 broad categories of task-oriented facilitation techniques (changing the focus, clarification) and 1 category of socioemotional facilitation techniques (showing support). Support group facilitators need the ability to facilitate both task and relational aspects of social support. Facilitator behaviors were highlighted as being instrumental to the creation of social support. The results from this study indicate that the ability to change the focus of interaction, to provide and require clarification on complex issues, and to show support through relational messages is needed in facilitator training.

Management and Accountability Procedures: DEEP - The New Mexico State Facilitator.

ERIC Educational Resources Information Center

New Mexico Univ., Albuquerque. Coll. of Education.

Presented is a description of how DEEP (Developmental Economic Education Program) monitors activity and achievements to ensure that objectives are met effectively and efficiently, and that evidence of achievement is available for reports. The purposes of DEEP management and accountability procedures are: (1) to maintain both long term and short…

Neophyte facilitator experiences of interprofessional education: implications for faculty development.

PubMed

Egan-Lee, Eileen; Baker, Lindsay; Tobin, Stasey; Hollenberg, Elisa; Dematteo, Dale; Reeves, Scott

2011-09-01

The facilitation of learners from different professional groups requires a range of interprofessional knowledge and skills (e.g. an understanding of possible sources of tension between professions) in addition to those that are more generic, such as how to manage a small group of learners. The development and delivery of interprofessional education (IPE) programs tends to rely on a small cohort of facilitators who have typically gained expertise through 'hands-on' involvement in facilitating IPE and through mentorship from more experienced colleagues. To avoid burn-out and to meet a growing demand for IPE, a larger number of facilitators are needed. However, empirical evidence regarding effective approaches to prepare for this type of work is limited. This article draws on data from a multiple case study of four IPE programs based in an urban setting in North America with a sample of neophyte facilitators and provides insight into their perceptions and experiences in preparing for and delivering IPE. Forty-one semi-structured interviews were conducted before (n = 20) and after (n = 21) program delivery with 21 facilitators. Findings indicated that despite participating in a three-fold faculty development strategy designed to support them in their IPE facilitation work, many felt unprepared and continued to have a poor conceptual understanding of core IPE and interprofessional collaboration principles, resulting in problematic implications (e.g. 'missed teachable moments') within their IPE programs. Findings from this study are discussed in relation to the IPE, faculty development and wider educational literature before implications are offered for the future delivery of interprofessional faculty development activities.

Using collaborative research to facilitate student learning.

PubMed

Thompson, C J; McNeill, J A; Sherwood, G D; Starck, P L

2001-08-01

Developing research partnerships between academia and the service sector is an innovative way to meet the demand for high-quality, cost-effective, and clinically oriented research. Undergraduate student participation in clinical research is an educational strategy to facilitate positive mindsets toward research. This article outlines the methodological steps in recruiting and training undergraduate students for clinical research teams to benefit nurse educators, nurse researchers, students, and institutional partners. Student volunteers collected data for a study examining patient satisfaction with pain management practices. The research proposal was used to demonstrate principles of the research process and to familiarize the students with the study. A detailed study protocol guided the entire team through the project. Student sensitivity to pain assessment and management was enhanced. Learning the research process and the students' appreciation for the rigors of research were reinforced using this experiential model. Student evaluation of the research experience is presented.

Oligonucleotide facilitators may inhibit or activate a hammerhead ribozyme.

PubMed Central

Jankowsky, E; Schwenzer, B

1996-01-01

Facilitators are oligonucleotides capable of affecting hammerhead ribozyme activity by interacting with the substrate at the termini of the ribozyme. Facilitator effects were determined in vitro using a system consisting of a ribozyme with 7 nucleotides in every stem sequence and two substrates with inverted facilitator binding sequences. The effects of 9mer and 12mer RNA as well as DNA facilitators which bind either adjacent to the 3'- or 5'-end of the ribozyme were investigated. A kinetic model was developed which allows determination of the apparent dissociation constant of the ribozyme-substrate complex from single turnover reactions. We observed a decreased dissociation constant of the ribozyme-substrate complex due to facilitator addition corresponding to an additional stabilization energy of delta delta G=-1.7 kcal/mol with 3'-end facilitators. The cleavage rate constant was increased by 3'-end facilitators and decreased by 5'-end facilitators. Values for Km were slightly lowered by all facilitators and kcat was increased by 3'-end facilitators and decreased by 5'-end facilitators in our system. Generally the facilitator effects increased with the length of the facilitators and RNA provided greater effects than DNA of the same sequence. Results suggest facilitator influences on several steps of the hammerhead reaction, substrate association, cleavage and dissociation of products. Moreover, these effects are dependent in different manners on ribozyme and substrate concentration. This leads to the conclusion that there is a concentration dependence whether activation or inhibition is caused by facilitators. Conclusions are drawn with regard to the design of hammerhead ribozyme facilitator systems. PMID:8602353

Tactile Ranschburg effects: facilitation and inhibitory repetition effects analogous to verbal memory.

PubMed

Roe, Daisy; Miles, Christopher; Johnson, Andrew J

2017-07-01

The present paper examines the effect of within-sequence item repetitions in tactile order memory. Employing an immediate serial recall procedure, participants reconstructed a six-item sequence tapped upon their fingers by moving those fingers in the order of original stimulation. In Experiment 1a, within-sequence repetition of an item separated by two-intervening items resulted in a significant reduction in recall accuracy for that repeated item (i.e., the Ranschburg effect). In Experiment 1b, within-sequence repetition of an adjacent item resulted in significant recall facilitation for that repeated item. These effects mirror those reported for verbal stimuli (e.g., Henson, 1998a . Item repetition in short-term memory: Ranschburg repeated. Journal of Experimental Psychology: Learning, Memory, and Cognition, 24(5), 1162-1181. doi:doi.org/10.1037/0278-7393.24.5.1162). These data are the first to demonstrate the Ranschburg effect with non-verbal stimuli and suggest further cross-modal similarities in order memory.

Factors that facilitate registered nurses in their first-line nurse manager role.

PubMed

Cziraki, Karen; McKey, Colleen; Peachey, Gladys; Baxter, Pamela; Flaherty, Brenda

2014-11-01

To determine the factors that attract and retain Registered Nurses in the first-line nurse manager role. The first-line nurse manger role is pivotal in health-care organisations. National demographics suggest that Canada will face a first-line nurse manager shortage because of retirement in the next decade. Determination of factors that attract and retain Registered Nurses will assist organisations and policy makers to employ strategies to address this shortage. The study used an exploratory, descriptive qualitative approach, consisting of semi-structured individual interviews with 11 Registered Nurses in first-line nurse manager roles. The findings revealed a discrepancy between the factors that attract and retain Registered Nurses in the first-line nurse manager role, underscored the importance of the mentor role and confirmed the challenges encountered by first-line nurse managers practicing in the current health-care environment. The first-line nurse manager role has been under studied. Further research is warranted to understand which strategies are most effective in supporting first-line nurse managers. Strategies to support nurses in the first-line nurse manager role are discussed for the individual, programme, organisation and health-care system/policy levels. © 2013 John Wiley & Sons Ltd.

Competition and cooperation among similar representations: toward a unified account of facilitative and inhibitory effects of lexical neighbors.

PubMed

Chen, Qi; Mirman, Daniel

2012-04-01

One of the core principles of how the mind works is the graded, parallel activation of multiple related or similar representations. Parallel activation of multiple representations has been particularly important in the development of theories and models of language processing, where coactivated representations (neighbors) have been shown to exhibit both facilitative and inhibitory effects on word recognition and production. Researchers generally ascribe these effects to interactive activation and competition, but there is no unified explanation for why the effects are facilitative in some cases and inhibitory in others. We present a series of simulations of a simple domain-general interactive activation and competition model that is broadly consistent with more specialized domain-specific models of lexical processing. The results showed that interactive activation and competition can indeed account for the complex pattern of reversals. Critically, the simulations revealed a core computational principle that determines whether neighbor effects are facilitative or inhibitory: strongly active neighbors exert a net inhibitory effect, and weakly active neighbors exert a net facilitative effect.

Landscapes of facilitation: how self-organized patchiness of aquatic macrophytes promotes diversity in streams.

PubMed

Cornacchia, Loreta; van de Koppel, Johan; van der Wal, Daphne; Wharton, Geraldene; Puijalon, Sara; Bouma, Tjeerd J

2018-04-01

Spatial heterogeneity plays a crucial role in the coexistence of species. Despite recognition of the importance of self-organization in creating environmental heterogeneity in otherwise uniform landscapes, the effects of such self-organized pattern formation in promoting coexistence through facilitation are still unknown. In this study, we investigated the effects of pattern formation on species interactions and community spatial structure in ecosystems with limited underlying environmental heterogeneity, using self-organized patchiness of the aquatic macrophyte Callitriche platycarpa in streams as a model system. Our theoretical model predicted that pattern formation in aquatic vegetation - due to feedback interactions between plant growth, water flow and sedimentation processes - could promote species coexistence, by creating heterogeneous flow conditions inside and around the plant patches. The spatial plant patterns predicted by our model agreed with field observations at the reach scale in naturally vegetated rivers, where we found a significant spatial aggregation of two macrophyte species around C. platycarpa. Field transplantation experiments showed that C. platycarpa had a positive effect on the growth of both beneficiary species, and the intensity of this facilitative effect was correlated with the heterogeneous hydrodynamic conditions created within and around C. platycarpa patches. Our results emphasize the importance of self-organized patchiness in promoting species coexistence by creating a landscape of facilitation, where new niches and facilitative effects arise in different locations. Understanding the interplay between competition and facilitation is therefore essential for successful management of biodiversity in many ecosystems. © 2018 The Authors Ecology published by Wiley Periodicals, Inc. on behalf of Ecological Society of America.

Effects of neuromuscular joint facilitation on bridging exercises with respect to deep muscle changes.

PubMed

Zhou, Bin; Huang, QiuChen; Zheng, Tao; Huo, Ming; Maruyama, Hitoshi

2015-05-01

[Purpose] This study examined the effects of neuromuscular joint facilitation on bridging exercises by assessing the cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis. [Subjects] Twelve healthy men. [Methods] Four exercises were evaluated: (a) supine resting, (b) bridging resistance exercise involving posterior pelvic tilting, (c) bridging resistance exercise involving anterior pelvic tilting, and (d) bridging resistance exercise involving neuromuscular joint facilitation. The cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis were measured during each exercise. [Results] The cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis were significantly greater in the neuromuscular joint facilitation group than the others. [Conclusion] Neuromuscular joint facilitation intervention improves the function of deep muscles such as the multifidus muscle and musculus transversus abdominis. Therefore, it can be recommended for application in clinical treatments such as that for back pain.

A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance.

PubMed

Hung, Susanna Lok Lam; Fu, Sau Nga; Lau, Po Shan; Wong, Samuel Yeung Shan

2015-01-31

This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer patients to the appropriate multidisciplinary team in public outpatient primary care setting. We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged ≥ 60 who failed to attend the nurse-led case manager clinic were interviewed. They all came from a socially deprived urban district in Hong Kong. Content and thematic analysis was performed. Seven men and twelve women aged 60 to 89 were interviewed. Nine of them received no formal education and ten of them attended up to primary school. The reasons for non-attendance included attitude and poor knowledge towards diabetes complication screening and confusion of the nurse-led clinic as an educational talk. Most respondents could not understand the reason for the screening of diabetic complications, the concept of multidisciplinary care and the procedure and outcomes of nurse assessment. Five respondents were unable to follow multiple appointments because they could not read. Other reasons included physical barriers and comorbidity, family and financial constraint. They either had a tight daily schedule because of the need to take care of family members, or the family members who brought them to clinic had difficulty in attending multiple appointments. Enhanced understanding of the importance and procedure of diabetes multidisciplinary management, a flexible appointment system and a single clear appointment sheet may facilitate their attendance. Poorly-educated Chinese elderly with DM and their care givers faced physical, social and psychological barriers when attending the nurse-led case manager clinic. Strategies targeting on their low literacy include effective communication and education

Barriers and facilitators to electronic documentation in a rural hospital.

PubMed

Whittaker, Alice A; Aufdenkamp, Marilee; Tinley, Susan

2009-01-01

The purpose of the study was to explore nurses' perceptions of barriers and facilitators to adoption of an electronic health record (EHR) in a rural Midwestern hospital. This study was a qualitative, descriptive design. The Staggers and Parks Nurse-Computer Interaction Framework was used to guide directed content analysis. Eleven registered nurses from oncology and medical-surgical units were interviewed using three semistructured interview questions. Predetermined codes and operational definitions were developed from the Staggers and Parks framework. Narrative data were analyzed by each member of the research team and group consensus on coding was reached through group discussions. Participants were able to identify computer-related, nurse-related, and contextual barriers and facilitators to implementation of EHR. In addition, two distinct patterns of perceptions and acceptance were identified. The Staggers and Parks Nurse-Computer Interaction framework was found to be useful in identifying computer, nurse, and contextual characteristics that act as facilitators or barriers to adoption of an EHR system. Acceptance and use of an EHR are enhanced when barriers are managed and facilitators are supported. Understanding and management of facilitators and barriers to EHR adoption may impact nurses' ability to provide and document nursing care.

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES.

PubMed

Ysa, Tamyko; Sierra, Vicenta; Esteve, Marc

2014-09-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized.

The immediate effect of neuromuscular joint facilitation on the rotation of the tibia during walking.

PubMed

Li, Desheng; Huang, Qiuchen; Huo, Ming; Hiiragi, Yukinobu; Maruyama, Hitoshi

2017-01-01

[Purpose] The aim of this study was to investigate the change in tibial rotation during walking among young adults after neuromuscular joint facilitation therapy. [Subjects and Methods] The subjects were twelve healthy young people (6 males, 6 females). A neuromuscular joint facilitation intervention and nonintervention were performed. The interventions were performed one after the other, separated by a 1-week interval. The order of the interventions was completely randomized. The rotation of the tibia during walking was evaluated before and after treatment. [Results] The neuromuscular joint facilitation group demonstrated increased lateral rotation of the tibia in the overall gait cycle and stance phase, and decreased medial rotation of the tibia in the overall gait cycle, stance phase, and swing phase after the neuromuscular joint facilitation intervention. In the control group, there were no significant differences. [Conclusion] These results suggest neuromuscular joint facilitation intervention has an immediate effect on the rotational function of the knee.

Side Effects (Management)

MedlinePlus

... cancer care is relieving side effects, called symptom management, palliative care, or supportive care. It is important ... treat them. To learn about the symptoms and management of the long-term side effects of cancer ...

Facilitating the use of implicit memory and learning in the physical therapy management of individuals with Alzheimer disease: a case series.

PubMed

White, Laura; Ford, Matthew P; Brown, Cynthia J; Peel, Claire; Triebel, Kristen L

2014-01-01

Physical rehabilitation of individuals with Alzheimer disease (AD) is often complicated by impairments in explicit memory and learning. Rehabilitation strategies that facilitate the use of the preserved implicit memory system may be effective in treating patients with AD. The purpose of this case series is to describe the application of these strategies, including high-repetition practice, errorless learning (EL), and spaced retrieval, to the physical therapy management of individuals with moderate AD. Three women aged 89 to 95 years with moderate AD who resided in an assisted living facility participated in physical therapy to address their mobility limitations. Twelve physical therapy sessions were scheduled over a period of 4 weeks. Interventions were individually designed to address the mobility needs of each patient, and rehabilitation strategies based on implicit learning principles were integrated into the interventions. All patients participated in at least 10 of the 12 physical therapy sessions. Improvements in performance of objective measures of balance were observed in all patients, although only 1 patient's balance score exceeded the minimal detectable change. No significant clinical change was observed in any patients on the Timed Up and Go Test or self-selected gait speed. Principles of implicit learning were integrated into the interventions for these patients with moderate AD. However, the feasibility of applying the EL paradigm was limited. Further research on the effectiveness of EL, spaced retrieval, and other rehabilitation strategies that facilitate implicit learning of mobility skills in patients with AD is needed to promote optimal physical therapy outcomes in this patient population.

Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'.

PubMed

Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F

2012-03-14

A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

50 CFR 648.15 - Facilitation of enforcement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Facilitation of enforcement. 648.15 Section 648.15 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE FISHERIES OF THE NORTHEASTERN UNITED STATES General...

Facilitating a just and trusting culture.

PubMed

Pattison, Jill; Kline, Theresa

2015-01-01

The purpose of this paper is to identify managerial and organizational characteristics and behaviors that facilitate the fostering of a just and trusting culture within the healthcare system. Two studies were conducted. The initial qualitative one was used to identify themes based on interviews with health care workers that facilitate a just and trusting culture. The quantitative one used a policy-capturing design to determine which factors were most likely to predict outcomes of manager and organizational trust. The factors of violation type (ability vs integrity), providing an explanation or not, blame vs no blame by manager, and blame vs no blame by organization were all significant predictors of perceptions of trust. Limitations to the generalizability of findings included both a small and non-representative sample from one health care region. The present findings can be useful in developing training systems for managers and organizational executive teams for managing medical error events in a manner that will help develop a just and trusting culture. A just and trusting culture should enhance the likelihood of reporting medical errors. Improved reporting, in turn, should enhance patient safety. This is the first field study experimentally manipulating aspects of organizational trust within the health care sector. The use of policy-capturing is a unique feature that sheds light into the decision-making of health care workers as to the efficaciousness of particular managerial and organizational characteristics that impact a just and trusting culture.

IPM Delivery and Facilitation of Innovation Through Technology - National

Science.gov Websites

Delivery IPM Delivery The Regional IPM Centers provide Information Systems to help facilitate communication and sharing of information related to Integrated Pest Management. Below are the various offerings that suggestions for add-ins that may assist project management. For more information, contact Joe LaForest or the

Practical ways to facilitate ergonomics improvements in occupational health practice.

PubMed

Kogi, Kazutaka

2012-12-01

Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES

PubMed Central

YSA, TAMYKO; SIERRA, VICENTA; ESTEVE, MARC

2014-01-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized. PMID:25520529

Barriers and facilitators of care for diverse patients: Nurse leader perspectives and nurse manager implications.

PubMed

Ogbolu, Yolanda; Scrandis, Debra A; Fitzpatrick, Grace

2018-01-01

To examine chief nurse executives' perspectives on: (1) the provision of culturally and linguistically appropriate services in hospitals and (2) to identify barriers and facilitators associated with the implementation of culturally and linguistically appropriate services. Hospitals continue to face challenges providing care to diverse patients. The uptake of standards related to culturally and linguistically appropriate services into clinical practice is sluggish, despite potential benefits, including reducing health disparities, patient errors, readmissions and improving patient experiences. A qualitative study with chief nurse executives from one eastern United States (US). Data were analysed using content analysis. Seven themes emerged: (1) lack of awareness of resources for health care organisations; (2) constrained cultural competency training; (3) suboptimal resources (cost and time); (4) mutual understanding; (5) limited workplace diversity; (6) community outreach programmes; and (7) the management of unvoiced patient expectations. As the American population diversifies, providing culturally and linguistically appropriate services remains a priority for nurse leaders. Being aware and utilizing the resources, policies and best practices available for the implementation of culturally and linguistically appropriate services can assist nursing managers in reaching their goals of providing high quality care to diverse populations. Nurse managers are key in aligning the unit's resources with organisational goals related to the provision of culturally and linguistically appropriate services by providing the operational leadership to eliminate barriers and to enhance the uptake of best practices related to culturally and linguistically appropriate services. © 2017 John Wiley & Sons Ltd.

Emotional Facilitation Effect in the Picture-Word Interference Task: An ERP Study

ERIC Educational Resources Information Center

Liu, Baolin; Xin, Shuai; Jin, Zhixing; Hu, Yu; Li, Yang

2010-01-01

In this paper, we aimed to verify the emotional facilitation effect in the picture-word interference task using event-related potentials. Twenty-one healthy subjects were asked to categorize the emotional valences of pictures accompanied by emotionally congruent, either centrally or laterally positioned Chinese words. For both the foveal and…

50 CFR 679.8 - Facilitation of enforcement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Facilitation of enforcement. 679.8 Section 679.8 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA General...

Effective behaviour change techniques in the prevention and management of childhood obesity.

PubMed

Martin, J; Chater, A; Lorencatto, F

2013-10-01

interventions (prompting generalisation of a target behaviour). We identified that for management trials, providing information on the consequences of behaviour in general was a feature of non-effective interventions and for prevention trials, providing information on the consequences of behaviour in general, providing rewards contingent on successful behaviour and facilitating social comparison were non-effective. To design effective behaviour change programmes for the prevention and management of childhood obesity, we would recommend utilising the BCTs identified as effective in this review. The impact on intervention effectiveness of combining BCTs should be the topic of further research.

Familiarity facilitates feature-based face processing.

PubMed

Visconti di Oleggio Castello, Matteo; Wheeler, Kelsey G; Cipolli, Carlo; Gobbini, M Ida

2017-01-01

Recognition of personally familiar faces is remarkably efficient, effortless and robust. We asked if feature-based face processing facilitates detection of familiar faces by testing the effect of face inversion on a visual search task for familiar and unfamiliar faces. Because face inversion disrupts configural and holistic face processing, we hypothesized that inversion would diminish the familiarity advantage to the extent that it is mediated by such processing. Subjects detected personally familiar and stranger target faces in arrays of two, four, or six face images. Subjects showed significant facilitation of personally familiar face detection for both upright and inverted faces. The effect of familiarity on target absent trials, which involved only rejection of unfamiliar face distractors, suggests that familiarity facilitates rejection of unfamiliar distractors as well as detection of familiar targets. The preserved familiarity effect for inverted faces suggests that facilitation of face detection afforded by familiarity reflects mostly feature-based processes.

An effective tool to manage the distribution of medicines and monitor the treatment in hospital pharmacies.

PubMed

Franzoso, Gianpaolo

2014-01-01

Introduction The purpose of the article is to share a modus operandi and a tool that allows the recruitment and management of thousands of patients and their treatment by using a simple software created by the author and made freely available to all colleague-pharmacists. The author, a pharmacist, created this database because there were no tools on the market with all the features needed to manage the treatment of patients and the orders of drugs to ensure continuity of care without waste of public money. Methods The data collection is facilitated by the software and allows the monitoring of treatment of the patients and their re-evaluation. This tool can create a table containing all the information needed to predict the demand for drugs, the timing of therapies and of the treatment plans. It is an effective instrument to calculate the optimal purchase of drugs and the delivery of therapies to patients. Conclusions A simple tool that allows the management of many patients, reduces research time and facilitates the control of therapies. It allows us to optimize inventory and minimize the stock of drugs. It allows the pharmacist to focus attention on the clinical management of the patient by helping him to follow therapy and respond to his needs.

An Appreciative Exploration of How Schools Create a Sense of Belonging to Facilitate the Successful Transition to a New School for Pupils Involved in a Managed Move

ERIC Educational Resources Information Center

Flitcroft, Deborah; Kelly, Catherine

2016-01-01

Much of the current guidance on managed moves focuses on the benefits of the "fresh start" provided. This paper describes an appreciative inquiry to explore how schools in one local authority create a sense of belonging to facilitate a fresh start for pupils involved in a managed move to a new school. Six deputy head teachers with…

Spatial pattern formation facilitates eradication of infectious diseases

PubMed Central

Eisinger, Dirk; Thulke, Hans-Hermann

2008-01-01

Control of animal-born diseases is a major challenge faced by applied ecologists and public health managers. To improve cost-effectiveness, the effort required to control such pathogens needs to be predicted as accurately as possible. In this context, we reviewed the anti-rabies vaccination schemes applied around the world during the past 25 years. We contrasted predictions from classic approaches based on theoretical population ecology (which governs rabies control to date) with a newly developed individual-based model. Our spatially explicit approach allowed for the reproduction of pattern formation emerging from a pathogen's spread through its host population. We suggest that a much lower management effort could eliminate the disease than that currently in operation. This is supported by empirical evidence from historic field data. Adapting control measures to the new prediction would save one-third of resources in future control programmes. The reason for the lower prediction is the spatial structure formed by spreading infections in spatially arranged host populations. It is not the result of technical differences between models. Synthesis and applications. For diseases predominantly transmitted by neighbourhood interaction, our findings suggest that the emergence of spatial structures facilitates eradication. This may have substantial implications for the cost-effectiveness of existing disease management schemes, and suggests that when planning management strategies consideration must be given to methods that reflect the spatial nature of the pathogen–host system. PMID:18784795

50 CFR 600.730 - Facilitation of enforcement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Facilitation of enforcement. 600.730 Section 600.730 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... preferred method for communicating between vessels. If the size of the vessel and the wind, sea, and...

50 CFR 600.730 - Facilitation of enforcement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Facilitation of enforcement. 600.730 Section 600.730 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... preferred method for communicating between vessels. If the size of the vessel and the wind, sea, and...

50 CFR 600.730 - Facilitation of enforcement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Facilitation of enforcement. 600.730 Section 600.730 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... preferred method for communicating between vessels. If the size of the vessel and the wind, sea, and...

50 CFR 640.8 - Facilitation of enforcement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Facilitation of enforcement. 640.8 Section 640.8 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE SPINY LOBSTER FISHERY OF THE GULF OF MEXICO AND SOUTH ATLANTIC General...

50 CFR 640.8 - Facilitation of enforcement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Facilitation of enforcement. 640.8 Section 640.8 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE SPINY LOBSTER FISHERY OF THE GULF OF MEXICO AND SOUTH ATLANTIC General...

Barriers and Facilitators Affecting Patient Portal Implementation from an Organizational Perspective: Qualitative Study.

PubMed

Kooij, Laura; Groen, Wim G; van Harten, Wim H

2018-05-11

The number of patient portals is rising, and although portals can have positive effects, their implementation has major impacts on the providing health care institutions. However, little is known about the organizational factors affecting successful implementation. Knowledge of the specific barriers to and facilitators of various stakeholders is likely to be useful for future implementations. The objective of this study was to identify the barriers to and facilitators of patient portal implementation facing various stakeholders within hospital organizations in the Netherlands. Purposive sampling was used to select hospitals of various types. A total of 2 university medical centers, 3 teaching hospitals, and 2 general hospitals were included. For each, 3 stakeholders were interviewed: (1) medical professionals, (2) managers, and (3) information technology employees. In total, 21 semistructured interviews were conducted using the Grol and Wensing model, which describes barriers to and facilitators of change in health care practice at 6 levels: (1) innovation; (2) individual professional; (3) patient; (4) social context; (5) organizational context; and (6) economic and political context. Two researchers independently selected and coded quotes by applying this model using a (deductive) directed content approach. Additional factors related to technical and portal characteristics were added using the model of McGinn et al, developed for implementation of electronic health records. In total, we identified 376 quotes, 26 barriers, and 28 facilitators. Thirteen barriers and 12 facilitators were common for all stakeholder groups. The facilitators' perceived usefulness (especially less paperwork) was mentioned by all the stakeholders, followed by subjects' positive attitude. The main barriers were lack of resources (namely, lack of staff and materials), financial difficulties (especially complying with high costs, lack of reimbursements), and guaranteeing privacy and security

Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: a reflective tool to enhance interdisciplinary teamwork using Structured, Facilitated Action Research for Implementation.

PubMed

Nancarrow, Susan A; Smith, Tony; Ariss, Steven; Enderby, Pamela M

2015-07-01

Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool (IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take

A Facilitating Effective Teaching through Learning Based on Learning Styles and Ways of Thinking

ERIC Educational Resources Information Center

Ginting, Siti Aisyah

2017-01-01

The study deals with learning styles and ways of thinking in facilitating effective teaching. The objective of this study was to investigate the relationship between students' learning style and ways of thinking toward effective teaching. This study was conducted by using correlational design. The population of the study were 360 university…

Stress management can facilitate weight loss in Greek overweight and obese women: a pilot study.

PubMed

Christaki, E; Kokkinos, A; Costarelli, V; Alexopoulos, E C; Chrousos, G P; Darviri, C

2013-07-01

Stress and negative emotions have been shown to be critical factors in inducing overeating as a form of maladaptive coping in obese people. The present study aimed to evaluate the efficacy of an 8-week stress management programme that includes progressive muscle relaxation (PMR) and diaphragmatic breathing on weight loss and eating behaviour in a sample of overweight and obese women who started a weight-loss programme. A total of 34 women with a mean (SD) body mass index of 38.17 (7.19) kg m(-) ² and mean (SD) age 47.35 (11.64) years were recruited from the outpatients Obesity Clinic of a public hospital in Athens. Participants were randomly assigned into a Stress Management (SM) and a control group. Anthropometric measurements were taken before and after the intervention, and the participants completed the following questionnaires: Dutch Eating Behaviour Questionnaire (DEBQ), Eating Attitudes Test (Eat-26), Health Locus of Control (HLC) and Perceived Stress Scale (PSS) before and after the intervention. The findings indicated a significant improvement in weight loss in the SM group [4.44 (0.83) kg] after intervention compared to the control group [1.38 (0.78) kg] (P < 0.05). A higher restrained eating behaviour was observed in the SM group after intervention compared to the control group, although there was no significant difference in perceived stress levels. The intervention group showed greater weight reduction, possibly because of the stress management programme, and a greater dietary restraint was demonstrated by them compared to the control group. It is likely that stress management could facilitate weight loss in obese women; however, more studies are needed to confirm this hypothesis. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

50 CFR 654.8 - Facilitation of enforcement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Facilitation of enforcement. 654.8 Section 654.8 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE STONE CRAB FISHERY OF THE GULF OF MEXICO General Measures § 654.8...

NASA's Risk Management System

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2013-01-01

Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

Watershed Management Optimization Support Tool (WMOST) v3: User Guide

EPA Science Inventory

The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that facilitates integrated water management at the local or small watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed context that is, accou...

Watershed Management Optimization Support Tool (WMOST) v3: Theoretical Documentation

EPA Science Inventory

The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that facilitates integrated water management at the local or small watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed context, accounting fo...

Clinical Data Warehouse: An Effective Tool to Create Intelligence in Disease Management.

PubMed

Karami, Mahtab; Rahimi, Azin; Shahmirzadi, Ali Hosseini

Clinical business intelligence tools such as clinical data warehouse enable health care organizations to objectively assess the disease management programs that affect the quality of patients' life and well-being in public. The purpose of these programs is to reduce disease occurrence, improve patient care, and decrease health care costs. Therefore, applying clinical data warehouse can be effective in generating useful information about aspects of patient care to facilitate budgeting, planning, research, process improvement, external reporting, benchmarking, and trend analysis, as well as to enable the decisions needed to prevent the progression or appearance of the illness aligning with maintaining the health of the population. The aim of this review article is to describe the benefits of clinical data warehouse applications in creating intelligence for disease management programs.

Facilitating smallholder tree farming in fragmented tropical landscapes: Challenges and potentials for sustainable land management.

PubMed

Rahman, Syed Ajijur; Sunderland, Terry; Roshetko, James M; Healey, John Robert

2017-08-01

Under changing land use in tropical Asia, there is evidence of forest product diversification through implementation of tree-based farming by smallholders. This paper assesses in two locations, West Java, Indonesia and eastern Bangladesh, current land use conditions from the perspective of smallholder farmers, the factors that facilitate their adoption of tree farming, and the potential of landscape-scale approaches to foster sustainable land management. Data were collected through rapid rural appraisals, focus group discussions, field observations, semi-structured interviews of farm households and key informant interviews of state agricultural officers. Land at both study sites is typically fragmented due to conversion of forest to agriculture and community settlement. Local land use challenges are associated with pressures of population increase, poverty, deforestation, shortage of forest products, lack of community-scale management, weak tenure, underdeveloped markets, government decision-making with insufficient involvement of local people, and poor extension services. Despite these challenges, smallholder tree farming is found to be successful from farmers' perspectives. However, constraints of local food crop cultivation traditions, insecure land tenure, lack of capital, lack of knowledge, lack of technical assistance, and perceived risk of investing in land due to local conflict (in Bangladesh) limit farmers' willingness to adopt this land use alternative. Overcoming these barriers to adoption will require management at a landscape scale, including elements of both segregation and integration of land uses, supported by competent government policies and local communities having sufficiently high social capital. Copyright © 2017 Elsevier Ltd. All rights reserved.

Developing facilitation skills--a narrative.

PubMed

Newton, Jennifer M

2003-07-01

Effective facilitation has been identified in the literature as one of three elements, along with context and evidence, that have a dynamic and coexisting relationship to enable the successful uptake of evidence into practice. This paper presents an overview of the concept of facilitation within the context of practice development, ahead of a personal and professional reflective account of a 'developing facilitator'. In the summer of 2001, the author was instrumental in organising the first Practice Development School in Melbourne. Thrown in at the deep end, she found herself co-facilitating with an experienced practice developer from the United Kingdom. Having never facilitated in the arena of an action learning group, nor worked in the field of practice development, there was initially a sense of impending overload and drowning in the new knowledge and skills that needed to be acquired. Drawing upon the work of narrative inquiry the author shares her experiences in the anticipation that in telling her story it will assist others in their journey of becoming a facilitator.

Facilitation drives 65 years of vegetation change in the Sonoran Desert

USGS Publications Warehouse

Butterfield, Bradley J.; Betancourt, Julio L.; Turner, Raymond M.; Briggs, John M.

2010-01-01

Ecological processes of low-productivity ecosystems have long been considered to be driven by abiotic controls with biotic interactions playing an insignificant role. However, existing studies present conflicting evidence concerning the roles of these factors, in part due to the short temporal extent of most data sets and inability to test indirect effects of environmental variables modulated by biotic interactions. Using structural equation modeling to analyze 65 years of perennial vegetation change in the Sonoran Desert, we found that precipitation had a stronger positive effect on recruitment beneath existing canopies than in open microsites due to reduced evaporation rates. Variation in perennial canopy cover had additional facilitative effects on juvenile recruitment, which was indirectly driven by effects of density and precipitation on cover. Mortality was strongly influenced by competition as indicated by negative density-dependence, whereas precipitation had no effect. The combined direct, indirect, and interactive facilitative effects of precipitation and cover on recruitment were substantial, as was the effect of competition on mortality, providing strong evidence for dual control of community dynamics by climate and biotic interactions. Through an empirically derived simulation model, we also found that the positive feedback of density on cover produces unique temporal abundance patterns, buffering changes in abundance from high frequency variation in precipitation, amplifying effects of low frequency variation, and decoupling community abundance from precipitation patterns at high abundance. Such dynamics should be generally applicable to low-productivity systems in which facilitation is important and can only be understood within the context of long-term variation in climatic patterns. This predictive model can be applied to better manage low-productivity ecosystems, in which variation in biogeochemical processes and trophic dynamics may be driven by

Independent Effects of Orthographic and Phonological Facilitation on Spoken Word Production in Mandarin

ERIC Educational Resources Information Center

Zhang, Qingfang; Chen, Hsuan-Chih; Weekes, Brendan Stuart; Yang, Yufang

2009-01-01

A picture-word interference paradigm with visually presented distractors was used to investigate the independent effects of orthographic and phonological facilitation on Mandarin monosyllabic word production. Both the stimulus-onset asynchrony (SOA) and the picture-word relationship along different lexical dimensions were varied. We observed a…

Defining the Enrollment Manager: Visionary, Facilitator and Collaborator

ERIC Educational Resources Information Center

Stewart, Gregory

2004-01-01

As enrollments expand, student affairs professionals must recruit and retain students, and manage enrollments. Garland and Grace (1993) note that as a set of strategies, enrollment management provides a systematic approach to attracting, retaining and graduating students, and, therefore, is a critical component in the stable operation of a higher…

Facilitating effects of deep brain stimulation on feedback learning in Parkinson's disease.

PubMed

Meissner, Sarah Nadine; Südmeyer, Martin; Keitel, Ariane; Pollok, Bettina; Bellebaum, Christian

2016-10-15

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) provides an effective treatment for Parkinson's disease (PD) motor symptoms. However, findings of effects on cognitive function such as feedback learning remain controversial and rare. The aim of the present study was to gain a better understanding of cognitive alterations associated with STN-DBS. Therefore, we investigated effects of STN-DBS on active and observational feedback learning in PD. 18 PD patients with STN-DBS and 18 matched healthy controls completed active and observational feedback learning tasks. Patients were investigated ON and OFF STN-DBS. Tasks consisted of learning (with feedback) and test phases (without feedback). STN-DBS improved active learning during feedback trials and PD patients ON (but not OFF) STN-DBS showed comparable performance patterns as healthy controls. No STN-DBS effect was found when assessing performance during active test trials without feedback. In this case, however, STN-DBS effects were found to depend on symptom severity. While more impaired patients benefited from STN-DBS, stimulation had no facilitating effect on patients with less severe symptoms. Along similar lines, the severity of motor symptoms tended to be significantly correlated with differences in active test performance due to STN-DBS. For observational feedback learning, there was a tendency for a positive STN-DBS effect with patients reaching the performance level of healthy controls only ON STN-DBS. The present data suggest that STN-DBS facilitates active feedback learning in PD patients. Furthermore, they provide first evidence that STN-DBS might not only affect learning from own but also from observed actions and outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

Higher Education Change and Its Managers: Alternative Constructions

ERIC Educational Resources Information Center

Hotho, Sabine

2013-01-01

This article is based on a case study conducted in the context of UK higher education change. The article argues that "change" is a construct created in discourses of change policy and change management, and resulting in reductivist change management discourses which may impede rather than facilitate effective change management in the…

Facilitation of contrast detection in near-peripheral vision.

PubMed

Giorgi, Robert G; Soong, Grace P; Woods, Russell L; Peli, Eli

2004-12-01

Foveal detection of a Gabor patch (target) is facilitated by collinear, displaced high-contrast flankers. Polat and Sagi reported that the same phenomenon occurred in the periphery, but no data were presented [Proc. Natl. Acad. Sci. 91 (1994) 1206]. Others have found no facilitation in a limited number of conditions tested. To resolve this apparent conflict, we measured lateral facilitation in the near-periphery using a range of stimulus parameters. We found facilitation for a range of target-flanker distances for peripheral eccentricities up to 6 degrees , but the magnitude of the effect was less than found in central vision. Facilitation varied across subjects and with spatial frequency. Flanker contrast had no effect over the range evaluated (10-80%). Equal facilitation was found for two global arrangements of the stimulus pattern. Facilitation was found using a temporal, but not a spatial two-alternative forced-choice paradigm, accounting for the different results among previous studies. This finding supports previous indications of the role of attention in altering such facilitation. The value of facilitation from lateral interactions for persons with central vision impairment, who have to shift their attention to a peripheral locus constantly, needs to be examined.

Management of recurrent depression.

PubMed

Howell, Cate; Marshall, Charlotte; Opolski, Melissa; Newbury, Wendy

2008-09-01

Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and these principles can be applied to managing depression. This article outlines the principles of chronic disease management, including the use of management plans and a team care approach, and their application to the management of depression. Treatment approaches that systematically assist patients in managing their chronic disease are more effective than those based on acute care. Depression treatment guidelines are available, as well as primary care initiatives which facilitate comprehensive and long term mental health care, including relapse prevention strategies. A number of risk factors for depression relapse have been identified, and research has recommended that novel intensive relapse prevention programs need to be developed.

Barriers and facilitators of evidence-based management of patients with bacterial infections among general dental practitioners: a theory-informed interview study.

PubMed

Newlands, Rumana; Duncan, Eilidh M; Prior, Maria; Elouafkaoui, Paula; Elders, Andrew; Young, Linda; Clarkson, Jan E; Ramsay, Craig R

2016-01-29

General dental practitioners (GDPs) regularly prescribe antibiotics to manage dental infections although most infections can be treated successfully by local measures. Published guidance to support GDPs to make appropriate prescribing decisions exists but there continues to be wide variation in dental antibiotic prescribing. An interview study was conducted as part of the Reducing Antibiotic Prescribing in Dentistry (RAPiD) trial to understand the barriers and facilitators of using local measures instead of prescribing antibiotics to manage bacterial infections. Thirty semi-structured one-to-one telephone interviews were conducted using the Theoretical Domains Framework (TDF). Responses were coded into domains of the TDF and sub-themes. Priority domains (high frequency: ≥50 % interviewees discussed) relevant to behaviour change were identified as targets for future intervention efforts and mapped onto 'intervention functions' of the Behaviour Change Wheel system. Five domains (behavioural regulation, social influences, reinforcement, environmental context and resources, and beliefs about consequences) with seven sub-themes were identified as targets for future intervention. All participants had knowledge about the evidence-based management of bacterial infections, but they reported difficulties in following this due to patient factors and time management. Lack of time was found to significantly influence their decision processes with regard to performing local measures. Beliefs about their capabilities to overcome patient influence, beliefs that performing local measures would impact on subsequent appointment times as well as there being no incentives for performing local measures were also featured. Though no knowledge or basic skills issues were identified, the participants suggested some continuous professional development programmes (e.g. time management, an overview of published guidance) to address some of the barriers. The domain results suggest a number

Emotion processing facilitates working memory performance.

PubMed

Lindström, Björn R; Bohlin, Gunilla

2011-11-01

The effect of emotional stimulus content on working memory performance has been investigated with conflicting results, as both emotion-dependent facilitation and impairments are reported in the literature. To clarify this issue, 52 adult participants performed a modified visual 2-back task with highly arousing positive stimuli (sexual scenes), highly arousing negative stimuli (violent death) and low-arousal neutral stimuli. Emotional stimulus processing was found to facilitate task performance relative to that of neutral stimuli, both in regards to response accuracy and reaction times. No emotion-dependent differences in false-alarm rates were found. These results indicate that emotional information can have a facilitating effect on working memory maintenance and processing of information.

[The Utilization of Health-Related Applications in Chronic Disease Self-Management].

PubMed

Kao, Chi-Wen; Chuang, Hui-Wan; Chen, Ting-Yu

2017-08-01

The dramatic increase in smartphone usage has spurred the development of many health-related mobile applications (apps). On the other hand, population aging and the associated rise in the incidence of chronic disease is increasing the demand for long-term care. Effective chronic disease self-management has been shown to help patients improve their health condition. Numerous smartphone applications currently support patient self-management of chronic disease, facilitating health management and health promotion. The purpose of the present article was to introduce the definition, contents, and types of health-related apps; to discuss the effectiveness of self-management health-related apps in promoting chronic disease management; and to assess and evaluate these apps. We hope that the present article helps give to healthcare professionals and patients who are willing to manage their diseases a general understanding of health-related apps and their potential to facilitate the self-management of chronic diseases.

How Identification Facilitates Effective Learning: The Evaluation of Generic versus Localized Professionalization Training

ERIC Educational Resources Information Center

Bjerregaard, Kirstien; Haslam, S. Alexander; Morton, Thomas

2016-01-01

Worldwide, organizations are keen to ensure that they achieve a performance return from the large investment they make in employee training. This study examines the way in which workgroup identification facilitates trainees' motivation to transfer learning into workplace performance. A 2 × 2 longitudinal study evaluated the effects of a new…

[Effectiveness of managing styles of nursing management staff].

PubMed

Stychno, Ewa

2002-01-01

There are many possibilities of the division of the managing styles. In theory one can distinguish two basic styles: directive and integrative. Generalisations describing both styles result in the fact that they do not reflect reality taking place at work. Because of it they cannot be applied in such a form. Therefore, it is necessary to build up the theoretical concept of the managing styles through decreasing their generality and adjusting them to the reality requirements at the same time. For the reality of management Reddin concept seems to be useful. It describes the organizational behaviour of managers. He noticed that the managing style is effective when it fits into the manager's situation whereas it is ineffective in such a situation, when the manager cannot select and adjust the managing techniques to the circumstances of the concrete decision-taking situation. Putting together 3 handling ways: orientation on assignments, orientation on staff, effectiveness, 8 managing can be differentiated. The aim of the paper was an attempt to check what managing styles are used by the nursing management staff working in hospitals. To determine the managing style a questionnaire consisting of 64 statements divided into 8 groups was applied. The examined persons were assigned to distribute 10 points among the statements belonging to each group of tasks which are supposed to specify their solution in the best way. The nursing management staff prefer the styles belonging to the more effective one in which there is a high orientation on staff.

Barriers and Facilitators Affecting Patient Portal Implementation from an Organizational Perspective: Qualitative Study.

PubMed Central

Kooij, Laura; Groen, Wim G

2018-01-01

Background The number of patient portals is rising, and although portals can have positive effects, their implementation has major impacts on the providing health care institutions. However, little is known about the organizational factors affecting successful implementation. Knowledge of the specific barriers to and facilitators of various stakeholders is likely to be useful for future implementations. Objective The objective of this study was to identify the barriers to and facilitators of patient portal implementation facing various stakeholders within hospital organizations in the Netherlands. Methods Purposive sampling was used to select hospitals of various types. A total of 2 university medical centers, 3 teaching hospitals, and 2 general hospitals were included. For each, 3 stakeholders were interviewed: (1) medical professionals, (2) managers, and (3) information technology employees. In total, 21 semistructured interviews were conducted using the Grol and Wensing model, which describes barriers to and facilitators of change in health care practice at 6 levels: (1) innovation; (2) individual professional; (3) patient; (4) social context; (5) organizational context; and (6) economic and political context. Two researchers independently selected and coded quotes by applying this model using a (deductive) directed content approach. Additional factors related to technical and portal characteristics were added using the model of McGinn et al, developed for implementation of electronic health records. Results In total, we identified 376 quotes, 26 barriers, and 28 facilitators. Thirteen barriers and 12 facilitators were common for all stakeholder groups. The facilitators’ perceived usefulness (especially less paperwork) was mentioned by all the stakeholders, followed by subjects’ positive attitude. The main barriers were lack of resources (namely, lack of staff and materials), financial difficulties (especially complying with high costs, lack of

Facilitating LOS Debriefings: A Training Manual

NASA Technical Reports Server (NTRS)

McDonnell, Lori K.; Jobe, Kimberly K.; Dismukes, R. Key

1997-01-01

This manual is a practical guide to help airline instructors effectively facilitate debriefings of Line Oriented Simulations (LOS). It is based on a recently completed study of Line Oriented Flight Training (LOFT) debriefings at several U.S. airlines. This manual presents specific facilitation tools instructors can use to achieve debriefing objectives. The approach of the manual is to be flexible so it can be tailored to the individual needs of each airline. Part One clarifies the purpose and objectives of facilitation in the LOS setting. Part Two provides recommendations for clarifying roles and expectations and presents a model for organizing discussion. Part Tree suggests techniques for eliciting active crew participation and in-depth analysis and evaluation. Finally, in Part Four, these techniques are organized according to the facilitation model. Examples of how to effectively use the techniques are provided throughout, including strategies to try when the debriefing objectives are not being fully achieved.

Does the knowledge-to-action (KTA) framework facilitate physical demands analysis development for firefighter injury management and return-to-work planning?

PubMed

Sinden, Kathryn; MacDermid, Joy C

2014-03-01

Employers are tasked with developing injury management and return-to-work (RTW) programs in response to occupational health and safety policies. Physical demands analyses (PDAs) are the cornerstone of injury management and RTW development. Synthesizing and contextualizing policy knowledge for use in occupational program development, including PDAs, is challenging due to multiple stakeholder involvement. Few studies have used a knowledge translation theoretical framework to facilitate policy-based interventions in occupational contexts. The primary aim of this case study was to identify how constructs of the knowledge-to-action (KTA) framework were reflected in employer stakeholder-researcher collaborations during development of a firefighter PDA. Four stakeholder meetings were conducted with employee participants who had experience using PDAs in their occupational role. Directed content analysis informed analyses of meeting minutes, stakeholder views and personal reflections recorded throughout the case. Existing knowledge sources including local data, stakeholder experiences, policies and priorities were synthesized and tailored to develop a PDA in response to the barriers and facilitators identified by the firefighters. The flexibility of the KTA framework and synthesis of multiple knowledge sources were identified strengths. The KTA Action cycle was useful in directing the overall process but insufficient for directing the specific aspects of PDA development. Integration of specific PDA guidelines into the process provided explicit direction on best practices in tailoring the PDA and knowledge synthesis. Although the themes of the KTA framework were confirmed in our analysis, order modification of the KTA components was required. Despite a complex context with divergent perspectives successful implementation of a draft PDA was achieved. The KTA framework facilitated knowledge synthesis and PDA development but specific standards and modifications to the KTA

Facilitating the implementation of clinical technology in healthcare: what role does a national agency play?

PubMed

Harvey, Gill; Llewellyn, Sue; Maniatopoulos, Greg; Boyd, Alan; Procter, Rob

2018-05-10

Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi-structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency's intended roll out strategy using passive web-based facilitation appeared to have little impact. When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active

A systematic review of factors influencing knowledge management and the nurse leaders' role.

PubMed

Lunden, Anne; Teräs, Marianne; Kvist, Tarja; Häggman-Laitila, Arja

2017-09-01

To describe factors facilitating or inhibiting the development of registered nurses' competency and nurse leader's role in knowledge management. Nurses' competency directly influences patient safety and the quality and effectiveness of patient care. Challenges of nurse leaders in knowledge management include acquiring, assessing and utilising current knowledge and assessing and enhancing competency. A systematic search was conducted in PubMed, CINAHL, SCOPUS and ERIC databases in April 2015. The search identified 18 relevant research articles published between 2009 and 2015. The quality of the studies was appraised in accordance with study designs. Knowledge management is facilitated by an organisation culture that supports learning, sharing of information and learning together. Leader commitment and competency were factors related to leadership facilitating knowledge management. Nurse leaders need evidence-based interventions to support shared learning and to create infrastructures that facilitate competence development. Future research is especially needed to evaluate connections between knowledge management and patient outcomes. The results of this review can be utilised in enhancing factors to facilitate knowledge management in clinical practice and identifying nurse leaders' role in strengthening nurses' competency. © 2017 John Wiley & Sons Ltd.

Orthographic Facilitation Effects on Spoken Word Production: Evidence from Chinese

ERIC Educational Resources Information Center

Zhang, Qingfang; Weekes, Brendan Stuart

2009-01-01

The aim of this experiment was to investigate the time course of orthographic facilitation on picture naming in Chinese. We used a picture-word paradigm to investigate orthographic and phonological facilitation on monosyllabic spoken word production in native Mandarin speakers. Both the stimulus-onset asynchrony (SOA) and the picture-word…

Does d-cycloserine facilitate the effects of homework compliance on social anxiety symptom reduction?

PubMed

Roque, Andres D; Rosenfield, David; Smits, Jasper A J; Simon, Naomi; Otto, Michael W; Marques, Luana; Pollack, Mark H; Hofmann, Stefan G; Meuret, Alicia E

2018-01-01

Prior studies examining the effect of d-cycloserine (DCS) on homework compliance and outcome in cognitive-behavior therapy (CBT) have yielded mixed results. The aim of this study was to investigate whether DCS facilitates the effects of homework compliance on symptom reduction in a large-scale study for social anxiety disorder (SAD). 169 participants with generalized SAD received DCS or pill placebo during 12-session exposure-based group CBT. Improvements in social anxiety were assessed by independent raters at each session using the Liebowitz social anxiety scale (LSAS). Controlling for LSAS at the previous session, and irrespective of treatment condition, greater homework compliance in the week prior related to lower LSAS at the next session. However, DCS did not moderate the effect of homework compliance and LSAS, LSAS on homework compliance, or the overall augmenting effect of DCS on homework compliance. Furthermore, LSAS levels were not predictive of homework compliance in the following week. The findings support the general benefits of homework compliance on outcome, but not a DCS-augmenting effect. The comparably small number of DCS-enhanced sessions in this study could be one reason for the failure to find a facilitating effect of DCS. Copyright © 2017. Published by Elsevier Ltd.

NASA's Risk Management System

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2011-01-01

Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

Effects of ultraviolet-B irradiance on intraspecific competition and facilitation of plants: self-thinning, size inequality, and phenotypic plasticity.

PubMed

Zhang, Rui-Chang; Lin, Yue; Yue, Ming; Li, Qian; Zhang, Xiao-Fei; Liu, Xiao; Chi, Hong; Chai, Yong-Fu; Wang, Mao

2012-01-01

(1) The effects of facilitation on the structure and dynamics of plant populations have not been studied so widely as competition. The UV-B radiation, as a typical environmental factor causing stress, may result in direct stress and facilitation. (2) The effects of UV-B radiation on intraspecific competition and facilitation were investigated based on the following three predictions on self-thinning, size inequality, and phenotypic plasticity: i) Self-thinning is the reduction in density that results from the increase in the mean biomass of individuals in crowded populations, and is driven by competition. In this study, the mortality rate of the population is predicted to decrease from UV-B irradiance. ii) The size inequality of a population increases with competition intensity because larger individuals receive a disproportionate share of resources, thereby leaving limited resources for smaller individuals. The second hypothesis assumes that direct stress decreases the size inequality of the population. iii) Phenotypic plasticity is the ability to alter one's morphology in response to environmental changes. The third hypothesis assumes that certain morphological indices can change among the trade-offs between competition, facilitation, and stress. These predictions were tested by conducting a field pot experiment using mung beans, and were supported by the following results: (3) UV-B radiation increased the survival rate of the population at the end of self-thinning. However, this result was mainly due to direct stress rather than facilitation. (4) Just as competitor, facilitation was also asymmetric. It increased the size inequality of populations during self-thinning, whereas stress decreased the size inequality. (5) Direct stress and facilitation influence plants differently on various scales. Stress inhibited plant growth, whereas facilitation showed the opposite on an individual scale. Stress increased survival rate, whereas facilitation increased individual

Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management

NASA Astrophysics Data System (ADS)

Dreiss, Lindsay M.; Hessenauer, Jan-Michael; Nathan, Lucas R.; O'Connor, Kelly M.; Liberati, Marjorie R.; Kloster, Danielle P.; Barclay, Janet R.; Vokoun, Jason C.; Morzillo, Anita T.

2017-02-01

Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management.

PubMed

Dreiss, Lindsay M; Hessenauer, Jan-Michael; Nathan, Lucas R; O'Connor, Kelly M; Liberati, Marjorie R; Kloster, Danielle P; Barclay, Janet R; Vokoun, Jason C; Morzillo, Anita T

2017-02-01

Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

Online interprofessional education facilitation: A scoping review.

PubMed

Evans, Sherryn Maree; Ward, Catherine; Reeves, Scott

2018-04-22

The use of online media to deliver interprofessional education (IPE) is becoming more prevalent across health professions education settings. Facilitation of IPE activities is known to be critical to the effective delivery of IPE, however, specifics about the nature of online IPE facilitation remains unclear. To explore the health professions education literature to understand the extent, range and nature of research on online IPE facilitation. Scoping review methodology was used to guide a search of four electronic databases for relevant papers. Of the 2095 abstracts initially identified, after screening of both abstracts and full-text papers, 10 studies were selected for inclusion in this review. Following abstraction of key information from each study, a thematic analysis was undertaken. Three key themes emerged to describe the nature of the IPE facilitation literature: (1) types of online IPE facilitation contributions, (2) the experience of online IPE facilitation and (3) personal outcomes of online IPE facilitation. These IPE facilitation themes were particularly focused on facilitation of interprofessional student teams on an asynchronous basis. While the included studies provide some insight into the nature of online IPE facilitation, future research is needed to better understand facilitator contributions, and the facilitation experience and associated outcomes, both relating to synchronous and asynchronous online environments.

Toolbox for Research, or how to facilitate a central data management in small-scale research projects.

PubMed

Bialke, Martin; Rau, Henriette; Thamm, Oliver C; Schuldt, Ronny; Penndorf, Peter; Blumentritt, Arne; Gött, Robert; Piegsa, Jens; Bahls, Thomas; Hoffmann, Wolfgang

2018-01-25

In most research projects budget, staff and IT infrastructures are limiting resources. Especially for small-scale registries and cohort studies professional IT support and commercial electronic data capture systems are too expensive. Consequently, these projects use simple local approaches (e.g. Excel) for data capture instead of a central data management including web-based data capture and proper research databases. This leads to manual processes to merge, analyze and, if possible, pseudonymize research data of different study sites. To support multi-site data capture, storage and analyses in small-scall research projects, corresponding requirements were analyzed within the MOSAIC project. Based on the identified requirements, the Toolbox for Research was developed as a flexible software solution for various research scenarios. Additionally, the Toolbox facilitates data integration of research data as well as metadata by performing necessary procedures automatically. Also, Toolbox modules allow the integration of device data. Moreover, separation of personally identifiable information and medical data by using only pseudonyms for storing medical data ensures the compliance to data protection regulations. This pseudonymized data can then be exported in SPSS format in order to enable scientists to prepare reports and analyses. The Toolbox for Research was successfully piloted in the German Burn Registry in 2016 facilitating the documentation of 4350 burn cases at 54 study sites. The Toolbox for Research can be downloaded free of charge from the project website and automatically installed due to the use of Docker technology.

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process

PubMed Central

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O’Leary, James; Ruffner, BW; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2013-01-01

Aims The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. Materials & methods The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. Results A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Conclusions Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement. PMID:23459832

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process.

PubMed

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O'Leary, James; Ruffner, B W; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2012-07-01

The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement.

Barriers to and facilitators of partner notification for chlamydia trachomatis among health care professionals.

PubMed

Theunissen, Kevin A T M; Schipper, Pim; Hoebe, Christian J P A; Crutzen, Rik; Kok, Gerjo; Dukers-Muijrers, Nicole H T M

2014-12-20

Partner notification (PN) is an essential case-finding tool in the management of sexually transmitted infections (STIs). Yet, data on the effectiveness and factors impacting implementation of PN in the Netherlands are lacking. With the aim of further exploring and improving the PN process, the current study assessed perceived barriers and facilitators among health care professionals in the STI clinical setting. In particular, we explored the management of PN in young heterosexual patients diagnosed with Chlamydia trachomatis (Ct). We conducted semi-structured interviews among 22 health care professionals (response rate 52%) from 5 of the 8 national STI clinics in the Netherlands. We carried out qualitative content analysis using a framework approach. All participants were nurses, aged mid 20's to late 50's, and all but one were female. All health care professionals felt comfortable discussing PN. Other perceived facilitators for PN included: time, one-on-one consultations, interviewing skills (i.e. Motivational Interviewing) and a proactive helping style. Important barriers were identified as: sub-optimal guidelines, inaccurate sexual history, a lack of feedback regarding the motivational strategies that were used, and the lack of feedback regarding overall PN effectiveness. The health care professionals placed an emphasis on the care and treatment of the individual index patient rather than on discussion of PN, or on motivating and helping patients to engage in PN. Health care professionals identified several barriers that need to be overcome, and facilitators which need to be maintained. Future efforts should concentrate on introducing PN protocols, providing feedback on both the effectiveness of strategies used by health care professionals, and on the PN process as a whole, and educating health care professionals about Motivational Interviewing strategies. Moreover, the possible implementation of an Internet-based PN system should be explored.

An adverse drug event manager facilitates spontaneous reporting of adverse drug reactions.

PubMed

Vinther, Siri; Klarskov, Pia; Borgeskov, Hanne; Darsø, Perle; Christophersen, Anette Kvindebjerg; Borck, Bille; Christensen, Catrine; Hansen, Melissa Voigt; Halladin, Natalie Monica Løvland; Christensen, Mikkel Bring; Harboe, Kirstine Moll; Lund, Marie; Jimenez-Solem, Espen

2017-01-01

Spontaneous reporting of adverse drug reactions (ADRs) is used for continuous risk-benefit evaluation of marketed pharmaceutical products and for signal detection. The Adverse Drug Event Manager (ADEM) is a service offered to clinicians employed at hospitals in the Capital Region of Denmark. The ADEM assists healthcare professionals in reporting suspected ADRs to the Danish Health Authority. The aim of this retrospective observational study was to quantify and describe ADRs reported via the ADEM in 2014. All ADR reports handled by the ADEM in 2014 were recorded anonymously and analysed descriptively. A total of 484 ADRs were reported through the ADEM in 2014 (the median number of reports per month was 37; range: 17-78). The majority of the reports came from departments of internal medicine (61%), psychiatry (14%) and dermatology, ophthalmology or otorhinolaryngology (11%). The drugs most frequently reported were lisdexamphetamine (n = 40), rivaroxaban (n = 16) and warfarin (n = 15) (vaccines excluded). In 13 out of 484 reports, the ADR was associated with a fatal outcome. The findings of this study indicate that an ADEM promotes and facilitates spontaneous ADR reporting and helps raise awareness about ADRs, including how and why they should be reported. Hopefully, this will assist national and European spontaneous reporting systems in their work to increase patient safety nationally and abroad. none. not relevant. .

Effective Management Techniques in Tertiary Administration: A Risk Management Framework.

ERIC Educational Resources Information Center

McNamara, R. P.; Booth, P.

1984-01-01

A management strategy that is potentially more fruitful for the nonprofit sector than traditional management toward a primary objective is a risk management approach to organizational effectiveness. The organization's effectiveness, its survival, can be analyzed by categorizing the risks facing it and assessing its performance in managing these…

A care improvement program acting as a powerful learning environment to support nursing students learning facilitation competencies.

PubMed

Jukema, Jan S; Harps-Timmerman, Annelies; Stoopendaal, Annemiek; Smits, Carolien H M

2015-11-01

Change management is an important area of training in undergraduate nursing education. Successful change management in healthcare aimed at improving practices requires facilitation skills that support teams in attaining the desired change. Developing facilitation skills in nursing students requires formal educational support. A Dutch Regional Care Improvement Program based on a nationwide format of change management in healthcare was designed to act as a Powerful Learning Environment for nursing students developing competencies in facilitating change. This article has two aims: to provide comprehensive insight into the program components and to describe students' learning experiences in developing their facilitation skills. This Dutch Regional Care Improvement Program considers three aspects of a Powerful Learning Environment: self-regulated learning; problem-based learning; and complex, realistic and challenging learning tasks. These three aspects were operationalised in five distinct areas of facilitation: increasing awareness of the need for change; leadership and project management; relationship building and communication; importance of the local context; and ongoing monitoring and evaluation. Over a period of 18 months, 42 nursing students, supported by trained lecturer-coaches, took part in nine improvement teams in our Regional Care Improvement Program, executing activities in all five areas of facilitation. Based on the students' experiences, we propose refinements to various components of this program, aimed at strengthenin the learning environment. There is a need for further detailed empirical research to study the impact this kind of learning environment has on students developing facilitation competencies in healthcare improvement. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prevalence of Barriers and Facilitators to Enhancing Conservative Kidney Management for Older Adults in the Primary Care Setting.

PubMed

Tam-Tham, Helen; King-Shier, Kathryn M; Thomas, Chandra M; Quinn, Robert R; Fruetel, Karen; Davison, Sara N; Hemmelgarn, Brenda R

2016-11-07

Conservative management of adults with stage 5 CKD (eGFR<15 ml/min per 1.73 m 2 ) is increasingly being provided in the primary care setting. We aimed to examine perceived barriers and facilitators for conservative management of older adults by primary care physicians. In 2015, we conducted a cross-sectional, population-based survey of all primary care physicians in Alberta, Canada. Eligible participants had experience caring for adults ages ≥75 years old with stage 5 CKD not planning on initiating dialysis. Questionnaire items were on the basis of a qualitative descriptive study informed by the Behavior Change Wheel and tested for face and content validity. Physicians were contacted via postal mail and/or fax on the basis of a modified Dillman method. Four hundred nine eligible primary care physicians completed the questionnaire (9.6% response rate). The majority of respondents were men (61.6%), were ages 40-60 years old (62.6%), and practiced in a large/medium population center (68.0%). The most common barrier to providing conservative care in the primary care setting was the inability to access support to maintain patients in the home setting (39.1% of respondents; 95% confidence interval, 34.6% to 43.6%). The second most common barrier was working with nonphysician providers with limited kidney-specific clinical expertise (32.3%; 95% confidence interval, 28.0% to 36.7%). Primary care physicians indicated that the two most common strategies that would enhance their ability to provide conservative management would be the ability to use the telephone to contact a nephrologist or clinical staff from the conservative care clinic (86.9%; 95% confidence interval, 83.7% to 90.0% and 85.6%; 95% confidence interval, 82.4% to 88.9%, respectively). We identified important areas to inform clinical programs to reduce barriers and enhance facilitators to improve primary care physicians' provision of conservative kidney care. In particular, primary care physicians require

Prevalence of Barriers and Facilitators to Enhancing Conservative Kidney Management for Older Adults in the Primary Care Setting

PubMed Central

Tam-Tham, Helen; King-Shier, Kathryn M.; Thomas, Chandra M.; Quinn, Robert R.; Fruetel, Karen; Davison, Sara N.

2016-01-01

Background and objectives Conservative management of adults with stage 5 CKD (eGFR<15 ml/min per 1.73 m2) is increasingly being provided in the primary care setting. We aimed to examine perceived barriers and facilitators for conservative management of older adults by primary care physicians. Design, setting, participants, & measurements In 2015, we conducted a cross–sectional, population–based survey of all primary care physicians in Alberta, Canada. Eligible participants had experience caring for adults ages ≥75 years old with stage 5 CKD not planning on initiating dialysis. Questionnaire items were on the basis of a qualitative descriptive study informed by the Behavior Change Wheel and tested for face and content validity. Physicians were contacted via postal mail and/or fax on the basis of a modified Dillman method. Results Four hundred nine eligible primary care physicians completed the questionnaire (9.6% response rate). The majority of respondents were men (61.6%), were ages 40–60 years old (62.6%), and practiced in a large/medium population center (68.0%). The most common barrier to providing conservative care in the primary care setting was the inability to access support to maintain patients in the home setting (39.1% of respondents; 95% confidence interval, 34.6% to 43.6%). The second most common barrier was working with nonphysician providers with limited kidney–specific clinical expertise (32.3%; 95% confidence interval, 28.0% to 36.7%). Primary care physicians indicated that the two most common strategies that would enhance their ability to provide conservative management would be the ability to use the telephone to contact a nephrologist or clinical staff from the conservative care clinic (86.9%; 95% confidence interval, 83.7% to 90.0% and 85.6%; 95% confidence interval, 82.4% to 88.9%, respectively). Conclusions We identified important areas to inform clinical programs to reduce barriers and enhance facilitators to improve primary care

Barriers and facilitating factors for disease self-management: a qualitative analysis of perceptions of patients receiving care for type 2 diabetes and/or hypertension in San José, Costa Rica and Tuxtla Gutiérrez, Mexico.

PubMed

Fort, Meredith P; Alvarado-Molina, Nadia; Peña, Liz; Mendoza Montano, Carlos; Murrillo, Sandra; Martínez, Homero

2013-09-04

The burden of cardiovascular disease is growing in the Mesoamerican region. Patients' disease self-management is an important contributor to control of cardiovascular disease. Few studies have explored factors that facilitate and inhibit disease self-management in patients with type 2 diabetes and hypertension in urban settings in the region. This article presents patients' perceptions of barriers and facilitating factors to disease self-management, and offers considerations for health care professionals in how to support them. In 2011, 12 focus groups were conducted with a total of 70 adults with type 2 diabetes and/or hypertension who attended urban public health centers in San José, Costa Rica and Tuxtla Gutiérrez, Chiapas, Mexico. Focus group discussions were transcribed and coded using a content analysis approach to identify themes. Themes were organized using the trans-theoretical model, and other themes that transcend the individual level were also considered. Patients were at different stages in their readiness-to-change, and barriers and facilitating factors are presented for each stage. Barriers to disease self-management included: not accepting the disease, lack of information about symptoms, vertical communication between providers and patients, difficulty negotiating work and health care commitments, perception of healthy food as expensive or not filling, difficulty adhering to treatment and weight loss plans, additional health complications, and health care becoming monotonous. Factors facilitating disease self-management included: a family member's positive experience, sense of urgency, accessible health care services and guidance from providers, inclusive communication, and family and community support.Financial difficulty, gender roles, differences by disease type, faith, and implications for families and their support were identified as cross-cutting themes that may add an additional layer of complexity to disease management at any stage. These

The Groot Effect: Plant facilitation and desert shrub regrowth following extensive damage.

PubMed

Lortie, Christopher J; Gruber, Eva; Filazzola, Alex; Noble, Taylor; Westphal, Michael

2018-01-01

Deserts are increasing in extent globally, but existing deserts are decreasing in health. The basic biology and ecology of foundation plant species in deserts are limited. This is a direct study that provides an estimate of the capacity for a locally dominant foundation shrub species in California to recover from damage. Desert shrubs are cleared and damaged by humans for many purposes including agriculture, oil and gas production, and sustainable energy developments; we need to know whether foundation species consistently facilitate the abundance and diversity of other plants in high-stress ecosystems and whether they can recover. A total of 20 Ephedra californica shrubs were clipped to the ground at a single site and systematically resampled for regrowth 2 years later. These shrubs were damaged once and regrew rapidly, and relatively, larger shrubs were not more resilient. This study provides evidence for what we termed the "Groot Effect" because smaller individuals of this shrub species can recover from significant aboveground damage and continue to have positive effects on other plant species (similar to the popular culture reference to a benefactor tree species). The density of other plant species was consistently facilitated while effects on diversity varied with season. These findings confirm that E. californica is a foundation species that can be an important restoration tool within the deserts of California in spite of extreme cycles of drought and physical damage to its canopy.

Facilitating Trust in Privacy-Preserving E-Learning Environments

ERIC Educational Resources Information Center

Anwar, M.; Greer, J.

2012-01-01

This research explores a new model for facilitating trust in online e-learning activities. We begin by protecting the privacy of learners through identity management (IM), where personal information can be protected through some degree of participant anonymity or pseudonymity. In order to expect learners to trust other pseudonymous participants,…

Importance of stimulation paradigm in determining facilitation and effects of neuromodulation.

PubMed

Crider, M E; Cooper, R L

1999-09-25

Evoked synaptic activity within the CNS and at the neuromuscular junction in most in vivo preparations studied occurs not with single isolated stimuli, but with trains, or bursts, of stimuli. Although for ease in studying the mechanisms of vesicular synaptic transmission one often uses single discrete stimuli, the true mechanisms in the animal may be far more complex. When repetitive stimuli are present at a nerve terminal, often a heightened (i.e., facilitated) postsynaptic potential can be as a result. Facilitation is commonly used as an index of synaptic function and plasticity induced by chronic stimulation or by neuromodulation. The mechanisms that give rise to facilitation are thought to be the same that may underlie short-term learning and memory [C.H. Bailey, E.R. Kandel, Structural changes accompanying memory storage. Annu. Rev. Physiol. 55 (1993) 397-426.]. Differences in short term facilitation (STF) are seen depending on the conventional stimulation paradigm (twin pulse, train, or continuous) used to induce facilitation. Thus, a battery of paradigms should be used to characterize synaptic function to obtain a closer understanding of the possible in vivo conditions.

Space technology, sustainable development and community applications: Internet as a facilitator

NASA Astrophysics Data System (ADS)

Peter, Nicolas; Afrin, Nadia; Goh, Gérardine; Chester, Ed

2006-07-01

Among other approaches, space technologies are currently being deployed for disaster management, environmental monitoring, urban planning, health applications, communications, etc. Although space-based applications have tremendous potential for socioeconomic development, they are primarily technology driven and the requirements from the end-users (i.e. the development community) are rarely taken into consideration during the initial development stages. This communication gap between the "space" and "development" communities can be bridged with the help of the web-based knowledge sharing portal focused on space applications for development. This online community uses the development gateway foundation's sophisticated content management system. It is modeled after the development gateway's knowledge sharing portals ( http://topics.developmentgateway.org) and draws from their expertise in knowledge management, partnership building and marketing. These types of portal are known to facilitate broad-based partnerships across sectors, regions and the various stakeholders but also to facilitate North-South and South-South cooperation. This paper describes the initiative "Space for Development" ( http://topics.developmentgateway.org/space) started in 2004 which aims to demonstrate how such a web-based portal can be structured to facilitate knowledge sharing in order to bridge the gap between the "space" and "development" communities in an innovative and global manner.

Impression Management Training: Conceptualization and Application to Personal Selling.

ERIC Educational Resources Information Center

Leathers, Dale G.

1988-01-01

Discusses the importance of impression management, an individual's conscious attempt to exercise control over selected communicative behaviors and cues for purposes of making a desired impression. Provides a comprehensive conceptualization of the impression-management process, and demonstrates how this process can facilitate effective training of…

Synergies between climate anomalies and hydrological modifications facilitate estuarine biotic invasions.

PubMed

Winder, Monika; Jassby, Alan D; Mac Nally, Ralph

2011-08-01

Environmental perturbation, climate change and international commerce are important drivers for biological invasions. Climate anomalies can further increase levels of habitat disturbance and act synergistically to elevate invasion risk. Herein, we use a historical data set from the upper San Francisco Estuary to provide the first empirical evidence for facilitation of invasions by climate extremes. Invasive zooplankton species did not become established in this estuary until the 1970s when increasing propagule pressure from Asia coincided with extended drought periods. Hydrological management exacerbated the effects of post-1960 droughts and reduced freshwater inflow even further, increasing drought severity and allowing unusually extreme salinity intrusions. Native zooplankton experienced unprecedented conditions of high salinity and intensified benthic grazing, and life history attributes of invasive zooplankton were advantageous enough during droughts to outcompete native species and colonise the system. Extreme climatic events can therefore act synergistically with environmental perturbation to facilitate the establishment of invasive species. © 2011 Blackwell Publishing Ltd/CNRS.

Managing treatment for end-stage renal disease--a qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence.

PubMed

Griva, K; Ng, H J; Loei, J; Mooppil, N; McBain, H; Newman, S P

2013-01-01

Although adherence to hemodialysis (HD) regimes is important to maximise good clinical outcomes, it remains suboptimal and not well understood, particularly for those in non-Western settings and patients from Asian cultures. This qualitative study sought to explore cultural perspectives on facilitators and barriers to treatment adherence in HD patients. A descriptive exploratory design was used for the study, incorporating individual semi-structured interviews (n = 17) and three focus groups (n = 20). Each interview/focus group was audio-taped and transcribed verbatim, and coding was conducted by two coders using an iterative process. Study participants identified personal and social/contextual factors as major barriers or facilitators of treatment adherence. Barriers include time consumption, forgetfulness, concerns about safety, poor knowledge/understanding, poor communication and lack of control/social pressure. Participants also identified facilitators, both internal (self-initiated) and external (initiated by family, health care professional and peers) to ensure treatment adherence. These included support from family members and social obligation towards others, risk perception, establishment of routines and peer support. Internal and external factors can hinder or facilitate adherence to diet, fluid and medications in the context of dialysis. Several of these barriers/facilitators can be effectively addressed in the context of interventions and psycho-educational programmes.

The characteristics of effective secondary math and science instructional facilitators and the necessary support structures as perceived by practitioners and principals

NASA Astrophysics Data System (ADS)

Mahagan, Vikki Lynn

Instructional facilitators are known by a variety of titles depending on the school district in which they are employed. They are sometimes called instructional coaches, teacher leaders, lead teachers, and instructional specialist (Denton & Hasbrouck, 2009). Throughout this study, the title instructional facilitator was used and will refer to secondary math or science instructional facilitators who are housed at least one day per week on a campus. This study is a mixed-methods descriptive study which has identified character traits, specials skill, and talents possessed by effective secondary math and science instructional facilitators as perceived by practicing facilitators and principals and assistant principals who work along side instructional facilitators. Specific job training to help ensure the success of a facilitator was identified as viewed by both facilitators and principals. Additionally, this study compared the perceptions of practicing facilitators and principals to determine if significant differences exist with respect to perceptions of staff development opportunities, support structures, and resources available for instructional facilitators.

Telemedicine Facilitates CHF Home Health Care for Those with Systolic Dysfunction

PubMed Central

Seibert, Pennie S.; Whitmore, Tiffany A.; Patterson, Carin; Parker, Patrick D.; Otto, Caitlin; Basom, Jean; Whitener, Nichole; Zimmerman, Christian G.

2008-01-01

An estimated 5 million Americans have congestive heart failure (CHF) and one in five over the age of 40 will develop CHF. There are numerous examples of CHF patients living beyond the years normally expected for people with the disease, usually attributed to taking an active role in disease management. A relatively new alternative for CHF outpatient care is telemedicine and e-health. We investigated the effects of a 6-week in-home telemedicine education and monitoring program for those with systolic dysfunction on the utilization of health care resources. We also measured the effects of the unit 4.5 months after its removal (a total of 6 months post introduction of the unit into the home). Concurrently, we assessed participants' perceptions of the value of having a telemedicine unit. Participants in the telemedicine group reported weighing more times a week with less variability than did the control group. Telemedicine led to a reduction in physician and emergency department visits and those in the experimental group reported the unit facilitating self-care, though this was not significantly different from the control group (possibly due to small sample size). These findings suggest a possibility for improvement in control of CHF when telemedicine is implemented. Our review of the literature also supports the role of telemedicine in facilitating home health care and self-management for CHF patients. There are many challenges still to be addressed before this potential can be reached and further research is needed to identify opportunities in telemedicine. PMID:18369411

Serious Game Leverages Productive Negativity to Facilitate Conceptual Change in Undergraduate Molecular Biology: A Mixed-Methods Randomized Controlled Trial

ERIC Educational Resources Information Center

Gauthier, Andrea; Jenkinson, Jodie

2017-01-01

We designed a serious game, MolWorlds, to facilitate conceptual change about molecular emergence by using game mechanics (resource management, immersed 3rd person character, sequential level progression, and 3-star scoring system) to encourage cycles of productive negativity. We tested the value-added effect of game design by comparing and…

Effects of Ultraviolet-B Irradiance on Intraspecific Competition and Facilitation of Plants: Self-Thinning, Size Inequality, and Phenotypic Plasticity

PubMed Central

Zhang, Rui-Chang; Lin, Yue; Yue, Ming; Li, Qian; Zhang, Xiao-Fei; Liu, Xiao; Chi, Hong; Chai, Yong-Fu; Wang, Mao

2012-01-01

(1) The effects of facilitation on the structure and dynamics of plant populations have not been studied so widely as competition. The UV-B radiation, as a typical environmental factor causing stress, may result in direct stress and facilitation. (2) The effects of UV-B radiation on intraspecific competition and facilitation were investigated based on the following three predictions on self-thinning, size inequality, and phenotypic plasticity: i) Self-thinning is the reduction in density that results from the increase in the mean biomass of individuals in crowded populations, and is driven by competition. In this study, the mortality rate of the population is predicted to decrease from UV-B irradiance. ii) The size inequality of a population increases with competition intensity because larger individuals receive a disproportionate share of resources, thereby leaving limited resources for smaller individuals. The second hypothesis assumes that direct stress decreases the size inequality of the population. iii) Phenotypic plasticity is the ability to alter one’s morphology in response to environmental changes. The third hypothesis assumes that certain morphological indices can change among the trade-offs between competition, facilitation, and stress. These predictions were tested by conducting a field pot experiment using mung beans, and were supported by the following results: (3) UV-B radiation increased the survival rate of the population at the end of self-thinning. However, this result was mainly due to direct stress rather than facilitation. (4) Just as competitor, facilitation was also asymmetric. It increased the size inequality of populations during self-thinning, whereas stress decreased the size inequality. (5) Direct stress and facilitation influence plants differently on various scales. Stress inhibited plant growth, whereas facilitation showed the opposite on an individual scale. Stress increased survival rate, whereas facilitation increased

Facilitating classroom based interprofessional learning: a grounded theory study of university educators' perceptions of their role adequacy as facilitators.

PubMed

Derbyshire, Julie A; Machin, Alison I; Crozier, Suzanne

2015-01-01

The provision of inter professional learning (IPL) within undergraduate programmes is now well established within many Higher Education Institutions (HEIs). IPL aims to better equip nurses and other health professionals with effective collaborative working skills and knowledge to improve the quality of patient care. Although there is still ambiguity in relation to the optimum timing and method for delivering IPL, effective facilitation is seen as essential. This paper reports on a grounded theory study of university educators' perceptions of the knowledge and skills needed for their role adequacy as IPL facilitators. Data was collected using semi structured interviews with nine participants who were theoretically sampled from a range of professional backgrounds, with varied experiences of education and involvement in facilitating IPL. Constant comparative analysis was used to generate four data categories: creating and sustaining an IPL group culture through transformational IPL leadership (core category), readiness for IPL facilitation, drawing on past interprofessional learning and working experiences and role modelling an interprofessional approach. The grounded theory generated from this study, although propositional, suggests that role adequacy for IPL facilitation is dependent on facilitator engagement in a process of 'transformational interprofessional learning leadership' to create and sustain a group culture. Copyright © 2014 Elsevier Ltd. All rights reserved.

Facilitator training program: The Université Laval Interprofessional Initiative.

PubMed

Milot, Élise; Museux, Anne-Claire; Careau, Emmanuelle

2017-03-01

A facilitator training program (FTP) for interprofessional learning (IPL) facilitators has been developed at Université Laval. This article describes the impacts of this program as perceived by the 22 IPL facilitators involved and outlines recommendations. Two qualitative data collection strategies were used to document the facilitators' pedagogical needs and views of the program's impacts. Results suggest that the FTP's pedagogical approach was effective. The IPL facilitators became more aware of their challenges and identified concrete strategies to use. Training initiatives should equip IPL facilitators to cope with uncertainty, create a climate supporting active learning, and facilitate positive interactions between students.

Earned Value Management (EVM) Implementation Handbook

NASA Technical Reports Server (NTRS)

2013-01-01

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

Earned Value Management (EVM) Implementation Handbook

NASA Technical Reports Server (NTRS)

Terrell, Stefanie M.; Richards, Brad W.

2018-01-01

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

Producing Gestures Facilitates Route Learning

PubMed Central

So, Wing Chee; Ching, Terence Han-Wei; Lim, Phoebe Elizabeth; Cheng, Xiaoqin; Ip, Kit Yee

2014-01-01

The present study investigates whether producing gestures would facilitate route learning in a navigation task and whether its facilitation effect is comparable to that of hand movements that leave physical visible traces. In two experiments, we focused on gestures produced without accompanying speech, i.e., co-thought gestures (e.g., an index finger traces the spatial sequence of a route in the air). Adult participants were asked to study routes shown in four diagrams, one at a time. Participants reproduced the routes (verbally in Experiment 1 and non-verbally in Experiment 2) without rehearsal or after rehearsal by mentally simulating the route, by drawing it, or by gesturing (either in the air or on paper). Participants who moved their hands (either in the form of gestures or drawing) recalled better than those who mentally simulated the routes and those who did not rehearse, suggesting that hand movements produced during rehearsal facilitate route learning. Interestingly, participants who gestured the routes in the air or on paper recalled better than those who drew them on paper in both experiments, suggesting that the facilitation effect of co-thought gesture holds for both verbal and nonverbal recall modalities. It is possibly because, co-thought gesture, as a kind of representational action, consolidates spatial sequence better than drawing and thus exerting more powerful influence on spatial representation. PMID:25426624

Reviewing audit: barriers and facilitating factors for effective clinical audit.

PubMed

Johnston, G; Crombie, I K; Davies, H T; Alder, E M; Millard, A

2000-03-01

To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. Clinical audit can be a valuable assistance to any programme which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at nurturing effective audits, valuable opportunities will be lost

How work-self conflict/facilitation influences exhaustion and task performance: A three-wave study on the role of personal resources.

PubMed

Demerouti, Evangelia; Sanz-Vergel, Ana Isabel; Petrou, Paraskevas; van den Heuvel, Machteld

2016-10-01

Although work and family are undoubtedly important life domains, individuals are also active in other life roles which are also important to them (like pursuing personal interests). Building on identity theory and the resource perspective on work-home interface, we examined whether there is an indirect effect of work-self conflict/facilitation on exhaustion and task performance over time through personal resources (i.e., self-efficacy and optimism). The sample was composed of 368 Dutch police officers. Results of the 3-wave longitudinal study confirmed that work-self conflict was related to lower levels of self-efficacy, whereas work-self facilitation was related to improved optimism over time. In turn, self-efficacy was related to higher task performance, whereas optimism was related to diminished levels of exhaustion over time. Further analysis supported the negative, indirect effect of work-self facilitation on exhaustion through optimism over time, and only a few reversed causal effects emerged. The study contributes to the literature on interrole management by showing the role of personal resources in the process of conflict or facilitation over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The disruption management model.

PubMed

McAlister, James

2011-10-01

Within all organisations, business continuity disruptions present a set of dilemmas that managers may not have dealt with before in their normal daily duties. The disruption management model provides a simple but effective management tool to enable crisis management teams to stay focused on recovery in the midst of a business continuity incident. The model has four chronological primary headlines, which steer the team through a quick-time crisis decision-making process. The procedure facilitates timely, systematic, rationalised and justified decisions, which can withstand post-event scrutiny. The disruption management model has been thoroughly tested within an emergency services environment and is proven to significantly support clear and concise decision making in a business continuity context.

Acute effect of scapular proprioceptive neuromuscular facilitation (PNF) techniques and classic exercises in adhesive capsulitis: a randomized controlled trial

PubMed Central

Balcı, Nilay Comuk; Yuruk, Zeliha Ozlem; Zeybek, Aslican; Gulsen, Mustafa; Tekindal, Mustafa Agah

2016-01-01

[Purpose] The aim of our study was to compare the initial effects of scapular proprioceptive neuromuscular facilitation techniques and classic exercise interventions with physiotherapy modalities on pain, scapular dyskinesis, range of motion, and function in adhesive capsulitis. [Subjects and Methods] Fifty-three subjects were allocated to 3 groups: scapular proprioceptive neuromuscular facilitation exercies and physiotherapy modalities, classic exercise and physiotherapy modalities, and only physiotherapy modalities. The intervention was applied in a single session. The Visual Analog Scale, Lateral Scapular Slide Test, range of motion and Simple Shoulder Test were evaluated before and just after the one-hour intervention in the same session (all in one session). [Results] All of the groups showed significant differences in shoulder flexion and abduction range of motion and Simple Shoulder Test scores. There were statistically significant differences in Visual Analog Scale scores in the proprioceptive neuromuscular facilitation and control groups, and no treatment method had significant effect on the Lateral Scapular Slide Test results. There were no statistically significant differences between the groups before and after the intervention. [Conclusion] Proprioceptive neuromuscular facilitation, classic exercise, and physiotherapy modalities had immediate effects on adhesive capsulitis in our study. However, there was no additional benefit of exercises in one session over physiotherapy modalities. Also, an effective treatment regimen for shoulder rehabilitation of adhesive capsulitis patients should include scapular exercises. PMID:27190456

An RF-based wearable sensor system for indoor tracking to facilitate efficient healthcare management.

PubMed

Yuzhe Ouyang; Shan, Kai; Bui, Francis Minhthang

2016-08-01

To understand the utilization of clinical resources and improve the efficiency of healthcare, it is often necessary to accurately locate patients and doctors in a healthcare facility. However, existing tracking methods, such as GPS, Wi-Fi and RFID, have technological drawbacks or impose significant costs, thus limiting their applications in many clinical environments, especially those with indoor enclosures. This paper proposes a low-cost and flexible tracking system that is well suited for operating in an indoor environment. Based on readily available RF transceivers and microcontrollers, our wearable sensor system can facilitate locating users (e.g., patients or doctors) or objects (e.g., medical devices) in a building. The strategic construction of the sensor system, along with a suitably designed tracking algorithm, together provide for reliability and dispatch in localization performance. For demonstration purposes, several simplified experiments, with different configurations of the system, are implemented in two testing rooms to assess the baseline performance. From the obtained results, our system exhibits immense promise in acquiring a user location and corresponding time-stamp, with high accuracy and rapid response. This capability is conducive to both short- and long-term data analytics, which are crucial for improving healthcare management.

Facilitating professional liaison in collaborative care for depression in UK primary care; a qualitative study utilising normalisation process theory.

PubMed

Coupe, Nia; Anderson, Emma; Gask, Linda; Sykes, Paul; Richards, David A; Chew-Graham, Carolyn

2014-05-01

Collaborative care (CC) is an organisational framework which facilitates the delivery of a mental health intervention to patients by case managers in collaboration with more senior health professionals (supervisors and GPs), and is effective for the management of depression in primary care. However, there remains limited evidence on how to successfully implement this collaborative approach in UK primary care. This study aimed to explore to what extent CC impacts on professional working relationships, and if CC for depression could be implemented as routine in the primary care setting. This qualitative study explored perspectives of the 6 case managers (CMs), 5 supervisors (trial research team members) and 15 general practitioners (GPs) from practices participating in a randomised controlled trial of CC for depression. Interviews were transcribed verbatim and data was analysed using a two-step approach using an initial thematic analysis, and a secondary analysis using the Normalisation Process Theory concepts of coherence, cognitive participation, collective action and reflexive monitoring with respect to the implementation of CC in primary care. Supervisors and CMs demonstrated coherence in their understanding of CC, and consequently reported good levels of cognitive participation and collective action regarding delivering and supervising the intervention. GPs interviewed showed limited understanding of the CC framework, and reported limited collaboration with CMs: barriers to collaboration were identified. All participants identified the potential or experienced benefits of a collaborative approach to depression management and were able to discuss ways in which collaboration can be facilitated. Primary care professionals in this study valued the potential for collaboration, but GPs' understanding of CC and organisational barriers hindered opportunities for communication. Further work is needed to address these organisational barriers in order to facilitate

A Physical Education Teacher's Journey: From District Coordinator to Facilitator

ERIC Educational Resources Information Center

Hunuk, Deniz

2017-01-01

Background: Despite the accumulating evidence highlighting the significant roles of an effective facilitator and appropriate pedagogies that a facilitator employs in shaping the professional learning environment, there is a paucity of research that explores how facilitators learn to facilitate. Purpose: The overall purpose of this study was to…

Personal discovery in diabetes self-management: Discovering cause and effect using self-monitoring data.

PubMed

Mamykina, Lena; Heitkemper, Elizabeth M; Smaldone, Arlene M; Kukafka, Rita; Cole-Lewis, Heather J; Davidson, Patricia G; Mynatt, Elizabeth D; Cassells, Andrea; Tobin, Jonathan N; Hripcsak, George

2017-12-01

To outline new design directions for informatics solutions that facilitate personal discovery with self-monitoring data. We investigate this question in the context of chronic disease self-management with the focus on type 2 diabetes. We conducted an observational qualitative study of discovery with personal data among adults attending a diabetes self-management education (DSME) program that utilized a discovery-based curriculum. The study included observations of class sessions, and interviews and focus groups with the educator and attendees of the program (n = 14). The main discovery in diabetes self-management evolved around discovering patterns of association between characteristics of individuals' activities and changes in their blood glucose levels that the participants referred to as "cause and effect". This discovery empowered individuals to actively engage in self-management and provided a desired flexibility in selection of personalized self-management strategies. We show that discovery of cause and effect involves four essential phases: (1) feature selection, (2) hypothesis generation, (3) feature evaluation, and (4) goal specification. Further, we identify opportunities to support discovery at each stage with informatics and data visualization solutions by providing assistance with: (1) active manipulation of collected data (e.g., grouping, filtering and side-by-side inspection), (2) hypotheses formulation (e.g., using natural language statements or constructing visual queries), (3) inference evaluation (e.g., through aggregation and visual comparison, and statistical analysis of associations), and (4) translation of discoveries into actionable goals (e.g., tailored selection from computable knowledge sources of effective diabetes self-management behaviors). The study suggests that discovery of cause and effect in diabetes can be a powerful approach to helping individuals to improve their self-management strategies, and that self-monitoring data can

Healthy Eating Practices: Perceptions, Facilitators, and Barriers Among Youth With Diabetes

PubMed Central

Gellar, Lauren A.; Schrader, Kelly; Nansel, Tonja R.

2008-01-01

Purpose The purpose of this study was to explore the perceptions of healthy eating by youth with diabetes as well as facilitators of and barriers to healthy eating behavior. Methods One hundred forty youth aged 7 to 16 years with diabetes participated in 18 focus groups. Sample race/ethnicity was 71% white, 18% African American, 6% Hispanic, and 5% other; 69% of the participants were female. Results Healthy eating was defined primarily in terms of eating fruits and vegetables, low fat, low sugar, and eating to keep blood sugar in range. However, there were notable differences in perceptions of healthy eating versus perceptions of eating practices good for diabetes management. Specifically, “free” foods (foods high in fat but low in carbohydrate) were commonly reported as being good for diabetes management. Major barriers to healthy eating included widespread availability of unhealthy foods, preparation time, and social situations. Parental behaviors, including monitoring food choices and positive modeling, were the most commonly reported facilitators of healthy eating. Conclusion Findings suggest that youth with diabetes have a general understanding of healthy eating and face similar barriers and facilitators to healthy eating as nondiabetic children do. However, the diabetes regimen may influence their understanding of healthy eating, sometimes negatively. Diabetes nutrition education sessions should emphasize the connection between healthy eating and both short-and long-term diabetes outcomes, and they should highlight strategies to reduce saturated fat consumption while avoiding excessive carbohydrate consumption. The diabetes educator can play an integral role in promoting healthy dietary practices by facilitating parental involvement, designing action plans for managing social situations, and increasing awareness of healthier alternatives to widely available unhealthy foods. PMID:17684168

Time management strategies for research productivity.

PubMed

Chase, Jo-Ana D; Topp, Robert; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy; Zerwic, Julie J; Benefield, Lazelle E; Anderson, Cindy M; Conn, Vicki S

2013-02-01

Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

Exploring the Supervisor Role as a Facilitator of Knowledge Sharing in Teams

ERIC Educational Resources Information Center

MacNeil, Christina Mary

2004-01-01

This paper explores the themes and implications, concerning the role of the supervisor as a facilitator of knowledge sharing in teams. After describing the strategic context for devolving human resource responsibilities to line managers, the paper defines and discusses the line manager/supervisor role. The barriers to learning in the workplace are…

Barriers to and facilitators of implementing complex workplace dietary interventions: process evaluation results of a cluster controlled trial.

PubMed

Fitzgerald, Sarah; Geaney, Fiona; Kelly, Clare; McHugh, Sheena; Perry, Ivan J

2016-04-21

Ambiguity exists regarding the effectiveness of workplace dietary interventions. Rigorous process evaluation is vital to understand this uncertainty. This study was conducted as part of the Food Choice at Work trial which assessed the comparative effectiveness of a workplace environmental dietary modification intervention and an educational intervention both alone and in combination versus a control workplace. Effectiveness was assessed in terms of employees' dietary intakes, nutrition knowledge and health status in four large manufacturing workplaces. The study aimed to examine barriers to and facilitators of implementing complex workplace interventions, from the perspectives of key workplace stakeholders and researchers involved in implementation. A detailed process evaluation monitored and evaluated intervention implementation. Interviews were conducted at baseline (27 interviews) and at 7-9 month follow-up (27 interviews) with a purposive sample of workplace stakeholders (managers and participating employees). Topic guides explored factors which facilitated or impeded implementation. Researchers involved in recruitment and data collection participated in focus groups at baseline and at 7-9 month follow-up to explore their perceptions of intervention implementation. Data were imported into NVivo software and analysed using a thematic framework approach. Four major themes emerged; perceived benefits of participation, negotiation and flexibility of the implementation team, viability and intensity of interventions and workplace structures and cultures. The latter three themes either positively or negatively affected implementation, depending on context. The implementation team included managers involved in coordinating and delivering the interventions and the researchers who collected data and delivered intervention elements. Stakeholders' perceptions of the benefits of participating, which facilitated implementation, included managers' desire to improve company

Managing Chemotherapy Side Effects: Constipation

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Constipation Take these steps: Eat high-fiber foods ... SERVICES National Institutes of Health Managing Chemotherapy Side Effects: Constipation These foods may help if you are ...

Barriers and facilitators to effective coverage of Intimate Partner Violence services for immigrant women in Spain.

PubMed

Briones-Vozmediano, Erica; La Parra, Daniel; Vives-Cases, Carmen

2015-12-01

To explore service providers' perceptions in order to identify barriers and facilitators to effective coverage of Intimate Partner Violence (IPV) services for immigrant women in Spain, according to the different categories proposed in Tanahashi's model of effective coverage. A qualitative study based on 29 in-depth personal interviews and four group interviews with a total of 43 professionals working in public services (social and health-care services, women's refuges, the police force, the judiciary) and NGOs in Barcelona, Madrid, Valencia and Alicante (Spain) in 2011. Current IPV services in Spain partially fail in their coverage of abused immigrant women due to barriers of (i) availability, such as the inexistence of culturally appropriate services; (ii) accessibility, as having a residence permit is a prerequisite for women's access to different services and rights; (iii) acceptability, such as women's lack of confidence in the effectiveness of services; and (iv) effectiveness, for example, lack of specific training among professionals on the issues of IPV and immigration. However, interviewees also identified facilitators, such as the enabling environment promoted by the Spanish Law on Gender-Based Violence (1/2004), and the impetus it has provided for the development of other specific legislative tools to address IPV in immigrant populations in Spain (availability, accessibility and effectiveness). Whilst not dismissing cultural barriers, aspects related to service structure are identified by providers as the main barriers and facilitators to immigrant women use of IPV services. Despite noteworthy achievements, improvements are still required in terms of mainstreaming assistance tailored to immigrant women's needs in IPV policies and services. © 2014 John Wiley & Sons Ltd.

Managing Chemotherapy Side Effects: Pain

MedlinePlus

N ational C ancer I nstitute Managing Chemotherapy Side Effects Pain It’s important to treat pain. If ... help to pay for pain medicine. Managing Chemotherapy Side Effects: Pain Keep track of the pain. Each ...

Effectiveness and cost-effectiveness of facilitated percutaneous coronary intervention compared with primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction transferred from community hospitals.

PubMed

Coleman, Craig I; McKay, Raymond G; Boden, William E; Mather, Jeffrey F; White, C Michael

2006-07-01

Primary percutaneous coronary intervention ([PCI], percutaneous transluminal coronary angioplasty+stenting) for ST-segment elevation myocardial infarction (STEMI) is regarded as superior to fibrinolysis even if it means that patients need to be transferred from one center to another to undergo the procedure. However, this inevitable delay between symptom onset and PCI, caused by the time required to travel, might increase the occurrence of cardiac events. A hybrid method called facilitated PCI uses fibrinolysis and/or glycoprotein (GP) IIb/IIIa inhibitors before transfer to a tertiary medical center where urgent PCI might be performed. This approach, however, has not been systematically evaluated. The purpose of this study was to compare the effectiveness (combined end point of in-hospital mortality, reinfarction, stroke, or emergency revascularization) and cost-effectiveness of utilizing a bolus thrombolytic agent with GP IIb/IIIa inhibitor followed by transfer to a tertiary institution for facilitated PCI or standard of care transfer without primary PCI drugs among patients presenting to a community hospital with STEMI. This was a prospective, single-center, cohort study comprising data from STEMI patients transferred from community hospitals to Hartford Hospital, Hartford, Connecticut, from the years 2000 to 2003. At the time of analysis, patients receiving primary PCI were matched (1:1) with those receiving facilitated PCI, utilizing propensity scores to assure similar demographics. The combined incidence of major adverse cardiac end points (MACE) and total hospital costs was compared between groups. Non-parametric bootstrapping was conducted to calculate CIs for the incremental cost-effectiveness ratio and generate a quadrant analysis. Based on 254 propensity score-matched patients (127 facilitated PCI and 127 primary PCI), in-hospital MACE and total hospital costs were reduced by 61.3% and US 4563 dollars (2005), respectively, in patients receiving

Implementing a novel dance intervention in rehabilitation: perceived barriers and facilitators.

PubMed

Demers, Marika; Thomas, Aliki; Wittich, Walter; McKinley, Patricia

2015-01-01

To identify clinicians' perceptions regarding the facilitators and barriers to the use of dance in rehabilitation. This study used a qualitative descriptive design. Three focus groups were conducted with clinicians across three purposively selected rehabilitation centers. Data were analyzed using thematic content analysis. Fourteen allied health-care professionals (six occupational therapists, six physical therapists, and two social workers) with previous dance experience participated in this study. Four main themes emerged from the analysis representing the personal and organizational factors influencing on the implementation of dance interventions: (1) Clinician's dance experience and training, (2) Interest and personal beliefs towards using dance as a potential intervention, (3) Support from the organization of the institution, and (4) Available resources. Although each site was different, the main factors acting as barriers and facilitators were similar for all three sites. The identification of the barriers and facilitators to implementing dance in rehabilitation is the first step to support the translation of knowledge about dance. A tailored approach designed for clinicians and managers should address the main barriers to knowledge use about dance, as a potential rehabilitation modality for individuals with disabilities. Personal and organizational factors can act simultaneously as barriers and facilitators to the implementation of a dance intervention. Lack of time for professional development and lack of support from the organization are the main barriers to the uptake of knowledge about dance in rehabilitation. A knowledge translation strategy addressing the barriers to knowledge use is helpful for clinicians and managers facilitating the implementation of dance in rehabilitation settings.

The Effects of Work Demands and Resources on Work-to-family Conflict and Facilitation

ERIC Educational Resources Information Center

Voydanoff, Patricia

2004-01-01

This article uses a differential salience-comparable salience approach to examine the effects of work demands and resources on work-to-family conflict and facilitation. The analysis is based on data from 1,938 employed adults living with a family member who were interviewed for the 1997 National Study of the Changing Workforce. The results support…

Improving productivity through more effective time management.

PubMed

Arnold, Edwin; Pulich, Marcia

2004-01-01

Effective time management has become increasingly important for managers as they seek to accomplish objectives in today's organizations, which have been restructured for efficiency while employing fewer people. Managers can improve their ability to manage time effectively by examining their attitudes toward time, analyzing time-wasting behaviors, and developing better time management skills. Managers can improve their performance and promotion potential with more effective time utilization. Strategies for improving time management skills are presented.

Developing the practice context to enable more effective pain management with older people: an action research approach

PubMed Central

2011-01-01

Background This paper, which draws upon an Emancipatory Action Research (EAR) approach, unearths how the complexities of context influence the realities of nursing practice. While the intention of the project was to identify and change factors in the practice context that inhibit effective person-centred pain management practices with older people (65 years or older), reflective critical engagement with the findings identified that enhancing pain management practices with older people was dependent on cultural change in the unit as a whole. Methods An EAR approach was utilised. The project was undertaken in a surgical unit that conducted complex abdominal surgery. Eighty-five percent (n = 48) of nursing staff participated in the two-year project (05/NIR02/107). Data were obtained through the use of facilitated critical reflection with nursing staff. Results Three key themes (psychological safety, leadership, oppression) and four subthemes (power, horizontal violence, distorted perceptions, autonomy) were found to influence the way in which effective nursing practice was realised. Within the theme of 'context,' effective leadership and the creation of a psychologically safe environment were key elements in the enhancement of all aspects of nursing practice. Conclusions Whilst other research has identified the importance of 'practice context' and models and frameworks are emerging to address this issue, the theme of 'psychological safety' has been given little attention in the knowledge translation/implementation literature. Within the principles of EAR, facilitated reflective sessions were found to create 'psychologically safe spaces' that supported practitioners to develop effective person-centred nursing practices in complex clinical environments. PMID:21284857

Managing Chemotherapy Side Effects: Anemia

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Anemia “I told my doctor that I was ... exercise a little every day. Managing Chemotherapy Side Effects: Anemia Eat and drink well. ● ● Talk with your ...

From parent to 'peer facilitator': a qualitative study of a peer-led parenting programme.

PubMed

Thomson, S; Michelson, D; Day, C

2015-01-01

Peer-led interventions are increasingly common in community health settings. Although peer-led approaches have proven benefits for service users, relatively little is known about the process and outcomes of participation for peer leaders. This study investigated experiences of parents who had participated as 'peer facilitators' in Empowering Parents, Empowering Communities (EPEC), a peer-led programme designed to improve access to evidence-based parenting support in socially disadvantaged communities. A qualitative cross-sectional design was used. Semi-structured interviews were conducted with 14 peer facilitators and scrutinized using thematic analysis. Peer facilitators developed their knowledge and skills through personal experience of receiving parenting support, participation in formal training and supervised practice, access to an intervention manual, and peer modelling. Peer facilitators described positive changes in their own families, confidence and social status. Transformative personal gains reinforced peer facilitators' role commitment and contributed to a cohesive 'family' identity among EPEC staff and service users. Peer facilitators' enthusiasm, openness and mutual identification with families were seen as critical to EPEC's effectiveness and sustainability. Peer facilitators also found the training emotionally and intellectually demanding. There were particular difficulties around logistical issues (e.g. finding convenient supervision times), managing psychosocial complexity and child safeguarding. The successful delivery and sustained implementation of peer-led interventions requires careful attention to the personal qualities and support of peer leaders. Based on the findings of this study, support should include training, access to intervention manuals, regular and responsive supervision, and logistical/administrative assistance. Further research is required to elaborate and extend these findings to other peer-led programmes. © 2014 John Wiley

Assessing Facilitator Performance as an Influence on Student Satisfaction

ERIC Educational Resources Information Center

Dunlap, Scotty; May, David

2011-01-01

Growth in class size within the online environment has resulted in a facilitator model in which an instructor teaches the class with the assistance of facilitators who interact with students in smaller groups. This research sought to determine the effectiveness of a structured performance evaluation for facilitators and the correlation to student…

Going beyond the identification of change facilitators to effectively implement a new model of services: lessons learned from a case example in paediatric rehabilitation.

PubMed

Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Carrière, Monique

2011-01-01

To identify facilitators and barriers to service reorganization, how they evolved and interacted to influence change during the implementation of a new service delivery model of paediatric rehabilitation. Over 3 years, different stakeholders responded to SWOT questionnaires (n = 139) and participated in focus groups (n = 19) and telephone interviews (n = 13). A framework based on socio constructivist theories made sense of the data. Facilitators related to the programme's structure (e.g. funding), the actors (e.g. willingness to test the new service model) and the change management process (e.g. participative approach). Some initial facilitators became barriers (e.g. leadership lacked at the end), while other barriers emerged (e.g. lack of tools). Understanding factor interactions requires examining the multiple actors' intentions, actions and consequences and their relations with structural elements. Analysing facilitators and barriers helped better understand the change processes, but this must be followed by concrete actions to successfully implement new paediatric rehabilitation models.

A Qualitative Study of Doctors of Chiropractic in a Nova Scotian Practice-based Research Network: Barriers and Facilitators to the Screening and Management of Psychosocial Factors for Patients With Low Back Pain.

PubMed

Stilwell, Peter; Hayden, Jill A; Des Rosiers, Piaf; Harman, Katherine; French, Simon D; Curran, Janet A; Hefford, Warren

2018-01-01

This study aimed to assess chiropractors' awareness of clinical practice guidelines for low back pain and to identify barriers and facilitators to the screening and management of psychosocial factors in patients with low back pain. This qualitative study used semi-structured interviews informed by the Theoretical Domains Framework with 10 Nova Scotian chiropractors who were members of a practice-based research network. The participants correctly identified what the guidelines generally recommend and described the value of psychosocial factors; however, none of the participants could name specific clinical practice guidelines for low back pain. We identified 6 themes related to barriers and facilitators for chiropractors screening and managing psychosocial factors. The themes revolved around the participants' desire to fulfill patients' anatomy-focused treatment expectations and a perceived lack of training for managing psychosocial factors. Participants had concerns about going beyond the chiropractic scope of practice, and they perceived a lack of practical psychosocial screening and management resources. Social factors, such as the influence of other health care practitioners, were reported as both barriers and facilitators to screening and managing psychosocial factors. The participants in this study reported that they mostly treated with an anatomical and biomechanical focus and that they did not always address psychosocial factors identified in their patients with low back pain. Although these findings are limited to Nova Scotian chiropractors, the barriers identified appeared to be potentially modifiable and could be considered in other groups. Low-cost interventions, such as continuing education using evidence-informed behavior change techniques, could be considered to address these barriers. Copyright © 2017. Published by Elsevier Inc.

Further development of pharmacy student-facilitated diabetes management clinics.

PubMed

Nuffer, Wesley; McCollum, Marianne; Ellis, Samuel L; Turner, Christopher J

2012-04-10

To further develop and evaluate a diabetes disease state management (DSM) program that provided direct patient care responsibilities to advanced pharmacy practice experience (APPE) students as members of healthcare teams. Nine new clinics and 3 established sites that provide self-care management education to patients with diabetes were established and maintained in rural Colorado pharmacies and supported by students in APPE training for 48 weeks per year. The 12 clinics provided 120 APPE student placements in 2010-2011. Students' perceptions of their experiences were positive. Patients who completed the student-supported diabetes self-management education program had improvements in blood glucose, blood pressure, and lipid values. Twelve diabetes DSM clinics provided direct patient care opportunities to APPE students working as part of healthcare teams while expanding healthcare resources in underserved communities in Colorado.

Facilitating the inclusion of nonmarket values in Bureau of Land Management planning and project assessments—Final report

USGS Publications Warehouse

Huber, Chris; Richardson, Leslie

2016-11-23

Executive SummaryThis report summarizes the results of a series of field-based case studies conducted by the U.S. Geological Survey (USGS) to (1) evaluate the use of nonmarket values in Bureau of Land Management (BLM) planning and project assessments, (2) update existing technical resources for measuring those values, and (3) provide guidance to field staff on the use of nonmarket values. Four BLM pilot sites participated in this effort: Canyons of the Ancients National Monument in Colorado, Red Cliffs and Beaver Dam Wash National Conservation Areas in Utah, BLM’s Taos Field Office in New Mexico, and BLM's Tuscarora Field Office in Nevada. The focus of the case studies was on practical applications of nonmarket valuation. USGS worked directly with BLM field staff at the pilot sites to demonstrate the process of considering nonmarket values in BLM decisionmaking and document the questions, challenges, and opportunities that arise when tying economic language to projects.As part of this effort, a Web-based toolkit, available at https://my.usgs.gov/benefit-transfer/, was updated and expanded to help facilitate benefit transfers (that is, the use of existing economic data to quantify nonmarket values) and qualitative discussions of nonmarket values. A total of 53 new or overlooked nonmarket valuation studies comprising 494 nonmarket value estimates for various recreational activities and the preservation of threatened, endangered, and rare species were added to existing databases within this Benefit Transfer Toolkit. In addition, four meta-regression functions focused on hunting, wildlife viewing, fishing, and trail use recreation were developed and added to the Benefit Transfer Toolkit.Results of this effort demonstrate that there are two main roles for nonmarket valuation in BLM planning. The first is to improve the decisionmaking process by contributing to a more comprehensive comparison of economic benefits and cost when evaluating resource tradeoffs for National

Barriers and facilitators to implementing electronic prescription: a systematic review of user groups' perceptions.

PubMed

Gagnon, Marie-Pierre; Nsangou, Édith-Romy; Payne-Gagnon, Julie; Grenier, Sonya; Sicotte, Claude

2014-01-01

We conducted a systematic review identifying users groups' perceptions of barriers and facilitators to implementing electronic prescription (e-prescribing) in primary care. We included studies following these criteria: presence of an empirical design, focus on the users' experience of e-prescribing implementation, conducted in primary care, and providing data on barriers and facilitators to e-prescribing implementation. We used the Donabedian logical model of healthcare quality (adapted by Barber et al) to analyze our findings. We found 34 publications (related to 28 individual studies) eligible to be included in this review. These studies identified a total of 594 elements as barriers or facilitators to e-prescribing implementation. Most user groups perceived that e-prescribing was facilitated by design and technical concerns, interoperability, content appropriate for the users, attitude towards e-prescribing, productivity, and available resources. This review highlights the importance of technical and organizational support for the successful implementation of e-prescribing systems. It also shows that the same factor can be seen as a barrier or a facilitator depending on the project's own circumstances. Moreover, a factor can change in nature, from a barrier to a facilitator and vice versa, in the process of e-prescribing implementation. This review summarizes current knowledge on factors related to e-prescribing implementation in primary care that could support decision makers in their design of effective implementation strategies. Finally, future studies should emphasize on the perceptions of other user groups, such as pharmacists, managers, vendors, and patients, who remain neglected in the literature.

Integrated management of depression: improving system quality and creating effective interfaces.

PubMed

Myette, Thomas L

2008-04-01

Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce. To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems. After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced. A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes. Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.

Risk Management Issues - An Aerospace Perspective

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2011-01-01

Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks--risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements.. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner, Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: a systematic review and thematic analysis.

PubMed

Bornbaum, Catherine C; Kornas, Kathy; Peirson, Leslea; Rosella, Laura C

2015-11-20

Knowledge brokers (KBs) work collaboratively with key stakeholders to facilitate the transfer and exchange of information in a given context. Currently, there is a perceived lack of evidence about the effectiveness of knowledge brokering and the factors that influence its success as a knowledge translation (KT) mechanism. Thus, the goal of this review was to systematically gather evidence regarding the nature of knowledge brokering in health-related settings and determine if KBs effectively contributed to KT in these settings. A systematic review was conducted using a search strategy designed by a health research librarian. Eight electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, ERIC, Scopus, SocINDEX, and Health Business Elite) and relevant grey literature sources were searched using English language restrictions. Two reviewers independently screened the abstracts, reviewed full-text articles, extracted data, and performed quality assessments. Analysis included a confirmatory thematic approach. To be included, studies must have occurred in a health-related setting, reported on an actual application of knowledge brokering, and be available in English. In total, 7935 records were located. Following removal of duplicates, 6936 abstracts were screened and 240 full-text articles were reviewed. Ultimately, 29 articles, representing 22 unique studies, were included in the thematic analysis. Qualitative (n = 18), quantitative (n = 1), and mixed methods (n = 6) designs were represented in addition to grey literature sources (n = 4). Findings indicated that KBs performed a diverse range of tasks across multiple health-related settings; results supported the KB role as a 'knowledge manager', 'linkage agent', and 'capacity builder'. Our systematic review explored outcome data from a subset of studies (n = 8) for evidence of changes in knowledge, skills, and policies or practices related to knowledge brokering. Two studies met standards for

Management Strategies to Facilitate Optimal Outcomes for Patients Treated with Delayed-release Dimethyl Fumarate.

PubMed

Mayer, Lori; Fink, Mary Kay; Sammarco, Carrie; Laing, Lisa

2018-04-01

Delayed-release dimethyl fumarate is an oral disease-modifying therapy that has demonstrated significant efficacy in adults with relapsing-remitting multiple sclerosis. Incidences of flushing and gastrointestinal adverse events are common in the first month after delayed-release dimethyl fumarate initiation. Our objective was to propose mitigation strategies for adverse events related to initiation of delayed-release dimethyl fumarate in the treatment of patients with multiple sclerosis. Studies of individually developed mitigation strategies and chart reviews were evaluated. Those results, as well as mitigation protocols developed at multiple sclerosis care centers, are summarized. Key steps to optimize the effectiveness of delayed-release dimethyl fumarate treatment include education prior to and at the time of delayed-release dimethyl fumarate initiation, initiation dose protocol gradually increasing to maintenance dose, dietary suggestions for co-administration with food, gastrointestinal symptom management with over-the-counter medications, flushing symptom management with aspirin, and temporary dose reduction. Using the available evidence from clinical trials and evaluations of post-marketing studies, these strategies to manage gastrointestinal and flushing symptoms can be effective and helpful to the patient when initiating delayed-release dimethyl fumarate.

Regulating and facilitating: the role of emotional intelligence in maintaining and using positive affect for creativity.

PubMed

Parke, Michael R; Seo, Myeong-Gu; Sherf, Elad N

2015-05-01

Although past research has identified the effects of emotional intelligence on numerous employee outcomes, the relationship between emotional intelligence and creativity has not been well established. We draw upon affective information processing theory to explain how two facets of emotional intelligence-emotion regulation and emotion facilitation-shape employee creativity. Specifically, we propose that emotion regulation ability enables employees to maintain higher positive affect (PA) when faced with unique knowledge processing requirements, while emotion facilitation ability enables employees to use their PA to enhance their creativity. We find support for our hypotheses using a multimethod (ability test, experience sampling, survey) and multisource (archival, self-reported, supervisor-reported) research design of early career managers across a wide range of jobs. (c) 2015 APA, all rights reserved.

Characteristics of effective health care managers.

PubMed

Johnson, Sherryl W

2005-01-01

This article provides an overview of traditional and contemporary management theories. Concerns, characteristics, and skills of effective managers are also presented. Further, a self-assessment (survey) of 7 highly effective health care managers in a South Georgia community was conducted to determine their ratings on 6 management indices. The assessment or Scale of Transformational Leadership uses a Likert-type scale to allow for the evaluation of managers. The scale contains 6 management elements for assessment: attention, meaning, trust, self, vision, and feeling. Individual ratings and group summary skills rating are presented. Findings revealed the order of managerial importance of the elements as follows (from highest to lowest): Management of Trust, Management of Attention, Management of Self, Management of Feeling, Management of Meaning, and Management of Risk. As a second tier, the final ratings are corroborated by health care management interns.

A randomized controlled trial of a Return-to-Work Coordinator model of care in a general hospital to facilitate return to work of injured workers.

PubMed

Tan, Heidi Siew Khoon; Yeo, Doreen Sai Ching; Giam, Joanna Yu Ting; Cheong, Florence Wai Fong; Chan, Kay Fei

2016-04-07

Return-to-work (RTW) programmes for injured workers have been prevalent in Western countries with established work injury management policies for decades. In recent years, more Asian countries have started to develop RTW programmes in the absence of work injury management policies. However, few studies have evaluated the effectiveness of RTW programmes in Asia. Return-to-work coordination has been found to be an important facilitator in RTW programmes. This study seeks to determine the effectiveness of a Return-to-work coordinator (RTWC) model of care in facilitating early RTW for injured workers in Singapore. A randomized controlled trial was used. 160 injured workers in a general hospital were randomly allocated to either control (receive usual hospital standard care) or intervention (assigned a RTWC) group. The RTWC closely supported RTW arrangements and proactively liaised with employers and healthcare professionals on RTW solutions for the injured workers. At three months post injury, workers in the intervention group RTW 10 days earlier than the control group, with a higher proportion of workers in the intervention group returning to modified jobs. There were no significant differences in the quality of life measures between the two groups. The addition of a RTWC into the hospital model of care is effective in facilitating early RTW for injured workers. This could be a potential model of care for injured workers in Asian countries where work injury management policies are not yet established.

[Facilitators in the implantation of telemedicine services. Perspective of professionals involved in its design and implementation].

PubMed

Loscertales, F Roig; Rubió, F Saigí

2011-01-01

Given the difficulties encountered by Telemedicine for final incorporation into clinical practice and given the lack of scientific evidence regarding the most appropriate implementation strategies, it is necessary to collect and disseminate lessons gained from experience in its introduction and diffusion in our health system. The aim of this study is to identify the facilitators perceived by professionals who actively participate in the design and implementation of telemedicine projects in the health care system. Qualitative study of data from semi-structured interviews with 17 key informants belonging to different Catalan health organizations. The identified facilitators are grouped in four broad areas: a TM service that meets a need clearly perceived by practitioners; a core leadership with a clinical profile, managing an open, participatory and flexible model that takes into account the needs of professionals; the ability to establish partnerships with different stakeholders beyond the customer-supplier relationship; and the inclusion in the initial design of a strategy for sustainability and normalization. Understanding the facilitators and barriers that appear in the process of implementing TM experiences in health care organizations becomes an item of high value for its final introduction. An approach combining the evidence on clinical effectiveness and cost-benefit with lessons learned about the dynamics of implementation and normalization will allow for a holistic understanding of the adoption of the TM and provide guidance for improving its organizational management.

77 FR 16942 - Magnuson-Stevens Fishery Conservation and Management Act Provisions; Fisheries of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-23

... Multispecies Fishery Management Plan which was approved on March 8, 2012. This action amends the Northeast Multispecies Fishery Management Plan to explicitly define and facilitate the effective operation of state.... 110901552-20494-02] RIN 0648-BB34 Magnuson-Stevens Fishery Conservation and Management Act Provisions...

Managing Data and Facilitating Science: A spectrum of activities in the Centre for Environmental Data Archival. (Invited)

NASA Astrophysics Data System (ADS)

Lawrence, B.; Bennett, V.; Callaghan, S.; Juckes, M. N.; Pepler, S.

2013-12-01

The UK Centre for Environmental Data Archival (CEDA) hosts a number of formal data centres, including the British Atmospheric Data Centre (BADC), and is a partner in a range of national and international data federations, including the InfraStructure for the European Network for Earth system Simulation, the Earth System Grid Federation, and the distributed IPCC Data Distribution Centres. The mission of CEDA is to formally curate data from, and facilitate the doing of, environmental science. The twin aims are symbiotic: data curation helps facilitate science, and facilitating science helps with data curation. Here we cover how CEDA delivers this strategy by established internal processes supplemented by short-term projects, supported by staff with a range of roles. We show how CEDA adds value to data in the curated archive, and how it supports science, and show examples of the aforementioned symbiosis. We begin by discussing curation: CEDA has the formal responsibility for curating the data products of atmospheric science and earth observation research funded by the UK Natural Environment Research Council (NERC). However, curation is not just about the provider community, the consumer communities matter too, and the consumers of these data cross the boundaries of science, including engineers, medics, as well as the gamut of the environmental sciences. There is a small, and growing cohort of non-science users. For both producers and consumers of data, information about data is crucial, and a range of CEDA staff have long worked on tools and techniques for creating, managing, and delivering metadata (as well as data). CEDA "science support" staff work with scientists to help them prepare and document data for curation. As one of a spectrum of activities, CEDA has worked on data Publication as a method of both adding value to some data, and rewarding the effort put into the production of quality datasets. As such, we see this activity as both a curation and a

Building Resilience against Climate Effects—A Novel Framework to Facilitate Climate Readiness in Public Health Agencies

PubMed Central

Marinucci, Gino D.; Luber, George; Uejio, Christopher K.; Saha, Shubhayu; Hess, Jeremy J.

2014-01-01

Climate change is anticipated to have several adverse health impacts. Managing these risks to public health requires an iterative approach. As with many risk management strategies related to climate change, using modeling to project impacts, engaging a wide range of stakeholders, and regularly updating models and risk management plans with new information—hallmarks of adaptive management—are considered central tenets of effective public health adaptation. The Centers for Disease Control and Prevention has developed a framework, entitled Building Resilience Against Climate Effects, or BRACE, to facilitate this process for public health agencies. Its five steps are laid out here. Following the steps laid out in BRACE will enable an agency to use the best available science to project likely climate change health impacts in a given jurisdiction and prioritize interventions. Adopting BRACE will also reinforce public health’s established commitment to evidence-based practice and institutional learning, both of which will be central to successfully engaging the significant new challenges that climate change presents. PMID:24991665

An Interactive Mobile Phone-Website Platform to Facilitate Real-Time Management of Medication in Chronically ill Patients.

PubMed

Anglada-Martínez, Helena; Martin-Conde, Maite; Rovira-Illamola, Marina; Sotoca-Momblona, Jose Miguel; Sequeira, Ethel; Aragunde, Valentin; Codina-Jané, Carles

2017-08-01

Poor adherence to medication is a prevalent issue that affects 50-60% of chronically ill patients. We present Medplan, a platform for patients/caregivers and healthcare professionals (HCPs) that aims to enhance adherence, increase patient medication knowledge, and facilitate communication between patients and HCPs. The Medplan platform was designed and developed by a multidisciplinary team composed of primary care and hospital physicians, pharmacists, patients, and developers. We questioned 62 patients in order to know their opinion about the different functions the app would incorporate and other possible features that should be taken into consideration. Medplan comprises a website for HCPs and an application (app) that is installed on the patient's phone. The app is available in Spanish, Catalan, and English. The patient's medication plan was introduced by the HCP and interfaced with the app. Each medicine is represented by an icon showing the indication of the treatment, the trade name, active ingredients, dose, and route of administration. Information about special requirements (e.g., need to take medication on an empty stomach), side effects, or lifestyle recommendations can also be provided. Additional functions include a medication reminder alarm system, by which patients can confirm whether or not they have taken the drug. Patients can self-track their adherence, and all data collected are sent automatically to the website for analysis by the HCP. Weekly motivation messages are sent to encourage adherence. A tool enabling interactive communication between patients and HCPs (primary care or hospital care) is also included. The app contains a feature enabling the HCP to verify the suitability of over-the-counter drugs. Medplan has the potential to significantly improve management of medication in chronically ill patients. A pilot study is being conducted to test whether Medplan is useful and effective.

Role-play facilitates children's mindreading of those with atypical color perception.

PubMed

Furumi, Fumikazu; Koyasu, Masuo

2014-01-01

The present study examined the effects of role-play experience on children's mindreading ability. Forty-one primary school children (20 boys, 21 girls, mean age: 9.37 years, range: 8-11 years) were introduced to a communication task in which the use of mindreading was essential. During each trial, participants viewed a shelf, presented on a laptop, which contained several familiar objects, and they were instructed to touch an object on the shelf following an order issued by a "manager" who stood at the opposite side of the shelf. There were two managers: one was a monkey manager with normal color vision, and the other was a dog manager with restricted color vision. The monkey manager could see all the objects in the same colors as the participants, whereas the dog manager saw some objects in different colors. Participants were required to respond according to the manager's instruction. In the restricted color vision condition, the dog manager saw the colors of objects differently; thus, participants had to work out his intentions, according to his different perspective. In the normal color vision condition, all objects were in the same colors as those seen by the monkey manager. Before the test phase, participants in the role-play group were provided a role-play experience in which they assumed the role of the dog manager with restricted color vision. The experimental data were analyzed using a 2 × 2 mixed-design ANOVA (role-play condition × communication partner condition) to examine differences in the error rate. Both main effects and its interaction were significant. According to the post-hoc analyses, participants in the no-role-play condition made significantly more errors in the restricted color vision condition than in the normal color vision condition, whereas no such difference was found among participants in the role-play condition. These results suggest that role-play experience could facilitate mindreading of characters with restricted color vision.

Managing Postsocialist Transitions: Politicized Sense Making as a Facilitator of Organizational Change

ERIC Educational Resources Information Center

Tiplic, Dijana

2011-01-01

This study explores what organizational strategies are employed to initiate and facilitate organizational change in higher education institutions in the increasingly complex and competitive postsocialist environment of Bosnia-Herzegovina. By studying organizations trapped between their inert socialist-era legacies and desired organizational…

The Influence of Facilitator and Facilitation Characteristics on Participants' Ratings of Stepfamily Education

ERIC Educational Resources Information Center

Higginbotham, Brian J.; Myler, Cory

2010-01-01

We examine the relative importance of facilitator and facilitation characteristics on participant ratings of a stepfamily education program. Data from 48 facilitators and 598 participants suggest that quality facilitation is more meaningful to participants than whether facilitators have comparable demographic characteristics or life experiences.…

Barriers and facilitators to healthy eating and disease self-management among older adults residing in subsidized housing.

PubMed

Petroka, Katherine; Campbell-Bussiere, Rania; Dychtwald, Dan K; Milliron, Brandy-Joe

2017-09-01

As adults transition into older ages, meeting age-specific dietary recommendations can become increasingly challenging, especially for low-income seniors who reside in publicly subsidized rental housing. The primary objectives of this study were to: 1) identify barriers and facilitators to healthy eating and self-management of nutrition-related chronic illnesses experienced by low-income seniors residing in a subsidized housing setting; and 2) assess the interest in community nutrition programming among low-income seniors residing in a subsidized housing setting. A qualitative study design, using food focus groups and food pantry observations, was used. Participants included 24 male and female senior adults, between 65 and 75 years of age, residing in a subsidized housing community in Philadelphia, PA. This setting also included the unique features of a community garden and food pantry. Data were manually analyzed using a content analysis approach, which included familiarization, identification of themes, categorization and interpretation; and verified using NVivo 10. Personal barriers, including food cost and accessibility, physical limitations, desire for convenience, and low self-efficacy to change dietary habits, inhibited motivation to change. External barriers in the food environment, including lack of transportation and distance of markets to access fresh produce, were commonly cited; as well as negative influences of the internal environment, such as the presence of vending machines, common cultural cooking and eating practices, and the lack of social cohesion. Facilitators focused on food preparation and recipe adaptation. Participants expressed an interest in learning more about food, nutrition, and health through community-based programming.

Adolescent Female Cannabinoid Exposure Diminishes the Reward-Facilitating Effects of Δ9-Tetrahydrocannabinol and d-Amphetamine in the Adult Male Offspring.

PubMed

Pitsilis, George; Spyridakos, Dimitrios; Nomikos, George G; Panagis, George

2017-01-01

Marijuana is currently the most commonly abused illicit drug. According to recent studies, cannabinoid use occurring prior to pregnancy can impact brain plasticity and behavior in future generations. The purpose of the present study was to determine whether adolescent exposure of female rats to Δ 9 -tetrahydrocannabinol (Δ 9 -THC) induces transgenerational effects on the reward-facilitating effects of Δ 9 -THC and d -amphetamine in their adult male offspring. Female Sprague-Dawley rats received Δ 9 -THC (0.1 or 1 mg/kg, i.p.) or vehicle during postnatal days 28-50. As adults, females were mated with drug-naïve males. We then assessed potential alterations of the Δ 9 -THC's (0, 0.1, 0.5, and 1 mg/kg, i.p.) and d -amphetamine's (0, 0.1, 0.5, and 1 mg/kg, i.p.) reward-modifying effects using the curve-shift variant of the intracranial self-stimulation (ICSS) procedure in their adult male F1 offspring. The reward-facilitating effect of the 0.1 mg dose of Δ 9 -THC was abolished in the F1 offspring of females that were exposed to Δ 9 -THC (0.1 or 1 mg/kg), whereas the reward-attenuating effect of the 1 mg dose of Δ 9 -THC remained unaltered. The reward-facilitating effects of 0.5 and 1 mg of d -amphetamine were significantly decreased in the F1 offspring of females that were exposed to Δ 9 -THC (1 mg/kg and 0.1 or 1 mg, respectively). The present results reveal that female Δ 9 -THC exposure during adolescence can diminish the reward-facilitating effects of Δ 9 -THC and d -amphetamine in the adult male offspring. These transgenerational effects occur in the absence of in utero exposure. It is speculated that Δ 9 -THC exposure during female adolescence may affect neural mechanisms that are shaping reward-related behavioral responses in a subsequent generation, as indicated by the shifts in the reward-facilitating effects of commonly used and abused drugs.

Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis.

PubMed

Geneen, Louise J; Martin, Denis J; Adams, Nicola; Clarke, Clare; Dunbar, Martin; Jones, Derek; McNamee, Paul; Schofield, Pat; Smith, Blair H

2015-10-01

Chronic pain can contribute to disability, depression, anxiety, sleep disturbances, poor quality of life and increased health care costs, with close to 20 % of the adult population in Europe reporting chronic pain. To empower the person to self-manage, it is advocated that education and training about the nature of pain and its effects and how to live with pain is provided. The objective of this review is to determine the level of evidence for education to facilitate knowledge about chronic pain, delivered as a stand-alone intervention for adults, to reduce pain and disability. We identified randomised controlled trials of educational intervention for chronic pain by searching CENTRAL, MEDLINE, EMBASE and ongoing trials registries (inception to December 2013). Main inclusion criteria were (1) pain >3 months; (2) study design that allowed isolation of effects of education and (3) measures of pain or disability. Two reviewers independently screened and appraised each study. Nine studies were analysed. Pooled data from five studies, where the comparator group was usual care, showed no improvement in pain or disability. In the other four studies, comparing different types of education, there was no evidence for an improvement in pain; although, there was evidence (from one study) of a decrease in disability with a particular form of education-pain neurophysiology education (PNE). Post-hoc analysis of psychosocial outcomes reported in the studies showed evidence of a reduction in catastrophising and an increase of knowledge about pain following PNE. The evidence base is limited by the small numbers of studies, their relatively small sample sizes, and the diversity in types of education studied. From that limited evidence, the only support for this type of education is for PNE, though it is insufficiently strong to recommend conclusively that PNE should be delivered as a stand-alone intervention. It therefore remains sensible to recommend that education be delivered in

Personal discovery in diabetes self-management: Discovering cause and effect using self-monitoring data

PubMed Central

Mamykina, Lena; Heitkemper, Elizabeth M.; Smaldone, Arlene M.; Kukafka, Rita; Cole-Lewis, Heather J.; Davidson, Patricia G.; Mynatt, Elizabeth D.; Cassells, Andrea; Tobin, Jonathan N.; Hripcsak, George

2017-01-01

Objective To outline new design directions for informatics solutions that facilitate personal discovery with self-monitoring data. We investigate this question in the context of chronic disease self-management with the focus on type 2 diabetes. Materials and methods We conducted an observational qualitative study of discovery with personal data among adults attending a diabetes self-management education (DSME) program that utilized a discovery-based curriculum. The study included observations of class sessions, and interviews and focus groups with the educator and attendees of the program (n = 14). Results The main discovery in diabetes self-management evolved around discovering patterns of association between characteristics of individuals’ activities and changes in their blood glucose levels that the participants referred to as “cause and effect”. This discovery empowered individuals to actively engage in self-management and provided a desired flexibility in selection of personalized self-management strategies. We show that discovery of cause and effect involves four essential phases: (1) feature selection, (2) hypothesis generation, (3) feature evaluation, and (4) goal specification. Further, we identify opportunities to support discovery at each stage with informatics and data visualization solutions by providing assistance with: (1) active manipulation of collected data (e.g., grouping, filtering and side-by-side inspection), (2) hypotheses formulation (e.g., using natural language statements or constructing visual queries), (3) inference evaluation (e.g., through aggregation and visual comparison, and statistical analysis of associations), and (4) translation of discoveries into actionable goals (e.g., tailored selection from computable knowledge sources of effective diabetes self-management behaviors). Discussion The study suggests that discovery of cause and effect in diabetes can be a powerful approach to helping individuals to improve their self-management

Developing Critical Reflection in Professional Focused Doctorates: A Facilitator's Perspective

ERIC Educational Resources Information Center

Sambrook, Sally; Stewart, Jim

2008-01-01

Purpose: This paper aims to explore the challenges and opportunities for expediting critical reflection in management education and development to highlight particularly how critical reflection has been facilitated within the context of a professionally focused doctoral programme. Design/methodology/approach: The paper draws on empirical research…

Exploring the effect of at-risk case management compensation on hospital pay-for-performance outcomes: tools for change.

PubMed

Granata, Randy L; Hamilton, Karen

2015-01-01

Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.

Can Questions Facilitate Learning from Illustrated Science Texts?

ERIC Educational Resources Information Center

Iding, Marie K.

1997-01-01

Examines the effectiveness of using questions to facilitate processing of diagrams in science texts. Investigates three different elements in experiments on college students. Finds that questions about illustrations do not facilitate learning. Discusses findings with reference to cognitive load theory, the dual coding perspective, and the…

Using Text Mining to Characterize Online Discussion Facilitation

ERIC Educational Resources Information Center

Ming, Norma; Baumer, Eric

2011-01-01

Facilitating class discussions effectively is a critical yet challenging component of instruction, particularly in online environments where student and faculty interaction is limited. Our goals in this research were to identify facilitation strategies that encourage productive discussion, and to explore text mining techniques that can help…

Barriers and facilitators of treatment for depression in a latino community: a focus group study.

PubMed

Uebelacker, Lisa A; Marootian, Beth A; Pirraglia, Paul A; Primack, Jennifer; Tigue, Patrick M; Haggarty, Ryan; Velazquez, Lavinia; Bowdoin, Jennifer J; Kalibatseva, Zornitsa; Miller, Ivan W

2012-02-01

We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician, and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes: vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments, healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead to interventions better able to meet the needs of this particular group.

Tank waste remediation system immobilized high-level waste storage project configuration management implementation plan

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

Burgard, K.G.

This Configuration Management Implementation Plan was developed to assist in the management of systems, structures, and components, to facilitate the effective control and statusing of changes to systems, structures, and components; and to ensure technical consistency between design, performance, and operational requirements. Its purpose is to describe the approach Project W-464 will take in implementing a configuration management control, to determine the rigor of control, and to identify the mechanisms for imposing that control.This Configuration Management Implementation Plan was developed to assist in the management of systems, structures, and components, to facilitate the effective control and statusing of changes tomore » systems, structures, and components; and to ensure technical consistency between design, performance, and operational requirements. Its purpose is to describe the approach Project W-464 will take in implementing a configuration management control, to determine the rigor of control, and to identify the mechanisms for imposing that control.« less

Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: a scoping review protocol

PubMed Central

Tricco, Andrea C; Zarin, Wasifa; Rios, Patricia; Pham, Ba’; Straus, Sharon E; Langlois, Etienne V

2016-01-01

Introduction Engaging policymakers, healthcare managers and policy analysts in the conduct of knowledge synthesis can help increase its impact. This is particularly important for knowledge synthesis studies commissioned by decision-makers with limited timelines, as well as reviews of health policy and systems research. A scoping review will be conducted to assess barriers, facilitators, strategies and outcomes of engaging these individuals in the knowledge synthesis process. Methods and analysis We will follow the Joanna Briggs Institute guidance for scoping reviews. Literature searches of electronic databases (eg, MEDLINE, EMBASE, Cochrane Library, ERIC, PsycINFO) will be conducted from inception onwards. The electronic search will be supplemented by searching for sources that index unpublished/difficult to locate studies (eg, GreyNet International database), as well as through scanning of reference lists of reviews on related topics. All study designs using either qualitative or quantitative methodologies will be eligible if there is a description of the strategies, barriers or facilitators, and outcomes of engaging policymakers, healthcare managers and policy analysts in the knowledge synthesis process. Screening and data abstraction will be conducted by 2 team members independently after a calibration exercise across the team. A third team member will resolve all discrepancies. We will conduct frequency analysis and thematic analysis to chart and characterise the literature, identifying data gaps and opportunities for future research, as well as implications for policy. Ethics and dissemination This project was commissioned by the Alliance for Health Policy and Systems Research, WHO. The results will be used by Alliance Review Centers of health policy and systems research in low-income and middle-income countries that are conducting knowledge synthesis to inform health policymaking and decision-making. Our results will also be disseminated through conference

Change Management Model for Implementing an Effective First-Year Experience Program in the Community College Setting

ERIC Educational Resources Information Center

Tucker, Joy C.

2015-01-01

This study provides evidence that systematic management of change can facilitate the implementation of first-year experience programming that leads to improved results in retention and student success for community college students. The study includes four major themes: (a) first-year experience, (b) change management, (c) change leadership, and…

Fishing for leadership: The role diversification plays in facilitating change agents.

PubMed

Stoll, Joshua S

2017-09-01

Leadership is often viewed as being critical to successful natural resource management. This research focuses on a set of leaders identified through a social network analysis of fishers in a rural coastal region. Leaders' connections to different fisheries are evaluated, and these actors are found to be significantly more diversified than other fishers in the area. Drawing on theory related to institutional entrepreneurship and a series of in-depth interviews with these actors, this paper puts forward several hypotheses to explain how diverse social-ecological connections facilitate leadership. Three mechanisms are identified. Being diversified facilitates: (1) production of alternative visions; (2) framing of tractable strategies to sustain local marine resource; and (3) participation in the management process. While more research is needed to understand the relationship between diversification and leadership, these exploratory results suggest that leadership is, in part, a manifestation of ecological circumstance, supporting recent assertions that scholarship on leadership in natural resource management settings could benefit from being more attentive to the processes that shape leadership rather than fixating on individuals and their personal attributes. Given that fisheries policies increasingly constrain diversification, policymakers and managers should consider how specialization of fishers might change the form and function of leaders in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

The clinical and occupational effectiveness of condition management for Incapacity Benefit recipients.

PubMed

Kellett, Stephen; Bickerstaffe, Darren; Purdie, Fiona; Dyke, Andrew; Filer, Sarah; Lomax, Victoria; Tomlinson, Hayley

2011-06-01

OBJECTIVES. The aim of the Condition Management Programme (CMP) is to help Incapacity Benefit recipients manage their health conditions more effectively and return to work. This paper seeks to examine the clinical and employment outcomes from a group-based and mixed-condition CMP. DESIGN. In a prospective cohort design, measures of employment status and psychological well-being were taken at three time points; pre-CMP, post-CMP, and at 3-month follow-up. METHOD. Participants (N= 2,064) with a variety of physical and mental health conditions voluntarily attended a seven session cognitive-behaviourally informed psychoeducational group intervention. The psychological measures used were the Clinical Outcomes in Routine Evaluation - Outcome Measure, Work and Social Adjustment Scale, Self-Efficacy Scale, and the Intrinsic Motivation Scale. The employment status of participants was also measured at the three time points of the evaluation. RESULTS. Following CMP, 50% of participants experienced a reliable improvement in psychological well-being and 26% had either taken some steps towards work or returned to work at follow-up. Participants with a mental health condition were more likely to experience a reliable improvement in psychological well-being compared to those with physical health conditions. CONCLUSIONS. The results suggest that participation in CMP may be helpful in facilitating more effective self-management of the health conditions contributing to unemployment. The results have implications for whether formal employment assistance should be available in mental health services. ©2010 The British Psychological Society.

On the facilitative effects of face motion on face recognition and its development

PubMed Central

Xiao, Naiqi G.; Perrotta, Steve; Quinn, Paul C.; Wang, Zhe; Sun, Yu-Hao P.; Lee, Kang

2014-01-01

For the past century, researchers have extensively studied human face processing and its development. These studies have advanced our understanding of not only face processing, but also visual processing in general. However, most of what we know about face processing was investigated using static face images as stimuli. Therefore, an important question arises: to what extent does our understanding of static face processing generalize to face processing in real-life contexts in which faces are mostly moving? The present article addresses this question by examining recent studies on moving face processing to uncover the influence of facial movements on face processing and its development. First, we describe evidence on the facilitative effects of facial movements on face recognition and two related theoretical hypotheses: the supplementary information hypothesis and the representation enhancement hypothesis. We then highlight several recent studies suggesting that facial movements optimize face processing by activating specific face processing strategies that accommodate to task requirements. Lastly, we review the influence of facial movements on the development of face processing in the first year of life. We focus on infants' sensitivity to facial movements and explore the facilitative effects of facial movements on infants' face recognition performance. We conclude by outlining several future directions to investigate moving face processing and emphasize the importance of including dynamic aspects of facial information to further understand face processing in real-life contexts. PMID:25009517

Facilitating Elementary Science Teachers' Implementation of Inquiry-Based Science Teaching

ERIC Educational Resources Information Center

Qablan, Ahmad M.; DeBaz, Theodora

2015-01-01

Preservice science teachers generally feel that the implementation of inquiry-based science teaching is very difficult to manage. This research project aimed at facilitating the implementation of inquiry-based science teaching through the use of several classroom strategies. The evaluation of 15 classroom strategies from 80 preservice elementary…

Comparison of Anxiety Management Training and Self-Control Desensitization.

ERIC Educational Resources Information Center

Deffenbacher, Jerry L.; And Others

1980-01-01

Anxiety management training and self-control desensitization effectively reduced debilitating test anxiety and increased facilitating test anxiety. Follow-up demonstrated maintenance of debilitating test anxiety reduction. Subjects receiving treatment had significantly higher psychology grades. (Author)

Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study.

PubMed

Djalali, Ahmadreza; Khankeh, Hamidreza; Öhlén, Gunnar; Castrén, Maaret; Kurland, Lisa

2011-05-16

Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days. The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation. The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators. The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels.

Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study

PubMed Central

2011-01-01

Background Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days. Methods The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation. Results The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators. Conclusions The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels. PMID:21575233

[Facilitating the diagnosis of depression and burnout by identifying demographic and work-related risk and protective factors among nurses].

PubMed

Ádám, Szilvia; Nistor, Anikó; Nistor, Katalin; Cserháti, Zoltán; Mészáros, Veronika

2015-08-09

Depression and burnout are frequent comorbidities among nurses. Despite similar symptoms, their management differ. Therefore, their timely diagnosis is essential. To identify demographic and work-related risk and protective factors of burnout and depression, and facilitate their diagnosis. A cross-sectional study among 1,713 nurses was carried out. Depression and burnout were assessed by the shortened Beck Depression Questionnaire and Maclach Burnout Inventory, respectively. Risk and protective factors were explored using t-tests and analysis of variance. The prevalence of depression and moderate-to-high burnout was 35.1% and 34-74%, respectively. Having a partner/child and longer employment in the outpatient setting protected from burnout. Lack of a partner and male sex emerged as risk factors of depression and depersonalisation, respectively. High prevalence of depression and burnout among nurses poses a significant public health issue. Familiarity with the disease-specific risk and protective factors identified in this research may facilitate timely diagnosis and effective disease management.

Whose statistical reasoning is facilitated by a causal structure intervention?

PubMed

McNair, Simon; Feeney, Aidan

2015-02-01

People often struggle when making Bayesian probabilistic estimates on the basis of competing sources of statistical evidence. Recently, Krynski and Tenenbaum (Journal of Experimental Psychology: General, 136, 430-450, 2007) proposed that a causal Bayesian framework accounts for peoples' errors in Bayesian reasoning and showed that, by clarifying the causal relations among the pieces of evidence, judgments on a classic statistical reasoning problem could be significantly improved. We aimed to understand whose statistical reasoning is facilitated by the causal structure intervention. In Experiment 1, although we observed causal facilitation effects overall, the effect was confined to participants high in numeracy. We did not find an overall facilitation effect in Experiment 2 but did replicate the earlier interaction between numerical ability and the presence or absence of causal content. This effect held when we controlled for general cognitive ability and thinking disposition. Our results suggest that clarifying causal structure facilitates Bayesian judgments, but only for participants with sufficient understanding of basic concepts in probability and statistics.

A Facilitator's Guide for the Online Course: What Education Leaders Should Know about Virtual Education

ERIC Educational Resources Information Center

Rukobo, Emily Zyko; Penfold, Angela; Adler, C. Ralph; Larson, Heidi; Peterson, Kirsten

2012-01-01

This Facilitator's Guide is based on What Education Leaders Should Know about Virtual Education, an online course designed by the Center on Instruction and the New England Comprehensive Center. The Facilitator's Guide demonstrates step-by-step how to build the course on a learning management system (LMS) and provides instructions on all phases of…

The Immediate Effect of Neuromuscular Joint Facilitation (NJF) Treatment on Hip Muscle Strength.

PubMed

Wang, Hongdan; Huo, Ming; Huang, Qiuchen; Li, Desheng; Maruyama, Hitoshi

2013-11-01

[Purpose] This study investigated the change in hip muscle strength of younger persons after neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 45 healthy young people, who were divided into two groups: a NJF group and a proprioceptive neuromuscular facilitation (PNF) group. The NJF group consisted of 21 subjects (11 males, 10 females), and the PNF group consisted of 24 subjects (11 males, 13 females). [Methods] Participants in the NJF group received NJF treatment. We measured the maximal flexor strength and the maximal extensor strength during isokinetic movement of the hip joint before and after intervention in both groups. The angular velocities used were 60°/sec and 180°/sec. [Results] The NJF group showed significant increases in the maximal flexor strength and the maximal extensor strength after the intervention at each angular velocity. In the PNF group, the maximal flexor strength of 60°/sec and the maximal extensor strength of 180°/sec were significant increases. [Conclusion] These results suggest that there is an immediate effect of NJF intervention on hip muscle strength.

The cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains.

PubMed

Fatoye, Francis; Haigh, Carol

2016-05-01

To examine the cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains. Economic evaluation based on cost-utility analysis. Ankle sprains are a source of morbidity and absenteeism from work, accounting for 15-20% of all sports injuries. Semi-rigid ankle brace and taping are functional treatment interventions used by Musculoskeletal Physiotherapists and Nurses to facilitate return to work following acute ankle sprains. A decision model analysis, based on cost-utility analysis from the perspective of National Health Service was used. The primary outcomes measure was incremental cost-effectiveness ratio, based on quality-adjusted life years. Costs and quality of life data were derived from published literature, while model clinical probabilities were sourced from Musculoskeletal Physiotherapists. The cost and quality adjusted life years gained using semi-rigid ankle brace was £184 and 0.72 respectively. However, the cost and quality adjusted life years gained following taping was £155 and 0.61 respectively. The incremental cost-effectiveness ratio for the semi-rigid brace was £263 per quality adjusted life year. Probabilistic sensitivity analysis showed that ankle brace provided the highest net-benefit, hence the preferred option. Taping is a cheaper intervention compared with ankle brace to facilitate return to work following first-time ankle sprains. However, the incremental cost-effectiveness ratio observed for ankle brace was less than the National Institute for Health and Care Excellence threshold and the intervention had a higher net-benefit, suggesting that it is a cost-effective intervention. Decision-makers may be willing to pay £263 for an additional gain in quality adjusted life year. The findings of this economic evaluation provide justification for the use of semi-rigid ankle brace by Musculoskeletal Physiotherapists and Nurses to facilitate return to work in individuals with first-time ankle

Adopting Telemedicine for the Self-Management of Hypertension: Systematic Review.

PubMed

Mileski, Michael; Kruse, Clemens Scott; Catalani, Justin; Haderer, Tara

2017-10-24

Hypertension is a chronic condition that affects adults of all ages. In the United States, 1 in 3 adults has hypertension, and about half of the hypertensive population is adequately controlled. This costs the nation US $46 billion each year in health care services and medications required for treatment and missed workdays. Finding easier ways of managing this condition is key to successful treatment. A solution to reduce visits to physicians for chronic conditions is to utilize telemedicine. Research is limited on the effects of utilizing telemedicine in health care facilities. There are potential benefits for implementing telemedicine programs with patients dealing with chronic conditions. The purpose of this review was to weigh the facilitators against the barriers for implementing telemedicine. Searches were methodically conducted in the Cumulative Index to Nursing and Allied Health Literature Complete (CINAHL Complete) via Elton B Stephens Company (EBSCO) and PubMed (which queries MEDLINE) to collect information about self-management of hypertension through the use of telemedicine. Results identify facilitators and barriers corresponding to the implementation of self-management of hypertension using telemedicine. The most common facilitators include increased access, increase in health and quality, patient knowledge and involvement, technology growth with remote monitoring, cost-effectiveness, and increased convenience/ease. The most prevalent barriers include lack of evidence, self-management difficult to maintain, no long-term results/more areas to address, and long-term added workload commitment. This review guides health care professionals in incorporating new practices and identifying the best methods to introduce telemedicine into their practices. Understanding the facilitators and barriers to implementation is important, as is understanding how these factors will impact a successful implementation of telemedicine in the area of self-management of

Adopting Telemedicine for the Self-Management of Hypertension: Systematic Review

PubMed Central

2017-01-01

Background Hypertension is a chronic condition that affects adults of all ages. In the United States, 1 in 3 adults has hypertension, and about half of the hypertensive population is adequately controlled. This costs the nation US $46 billion each year in health care services and medications required for treatment and missed workdays. Finding easier ways of managing this condition is key to successful treatment. Objective A solution to reduce visits to physicians for chronic conditions is to utilize telemedicine. Research is limited on the effects of utilizing telemedicine in health care facilities. There are potential benefits for implementing telemedicine programs with patients dealing with chronic conditions. The purpose of this review was to weigh the facilitators against the barriers for implementing telemedicine. Methods Searches were methodically conducted in the Cumulative Index to Nursing and Allied Health Literature Complete (CINAHL Complete) via Elton B Stephens Company (EBSCO) and PubMed (which queries MEDLINE) to collect information about self-management of hypertension through the use of telemedicine. Results Results identify facilitators and barriers corresponding to the implementation of self-management of hypertension using telemedicine. The most common facilitators include increased access, increase in health and quality, patient knowledge and involvement, technology growth with remote monitoring, cost-effectiveness, and increased convenience/ease. The most prevalent barriers include lack of evidence, self-management difficult to maintain, no long-term results/more areas to address, and long-term added workload commitment. Conclusions This review guides health care professionals in incorporating new practices and identifying the best methods to introduce telemedicine into their practices. Understanding the facilitators and barriers to implementation is important, as is understanding how these factors will impact a successful implementation of

5 CFR 532.263 - Special wage schedules for production facilitating positions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Special wage schedules for production facilitating positions. 532.263 Section 532.263 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PREVAILING RATE SYSTEMS Prevailing Rate Determinations § 532.263 Special wage...

Barriers and Facilitators to Central Venous Catheter Insertion: A Qualitative Study.

PubMed

Cameron, Kenzie A; Cohen, Elaine R; Hertz, Joelle R; Wayne, Diane B; Mitra, Debi; Barsuk, Jeffrey H

2018-03-14

The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators. Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas. We conducted semistructured interviews to assess perceptions of barriers and facilitators to CVC insertion. Deidentified transcripts were analyzed using a grounded theory approach and the constant comparative method. We subsequently mapped identified barriers and facilitators to our SBML curriculum to determine whether or not the curriculum addresses these factors. We interviewed 28 providers at six Veterans Administration Medical Centers, identifying the following five overarching factors of perceived barriers to CVC insertion: (1) equipment, (2) personnel/staff, (3) setting or organizational context, (4) patient or provider, and (5) time-related barriers. Three overarching factors of facilitators emerged: (1) equipment, (2) personnel, and (3) setting or organizational context facilitators. The SBML curriculum seems to address most identified barriers, while leveraging many facilitators; building on the commonly identified facilitator of nursing staff contribution by expanding the curriculum to explicitly include nurse involvement could improve team efficiency and organizational culture of safety. Many identified facilitators (e.g., ability to use ultrasound, personnel confidence/competence) were also identified as barriers. Evidence-based SBML programs have the potential to amplify these facilitators while addressing the barriers by providing an opportunity to practice and master CVC insertion skills.

Organizational supports used by private child and family serving agencies to facilitate evidence use: a mixed methods study protocol.

PubMed

Chuang, Emmeline; Collins-Camargo, Crystal; McBeath, Bowen

2017-04-08

Challenges to evidence use are well documented. Less well understood are the formal supports-e.g., technical infrastructure, inter-organizational relationships-organizations may put in place to help overcome these challenges. This study will identify supports for evidence use currently used by private child and family serving agencies delivering publicly funded behavioral health and/or human services; examine contextual, organizational, and managerial factors associated with use of such supports; and determine how identified supports affect evidence use by staff at multiple levels of the organization. We will use a sequential explanatory mixed methods design, with study activities occurring in two sequential phases: In phase 1, quantitative survey data collected from managers of private child and family serving agencies in six states (CA, IN, KY, MO, PA, and WI) and analyzed using both regression and qualitative comparative analysis (QCA) will identify organizational supports currently being used to facilitate evidence use and examine the contextual, organizational, and managerial factors associated with the use of such supports. In phase 2, data from phase 1 will be used to select a purposive sample of 12 agencies for in-depth case studies. In those 12 agencies, semi-structured interviews with key informants and managers, focus groups with frontline staff, and document analysis will provide further insight into agencies' motivation for investing in organizational supports for evidence use and the facilitators and barriers encountered in doing so. Semi-structured interviews with managers and focus groups with frontline staff will also assess whether and how identified supports affect evidence use at different levels of the organization (senior executives, middle managers, frontline supervisors, and frontline staff). Within- and between-case analyses supplemented by QCA will identify combinations of factors associated with the highest and lowest levels of staff

Why (we think) facilitation works: insights from organizational learning theory.

PubMed

Berta, Whitney; Cranley, Lisa; Dearing, James W; Dogherty, Elizabeth J; Squires, Janet E; Estabrooks, Carole A

2015-10-06

Facilitation is a guided interactional process that has been popularized in health care. Its popularity arises from its potential to support uptake and application of scientific knowledge that stands to improve clinical and managerial decision-making, practice, and ultimately patient outcomes and organizational performance. While this popular concept has garnered attention in health services research, we know that both the content of facilitation and its impact on knowledge implementation vary. The basis of this variation is poorly understood, and understanding is hampered by a lack of conceptual clarity. In this paper, we argue that our understanding of facilitation and its effects is limited in part by a lack of clear theoretical grounding. We propose a theoretical home for facilitation in organizational learning theory. Referring to extant literature on facilitation and drawing on theoretical literature, we discuss the features of facilitation that suggest its role in contributing to learning capacity. We describe how facilitation may contribute to generating knowledge about the application of new scientific knowledge in health-care organizations. Facilitation's promise, we suggest, lies in its potential to stimulate higher-order learning in organizations through experimenting with, generating learning about, and sustaining small-scale adaptations to organizational processes and work routines. The varied effectiveness of facilitation observed in the literature is associated with the presence or absence of factors known to influence organizational learning, since facilitation itself appears to act as a learning mechanism. We offer propositions regarding the relationships between facilitation processes and key organizational learning concepts that have the potential to guide future work to further our understanding of the role that facilitation plays in learning and knowledge generation.

Sport Management Graduate Programs: Characteristics of Effectiveness.

ERIC Educational Resources Information Center

Li, Ming; And Others

1994-01-01

Reports a study that examined the characteristics that enable graduate sport management programs to achieve their objectives. Surveys of sport management educators found they agreed on 11 characteristics that indicated a sport management program's effectiveness. Respondents believed an effective program should produce sport managers, not…

Using servant leadership to facilitate healing after a drug diversion experience.

PubMed

Ramer, Lynne Marie

2008-08-01

Although much has been written about substance abuse in nursing, little attention has been paid to the reaction of a nurse's coworkers after he or she has been caught diverting drugs. The remaining staff members may enter into a grieving process, which can have a serious effect on the delivery of patient care and staff satisfaction. Devoting time and energy to addressing the challenges faced by staff members after a drug diversion experience is essential to reestablishing equilibrium in the department. Using the servant leadership model, managers can exemplify the characteristics of commitment, persuasion, awareness, and foresight to facilitate the grieving process and solidify staff cohesion to help ensure quality patient care.

Event-related theta oscillatory substrates for facilitation and interference effects of negative emotion on children's cognition.

PubMed

Jiang, Zhongqing; Waters, Allison C; Liu, Ying; Li, Wenhui; Yang, Lizhu

2017-06-01

We investigated the brain oscillatory contribution to emotion-cognition interaction in young children. Five-year-old participants (n=27) underwent EEG recording while engaged in a color identification task. Each trial began with an emotional prime. Response times indicated whether emotional primes facilitated or interfered with performance. Related effects were detected in theta-band power over parietal-occipital cortex, early in the response epoch (<500ms). Children in the emotion facilitation group showed greater theta synchronization for negative stimuli. The opposite trend was observed in the interference group. Results suggest a role for theta oscillations in children's adaptive response to emotional content in cognitive performance. Copyright © 2017 Elsevier B.V. All rights reserved.

Relative importance of perch and facilitative effects on nucleation in tropical woodland in Malawi

NASA Astrophysics Data System (ADS)

Fujita, Tomohiro

2016-01-01

Individual trees in open vegetation such as woodlands can act as "nuclei" for the colonization of forest tree species, which consequently lead to the formation of forest patches. This phenomenon is known as nucleation. The mechanism of nucleation is generally attributed to two factors: trees provide perches for frugivores that increase seed deposition (perch effect), and tree crowns ameliorate environmental conditions, which improves seedling establishment (facilitative effect). Few studies have attempted to distinguish the relative importance of these two factors. In this study, I separated these two effects in a woodland in northern Malawi. I chose Ficus natalensis as a potential nuclei tree because large individuals of this species are commonly located at the center of forest patches within open woodland at the study site. I monitored several environmental variables, seedling survival, seedling composition, and seed rain at three microsites: under F. natalensis, under Brachystegia floribunda (a dominant woodland species), and in open sites. Both tree species provided similar favorable conditions for the establishment of forest species compared to open sites. Thus, the survival of forest tree seedlings under F. natalensis and B. floribunda was similar, and substantially higher than seedling survival in open sites. However, communities of naturally occurring seedlings differed significantly between F. natalensis and B. floribunda. These results indicate that the facilitative effect alone cannot explain the nucleation pattern. I attribute this result to the perch effect of F. natalensis because the forest seedling species recorded under F. natalensis reportedly have small, brightly colored diaspores, which are indicative of dispersal by birds. Seed deposition of forest species under F. natalensis was significantly higher than that under B. floribunda or in open sites. My findings reinforce the idea that trees will lead to nucleation when they enhance seed

Acquisition Management for System of Systems: Affordability through Effective Portfolio Management

DTIC Science & Technology

2013-04-01

the management of strategic “ portfolios of systems” in military acquisitions; this includes application of Real Options (RO) theory and metrics such...Affordability Through Effective Portfolio Management Navindran Davendralingam and Daniel DeLaurentis Purdue University Published April 1, 2013...Systems: Affordability Through Effective Portfolio Management 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis.

PubMed

van Bruinessen, Inge Renske; van Weel-Baumgarten, Evelyn M; Gouw, Hans; Zijlstra, Josée M; Albada, Akke; van Dulmen, Sandra

2013-12-01

This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly. A qualitative approach was applied, derived from the context mapping framework. A total of 28 patients completed a set of assignments about their experiences with provider-patient communication during medical consultations. Subsequently, these patients and nine companions shared their experiences during a semistructured (group) interview, which was recorded on audiotape. The audiotapes and assignments were analysed with MAXQDA software. From the patients' viewpoint, communicating effectively appears to depend on their own attributes (e.g. emotions), the health care professionals' attributes (e.g. attitude) and external factors (e.g. time pressure). Three patient communication states were identified: (i) overwhelmed, passive; (ii) pro-active, self-motivated; and (iii) proficient, empowered. Patients seem to behave differently in the three communication states. This study lists patient-perceived communication barriers and facilitators and identifies three different communication states, which indicate when certain barriers and facilitators are encountered. These findings may support health care professionals to tailor the provision of support and information and remove communication barriers accordingly. Additionally, they provide input for interventions to support patients in effective communication. Copyright © 2013 John Wiley & Sons, Ltd.

The effect of facilitator training on the development and practice of participants in an online induction program for teachers of science and mathematics

NASA Astrophysics Data System (ADS)

Taylor, Peggy Sue

Learning in computer-mediated conferencing systems requires frequent and open interaction in environments that foster sharing and examination of group knowledge and experiences. Written dialogue is the means by which this interaction takes place. This study examined the effects of a training program designed for facilitators in the e-Mentoring for Student Success (eMSS) program, which provides online induction for beginning science and mathematics teachers. The training was designed to improve the quality of dialogue among participants in the program. The intervention consisted of three components: (1) an online training institute prior to beginning of the program year, (2) placement of facilitators in positions within the discussion areas of the program, and (3) ongoing online support for practicing facilitators. Three examinations were conducted in this mixed-method study. First, preintervention program dialogue was quantitatively compared to post-intervention program dialogue through use of a program-specific rubric to code program discussions. Second, case studies were conducted to determine how the training affected the practices of seven program facilitators and which components of the training effected change or growth. Third, pre and post intervention surveys were administered to all participants of the training to obtain their perceptions of their development as a result of the intervention. Comparison of dialogue before and after the intervention indicated a significant improvement in dialogue quality in the discussion areas of the program. Case studies of facilitators' practices revealed areas of the training that impacted the skills and strategies that facilitators used in efforts to foster increased and improved dialogue. Survey results indicated that participants gained a better understanding of what constituted quality dialogue in terms of the eMSS program and how better to foster quality dialogue in an online environment. Components of the training

The Effect of Visualized Instruction and Varied Rehearsal and Evaluation Strategies (Verbal and Visual) in Facilitating Students' Long-Term Retention on Tests Measuring Different Instructional Objectives.

ERIC Educational Resources Information Center

Dwyer, Francis M.

1985-01-01

This study investigated effects of rehearsal strategies and immediate test formats on delayed retention and effectiveness of visualization on material acquisition and retrieval. Findings indicate different rehearsal methods have different effects in facilitating delayed retention. Information acquisition is facilitated by visualization, although…

Facilitation and refractoriness of the electrically evoked compound action potential.

PubMed

Hey, Matthias; Müller-Deile, Joachim; Hessel, Horst; Killian, Matthijs

2017-11-01

In this study we aim to resolve the contributions of facilitation and refractoriness at very short pulse intervals. Measurements of the refractory properties of the electrically evoked compound action potential (ECAP) of the auditory nerve in cochlear implant (CI) users at inter pulse intervals below 300 μs are influenced by facilitation and recovery effects. ECAPs were recorded using masker pulses with a wide range of current levels relative to the probe pulse levels, for three suprathreshold probe levels and pulse intervals from 13 to 200 μs. Evoked potentials were measured for 21 CI patients by using the masked response extraction artifact cancellation procedure. During analysis of the measurements the stimulation current was not used as absolute value, but in relation to the patient's individual ECAP threshold. This enabled a more general approach to describe facilitation as a probe level independent effect. Maximum facilitation was found for all tested inter pulse intervals at masker levels near patient's individual ECAP threshold, independent from probe level. For short inter pulse intervals an increased N 1 P 1 amplitude was measured for subthreshold masker levels down to 120 CL below patient's individual ECAP threshold in contrast to the recreated state. ECAPs recorded with inter pulse intervals up to 200 μs are influenced by facilitation and recovery. Facilitation effects are most pronounced for masker levels at or below ECAP threshold, while recovery effects increase with higher masker levels above ECAP threshold. The local maximum of the ECAP amplitude for masker levels around ECAP threshold can be explained by the mutual influence of maximum facilitation and minimal refractoriness. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Comprehensive nursing case management. An advanced practice model.

PubMed

Taylor, P

1999-01-01

Under managed care and capitated reimbursement systems, case management is a core strategy for providing high-quality, cost-effective care by decreasing fragmentation, enhancing quality, ensuring efficient use of resources, and containing costs. Although case management is used in various areas of the healthcare arena, it suffers from a lack of consensus regarding its definition, essential components, and appropriate application. The purpose of this paper is to examine the components and limitations of existing case management models, outline the competencies of an effective case manager, and present a model of advanced practice nursing case management that focuses on a continuum of care that integrates medical and psychosocial resources to promote optimal clinical fiscal outcomes and enables patients to work as partners with the healthcare team in facilitating and maintaining their physical and emotional well-being.

The Role of New Information Technologies in Facilitating Professional Reflective Practice across the Supervisory Triad.

ERIC Educational Resources Information Center

Hodder, Jacqueline; Carter, David

This study investigated the role of new information management technologies in facilitating student teacher supervision across the supervisory triad of student teacher, cooperating teacher, and university supervisor. The study investigated how data routinely generated by teachers and stored within an Instructional Information Management System…

Managing Chemotherapy Side Effects: Memory Changes

MedlinePlus

... C ancer I nstitute Managing Chemotherapy Side Effects Memory Changes What is causing these changes? Your doctor ... thinking or remembering things Managing Chemotherapy Side Effects: Memory Changes Get help to remember things. Write down ...

Field manipulations of resources mediate the transition from intraspecific competition to facilitation.

PubMed

Svanfeldt, Karin; Monro, Keyne; Marshall, Dustin J

2017-05-01

Population density affects individual performance, though its effects are often mixed. For sessile species, increases in population density typically reduce performance. Still, cases of positive density-dependence do occur in sessile systems and demand explanation. The stress gradient hypothesis (SGH) predicts that under stressful conditions, positive effects of facilitation may outweigh the negative effects of competition. While some elements of the SGH are well studied, its potential to explain intraspecific facilitation has received little attention. Further, there have been questions regarding whether the SGH holds if the stressor is a resource. Most studies of interactions between the environment and intraspecific facilitation have relied on natural environmental gradients; manipulative studies are much rarer. To test the effects of intraspecific density and resources, we manipulated resource availability over natural population densities for the marine bryozoan Watersipora subtorquata. We found negative effects of density on colony performance in low resource environments, but mainly positive density-dependence in high resource environments. By adding resources, competition effects were reduced and the positive effects of facilitation were revealed. Our results suggest that resource availability mediates the relative strength of competition and facilitation in our system. We also suggest that intraspecific facilitation is more common than may be appreciated and that environmental variation may mediate the balance between negative and positive density-dependence. © 2017 The Authors. Journal of Animal Ecology © 2017 British Ecological Society.

Spatial part-set cuing facilitation.

PubMed

Kelley, Matthew R; Parasiuk, Yuri; Salgado-Benz, Jennifer; Crocco, Megan

2016-07-01

Cole, Reysen, and Kelley [2013. Part-set cuing facilitation for spatial information. Journal of Experimental Psychology: Learning, Memory, & Cognition, 39, 1615-1620] reported robust part-set cuing facilitation for spatial information using snap circuits (a colour-coded electronics kit designed for children to create rudimentary circuit boards). In contrast, Drinkwater, Dagnall, and Parker [2006. Effects of part-set cuing on experienced and novice chess players' reconstruction of a typical chess midgame position. Perceptual and Motor Skills, 102(3), 645-653] and Watkins, Schwartz, and Lane [1984. Does part-set cuing test for memory organization? Evidence from reconstructions of chess positions. Canadian Journal of Psychology/Revue Canadienne de Psychologie, 38(3), 498-503] showed no influence of part-set cuing for spatial information when using chess boards. One key difference between the two procedures was that the snap circuit stimuli were explicitly connected to one another, whereas chess pieces were not. Two experiments examined the effects of connection type (connected vs. unconnected) and cue type (cued vs. uncued) on memory for spatial information. Using chess boards (Experiment 1) and snap circuits (Experiment 2), part-set cuing facilitation only occurred when the stimuli were explicitly connected; there was no influence of cuing with unconnected stimuli. These results are potentially consistent with the retrieval strategy disruption hypothesis, as well as the two- and three-mechanism accounts of part-set cuing.

Effectiveness of a program to facilitate recovery for people with long-term mental illness in Japan.

PubMed

Chiba, Rie; Miyamoto, Yuki; Kawakami, Norito; Harada, Naoko

2014-09-01

Recovery is defined as the process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. This study aimed to develop a program to facilitate recovery and examine its effectiveness in a randomized controlled trial. The program was developed with three components that enhance benefit finding, personal meaning, and a sense of happiness. Sixty-three participants with long-term mental illness were randomly allocated to the intervention group (n = 32) or the control group (n = 31). The intervention group attended eight 2-h group sessions, with one held every week. Recovery was assessed at baseline, post-intervention, and at a three-month follow-up. In the per-protocol analysis, after excluding those who dropped out, the intervention group showed significant improvement in recovery compared with the control group (P < 0.05). In the intention-to-treat analysis, a repeated measures analysis of variance did not show any significant intervention effect (time × group) (P > 0.05). The program had the potential to facilitate recovery. © 2013 Wiley Publishing Asia Pty Ltd.

A model of human motor sequence learning explains facilitation and interference effects based on spike-timing dependent plasticity.

PubMed

Wang, Quan; Rothkopf, Constantin A; Triesch, Jochen

2017-08-01

The ability to learn sequential behaviors is a fundamental property of our brains. Yet a long stream of studies including recent experiments investigating motor sequence learning in adult human subjects have produced a number of puzzling and seemingly contradictory results. In particular, when subjects have to learn multiple action sequences, learning is sometimes impaired by proactive and retroactive interference effects. In other situations, however, learning is accelerated as reflected in facilitation and transfer effects. At present it is unclear what the underlying neural mechanism are that give rise to these diverse findings. Here we show that a recently developed recurrent neural network model readily reproduces this diverse set of findings. The self-organizing recurrent neural network (SORN) model is a network of recurrently connected threshold units that combines a simplified form of spike-timing dependent plasticity (STDP) with homeostatic plasticity mechanisms ensuring network stability, namely intrinsic plasticity (IP) and synaptic normalization (SN). When trained on sequence learning tasks modeled after recent experiments we find that it reproduces the full range of interference, facilitation, and transfer effects. We show how these effects are rooted in the network's changing internal representation of the different sequences across learning and how they depend on an interaction of training schedule and task similarity. Furthermore, since learning in the model is based on fundamental neuronal plasticity mechanisms, the model reveals how these plasticity mechanisms are ultimately responsible for the network's sequence learning abilities. In particular, we find that all three plasticity mechanisms are essential for the network to learn effective internal models of the different training sequences. This ability to form effective internal models is also the basis for the observed interference and facilitation effects. This suggests that STDP, IP, and SN

Decision Facilitator for Launch Operations using Intelligent Agents

NASA Technical Reports Server (NTRS)

Thirumalainambi, Rajkumar; Bardina, Jorge

2005-01-01

Launch operations require millions of micro-decisions which contribute to the macro decision of 'Go/No-Go' for a launch. Knowledge workers"(such as managers and technical professionals) need information in a timely precise manner as it can greatly affect mission success. The intelligent agent (web search agent) uses the words of a hypertext markup language document which is connected through the internet. The intelligent agent's actions are to determine if its goal of seeking a website containing a specified target (e.g., keyword or phrase), has been met. There are few parameters that should be defined for the keyword search like "Go" and "No-Go". Instead of visiting launch and range decision making servers individually, the decision facilitator constantly connects to all servers, accumulating decisions so the final decision can be decided in a timely manner. The facilitator agent uses the singleton design pattern, which ensures that only a single instance of the facilitator agent exists at one time. Negotiations could proceed between many agents resulting in a final decision. This paper describes details of intelligent agents and their interaction to derive an unified decision support system.

Using Hypertext to Facilitate Information Sharing in Biomedical Research Groups

PubMed Central

Chaney, R. Jesse; Shipman, Frank M.; Gorry, G. Anthony

1989-01-01

As part of our effort to create an Integrated Academic Information Management System at Baylor College of Medicine, we are developing information technology to support the efforts of scientific work groups. Many of our ideas in this regard are embodied in a system called the Virtual Notebook which is intended to facilitate information sharing and management in such groups. Here we discuss the foundations of that system - a hypertext system that we have developed using a relational data base and the distributable interface the we have written in the X Window System.

AGRICULTURAL BEST MANAGEMENT PRACTICE EFFECTIVENESS DATABASE

EPA Science Inventory

Resource Purpose:The Agricultural Best Management Practice Effectiveness Database contains the results of research projects which have collected water quality data for the purpose of determining the effectiveness of agricultural management practices in reducing pollutants ...

Can Civility Norms Boost Positive Effects of Management Commitment to Safety?

PubMed

McGonagle, Alyssa K; Childress, Niambi M; Walsh, Benjamin M; Bauerle, Timothy J

2016-07-03

We proposed that civility norms would strengthen relationships between management commitment to safety and workers' safety motivation, safety behaviors, and injuries. Survey data were obtained from working adults in hazardous jobs-those for which physical labor is required and/or a realistic possibility of physical injury is present (N = 290). Results showed that management commitment positively related to workers' safety motivation, safety participation, and safety compliance, and negatively related to minor injuries. Furthermore, management commitment to safety displayed a stronger positive relationship with safety motivation and safety participation, and a stronger negative relationship with minor worker injuries when civility norms were high (versus low). The results confirm existing known relationships between management commitment to safety and worker safety motivation and behavior; furthermore, civility norms facilitate the relationships between management commitment to safety and various outcomes important to worker safety. In order to promote an optimally safe working environment, managers should demonstrate a commitment to worker safety and promote positive norms for interpersonal treatment between workers in their units.

[Practice guidelines for the management of acute perioperative pain].

PubMed

Guevara-López, Uriah; Covarrubias-Gómez, Alfredo; Delille-Fuentes, Ramón; Hernández-Ortiz, Andrés; Carrillo-Esper, Raúl; Moyao-García, Diana

2005-01-01

The inadequacy of perioperative management causes a severe adverse outcome, a prolonged time of hospitalization and unnecessary suffering. Therefore, it is important to provide an effective management approach to the patient with perioperative pain. A task force with experience in this field systematically develops practice guidelines and the primary goal is to facilitate, to health care professionals, decision-making regarding pain relief. The well-known concept of "administer as needed" is inaccurate and must be eliminated from hospital's management protocols in order to facilitate the staff education to decrease the painful experience. A method to evaluate and document pain in an objective and periodic way shall be implemented. Also, analgesic therapy shall be individualized and chosen regarding pain intensity in every surgical procedure. The treatment options include the use of non-opiate and opiate drugs, regional analgesia and nonpharmacological techniques. The best analgesic will be the one that shall provide the highest relief of pain with the fewest side effects. In the pediatric and obstetric populations, special considerations for the ambulatory patient must be taken. Finally, these practice guidelines could be the reference for future practice guidelines on pain management in Mexico.

Germination phenology determines the propensity for facilitation and competition.

PubMed

Leverett, Lindsay D

2017-09-01

A single plant can interact both positively and negatively with its neighbors through the processes of facilitation and competition, respectively. Much of the variation in the balance of facilitation and competition that individuals experience can be explained by the degree of physical stress and the sizes or ages of plants during the interaction. Germination phenology partly controls both of these factors, but its role in defining the facilitation-competition balance has not been explicitly considered. I performed an experiment in a population of the winter annual Arabidopsis thaliana (Brassicaceae) to test whether germinating during physically stressful periods leads to facilitation while germinating during periods that promote growth and reproduction leads to competition. I manipulated germination and neighbor presence across two years in order to quantify the effects of the local plant community on survival, fecundity, and total fitness as a function of germination phenology. Neighbors increased survival when germination occurred under conditions that were unsuitable for survival, but they reduced fecundity in germinants that were otherwise the most fecund. Later germination was associated with facilitation in the first year but competition in the second year. These episodes of facilitation and competition opposed each other, leading to no net effect of neighbors when averaged over all cohorts. These results indicate that variation in germination timing can explain some of the variation in the facilitation-competition balance in plant communities. © 2017 by the Ecological Society of America.

Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us.

PubMed

Griffith, James L; Kohrt, Brandon A

2016-04-01

Psychiatric education is confronted with three barriers to managing stigma associated with mental health treatment. First, there are limited evidence-based practices for stigma reduction, and interventions to deal with stigma against mental health care providers are especially lacking. Second, there is a scarcity of training models for mental health professionals on how to reduce stigma in clinical services. Third, there is a lack of conceptual models for neuroscience approaches to stigma reduction, which are a requirement for high-tier competency in the ACGME Milestones for Psychiatry. The George Washington University (GWU) psychiatry residency program has developed an eight-week course on managing stigma that is based on social psychology and social neuroscience research. The course draws upon social neuroscience research demonstrating that stigma is a normal function of normal brains resulting from evolutionary processes in human group behavior. Based on these processes, stigma can be categorized according to different threats that include peril stigma, disruption stigma, empathy fatigue, moral stigma, and courtesy stigma. Grounded in social neuroscience mechanisms, residents are taught to develop interventions to manage stigma. Case examples illustrate application to common clinical challenges: (1) helping patients anticipate and manage stigma encountered in the family, community, or workplace; (2) ameliorating internalized stigma among patients; (3) conducting effective treatment from a stigmatized position due to prejudice from medical colleagues or patients' family members; and (4) facilitating patient treatment plans when stigma precludes engagement with mental health professionals. This curriculum addresses the need for educating trainees to manage stigma in clinical settings. Future studies are needed to evaluate changes in clinical practices and patient outcomes as a result of social neuroscience-based training on managing stigma.

Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us

PubMed Central

Griffith, James L.; Kohrt, Brandon A.

2016-01-01

Psychiatric education is confronted with three barriers to managing stigma associated with mental health treatment. First, there are limited evidence-based practices for stigma reduction, and interventions to deal with stigma against mental health care providers are especially lacking. Second, there is a scarcity of training models for mental health professionals on how to reduce stigma in clinical services. Third, there is a lack of conceptual models for neuroscience approaches to stigma reduction, which are a requirement for high-tier competency in the ACGME Milestones for Psychiatry. The George Washington University (GWU) psychiatry residency program has developed an eight-week course on managing stigma that is based on social psychology and social neuroscience research. The course draws upon social neuroscience research demonstrating that stigma is a normal function of normal brains resulting from evolutionary processes in human group behavior. Based on these processes, stigma can be categorized according to different threats that include peril stigma, disruption stigma, empathy fatigue, moral stigma, and courtesy stigma. Grounded in social neuroscience mechanisms, residents are taught to develop interventions to manage stigma. Case examples illustrate application to common clinical challenges: (1) helping patients anticipate and manage stigma encountered in the family, community, or workplace; (2) ameliorating internalized stigma among patients; (3) conducting effective treatment from a stigmatized position due to prejudice from medical colleagues or patients’ family members; and (4) facilitating patient treatment plans when stigma precludes engagement with mental health professionals. This curriculum addresses the need for educating trainees to manage stigma in clinical settings. Future studies are needed to evaluate changes in clinical practices and patient outcomes as a result of social neuroscience-based training on managing stigma. PMID:26162463

Facilitating Effects of Emotion on the Perception of Biological Motion: Evidence for a Happiness Superiority Effect.

PubMed

Lee, Hannah; Kim, Jejoong

2017-06-01

It has been reported that visual perception can be influenced not only by the physical features of a stimulus but also by the emotional valence of the stimulus, even without explicit emotion recognition. Some previous studies reported an anger superiority effect while others found a happiness superiority effect during visual perception. It thus remains unclear as to which emotion is more influential. In the present study, we conducted two experiments using biological motion (BM) stimuli to examine whether emotional valence of the stimuli would affect BM perception; and if so, whether a specific type of emotion is associated with a superiority effect. Point-light walkers with three emotion types (anger, happiness, and neutral) were used, and the threshold to detect BM within noise was measured in Experiment 1. Participants showed higher performance in detecting happy walkers compared with the angry and neutral walkers. Follow-up motion velocity analysis revealed that physical difference among the stimuli was not the main factor causing the effect. The results of the emotion recognition task in Experiment 2 also showed a happiness superiority effect, as in Experiment 1. These results show that emotional valence (happiness) of the stimuli can facilitate the processing of BM.

A facilitative effect of negative affective valence on working memory.

PubMed

Gotoh, Fumiko; Kikuchi, Tadashi; Olofsson, Ulrich

2010-06-01

Previous studies have shown that negatively valenced information impaired working memory performance due to an attention-capturing effect. The present study examined whether negative valence could also facilitate working memory. Affective words (negative, neutral, positive) were used as retro-cues in a working memory task that required participants to remember colors at different spatial locations on a computer screen. Following the cue, a target detection task was used to either shift attention to a different location or keep attention at the same location as the retro-cue. Finally, participants were required to discriminate the cued color from a set of distractors. It was found that negative cues yielded shorter response times (RTs) in the attention-shift condition and longer RTs in the attention-stay condition, compared with neutral and positive cues. The results suggest that negative affective valence may enhance working memory performance (RTs), provided that attention can be disengaged.

Threat facilitates subsequent executive control during anxious mood.

PubMed

Birk, Jeffrey L; Dennis, Tracy A; Shin, Lisa M; Urry, Heather L

2011-12-01

Dual competition framework (DCF) posits that low-level threat may facilitate behavioral performance by influencing executive control functions. Anxiety is thought to strengthen this effect by enhancing threat's affective significance. To test these ideas directly, we examined the effects of low-level threat and experimentally induced anxiety on one executive control function, the efficiency of response inhibition. In Study 1, briefly presented stimuli that were mildly threatening (i.e., fearful faces) relative to nonthreatening (i.e., neutral faces) led to facilitated executive control efficiency during experimentally induced anxiety. No such effect was observed during an equally arousing, experimentally induced happy mood state. In Study 2, we assessed the effects of low-level threat, experimentally induced anxiety, and individual differences in trait anxiety on executive control efficiency. Consistent with Study 1, fearful relative to neutral faces led to facilitated executive control efficiency during experimentally induced anxiety. No such effect was observed during an experimentally induced neutral mood state. Moreover, individual differences in trait anxiety did not moderate the effects of threat and anxiety on executive control efficiency. The findings are partially consistent with the predictions of DCF in that low-level threat improved executive control, at least during a state of anxiety. (c) 2011 APA, all rights reserved.

Effects of tree size and spatial distribution on growth of ponderosa pine forests under alternative management scenarios

Treesearch

C.W. Woodall; C.E. Fiedler; R.E. McRoberts

2009-01-01

Forest ecosystems may be actively managed toward heterogeneous stand structures to provide both economic (e.g., wood production and carbon credits) and environmental benefits (e.g., invasive pest resistance). In order to facilitate wider adoption of possibly more sustainable forest stand structures, defining growth expectations among alternative management scenarios is...

Improving EHR Capabilities to Facilitate Stage 3 Meaningful Use Care Coordination Criteria.

PubMed

Cross, Dori A; Cohen, Genna R; Nong, Paige; Day, Anya-Victoria; Vibbert, Danielle; Naraharisetti, Ramya; Adler-Milstein, Julia

Primary care practices have been limited in their ability to leverage electronic health records (EHRs) and health information exchange (HIE) to improve care coordination, but will soon be incentivized to do so under proposed Stage 3 meaningful use criteria. We use mixed methods to understand how primary care practices manage, share and reconcile electronic patient information across care settings, and identify innovations in EHR design to support enhanced care coordination. Opportunities identified by practices focused on availability and usability of features that facilitate (1) generation of customized summary of care records, (2) team-based care approaches, and (3) management of the increased volume of electronic information generated and exchanged during care transitions. More broadly, vendors and policymakers need to continue to work together to improve interoperability as the key to effective care coordination. If these EHR innovations were widespread, the value of meeting the proposed Stage 3 care coordination criteria would be substantially enhanced.

Facilitators and Barriers to Care Coordination in Patient-centered Medical Homes (PCMHs) from Coordinators’ Perspectives

PubMed Central

Friedman, Asia; Howard, Jenna; Shaw, Eric K.; Cohen, Deborah J.; Shahidi, Laleh; Ferrante, Jeanne M.

2016-01-01

Background Care coordinators are increasingly featured in patient-centered medical home (PCMH) projects, yet little research examines how coordinators themselves define and experience their role. This is the first study describing experiences of care coordinators across the US from their own perspectives. Methods This qualitative study used a 5-month private, online discussion forum to gather data from 25 care coordinators from PCMH practices representing diversity in practice size, setting, and type. Participants answered questions and interacted with one another, creating an online social learning collaborative while allowing for data collection for research. Results Coordinators identified barriers and facilitators in their work at the organization/system level, the interpersonal level, and the individual level. Some factors emerged as both barriers and facilitators, including the functionality of clinical information technology; the availability of community resources; interactions with clinicians and other health care facilities; interactions with patients; and self-care practices for mental health and wellness. Colocation and full integration into practices were other key facilitators, whereas excessive case loads and data management responsibilities were felt to be important barriers. Conclusions While all the barriers and facilitators were important to performing coordinators’ roles, relationship building materialized as key to effective care coordination, whether with clinicians, patients, or outside organizations. We discuss implications for practice and provide suggestions for further research. PMID:26769881

Facilitating Transfer in College Reading Programs.

ERIC Educational Resources Information Center

Nist, Sherrie; Simpson, Michele L.

1987-01-01

Gives three activities--journal writing, microteaching partners, and the PLAE model (planning, listing, activating, and evaluating)--that can facilitate learner independence and transfer of efficient and effective study strategies in college developmental reading programs. (NKA)

Facilitators and barriers of implementing and delivering social prescribing services: a systematic review.

PubMed

Pescheny, Julia Vera; Pappas, Yannis; Randhawa, Gurch

2018-02-07

Social Prescribing is a service in primary care that involves the referral of patients with non-clinical needs to local services and activities provided by the third sector (community, voluntary, and social enterprise sector). Social Prescribing aims to promote partnership working between the health and the social sector to address the wider determinants of health. To date, there is a weak evidence base for Social Prescribing services. The objective of the review was to identify factors that facilitate and hinder the implementation and delivery of SP services based in general practice involving a navigator. We searched eleven databases, the grey literature, and the reference lists of relevant studies to identify the barriers and facilitators to the implementation and delivery of Social Prescribing services in June and July 2016. Searches were limited to literature written in English. No date restrictions were applied. Findings were synthesised narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Eight studies were included in the review. The synthesis identified a range of factors that facilitate and hinder the implementation and delivery of SP services. Facilitators and barriers were related to: the implementation approach, legal agreements, leadership, management and organisation, staff turnover, staff engagement, relationships and communication between partners and stakeholders, characteristics of general practices, and the local infrastructure. The quality of most included studies was poor and the review identified a lack of published literature on factors that facilitate and hinder the implementation and delivery of Social Prescribing services. The review identified a range of factors that facilitate and hinder the implementation and delivery of Social Prescribing services. Findings of this review provide an insight for commissioners, managers, and providers

Structural plasticity in hippocampal cells related to the facilitative effect of intracranial self-stimulation on a spatial memory task.

PubMed

Chamorro-López, Jacobo; Miguéns, Miguel; Morgado-Bernal, Ignacio; Kastanauskaite, Asta; Selvas, Abraham; Cabané-Cucurella, Alberto; Aldavert-Vera, Laura; DeFelipe, Javier; Segura-Torres, Pilar

2015-12-01

Posttraining intracranial self-stimulation (SS) in the lateral hypothalamus facilitates the acquisition and retention of several implicit and explicit memory tasks. Here, intracellular injections of Lucifer yellow were used to assess morphological changes in hippocampal neurons that might be specifically related to the facilitative posttraining SS effect upon the acquisition and retention of a distributed spatial task in the Morris water maze. We examined the structure, size and branching complexity of cornus ammonis 1 (CA1) cells, and the spine density of CA1 pyramidal neurons and granular cells of the dentate gyrus (DG). Animals that received SS after each acquisition session performed faster and better than Sham ones--an improvement that was also evident in a probe trial 3 days after the last training session. The neuromorphological analysis revealed an increment in the size and branching complexity in apical CA1 dendritic arborization in SS-treated subjects as compared with Sham animals. Furthermore, increased spine density was observed in the CA1 field in SS animals, whereas no effects were observed in DG cells. Our results support the hypothesis that the facilitating effect of SS on the acquisition and retention of a spatial memory task could be related to structural plasticity in CA1 hippocampal cells. (c) 2015 APA, all rights reserved).

Negative Effects of Learning Spreadsheet Management on Learning Database Management

ERIC Educational Resources Information Center

Vágner, Anikó; Zsakó, László

2015-01-01

A lot of students learn spreadsheet management before database management. Their similarities can cause a lot of negative effects when learning database management. In this article, we consider these similarities and explain what can cause problems. First, we analyse the basic concepts such as table, database, row, cell, reference, etc. Then, we…

Lessons learned in the trenches: facilitating exercise adherence among breast cancer survivors in a group setting.

PubMed

Rogers, Laura Q; Vicari, Sandy; Courneya, Kerry S

2010-01-01

Improving effectiveness of group exercise counseling for breast cancer survivors is needed. The objective of this study was to describe clinical observations, with research and translation implications, derived during group exercise counseling for breast cancer survivors. While implementing group session components of an effective social cognitive theory-based exercise intervention, observations were made through verbal discussion with study staff, review of participant feedback, and prospective journaling by the group facilitator. The intervention has been implemented 11 times (ie, 63 survivors; 66 group sessions). Thematic consistency, application to intervention goals and design, and implications were reconciled between 2 investigators. Breast cancer diagnosis was a strong source of commonality among group participants. Participant age, time since diagnosis, and expectation for group sessions (eg, group support vs health education) hindered group commonality. Barriers unique to the breast cancer experience were infrequent, but people-pleasing behavior was often identified as a barrier to adherence. Feeling at risk for cancer recurrence was a major concern. Some participants required referral for mental health evaluation for preexisting conditions (eg, depression). Although participants easily understood time management, application of other behavioral modification techniques was more difficult. A breast cancer diagnosis alone is not sufficient for commonality among group members. Teaching time management and positive reframing is essential. Protocols for appropriate mental health referrals are needed. Our observations will assist group facilitators in enhancing group dynamics and addressing obstacles hindering counseling effectiveness. Moreover, our results suggest hypotheses related to enhancing behavior change in a group setting worthy of future study.

A survey of facilitators and barriers to recruitment to the MAGNETIC trial.

PubMed

Kaur, Geetinder; Smyth, Rosalind L; Powell, Colin V E; Williamson, Paula

2016-12-23

Recruitment to randomised controlled trials with children is challenging. It is imperative to understand the factors that boost or hinder recruitment of children to clinical trials. We conducted a survey of facilitators and barriers to recruitment to the MAGNETIC trial, using a previously developed web-based tool. MAGNETIC is a multicentre randomised trial of nebulised magnesium in acute severe asthma, recruiting 508 children from 30 UK sites. Recruiters were asked to grade a list of factors from -3 to +3 depending on whether the factor was perceived as a strong, intermediate or weak barrier (-3 to -1) or facilitator (+1 to + 3), and using (0) if it was thought to be not applicable. Free text responses were invited on strategies applied to counter the identified barriers. The commonly identified facilitators were motivation and experience of study teams, effective communication and coordination between teams at site and between sites and the Clinical Trials Unit, the presence of designated research nurses, good trial management, clinical trial publicity, simple inclusion criteria, effective communication with parents and presentation of trial information in a simple and clear manner. The commonly identified barriers were heavy clinical workload, shift patterns of work, Good Clinical Practice (GCP) training, inadequate number of trained staff, time and setting of consent seeking, non-availability of research staff out of hours and parents' concerns about their child taking an experimental medicine. Having a designated research nurse, arranging GCP training and trial-related training sessions for staff were the most commonly reported interventions. This study highlights important generic and trial-specific facilitators and barriers to recruitment to a paediatric trial in the acute setting and provides information on the recruitment strategies or interventions that were applied to overcome these barriers. This information can be very useful in informing the design

The Effects of Facilitating Feedback on Online Learners' Cognitive Engagement: Evidence from the Asynchronous Online Discussion

ERIC Educational Resources Information Center

Guo, Wenge; Chen, Ye; Lei, Jing; Wen, Yan

2014-01-01

With a large-scale online K-12 teacher professional development course as the research context, this study examined the effects of facilitating feedback on online learners' cognitive engagement using quasi-experiment method. A total of 1,540 discussion messages from 110 learners (65 in the experimental group and 45 in the control group) were both…

Making cognitive decision support work: Facilitating adoption, knowledge and behavior change through QI.

PubMed

Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A

2017-07-01

This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.

Facilitators and Barriers to Preparedness Partnerships: A Veterans Affairs Medical Center Perspective.

PubMed

Schmitz, Susan; Wyte-Lake, Tamar; Dobalian, Aram

2017-09-13

This study sought to understand facilitators and barriers faced by local US Department of Veterans Affairs Medical Center (VAMC) emergency managers (EMs) when collaborating with non-VA entities. Twelve EMs participated in semi-structured interviews lasting 60 to 90 minutes discussing their collaboration with non-VAMC organizations. Sections of the interview transcripts concerning facilitators and barriers to collaboration were coded and analyzed. Common themes were organized into 2 categories: (1) internal (ie, factors affecting collaboration from within VAMCs or by VA policy) and (2) external (ie, interagency or interpersonal factors). Respondents reported a range of facilitators and barriers to collaboration with community-based agencies. Internal factors facilitating collaboration included items such as leadership support. An internal barrier example included lack of clarity surrounding the VAMC's role in community disaster response. External factors noted as facilitators included a shared goal across organizations while a noted barrier was a perception that potential partners viewed a VAMC partnership with skepticism. Federal institutions are important partners for the success of community disaster preparedness and response. Understanding the barriers that VAMCs confront, as well as potential facilitators to collaboration, should enhance the development of VAMC-community partnerships and improve community health resilience. (Disaster Med Public Health Preparedness. 2017; page 1 of 6).

Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: a scoping review protocol.

PubMed

Tricco, Andrea C; Zarin, Wasifa; Rios, Patricia; Pham, Ba'; Straus, Sharon E; Langlois, Etienne V

2016-12-23

Engaging policymakers, healthcare managers and policy analysts in the conduct of knowledge synthesis can help increase its impact. This is particularly important for knowledge synthesis studies commissioned by decision-makers with limited timelines, as well as reviews of health policy and systems research. A scoping review will be conducted to assess barriers, facilitators, strategies and outcomes of engaging these individuals in the knowledge synthesis process. We will follow the Joanna Briggs Institute guidance for scoping reviews. Literature searches of electronic databases (eg, MEDLINE, EMBASE, Cochrane Library, ERIC, PsycINFO) will be conducted from inception onwards. The electronic search will be supplemented by searching for sources that index unpublished/difficult to locate studies (eg, GreyNet International database), as well as through scanning of reference lists of reviews on related topics. All study designs using either qualitative or quantitative methodologies will be eligible if there is a description of the strategies, barriers or facilitators, and outcomes of engaging policymakers, healthcare managers and policy analysts in the knowledge synthesis process. Screening and data abstraction will be conducted by 2 team members independently after a calibration exercise across the team. A third team member will resolve all discrepancies. We will conduct frequency analysis and thematic analysis to chart and characterise the literature, identifying data gaps and opportunities for future research, as well as implications for policy. This project was commissioned by the Alliance for Health Policy and Systems Research, WHO. The results will be used by Alliance Review Centers of health policy and systems research in low-income and middle-income countries that are conducting knowledge synthesis to inform health policymaking and decision-making. Our results will also be disseminated through conference presentations, train-the-trainer events, peer

Mobile applications to enhance self-management of gout.

PubMed

Nguyen, Amy D; Baysari, Melissa T; Kannangara, Diluk R W; Tariq, Amina; Lau, Annie Y S; Westbrook, Johanna I; Day, Richard O

2016-10-01

Gout is an arthritic condition that is characterised by extremely painful, debilitating acute attacks and eventual joint and organ damage if not controlled. Despite the availability of very effective therapies that, if adhered to, will prevent acute attacks and long-term damage, the disorder is increasingly prevalent. There is an urgent need to improve self-management of gout. Mobile health (mHealth) applications ('apps'), designed to facilitate management of chronic conditions, present novel opportunities for supporting patient self-management of gout. The aim of this review was to assess features of available gout management apps designed to assist consumers in managing their gout and their consistency with guidelines for gout management. English-language, smart-device apps designed to assist self-management of gout were identified using search term "gout" and downloaded from Apple and Google Play app stores. To be included in the review, apps had to allow users to monitor their gout disease (e.g. serum uric acid (sUA) tracking, record acute attacks) and/or educate patients about gout. Investigators derived patient-focused recommendations for gout management from contemporary guidelines. Features of reviewed apps were independently assessed by two reviewers for their facilitation of these recommendations. The search identified 57 apps possibly relevant to gout management, of which six met the inclusion criteria. One app incorporated all recommendations for patient-focused gout management from guidelines including monitoring sUA, recording attacks and lifestyle advice. However, the majority of these elements were not functional within the app, and instead required users to manually complete printouts. Currently, only one app exists that includes all recommendations to facilitate patient self-management of gout, however some features can only be actioned manually. Given the lack of progress in achieving better patient outcomes and the promise of m

Facilitating LOS Debriefings: A Training Manual

DOT National Transportation Integrated Search

1997-03-01

This manual is a practical guide to help airline instructors effectively : facilitate debriefings of Line Oriented Simulations (LOS). It is based on a : recently completed study of Line Oriented Flight Training (LOFT) debriefings at : several U.S. ai...

Barriers to and facilitators of the acceptance process for individuals with serious mental illness.

PubMed

Mizock, Lauren; Russinova, Zlatka; Millner, Uma Chandrika

2014-09-01

The process of acceptance of mental illness is a central component of recovery and has been linked to functioning, illness management, and quality of life. A number of barriers and facilitators have been theorized as impacting this process. This study was conducted with 30 participants with serious mental illness (a major psychiatric disorder with impairment in multiple areas of functioning) to elicit the barriers to and facilitators of the acceptance of mental illness. Grounded theory methodology was utilized to analyze the 30 semistructured interviews. Results revealed barriers to and facilitators of acceptance of mental illness at the micro level (cognitive, emotional, behavioral, identity-related), meso level (relational), and macro level (cultural, systemic). Clinical and research implications are discussed with regard to facilitating acceptance of mental illness. © The Author(s) 2014.

Situational Management, Standard Setting, and Self-Reward in a Behavior Modification Weight Loss Program.

ERIC Educational Resources Information Center

Chapman, Stanley L.; Jeffrey, D. Balfour

1978-01-01

In comprehensive wieght loss program, overweight women exposed to instruction in self-standard setting and to situational management techniques lost more weight than those instructed only in situational management techniques. Findings illustrate facilitative effect of teaching individuals to set specific, objective, and realistic goals for eating…

Management of older adults with hip fractures in India: a mixed methods study of current practice, barriers and facilitators, with recommendations to improve care pathways.

PubMed

Rath, Santosh; Yadav, Lalit; Tewari, Abha; Chantler, Tracey; Woodward, Mark; Kotwal, Prakash; Jain, Anil; Dey, Aparajit; Garg, Bhavuk; Malhotra, Rajesh; Goel, Ashish; Farooque, Kamran; Sharma, Vijay; Webster, Premila; Norton, Robyn

2017-12-01

Evidence-based management can reduce deaths and suffering of older adults with hip fractures. This study investigates the evidence-practice gaps in hip fracture care in three major hospitals in Delhi, potential barriers and facilitators to improving care, and consequently, identifies contextually appropriate interventions for implementing best practice for management of older adults with hip fractures in India. Hip fracture in older adults is a significant public health issue in India. The current study sought to document current practices, identify barriers and facilitators to adopting best practice guidelines and recommend improvements in the management of older adults with hip fractures in Delhi, India. This mixed methods observational study collected data from healthcare providers, patients, carers and medical records from three major public tertiary care hospitals in Delhi, India. All patients aged ≥50 years with an X-ray confirmed hip fracture that were admitted to these hospitals over a 10-week period were recruited. Patients' data were collected at admission, discharge and 30 days post-injury. Eleven key informant interviews and four focus group discussions were conducted with healthcare providers. Descriptive data for key quantitative variables were computed. The qualitative data were analysed and interpreted using a behaviour change wheel framework. A total of 136 patients, 74 (54%) men and 62 women, with hip fracture were identified in the three participating hospitals during the recruitment period and only 85 (63%) were admitted for treatment with a mean age of 66.5 years (SD 11.9). Of these, 30% received surgery within 48 h of hospital admission, 95% received surgery within 39 days of hospital admission and two (3%) had died by 30 days of injury. According to the healthcare providers, inadequate resources and overcrowding prevent adequate caring of the hip fracture patients. They unanimously felt the need for protocol-based management of hip

Students' Perception of Peer and Faculty Debriefing Facilitators Following Simulation- Based Education.

PubMed

Doherty-Restrepo, Jennifer; Odai, Michelle; Harris, Meisha; Yam, Tiffany; Potteiger, Kelly; Montalvo, Alicia

2018-01-01

Debriefing (discussion led by a facilitator) in simulation-based education enhances dual learning for facilitators and students. Debriefing guides students to critically reflect on their performance in a simulation setting, thus allowing improvement in cognitive and clinical skills. Research has examined the effectiveness of simulation-based education on knowledge, skills, and confidence; however, less research has examined students' perception of debriefing. To compare peer- and faculty-facilitated debriefing on students' confidence and perceptions of simulation effectiveness. Pretest-posttest design, evaluating 23 first-year athletic training students in a CAATE-accredited professional master's program. Participants responded to a series of questions at pre- and posttest using the Debriefing Assessment for Simulation in Healthcare (DASH) to evaluate participant self-confidence of select clinical skills and perceived effectiveness of debriefing. Participants reported a significant increase from pretest to posttest in their confidence in making a differential diagnosis (F=4.26, p=0.03) and ability to share thoughts and emotions without fear of being shamed or humiliated (F=2.08, p=0.05). Students perceived peer- and faculty-facilitated debriefing as equally effective. Peers may assume a facilitator role and provide an effective debriefing session following simulation.

Trophic facilitation or limitation? Comparative effects of pumas and black bears on the scavenger community.

PubMed

Allen, Maximilian L; Elbroch, L Mark; Wilmers, Christopher C; Wittmer, Heiko U

2014-01-01

Scavenging is a widespread behaviour and an important process influencing food webs and ecological communities. Large carnivores facilitate the movement of energy across trophic levels through the scavenging and decomposition of their killed prey, but competition with large carnivores is also likely to constrain acquisition of carrion by scavengers. We used an experimental approach based on motion-triggered video cameras at black-tailed deer (Odocoileus hemionus columbianus) carcasses to measure the comparative influences of two large carnivores in the facilitation and limitation of carrion acquisition by scavengers. We found that pumas (Puma concolor) and black bears (Ursus americanus) had different effects on their ecological communities. Pumas, as a top-level predator, facilitated the consumption of carrion by scavengers, despite significantly reducing their observed sum feeding times (165.7 min ± 21.2 SE at puma kills 264.3 min ± 30.1 SE at control carcasses). In contrast, black bears, as the dominant scavenger in the system, limited consumption of carrion by scavengers as evidenced by the observed reduction of scavenger species richness recorded at carcasses where they were present (mean = 2.33 ± 0.28 SE), compared to where they were absent (mean = 3.28 ± 0.23 SE). Black bears also had large negative effects on scavenger sum feeding times (88.5 min ± 19.8 SE at carcasses where bears were present, 372.3 min ± 50.0 SE at carcasses where bears were absent). In addition, we found that pumas and black bears both increased the nestedness (a higher level of order among species present) of the scavenger community. Our results suggest that scavengers have species-specific adaptions to exploit carrion despite large carnivores, and that large carnivores influence the structure and composition of scavenger communities. The interactions between large carnivores and scavengers should be considered in future studies of food webs and ecological communities.

Facilitators and barriers to application of the Canadian C-spine rule by emergency department triage nurses.

PubMed

Clement, Catherine M; Stiell, Ian G; Lowe, Maureen A; Brehaut, Jamie C; Calder, Lisa A; Vaillancourt, Christian; Perry, Jeffrey J

2016-07-01

We recently conducted a multicentre implementation study on the use of the Canadian C-Spine Rule (CCR) by emergency department (ED) nurses to clear the c-spine in alert and stable trauma patients (n = 4506). The objective of this study was to conduct a survey of nurses, physicians, and administrators to evaluate their views on the facilitators and barriers to the implementation of the CCR. We conducted both a paper-based and an electronic survey of the three different ED hospital staff groups of nine large teaching hospitals in Ontario, including six regional trauma centres. The content of this survey was informed by a qualitative evaluation of the opinions of the study nurses who had participated in the validation study. 57.5% (281/489) ED triage nurses, 50.2% ED physicians, and 82.8% of administrators responded. Nurse responses most often showed support from manager/educators and teamwork between physicians, nurses, and managers as being important facilitators to the use of the CCR. Physician responses most often identified the importance of a nurse leader/champion/educator, and presence of strong physician leaders. Administrator responses indicated the importance of nurse educators/champions, nurse engagement, and educational support. Barriers indicated by all three groups included busy department, lack of physician support, and lack of nursing support. Bringing about change in clinical practice is complex. Strong leadership, effective communication, and senior physician buy-in appear to be very important. Identification of system-specific barriers and facilitators are important components of successful knowledge translation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Maternally perceived barriers to and facilitators of establishing and maintaining tooth-brushing routines with infants and preschoolers.

PubMed

Elison, Sarah; Norgate, Sarah; Dugdill, Lindsey; Pine, Cynthia

2014-07-02

Establishing effective toothbrushing routines using fluoridated toothpaste in infancy has been suggested as important to dental health throughout childhood and into adulthood. However, previous studies have revealed a number of potential barriers to, and facilitators of caregivers ability to establish early dyadic toothbrushing routines with pre-schoolers. However, as yet no qualitative research has been conducted to ascertain potential barriers and facilitators of the earliest dyadic toothbrushing in infancy, and nor has any previous research specifically focused on how novice mothers of first-born infants and preschoolers manage this task. This study therefore outlines findings from a qualitative interview study with first-time mothers of children aged 24-30 months (n = 16) exploring perceived barriers to and facilitators of early dyadic toothbrushing routines with infants and preschoolers. A number of key themes were identified from interview transcripts and an 'ecological' approach conceptualised maternally perceived barriers to and facilitators of dyadic toothbrushing. Proximal influences were found to be located within the caregiver-child relationship ('micro-system'), including parental cognitions (e.g., PSE), parental behaviours (e.g., parenting practices) and infant and preschooler temperament and behaviours (e.g., tantrums). Distal factors were also identified as relevant to the establishment and maintenance of these routines, such as social support ('exosystem') and family history of tooth-brushing ('chronosystem').

Directing and Facilitating Distributed Pedagogical Leadership: Best Practices in Early Childhood Education

ERIC Educational Resources Information Center

Bøe, Marit; Hognestad, Karin

2017-01-01

This paper uses a hybrid leadership framework to examine how formal teacher leaders at the middle management level direct and facilitate staff resources for distributed pedagogical leadership. By conducting qualitative shadowing, involving video observation, field notes and stimulated recall interviews, and abductive analysis, this study…

General overview of the disaster management framework in Cameroon.

PubMed

Bang, Henry Ngenyam

2014-07-01

Efficient and effective disaster management will prevent many hazardous events from becoming disasters. This paper constitutes the most comprehensive document on the natural disaster management framework of Cameroon. It reviews critically disaster management in Cameroon, examining the various legislative, institutional, and administrative frameworks that help to facilitate the process. Furthermore, it illuminates the vital role that disaster managers at the national, regional, and local level play to ease the process. Using empirical data, the study analyses the efficiency and effectiveness of the actions of disaster managers. Its findings reveal inadequate disaster management policies, poor coordination between disaster management institutions at the national level, the lack of trained disaster managers, a skewed disaster management system, and a top-down hierarchical structure within Cameroon's disaster management framework. By scrutinising the disaster management framework of the country, policy recommendations based on the research findings are made on the institutional and administrative frameworks. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Tank waste remediation system privatization infrastructure program, configuration management implementation plan

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

Schaus, P.S.

This Configuration Management Implementation Plan (CMIP) was developed to assist in managing systems, structures, and components (SSCS), to facilitate the effective control and statusing of changes to SSCS, and to ensure technical consistency between design, performance, and operational requirements. Its purpose is to describe the approach Privatization Infrastructure will take in implementing a configuration management program, to identify the Program`s products that need configuration management control, to determine the rigor of control, and to identify the mechanisms for that control.

Developing standards for an integrated approach to workplace facilitation for interprofessional teams in health and social care contexts: a Delphi study.

PubMed

Martin, Anne; Manley, Kim

2018-01-01

Integration of health and social care forms part of health and social care policy in many countries worldwide in response to changing health and social care needs. The World Health Organization's appeal for systems to manage the global epidemiologic transition advocates for provision of care that crosses boundaries between primary, community, hospital, and social care. However, the focus on structural and process changes has not yielded the full benefit of expected advances in care delivery. Facilitating practice in the workplace is a widely recognised cornerstone for developments in the delivery of health and social care as collaborative and inclusive relationships enable frontline staff to develop effective workplace cultures that influence whether transformational change is achieved and maintained. Workplace facilitation embraces a number of different purposes which may not independently lead to better quality of care or improved patient outcomes. Holistic workplace facilitation of learning, development, and improvement supports the integration remit across health and social care systems and avoids duplication of effort and waste of valuable resources. To date, no standards to guide the quality and effectiveness of integrated facilitation have been published. This study aimed to identify key elements constitute standards for an integrated approach to facilitating work-based learning, development, improvement, inquiry, knowledge translation, and innovation in health and social care contexts using a three rounds Delphi survey of facilitation experts from 10 countries. Consensus about priority elements was determined in the final round, following an iteration process that involved modifications to validate content. The findings helped to identify key qualities and skills facilitators need to support interprofessional teams to flourish and optimise performance. Further research could evaluate the impact of skilled integrated facilitation on health and social care

Managing Work and Family: Do Control Strategies Help?

ERIC Educational Resources Information Center

Versey, H. Shellae

2015-01-01

How can we effectively manage competing obligations from work and family without becoming overwhelmed? This question inspires the current study by examining control strategies that may facilitate better work-life balance, with a specific focus on the role of lowered aspirations and positive reappraisals, attitudes that underlie adaptive coping…

Tales for Trainers. Using Stories and Metaphors to Facilitate Learning.

ERIC Educational Resources Information Center

Parkin, Margaret

This book is a resource for trainers or managers who provide training. The book is divided into two parts. Part one provides a brief overview of stories, metaphors, and myths and the purpose they have played over the years--and still do today. It explains how and why stories help to facilitate the learning process, and it gives guidance on where…

Implementing the work disability prevention paradigm among therapists in Hong Kong: facilitators and barriers.

PubMed

Szeto, Grace P Y; Cheng, Andy S K; Lee, Edwin W C; Schonstein, Eva; Gross, Douglas P

2011-03-01

This is a discussion paper to examine the issues surrounding management of work-related injuries by physiotherapists and occupational therapists in Hong Kong. Therapists working in public hospitals are faced with managing injured workers with limited resources and this frequently results in suboptimal outcomes. In this paper, five experienced therapists critically reviewed the current practices in the physiotherapy and occupational therapy professions in Hong Kong, with regard to managing patients with work injuries. In many hospitals, therapists still practice with a disease-based model focusing on symptom relief and restoration of general physical function. We collated information about current programs initiated by physiotherapists and occupational therapists to provide more strategic intervention strategies for early screening of high-risk patients and adaptive biopsychosocial interventions targeting return-to-work outcomes. Clinical and system-level barriers and facilitators of a major paradigm shift towards work disability prevention are discussed. Physiotherapists and occupational therapists need to develop more strategic collaborations and actively voice out the need for major systematic changes within the local healthcare system, in order to provide a more effective management approach in line with the concept of Work Disability Prevention.

Medications for addiction treatment: an opportunity for prescribing clinicians to facilitate remission from alcohol and opioid use disorders.

PubMed

Park, Tae Woo; Friedmann, Peter D

2014-10-01

Substance use disorders are a leading cause of morbidity and mortality in the United States. Medications for the treatment of substance use disorders are effective yet underutilized. This article reviews recent literature examining medications used for the treatment of alcohol and opioid use disorders. The neurobehavioral rationale for medication treatment and the most common ways medications work in the treatment of substance use disorders are discussed. Finally, the medications and the evidence behind their effectiveness are briefly reviewed. Physicians and other prescribing clinicians should take an active role in facilitating remission and recovery from substance use disorders by prescribing these effective medications with brief medical management counseling.

Data Overload Impact on Project Management: How Knowledge Management Systems Can Improve Federal Agencies Effectiveness

ERIC Educational Resources Information Center

Rodriguez, Jacinto

2013-01-01

This mixed method exploratory case study was used to explore the effect data overload has on project management, how data overload affects project management effectiveness, how prepared program office staff is to manage multiple projects effectively, and how the program office's organizational structure and data management systems affect project…

What Is Effective School Management.

ERIC Educational Resources Information Center

De Cicco, James M.

Effective school management requires managers who succeed in carrying out the organizational goals of their schools, utilizing the following leadership skills: planning (deciding how to accomplish the organization's goals); organizing (doing the necessary preparation); staffing (filling positions with the right people); directing (motivating staff…

Improving cost-effectiveness of and outcomes from drug therapy in patients with atrial fibrillation in managed care: role of the pharmacist.

PubMed

Johnson, Samuel G

2009-08-01

pharmacist-managed anticoagulation services for patients with AF are well documented. Pharmacist-managed antiarrhythmic drug monitoring is a less well-known case management strategy that facilitates early detection and intervention to minimize toxicity. Managed care pharmacists can play an instrumental role in implementing strategies to improve the cost-effectiveness of and outcomes from drug therapy for AF.

Preparing Facilitators for Experiential Education: The Role of Intentionality and Intuition

ERIC Educational Resources Information Center

Thomas, Glyn

2008-01-01

A facilitator is considered to act intentionally when they are deliberate about what they are doing and can provide rationales for their actions. The same facilitator is said to practice intuitively when they are not able to articulate a clear rationale for their actions, yet they are still able to facilitate effectively. A review of the…

Fire effects on soils in Lake States forests: A compilation of published research to facilitate long-term investigations

Treesearch

Jessica Miesel; P. Goebel; R. Corace; David Hix; Randall Kolka; Brian Palik; David Mladenoff

2012-01-01

Fire-adapted forests of the Lake States region are poorly studied relative to those of the western and southeastern United States and our knowledge base of regional short- and long-term fire effects on soils is limited. We compiled and assessed the body of literature addressing fire effects on soils in Lake States forests to facilitate the re-measurement of previous...

Evolution of local facilitation in arid ecosystems.

PubMed

Kéfi, Sonia; van Baalen, Minus; Rietkerk, Max; Loreau, Michel

2008-07-01

In harsh environments, sessile organisms can make their habitat more hospitable by buffering environmental stress or increasing resource availability. Although the ecological significance of such local facilitation is widely established, the evolutionary aspects have been seldom investigated. Yet addressing the evolutionary aspects of local facilitation is important because theoretical studies show that systems with such positive interactions can exhibit alternative stable states and that such systems may suddenly become extinct when they evolve (evolutionary suicide). Arid ecosystems currently experience strong changes in climate and human pressures, but little is known about the effects of these changes on the selective pressures exerted on the vegetation. Here, we focus on the evolution of local facilitation in arid ecosystems, using a lattice-structured model explicitly considering local interactions among plants. We found that the evolution of local facilitation depends on the seed dispersal strategy. In systems characterized by short-distance seed dispersal, adaptation to a more stressful environment leads to high local facilitation, allowing the population to escape extinction. In contrast, systems characterized by long-distance seed dispersal become extinct under increased stress even when allowed to adapt. In this case, adaptation in response to climate change and human pressures could give the final push to the desertification of arid ecosystems.

Facilitated versus Non-Facilitated Online Case Discussions: Comparing Differences in Problem Space Coverage

ERIC Educational Resources Information Center

Ertmer, Peggy A.; Koehler, Adrie A.

2015-01-01

The facilitator plays a key role in guiding students' efforts during case discussions. However, few studies have compared differences in learning outcomes for students participating in facilitated versus non-facilitated discussions. In this research, we used "problem space coverage" as a learning measure to compare outcomes between…

Facilitators and barriers to disclosing abuse among women with disabilities.

PubMed

Curry, Mary Ann; Renker, Paula; Robinson-Whelen, Susan; Hughes, Rosemary B; Swank, Paul; Oschwald, Mary; Powers, Laurie E

2011-01-01

An anonymous audio computer-assisted self-interview (A-CASI) designed to increase awareness of abuse was completed by 305 women with diverse disabilities. Data were also collected about lifetime and past year abuse; perpetrator risk characteristics; facilitators and barriers to disclosing abuse; abuse disclosure to a health provider, case manager, or police officer; and whether a health provider had ever discussed abuse or personal safety. A total of 276 (90%) women reported abuse, 208 (68%) reported abuse within the past year. Women who reported the most abuse experiences in the past year and the most dangerous perpetrators endorsed fewer facilitators and more barriers, but were also more likely to have ever disclosed abuse. Only 15% reported that a health provider had ever discussed abuse and personal safety.

Constructive Classroom Management.

ERIC Educational Resources Information Center

Dollard, Norin; And Others

1996-01-01

Reviews classroom management strategies that are child-centered and consistent with constructivist approaches to education, in which teachers create situations that facilitate learning. Describes strategies including techniques for establishing dialog, cognitive interventions (including self management and conflict resolution), cognitive…

The superior effect of nature based solutions in land management for enhancing ecosystem services.

PubMed

Keesstra, Saskia; Nunes, Joao; Novara, Agata; Finger, David; Avelar, David; Kalantari, Zahra; Cerdà, Artemi

2018-01-01

The rehabilitation and restoration of land is a key strategy to recover services -goods and resources- ecosystems offer to the humankind. This paper reviews key examples to understand the superior effect of nature based solutions to enhance the sustainability of catchment systems by promoting desirable soil and landscape functions. The use of concepts such as connectivity and the theory of system thinking framework allowed to review coastal and river management as a guide to evaluate other strategies to achieve sustainability. In land management NBSs are not mainstream management. Through a set of case studies: organic farming in Spain; rewilding in Slovenia; land restoration in Iceland, sediment trapping in Ethiopia and wetland construction in Sweden, we show the potential of Nature based solutions (NBSs) as a cost-effective long term solution for hydrological risks and land degradation. NBSs can be divided into two main groups of strategies: soil solutions and landscape solutions. Soil solutions aim to enhance the soil health and soil functions through which local eco-system services will be maintained or restored. Landscape solutions mainly focus on the concept of connectivity. Making the landscape less connected, facilitating less rainfall to be transformed into runoff and therefore reducing flood risk, increasing soil moisture and reducing droughts and soil erosion we can achieve the sustainability. The enhanced eco-system services directly feed into the realization of the Sustainable Development Goals of the United Nations. Copyright © 2017 Elsevier B.V. All rights reserved.

The factors facilitating and inhibiting effective clinical decision-making in nursing: a qualitative study

PubMed Central

Hagbaghery, Mohsen Adib; Salsali, Mahvash; Ahmadi, Fazlolah

2004-01-01

Background Nurses' practice takes place in a context of ongoing advances in research and technology. The dynamic and uncertain nature of health care environment requires nurses to be competent decision-makers in order to respond to clients' needs. Recently, the public and the government have criticized Iranian nurses because of poor quality of patient care. However nurses' views and experiences on factors that affect their clinical function and clinical decision-making have rarely been studied. Methods Grounded theory methodology was used to analyze the participants' lived experiences and their viewpoints regarding the factors affecting their clinical function and clinical decision-making. Semi-structured interviews and participant observation methods were used to gather the data. Thirty-eight participants were interviewed and twelve sessions of observation were carried out. Constant comparative analysis method was used to analyze the data. Results Five main themes emerged from the data. From the participants' points of view, "feeling competent", "being self-confident", "organizational structure", "nursing education", and "being supported" were considered as important factors in effective clinical decision-making. Conclusion As participants in this research implied, being competent and self-confident are the most important personal factors influencing nurses clinical decision-making. Also external factors such as organizational structure, access to supportive resources and nursing education have strengthening or inhibiting effects on the nurses' decisions. Individual nurses, professional associations, schools of nursing, nurse educators, organizations that employ nurses and government all have responsibility for developing and finding strategies that facilitate nurses' effective clinical decision-making. They are responsible for identifying barriers and enhancing factors within the organizational structure that facilitate nurses' clinical decision-making. PMID

Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded

Navigating change: how outreach facilitators can help clinicians improve patient outcomes.

PubMed

Laferriere, Dianne; Liddy, Clare; Nash, Kate; Hogg, William

2012-01-01

The objective of this study was to describe outreach facilitation as an effective method of assisting and supporting primary care practices to improve processes and delivery of care. We spent 4 years working with 83 practices in Eastern Ontario, Canada, on the Improved Delivery of Cardiovascular Care through the Outreach Facilitation program. Primary care practices, even if highly motivated, face multiple challenges when providing quality patient care. Outreach facilitation can be an effective method of assisting and supporting practices to make the changes necessary to improve processes and delivery of care. Multiple jurisdictions use outreach facilitation for system redesign, improved efficiencies, and advanced access. The development and implementation of quality improvement programs using practice facilitation can be challenging. Our research team has learned valuable lessons in developing tools, finding resources, and assisting practices to reach their quality improvement goals. These lessons can lead to improved experiences for the practices and overall improved outcomes for the patients they serve.

Emergency Management of Myasthenia Gravis

MedlinePlus

... to weakened throat muscles and accumulated secretions. EMERGENCY MANAGEMENT OF MG The MGFA mission is to facilitate ... fax mgfa@myasthenia.org • www.myasthenia.org EMERGENCY MANAGEMENT OF MG Emergency Management Important information for the ...

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

Neurophysiological Facilitation of Eating Skills in Children with Severe Handicaps.

ERIC Educational Resources Information Center

Sobsey, Richard; Orelove, Fred P.

1984-01-01

Effectiveness of neurophysiological facilitation procedures (exteroceptive and proprioceptive stimulation) was evaluated on lip closure, rotary chewing, and food spilling from the mouth of four severely disabled children (3-12 years old). Some improvements in eating skills were found in each student following facilitation procedures. (CL)

Contemporary behavior management techniques in clinical pediatric dentistry: out with the old and in with the new?

PubMed

Oliver, Kelly; Manton, David John

2015-01-01

Effective behavior management guides children through the complex social context of dentistry utilizing techniques based on a current understanding of the social, emotional, and cognitive development of children. Behavior management techniques facilitate effective communication and establish social and behavioral guidelines for the dental environment. Contemporary parenting styles, expectations, and attitudes of modern parents and society have influenced the use of behavior management techniques with a prevailing emphasis on communicative techniques and pharmacological management over aversive techniques.

Crisis Management in the Schools: New Aspects of Professionalism.

ERIC Educational Resources Information Center

Shrestha, Bijaya K.

1990-01-01

Effective crisis management as a function of the chief school administrator's role is examined. A new professionalism and recognition of districts and schools as complex organizations facilitate administrators' ability to handle this enlarged responsibility. Chapter 1 identifies forms of school crises and offers explanations, drawing upon…

Facilitating the Adoption of Contingency Management for the Treatment of Substance Use Disorders

PubMed Central

Roll, John M; Madden, Gregory J; Rawson, Richard; Petry, Nancy M

2009-01-01

Contingency management (CM) is an effective treatment strategy for addressing many types of substance abuse disorders and associated problems. Nonetheless, CM protocols have not been widely embraced by community-based treatment providers. Exploration of the viability of CM outside of a research context remains largely an academic pursuit. In this paper, we outline several areas that may hinder the transfer of CM technology into community-based practice settings, review the literature that may address these barriers, and offer suggestions to researchers for overcoming them. PMID:22477692

Quality management as knowledge sharing: experiences of the Napa County Health and Human Services Agency.

PubMed

Harrison, Lindsay

2012-01-01

Lacking a coordinated effort in utilizing data and tracking program outcomes, one agency developed a Quality Management (QM) division to facilitate and manage more effective data use. To support this process, the agency sought to develop a collective, agency-wide understanding and investment in improving and measuring client outcomes. Similarly, the agency also focused efforts on creating a culture of transparency and accountability, with goals of improving service, increasing agency integrity, meeting regulatory compliance, and engaging in effective risk management. Operationalizing the QM initiative involved developing procedures, systems, and guidelines that would facilitate the generation of reliable and accurate data that could be used to inform program change and decision-making. This case study describes this agency's experience in successfully creating and implementing a QM initiative aimed at engaging in greater knowledge sharing. Copyright © Taylor & Francis Group, LLC

Content and Knowledge Management in a Digital Library and Museum.

ERIC Educational Resources Information Center

Yeh, Jian-Hua; Chang, Jia-Yang; Oyang, Yen-Jen

2000-01-01

Discusses the design of the National Taiwan University Digital Library and Museum that addresses both content and knowledge management. Describes a two-tier repository architecture that facilitates content management, includes an object-oriented model to facilitate the management of temporal information, and eliminates the need to manually…

Effect of an emergency department-based electronic system for musculoskeletal consultation on facilitating care for common injuries.

PubMed

Mears, Simon C; Pantle, Hardin A; Bessman, Edward S; Lifchez, Scott D

2015-05-01

Access to musculoskeletal consultation in the emergency department (ED) is a nationwide problem. In addition, consultation from a subspecialist may be delayed or may not be available, which can slow down the ED flow and reduce patient satisfaction. The purpose of this study was to review the 1-year results of a change in the authors' institutional practice to reduce subspecialty consultation for select musculoskeletal problems while still ensuring adequate patient follow-up in orthopedic or plastic surgery clinics for patients not seen by these services in the ED. The authors hypothesized that select injuries could be safely managed in the ED by using an electronic system to ensure appropriate follow-up care. Using Kaizen methodology, a multidisciplinary group (including ED staff, orthopedics, plastic surgery, pediatrics, nursing, radiology, therapy, and administration) met to improve care for select musculoskeletal injuries. A system was agreed on in which ED providers managed select musculoskeletal injuries without subspecialist consultation. Follow-up was organized using an electronic system, which facilitated communication between the ED staff and the secretarial staff of the subspecialist departments. Over a 1-year period, 150 patients were treated using this system. Charts and radiographs were reviewed for missed injuries. Radiographic review revealed 2 missed injuries. One patient had additional back pain and a lumbar spine fracture was found during the subspecialist follow-up visit; it was treated nonoperatively. Another patient appeared to have scapholunate widening on the injury radiograph that was not appreciated in the ED. Of the 150 patients, 51 were seen in follow-up by a subspecialist at the authors' institution. An electronic system to organize follow-up with a subspecialist allowed the ED providers to deliver safe and effective care for simple musculoskeletal injuries. Copyright 2015, SLACK Incorporated.

The Role of Leadership in Facilitating Organisational Learning and Collective Capacity Building

ERIC Educational Resources Information Center

Piranfar, Hosein

2007-01-01

The paper examines the role of leadership in facilitating collective learning and capacity building by utilising ideas from the fields of evolutionary learning, operations strategy, quality, project and risk management. Two contrasting cases are chosen to show how success and failure can depend upon collective capacity building through…

Transition management - An analysis of strategic considerations for effective implementation

NASA Technical Reports Server (NTRS)

Hunsucker, John L.; Loos, David

1989-01-01

Six managerial guidelines are identified for facilitating successful change in an organization. They are: (1) the need for a catalyst to initiate change; (2) the setting of organizational goals which take into account the impact of technical, political, and cultural factors; (3) requiring a transition team to guide the change; (4) a demonstration by top management of a commitment to the change as well as their acting as change agents; (5) the utilization of employee participation and good communication to help overcome employee resistance; and (6) the evaluation of the change program as important to the success of present and future change programs. A description of each guideline is presented, and its importance is examined. Available options are also presented for management to deal with each of the guidelines.

Self-Management: Facilitating Employee Independence in Supported Employment Settings. Volume 4.

ERIC Educational Resources Information Center

Lagomarcino, Thomas R.; And Others

Seven papers address the teaching of self-management skills to disabled persons in supported employment settings. In "Competitive Employment: Teaching Mentally Retarded Employees to Maintain Their Work Behavior," (Frank Rusch and others), external cues managed by job coaches are contrasted to self-generated cues leading to employee self…

Facilitation of an end-of-life care programme into practice within UK nursing care homes: A mixed-methods study.

PubMed

Kinley, Julie; Preston, Nancy; Froggatt, Katherine

2018-06-01

The predicted demographic changes internationally have implications for the nature of care that older people receive and place of care as they age. Healthcare policy now promotes the implementation of end-of-life care interventions to improve care delivery within different settings. The Gold Standards Framework in Care Homes (GSFCH) programme is one end-of-life care initiative recommended by the English Department of Health. Only a small number of care homes that start the programme complete it, which raises questions about the implementation process. To identify the type, role, impact and cost of facilitation when implementing the GSFCH programme into nursing care home practice. A mixed-methods study. Nursing care homes in south-east England. Staff from 38 nursing care homes undertaking the GSFCH programme. Staff in 24 nursing care homes received high facilitation. Of those, 12 also received action learning. The remaining 14 nursing care homes received usual local facilitation of the GSFCH programme. Study data were collected from staff employed within nursing care homes (home managers and GSFCH coordinators) and external facilitators associated with the homes. Data collection included interviews, surveys and facilitator activity logs. Following separate quantitative (descriptive statistics) and qualitative (template) data analysis the data sets were integrated by 'following a thread'. This paper reports study data in relation to facilitation. Three facilitation approaches were provided to nursing home staff when implementing the GSFCH programme: 'fitting it in' facilitation; 'as requested' facilitation; and 'being present' facilitation. 'Being present' facilitation most effectively enabled the completion of the programme, through to accreditation. However, it was not sufficient to just be present. Without mastery and commitment, from all participants, including the external facilitator, learning and initiation of change failed to occur. Implementation of the

Facilitation or Competition? Tree Effects on Grass Biomass across a Precipitation Gradient

PubMed Central

Moustakas, Aristides; Kunin, William E.; Cameron, Tom C.; Sankaran, Mahesh

2013-01-01

Savanna ecosystems are dominated by two distinct plant life forms, grasses and trees, but the interactions between them are poorly understood. Here, we quantified the effects of isolated savanna trees on grass biomass as a function of distance from the base of the tree and tree height, across a precipitation gradient in the Kruger National Park, South Africa. Our results suggest that mean annual precipitation (MAP) mediates the nature of tree-grass interactions in these ecosystems, with the impact of trees on grass biomass shifting qualitatively between 550 and 737 mm MAP. Tree effects on grass biomass were facilitative in drier sites (MAP≤550 mm), with higher grass biomass observed beneath tree canopies than outside. In contrast, at the wettest site (MAP = 737 mm), grass biomass did not differ significantly beneath and outside tree canopies. Within this overall precipitation-driven pattern, tree height had positive effect on sub-canopy grass biomass at some sites, but these effects were weak and not consistent across the rainfall gradient. For a more synthetic understanding of tree-grass interactions in savannas, future studies should focus on isolating the different mechanisms by which trees influence grass biomass, both positively and negatively, and elucidate how their relative strengths change over broad environmental gradients. PMID:23451137

Direct procurement of wound management products.

PubMed

Jenkins, Trevor

2014-03-01

This article describes a collaborative project between Bedfordshire Community Health Services and Primary Care Trusts/Clinical Commissioning Groups to improve provision of dressings to nurses for the patients they treat. Commissioners have facilitated a transformational approach and encouraged development of efficient systems of increased cost-effectiveness rather than a transactional approach based on opportunistic cost improvement plans. Reconfiguration to direct procurement from GP prescribing has reduced wastage, released nurse time from processes to spend on clinical contact time with patients, increased efficiency, and reduced prescription workload for GPs, all without adverse effects on expenditure. Establishing a wound care products formulary placed control under the nurses treating patients and facilitated decision-making based on cost-effectiveness in clinical use. Nurses now manage 60% of expenditure in the local community health economy, and this is increasing. Relationships with the dressings manufacturing industry have also changed in a positive, constructive direction.

Barriers and facilitators to implementing the Baby-Friendly hospital initiative in neonatal intensive care units.

PubMed

Benoit, Britney; Semenic, Sonia

2014-01-01

To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU). Qualitative, descriptive design. Two university-affiliated level-III NICUs in Canada. A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners. In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis. Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration. Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

The Document Management Alliance.

ERIC Educational Resources Information Center

Fay, Chuck

1998-01-01

Describes the Document Management Alliance, a standards effort for document management systems that manages and tracks changes to electronic documents created and used by collaborative teams, provides secure access, and facilitates online information retrieval via the Internet and World Wide Web. Future directions are also discussed. (LRW)

Crisis management: an extended reference framework for decision makers.

PubMed

Carone, Alessandro; Iorio, Luigi Di

2013-01-01

The paper discusses a reference framework for capabilities supporting effective crisis management. This framework has been developed by joining experiences in the field and knowledge of organisational models for crisis management, and executives' empowerment, coaching and behavioural analysis. The paper is aimed at offering further insight to executives on critical success factors and means for managing crisis situations by extending the scope of analysis to human behaviour, to emotions and fears and their correlation with decision making. It is further intended to help familiarise them and to facilitate approaching a path towards emotional awareness.

Failing the Future: Three Unsuccessful Attempts to Replicate Bem's ‘Retroactive Facilitation of Recall’ Effect

PubMed Central

Ritchie, Stuart J.; Wiseman, Richard; French, Christopher C.

2012-01-01

Nine recently reported parapsychological experiments appear to support the existence of precognition. We describe three pre-registered independent attempts to exactly replicate one of these experiments, ‘retroactive facilitation of recall’, which examines whether performance on a memory test can be influenced by a post-test exercise. All three replication attempts failed to produce significant effects (combined n = 150; combined p = .83, one-tailed) and thus do not support the existence of psychic ability. PMID:22432019

Clinical multi-omics strategies for the effective cancer management.

PubMed

Yoo, Byong Chul; Kim, Kyung-Hee; Woo, Sang Myung; Myung, Jae Kyung

2017-08-15

Cancer is a global health issue as a multi-factorial complex disease, and early detection and novel therapeutic strategies are required for more effective cancer management. With the development of systemic analytical -omics strategies, the therapeutic approach and study of the molecular mechanisms of carcinogenesis and cancer progression have moved from hypothesis-driven targeted investigations to data-driven untargeted investigations focusing on the integrated diagnosis, treatment, and prevention of cancer in individual patients. Predictive, preventive, and personalized medicine (PPPM) is a promising new approach to reduce the burden of cancer and facilitate more accurate prognosis, diagnosis, as well as effective treatment. Here we review the fundamentals of, and new developments in, -omics technologies, together with the key role of a variety of practical -omics strategies in PPPM for cancer treatment and diagnosis. In this review, a comprehensive and critical overview of the systematic strategy for predictive, preventive, and personalized medicine (PPPM) for cancer disease was described in a view of cancer prognostic prediction, diagnostics, and prevention as well as cancer therapy and drug responses. We have discussed multi-dimensional data obtained from various resources and integration of multisciplinary -omics strategies with computational method which could contribute the more effective PPPM for cancer. This review has provided the novel insights of the current applications of each and combined -omics technologies, which showed their powerful potential for the establishment of PPPM for cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

A framework for engaging stakeholders on the management of alien species.

PubMed

Novoa, Ana; Shackleton, Ross; Canavan, Susan; Cybèle, Cathleen; Davies, Sarah J; Dehnen-Schmutz, Katharina; Fried, Jana; Gaertner, Mirijam; Geerts, Sjirk; Griffiths, Charles L; Kaplan, Haylee; Kumschick, Sabrina; Le Maitre, David C; Measey, G John; Nunes, Ana L; Richardson, David M; Robinson, Tamara B; Touza, Julia; Wilson, John R U

2018-01-01

Alien species can have major ecological and socioeconomic impacts in their novel ranges and so effective management actions are needed. However, management can be contentious and create conflicts, especially when stakeholders who benefit from alien species are different from those who incur costs. Such conflicts of interests mean that management strategies can often not be implemented. There is, therefore, increasing interest in engaging stakeholders affected by alien species or by their management. Through a facilitated workshop and consultation process including academics and managers working on a variety of organisms and in different areas (urban and rural) and ecosystems (terrestrial and aquatic), we developed a framework for engaging stakeholders in the management of alien species. The proposed framework for stakeholder engagement consists of 12 steps: (1) identify stakeholders; (2) select key stakeholders for engagement; (3) explore key stakeholders' perceptions and develop initial aims for management; (4) engage key stakeholders in the development of a draft management strategy; (5) re-explore key stakeholders' perceptions and revise the aims of the strategy; (6) co-design general aims, management objectives and time frames with key stakeholders; (7) co-design a management strategy; (8) facilitate stakeholders' ownership of the strategy and adapt as required; and (9) implement the strategy and monitor management actions to evaluate the need for additional or future actions. In case additional management is needed after these actions take place, some extra steps should be taken: (10) identify any new stakeholders, benefits, and costs; (11) monitor engagement; and (12) revise management strategy. Overall, we believe that our framework provides an effective approach to minimize the impact of conflicts created by alien species management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mapping Perceptions of Lupus Medication Decision-Making Facilitators: The Importance of Patient Context.

PubMed

Qu, Haiyan; Shewchuk, Richard M; Alarcón, Graciela; Fraenkel, Liana; Leong, Amye; Dall'Era, Maria; Yazdany, Jinoos; Singh, Jasvinder A

2016-12-01

Numerous factors can impede or facilitate patients' medication decision-making and adherence to physicians' recommendations. Little is known about how patients and physicians jointly view issues that affect the decision-making process. Our objective was to derive an empirical framework of patient-identified facilitators to lupus medication decision-making from key stakeholders (including 15 physicians, 5 patients/patient advocates, and 8 medical professionals) using a patient-centered cognitive mapping approach. We used nominal group patient panels to identify facilitators to lupus treatment decision-making. Stakeholders independently sorted the identified facilitators (n = 98) based on their similarities and rated the importance of each facilitator in patient decision-making. Data were analyzed using multidimensional scaling and hierarchical cluster analysis. A cognitive map was derived that represents an empirical framework of facilitators for lupus treatment decisions from multiple stakeholders' perspectives. The facilitator clusters were 1) hope for a normal/healthy life, 2) understand benefits and effectiveness of taking medications, 3) desire to minimize side effects, 4) medication-related data, 5) medication effectiveness for "me," 6) family focus, 7) confidence in physician, 8) medication research, 9) reassurance about medication, and 10) medication economics. Consideration of how different stakeholders perceive the relative importance of lupus medication decision-making clusters is an important step toward improving patient-physician communication and effective shared decision-making. The empirically derived framework of medication decision-making facilitators can be used as a guide to develop a lupus decision aid that focuses on improving physician-patient communication. © 2016, American College of Rheumatology.

Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review.

PubMed

Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

2016-02-01

Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists' perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers.

Stress Management for Special Educators: The Self-Administered Tool for Awareness and Relaxation (STAR)

ERIC Educational Resources Information Center

Williams, Krista; Poel, Elissa Wolfe

2006-01-01

The Self-Administered Tool for Awareness and Relaxation (STAR) is a stress management strategy designed to facilitate awareness of the physical, mental, emotional, and physiological effects of stress through the interconnectedness of the brain, body, and emotions. The purpose of this article is to present a stress-management model for teachers,…

Facilitating Involvement in Alcoholics Anonymous During Outpatient Treatment: A Randomized Clinical Trial

PubMed Central

Walitzer, Kimberly S.; Dermen, Kurt H.; Barrick, Christopher

2009-01-01

AIM This study evaluated two strategies to facilitate involvement in Alcoholics Anonymous (AA) – a 12-step-based directive approach and a motivational enhancement approach – during skills-focused individual treatment. DESIGN Randomized controlled trial with assessments at baseline, end of treatment, and 3, 6, 9, and 12 months after treatment. PARTICIPANTS, SETTING, and INTERVENTION 169 alcoholic outpatients (57 women) randomly assigned to one of three conditions: a directive approach to facilitating AA, a motivational enhancement approach to facilitating AA, or treatment as usual with no special emphasis on AA. MEASUREMENTS Self-report of AA meeting attendance and involvement, alcohol consumption (percent days abstinent, percent days heavy drinking), and negative alcohol consequences. FINDINGS Participants exposed to the 12-step directive condition for facilitating AA involvement reported more AA meeting attendance, more evidence of active involvement in AA, and a higher percent days abstinent relative to participants in the treatment-as-usual comparison group. Evidence suggested also that the effect of the directive strategy on abstinent days was partially mediated through AA involvement. The motivational enhancement approach to facilitating AA had no effect on outcome measures. CONCLUSIONS These results suggest that treatment providers can use a 12-step-based directive approach to effectively facilitate involvement in AA and thereby improve client outcome. PMID:19207347

Effects of Self-Management Support on Structure, Process, and Outcomes Among Vulnerable Patients With Diabetes

PubMed Central

Schillinger, Dean; Handley, Margaret; Wang, Frances; Hammer, Hali

2009-01-01

OBJECTIVE Despite the importance of self-management support (SMS), few studies have compared SMS interventions, involved diverse populations, or entailed implementation in safety net settings. We examined the effects of two SMS strategies across outcomes corresponding to the Chronic Care Model. RESEARCH DESIGN AND METHODS A total of 339 outpatients with poorly controlled diabetes from county-run clinics were enrolled in a three-arm trial. Participants, more than half of whom spoke limited English, were uninsured, and/or had less than a high school education, were randomly assigned to usual care, interactive weekly automated telephone self-management support with nurse follow-up (ATSM), or monthly group medical visits with physician and health educator facilitation (GMV). We measured 1-year changes in structure (Patient Assessment of Chronic Illness Care [PACIC]), communication processes (Interpersonal Processes of Care [IPC]), and outcomes (behavioral, functional, and metabolic). RESULTS Compared with the usual care group, the ATSM and GMV groups showed improvements in PACIC, with effect sizes of 0.48 and 0.50, respectively (P < 0.01). Only the ATSM group showed improvements in IPC (effect sizes 0.40 vs. usual care and 0.25 vs. GMV, P < 0.05). Both SMS arms showed improvements in self-management behavior versus the usual care arm (P < 0.05), with gains being greater for the ATSM group than for the GMV group (effect size 0.27, P = 0.02). The ATSM group had fewer bed days per month than the usual care group (−1.7 days, P = 0.05) and the GMV group (−2.3 days, P < 0.01) and less interference with daily activities than the usual care group (odds ratio 0.37, P = 0.02). We observed no differences in A1C change. CONCLUSIONS Patient-centered SMS improves certain aspects of diabetes care and positively influences self-management behavior. ATSM seems to be a more effective communication vehicle than GMV in improving behavior and quality of life. PMID:19131469

Successes and failures of using the cell phone as a main mode of communication between participants and facilitators from a distance: an innovative method of training rural health facility managers in Papua New Guinea.

PubMed

Au, Lucy

2012-01-01

Rural Health Facility Management Training is a training program developed by the National Department of Health in collaboration with AUSAID through the office of the Capacity Building Service Centre. The purpose of the training is to train officers-in-charge who did not acquire knowledge and skills of managing a health facility. As part of this study, it is essential to assess whether the cell phone is a better mode of communication between the participants and the facilitators compared with other modes of communication from a distance. The study used the cross-sectional method to collect 160 samples from 12 provinces and the statistical software Stata (version 8) was used to analyse the data. The results showed that mobile coverage is not very effective in most rural areas, though, it is efficient and accessible. Furthermore, it is expensive to make a call compared with sending text massages. In spite of the high cost involved, most health managers prefer to use the cell phone compared to normal post, email, or fax. This clearly shows that the mobile phone is a better device for distant learning in rural Papua New Guinea compared to other modes of communication.

Effective strategies for comprehensive corridor management

DOT National Transportation Integrated Search

2004-10-01

Despite the increasing importance of comprehensive corridor management at the state and local government level, questions remain regarding effective methods for developing and implementing corridor management plans. Further insight is also needed int...

Habitat manipulation in lowland rice-coconut cropping systems of the Philippines--an effective rodent pest management strategy?

PubMed

Stuart, Alexander M; Prescott, Colin V; Singleton, Grant R

2014-06-01

Reduction of vegetation height is recommended as a management strategy for controlling rodent pests of rice in South-east Asia, but there are limited field data to assess its effectiveness. The breeding biology of the main pest species of rodent in the Philippines, Rattus tanezumi, suggests that habitat manipulation in irrigated rice-coconut cropping systems may be an effective strategy to limit the quality and availability of their nesting habitat. The authors imposed a replicated manipulation of vegetation cover in adjacent coconut groves during a single rice-cropping season, and added artificial nest sites to facilitate capture and culling of young. Three trapping sessions in four rice fields (two treatments, two controls) adjacent to coconut groves led to the capture of 176 R. tanezumi, 12 Rattus exulans and seven Chrotomys mindorensis individuals. There was no significant difference in overall abundance between crop stages or between treatments, and there was no treatment effect on damage to tillers or rice yield. Only two R. tanezumi were caught at the artificial nest sites. Habitat manipulation to reduce the quality of R. tanezumi nesting habitat adjacent to rice fields is not effective as a lone rodent management tool in rice-coconut cropping systems. © 2013 Society of Chemical Industry.

Taking It Online--The Effects of Delivery Medium and Facilitator on Student Achievement in Problem-Based Learning

ERIC Educational Resources Information Center

Schoenfeld-Tacher, Regina; McConnell, Sherry; Kogan, Lori R.

2004-01-01

This study compares the effects of delivery medium (online vs. face-to-face) and facilitator content expertise on academic outcomes in a problem-based learning (PBL) course in anatomy for pre-health/medical majors. The content of online PBL sessions was examined to gain insight into the problem-solving process taking place in these situations.…

Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review

PubMed Central

2017-01-01

Objectives We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. Results There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. Conclusions The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required. PMID:28372351

Facilitating or undermining? The effect of reward on food acceptance. A narrative review.

PubMed

Cooke, Lucy J; Chambers, Lucy C; Añez, Elizabeth V; Wardle, Jane

2011-10-01

Using rewards in child feeding is commonplace and viewed as effective by parents, although some express concern about using 'bribery'. Psychological and economic theorists emphasize the beneficial effects of rewards in enhancing performance, although, there is evidence that the offer of rewards undermines intrinsic motivation and decreases enjoyment of the rewarded task. In the food domain, results have been mixed, but this may be explained, at least partly in terms of the measured outcome (liking vs intake) and the initial level of motivation towards the target foods (liked vs disliked). Where intake is the outcome, rewards have had broadly positive effects, but when it is liking, rewards can have negative effects if the target food is already liked. Another issue concerns the type of reward offered. While offering food as a reward appear to be universally negative, there is evidence to suggest that non-food tangible rewards (e.g., stickers), or non-tangible rewards (praise) can be highly effective in encouraging children to taste new or less liked foods sufficiently often to benefit from the 'mere exposure' effect. We suggest that the judicious use of rewards may facilitate children's acceptance of healthy foods. Copyright © 2011 Elsevier Ltd. All rights reserved.

A game plan: Gamification design principles in mHealth applications for chronic disease management.

PubMed

Miller, Aaron S; Cafazzo, Joseph A; Seto, Emily

2016-06-01

Effective chronic disease management is essential to improve positive health outcomes, and incentive strategies are useful in promoting self-care with longevity. Gamification, applied with mHealth (mobile health) applications, has the potential to better facilitate patient self-management. This review article addresses a knowledge gap around the effective use of gamification design principles, or mechanics, in developing mHealth applications. Badges, leaderboards, points and levels, challenges and quests, social engagement loops, and onboarding are mechanics that comprise gamification. These mechanics are defined and explained from a design and development perspective. Health and fitness applications with gamification mechanics include: bant which uses points, levels, and social engagement, mySugr which uses challenges and quests, RunKeeper which uses leaderboards as well as social engagement loops and onboarding, Fitocracy which uses badges, and Mango Health, which uses points and levels. Specific design considerations are explored, an example of the efficacy of a gamified mHealth implementation in facilitating improved self-management is provided, limitations to this work are discussed, a link between the principles of gaming and gamification in health and wellness technologies is provided, and suggestions for future work are made. We conclude that gamification could be leveraged in developing applications with the potential to better facilitate self-management in persons with chronic conditions. © The Author(s) 2014.

Understanding effective care management implementation in primary care: a macrocognition perspective analysis.

PubMed

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

2015-08-21

Care management in primary care can be effective in helping patients with chronic disease improve their health status. Primary care practices, however, are often challenged with its implementation. Incorporating care management involves more than a simple physical process redesign to existing clinical care routines. It involves changes to who is working with patients, and consequently such things as who is making decisions, who is sharing patient information, and how. Studying the range of such changes in "knowledge work" during implementation requires a perspective and tools designed to do so. We used the macrocognition perspective, which is designed to understand how individuals think in dynamic, messy real-world environments such as care management implementation. To do so, we used cognitive task analysis to understand implementation in terms of such thinking as decision making, knowledge, and communication. Data collection involved semi-structured interviews and observations at baseline and at approximately 9 months into implementation at five practices in one physician-owned administratively connected group of practices in the state of Michigan, USA. Practices were intervention participants in a larger trial of chronic care model implementation. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with macrocognition as a guiding framework. Seventy-four interviews and five observations were completed. There were differences in implementation success across the practices, and these differences in implementation success were well explained by macrocognition. Practices that used more macrocognition functions and used them more often were also more successful in care management implementation. Although care management can introduce many new changes into the delivery of primary care clinical practice, implementing it successfully as a new complex intervention is possible. Macrocognition is a

[The use of benchmarking to manage the healthcare supply chain: effects on purchasing cost and quality].