Sample records for factors affecting implementation

  1. Factors affecting strategic plan implementation using interpretive structural modeling (ISM).

    PubMed

    Bahadori, Mohammadkarim; Teymourzadeh, Ehsan; Tajik, Hamidreza; Ravangard, Ramin; Raadabadi, Mehdi; Hosseini, Seyed Mojtaba

    2018-06-11

    Purpose Strategic planning is the best tool for managers seeking an informed presence and participation in the market without surrendering to changes. Strategic planning enables managers to achieve their organizational goals and objectives. Hospital goals, such as improving service quality and increasing patient satisfaction cannot be achieved if agreed strategies are not implemented. The purpose of this paper is to investigate the factors affecting strategic plan implementation in one teaching hospital using interpretive structural modeling (ISM). Design/methodology/approach The authors used a descriptive study involving experts and senior managers; 16 were selected as the study sample using a purposive sampling method. Data were collected using a questionnaire designed and prepared based on previous studies. Data were analyzed using ISM. Findings Five main factors affected strategic plan implementation. Although all five variables and factors are top level, "senior manager awareness and participation in the strategic planning process" and "creating and maintaining team participation in the strategic planning process" had maximum drive power. "Organizational structure effects on the strategic planning process" and "Organizational culture effects on the strategic planning process" had maximum dependence power. Practical implications Identifying factors affecting strategic plan implementation is a basis for healthcare quality improvement by analyzing the relationship among factors and overcoming the barriers. Originality/value The authors used ISM to analyze the relationship between factors affecting strategic plan implementation.

  2. Factors Affecting Successful Implementation of Hospital Information Systems.

    PubMed

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

    2016-02-01

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

  3. Companion of choice at birth: factors affecting implementation.

    PubMed

    Kabakian-Khasholian, Tamar; Portela, Anayda

    2017-08-31

    Two recent recommendations made by the World Health Organization confirm the benefits of companion of choice at birth on labour outcomes; however institutional practices and policies do not always support its implementation in different settings around the world. We conducted a review to determine factors that affect implementation of this intervention considering the perspectives and experiences of different stakeholders and other institutional, systemic barriers and facilitators. Forty one published studies were included in this review. Thirty one publications were identified from a 2013 Cochrane review on the effectiveness of companion of choice at birth. We also reviewed 10 qualitative studies conducted alongside the trials or other interventions on labour and birth companionship identified through electronic searches. The SURE (Supporting the Use of Research Evidence) framework was used to guide the thematic analysis of implementation factors. Women and their families expressed appreciation for the continuous presence of a person to provide support during childbirth. Health care providers were concerned about the role of the companion and possible interference with activities in the labour ward. Allocation of resources, organization of care, facility-related constraints and cultural inclinations were identified as implementation barriers. Prior to introducing companion of choice at birth, understanding providers' attitudes and sensitizing them to the evidence is necessary. The commitment of the management of health care facilities is also required to change policies, including allocation of appropriate physical space that respects women's privacy. Implementation research to develop models for different contexts which could be scaled up would be useful, including documentation of factors that affected implementation and how they were addressed. Future research should also focus on documenting the costs related to implementation, and on measuring the impact of

  4. Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

    PubMed

    McGuire, Alan B; Salyers, Michelle P; White, Dominique A; Gilbride, Daniel J; White, Laura M; Kean, Jacob; Kukla, Marina

    2015-12-01

    Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (c) 2015 APA, all rights reserved).

  5. Factors affecting the implementation of clinical pharmacy services in China.

    PubMed

    Penm, Jonathan; Moles, Rebekah; Wang, Holly; Li, Yan; Chaar, Betty

    2014-03-01

    New policies in China have recently led to the implementation of clinical pharmacy services in hospitals. We explored the views of hospital administrators, pharmacy directors, clinical pharmacists, and dispensing pharmacists about the factors affecting clinical pharmacy services in China, using the framework approach and organizational theory. We conducted 30 interviews with 130 participants at 29 hospitals (both secondary and tertiary) in Beijing, Zhengzhou, Luoyang, and Shanghai. We found that the barriers to and facilitators of implementation of clinical pharmacy services slotted into the environment and participant dimensions of Scott's adapted version of Leavitt's organizational model. External support from government was perceived as crucial to promoting pharmacy services. It is proposed that the internationally recognized Basel Statements of the International Pharmaceutical Federation also provide a strong foundation for guiding China in implementing clinical pharmacy services.

  6. Organizational Factors that Affect the Implementation of Information Technology: Perspectives of Middle Managers in Iran.

    PubMed

    Barzekar, Hosein; Karami, Mahtab

    2014-10-01

    to examine the organizational factors affecting the application of information technology in hospitals. Since the organizational factors are one of the most important determinants of successful projects, by understanding their impact and identifying them it can help planning a systematic IT implementation. In this cross-sectional descriptive study 110 middle managers were chosen from teaching hospitals. Structured questionnaire was used for the data collection. There was a significant relationship between organization resource, organizational knowledge, process, management structure and values and goals with implementation of information technology. Findings showed that organizational factors had a considerable impact on implementation of information technology. Top managers must consider the important aspects of effective organizational factors.

  7. Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

    PubMed

    Jones, Eleri; Lattof, Samantha R; Coast, Ernestina

    2017-08-31

    The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

  8. Organizational Factors that Affect the Implementation of Information Technology: Perspectives of Middle Managers in Iran

    PubMed Central

    Barzekar, Hosein; Karami, Mahtab

    2014-01-01

    ABSTRACT Objective: to examine the organizational factors affecting the application of information technology in hospitals. Since the organizational factors are one of the most important determinants of successful projects, by understanding their impact and identifying them it can help planning a systematic IT implementation. Methods: In this cross-sectional descriptive study 110 middle managers were chosen from teaching hospitals. Structured questionnaire was used for the data collection. Results: There was a significant relationship between organization resource, organizational knowledge, process, management structure and values and goals with implementation of information technology. Conclusion: Findings showed that organizational factors had a considerable impact on implementation of information technology. Top managers must consider the important aspects of effective organizational factors. PMID:25568582

  9. Factors affecting the implementation of childhood vaccination communication strategies in Nigeria: a qualitative study.

    PubMed

    Oku, Afiong; Oyo-Ita, Angela; Glenton, Claire; Fretheim, Atle; Eteng, Glory; Ames, Heather; Muloliwa, Artur; Kaufman, Jessica; Hill, Sophie; Cliff, Julie; Cartier, Yuri; Bosch-Capblanch, Xavier; Rada, Gabriel; Lewin, Simon

    2017-02-15

    The role of health communication in vaccination programmes cannot be overemphasized: it has contributed significantly to creating and sustaining demand for vaccination services and improving vaccination coverage. In Nigeria, numerous communication approaches have been deployed but these interventions are not without challenges. We therefore aimed to explore factors affecting the delivery of vaccination communication in Nigeria. We used a qualitative approach and conducted the study in two states: Bauchi and Cross River States in northern and southern Nigeria respectively. We identified factors affecting the implementation of communication interventions through interviews with relevant stakeholders involved in vaccination communication in the health services. We also reviewed relevant documents. Data generated were transcribed verbatim and analysed using thematic analysis. We used the SURE framework to organise the identified factors (barriers and facilitators) affecting vaccination communication delivery. We then grouped these into health systems and community level factors. Some of the commonly reported health system barriers amongst stakeholders interviewed included: funding constraints, human resource factors (health worker shortages, training deficiencies, poor attitude of health workers and vaccination teams), inadequate infrastructure and equipment and weak political will. Community level factors included the attitudes of community stakeholders and of parents and caregivers. We also identified factors that appeared to facilitate communication activities. These included political support, engagement of traditional and religious institutions and the use of organised communication committees. Communication activities are a crucial element of immunization programmes. It is therefore important for policy makers and programme managers to understand the barriers and facilitators affecting the delivery of vaccination communication so as to be able to implement

  10. Organizational factors affecting safety implementation in food companies in Thailand.

    PubMed

    Chinda, Thanwadee

    2014-01-01

    Thai food industry employs a massive number of skilled and unskilled workers. This may result in an industry with high incidences and accident rates. To improve safety and reduce the accident figures, this paper investigates factors influencing safety implementation in small, medium, and large food companies in Thailand. Five factors, i.e., management commitment, stakeholders' role, safety information and communication, supportive environment, and risk, are found important in helping to improve safety implementation. The statistical analyses also reveal that small, medium, and large food companies hold similar opinions on the risk factor, but bear different perceptions on the other 4 factors. It is also found that to improve safety implementation, the perceptions of safety goals, communication, feedback, safety resources, and supervision should be aligned in small, medium, and large companies.

  11. Factors affecting speech pathologists' implementation of stroke management guidelines: a thematic analysis.

    PubMed

    Miao, Melissa; Power, Emma; O'Halloran, Robyn

    2015-01-01

    Although clinical practice guidelines can facilitate evidence-based practice and improve the health outcomes of stroke patients, they continue to be underutilised. There is limited research into the reasons for this, especially in speech pathology. This study provides the first in-depth, qualitative examination of the barriers and facilitators that speech pathologists perceive and experience when implementing guidelines. A maximum variation sample of eight speech pathologists participated in a semi-structured interview concerning the implementation of the National Stroke Foundation's Clinical Guidelines for Stroke Management 2010. Interviews were transcribed, thematically analysed and member checked before overall themes were identified. Three main themes and ten subthemes were identified. The first main theme, making implementation explicit, reflected the necessity of accessing and understanding guideline recommendations, and focussing specifically on implementation in context. In the second theme, demand versus ability to change, the size of changes required was compared with available resources and collaboration. The final theme, Speech pathologist motivation to implement guidelines, demonstrated the influence of individual perception of the guidelines and personal commitment to improved practice. Factors affecting implementation are complex, and are not exclusively barriers or facilitators. Some potential implementation strategies are suggested. Further research is recommended. In most Western nations, stroke remains the single greatest cause of disability, including communication and swallowing disabilities. Although adherence to stroke clinical practice guidelines improves stroke patient outcomes, guidelines continue to be underutilised, and the reasons for this are not well understood. This is the first in-depth qualitative study identifying the complex barriers and facilitators to guideline implementation as experienced by speech pathologists in stroke care

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

    PubMed

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

    2013-01-01

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

  13. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping.

    PubMed

    Green, Amy E; Aarons, Gregory A

    2011-09-07

    The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.

  14. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping

    PubMed Central

    2011-01-01

    Background The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Methods Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. Results A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. Conclusions EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light. PMID:21899754

  15. Do Program Implementation Factors or Fidelity Affect Chronic Disease Self-Management Education Programs' Outcomes?

    PubMed

    Brady, Teresa J; Murphy, Louise B; O'Colmain, Benita J; Hobson, Reeti Desai

    2017-09-01

    To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. Community. N = 10 792. Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. Meta-analysis using pooled effect sizes. Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.

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

    PubMed

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

    2014-01-01

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

  17. The impact of middle manager affective commitment on perceived improvement program implementation success.

    PubMed

    Fryer, Ashley-Kay; Tucker, Anita L; Singer, Sara J

    Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success. We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment. We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units' falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success. Middle manager affective commitment to their unit's falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers' affective commitment to their unit's falls program mediates the relationship between perceived organizational support for the program and perceived implementation success. We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program. Increasing levels of middle manager affective

  18. Factors affecting caregivers' ability to make environmental modifications.

    PubMed

    Messecar, D C

    2000-12-01

    This study explored factors that family caregivers described as affecting their ability to use environmental modifications. Intensive interviews and participant observation were used to collect detailed data from 24 primary family caregivers. Several factors that affect the caregivers' ability to implement modification strategies were identified in the analysis. These factors included attributes of the elderly individual, attributes of the modification, quality of the caregiver-elderly relationship, caregivers' skills, personal resources of the caregiver, and the informal and formal supports available. Of these factors, the most important were the salient skills that caregivers need to implement environmental modifications. These findings point to the importance of caregivers receiving skills training in this important dimension of caregiving. Intervention should be based on a collaborative approach that ensures the caregiver and care receiver's needs and preferences are respected.

  19. Factors affecting construction performance: exploratory factor analysis

    NASA Astrophysics Data System (ADS)

    Soewin, E.; Chinda, T.

    2018-04-01

    The present work attempts to develop a multidimensional performance evaluation framework for a construction company by considering all relevant measures of performance. Based on the previous studies, this study hypothesizes nine key factors, with a total of 57 associated items. The hypothesized factors, with their associated items, are then used to develop questionnaire survey to gather data. The exploratory factor analysis (EFA) was applied to the collected data which gave rise 10 factors with 57 items affecting construction performance. The findings further reveal that the items constituting ten key performance factors (KPIs) namely; 1) Time, 2) Cost, 3) Quality, 4) Safety & Health, 5) Internal Stakeholder, 6) External Stakeholder, 7) Client Satisfaction, 8) Financial Performance, 9) Environment, and 10) Information, Technology & Innovation. The analysis helps to develop multi-dimensional performance evaluation framework for an effective measurement of the construction performance. The 10 key performance factors can be broadly categorized into economic aspect, social aspect, environmental aspect, and technology aspects. It is important to understand a multi-dimension performance evaluation framework by including all key factors affecting the construction performance of a company, so that the management level can effectively plan to implement an effective performance development plan to match with the mission and vision of the company.

  20. Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures

    PubMed Central

    2013-01-01

    Background Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level framework that captures the predominant factors that impact implementation outcomes, conduct a systematic review of available measures assessing constructs subsumed within these primary factors, and determine the criterion validity of these measures in the search articles. Method We conducted a systematic literature review to identify articles reporting the use or development of measures designed to assess constructs that predict the implementation of evidence-based health innovations. Articles published through 12 August 2012 were identified through MEDLINE, CINAHL, PsycINFO and the journal Implementation Science. We then utilized a modified five-factor framework in order to code whether each measure contained items that assess constructs representing structural, organizational, provider, patient, and innovation level factors. Further, we coded the criterion validity of each measure within the search articles obtained. Results Our review identified 62 measures. Results indicate that organization, provider, and innovation-level constructs have the greatest number of measures available for use, whereas structural and patient-level constructs have the least. Additionally, relatively few measures demonstrated criterion validity, or reliable association with an implementation outcome (e.g., fidelity). Discussion In light of these findings, our discussion centers on strategies that researchers can utilize in order to identify, adapt, and improve extant measures for use in their own implementation research. In total, our literature review and resulting measures compendium increases the capacity of researchers to conceptualize and measure implementation

  1. Factors Affecting Service Learning Implementation: A Comparison of Novice and Veteran Teachers

    ERIC Educational Resources Information Center

    Losser, Janet L.; Caldarella, Paul; Black, Sharon J.; Pate, P. Elizabeth

    2018-01-01

    This qualitative study investigated factors that facilitate and hinder implementation of service learning for novice and veteran teachers. We conducted case studies of three novice teachers and three veteran teachers, using a cross-case analysis within and across groups. Confirming prior research, facilitating factors included teachers' knowledge…

  2. Factors Affecting the Implementation of Argument in the Elementary Science Classroom. A Longitudinal Case Study

    NASA Astrophysics Data System (ADS)

    Martin, Anita M.; Hand, Brian

    2009-01-01

    This longitudinal case study describes the factors that affect an experienced teacher’s attempt to shift her pedagogical practices in order to implement embedded elements of argument into her science classroom. Research data was accumulated over 2 years through video recordings of science classes. The Reformed Teacher Observation Protocol (RTOP) is an instrument designed to quantify changes in classroom environments as related to reform as defined by the National Research Council ( National science education standards. Washington, DC: National Academy Press, 1996b) and the National Research Council ( Fulfilling the promise: Biology education in the nation’s schools, Washington, DC: National Academy Press, 1990) and was used to analyze videotaped science lessons. Analysis of the data shows that there was a significant shift in the areas of teacher questioning, and student voice. Several levels of subsequent analysis were completed related to teacher questioning and student voice. The data suggests a relationship between these areas and the implementation of scientific argument. Results indicate that the teacher moved from a traditional, teacher-centered, didactic teaching style to instructional practices that allowed the focus and direction of the lesson to be affected by student voice. This was accomplished by a change in teacher questioning that included a shift from factual recall to more divergent questioning patterns allowing for increased student voice. As student voice increased, students began to investigate ideas, make statements or claims and to support these claims with strong evidence. Finally, students were observed refuting claims in the form of rebuttals. This study informs professional development related to experienced teachers in that it highlights pedagogical issues involved in implementing embedded elements of argument in the elementary classroom.

  3. Factors Affecting the Transformational Leadership Role of Principals in Implementing ICT in Schools

    ERIC Educational Resources Information Center

    Afshari, Mojgan; Bakar, Kamariah Abu; Luan, Wong Su; Siraj, Saedah

    2012-01-01

    Leadership is an important factor in the effective implementation of technology in schools. This study examines the transformational leadership role of principals to determine whether transformational leadership role of principals in ICT implementation in schools is influenced by the computer competence, level of computer use, and professional…

  4. Programmes for advance distribution of misoprostol to prevent post-partum haemorrhage: a rapid literature review of factors affecting implementation.

    PubMed

    Smith, Helen J; Colvin, Christopher J; Richards, Esther; Roberson, Jeffrey; Sharma, Geeta; Thapa, Kusum; Gülmezoglu, A Metin

    2016-02-01

    Recent efforts to prevent post-partum haemorrhage (PPH) in low-income countries have focused on providing women with access to oral misoprostol during home birth. The WHO recommends using lay health workers (LHWs) to administer misoprostol in settings where skilled birth attendants are not available. This review synthesizes current knowledge about the barriers and facilitators affecting implementation of advance community distribution of misoprostol to prevent PPH, where misoprostol may be self-administered or administered by an LHW.We searched for and summarized available empirical evidence, and collected primary data from programme stakeholders about their experiences of programme implementation.We present key outcomes and features of advanced distribution programmes that are in operation or have been piloted globally. We categorized factors influencing implementation into those that operate at the health system level, factors related to the community and policy context and those factors more closely connected to the end user.Debates around advance distribution have centred on the potential risks and benefits of making misoprostol available to pregnant women and community members during pregnancy for administration in the home. However, the risks of advance distribution appear manageable and the benefits of self-administration, especially for women who have little chance of expert care for PPH, are considerable. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  5. An Analysis of Some Factors That Affect Curriculum Implementation in Upper Volta.

    ERIC Educational Resources Information Center

    Ouedraogo, Mathieu R.

    Proposed reforms in the educational system of Upper Volta have brought to the surface a variety of opposing and negative reactions against implementing suggested changes. Factors that have emerged to hamper change are: (1) language of instruction (French vs Voltaic); (2) concentration on productive instruction (e.g., animal husbandry) gives rise…

  6. Factors related to the implementation and diffusion of new technologies: a pilot study

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

    Not Available

    1979-06-01

    In order to develop an understanding of how government intervention affects the processes of implementation and diffusion of new technologies, case studies of 14 technologies were carried out: automobiles; broadcast radio; frozen foods; black and white TV; color TV; polio vaccine; supersonic transport; fluoridation of water supplies; computer-aided instruction; basic oxygen process for steel; numerical control in manufacturing; digital computers; lasers; and integrated circuit. The key factors, their motivations for implementing/adopting the technology (or not doing so), the interactions among the key factors, and how these affected implementation/adoption are examined.

  7. A Contextual Factors Framework to Inform Implementation and Evaluation of Public Health Initiatives

    ERIC Educational Resources Information Center

    Vanderkruik, Rachel; McPherson, Marianne E.

    2017-01-01

    Evaluating initiatives implemented across multiple settings can elucidate how various contextual factors may influence both implementation and outcomes. Understanding context is especially critical when the same program has varying levels of success across settings. We present a framework for evaluating contextual factors affecting an initiative…

  8. Understanding key factors affecting electronic medical record implementation: a sociotechnical approach.

    PubMed

    Cucciniello, Maria; Lapsley, Irvine; Nasi, Greta; Pagliari, Claudia

    2015-07-17

    Recent health care policies have supported the adoption of Information and Communication Technologies (ICT) but examples of failed ICT projects in this sector have highlighted the need for a greater understanding of the processes used to implement such innovations in complex organizations. This study examined the interaction of sociological and technological factors in the implementation of an Electronic Medical Record (EMR) system by a major national hospital. It aimed to obtain insights for managers planning such projects in the future and to examine the usefulness of Actor Network Theory (ANT) as a research tool in this context. Case study using documentary analysis, interviews and observations. Qualitative thematic analysis drawing on ANT. Qualitative analyses revealed a complex network of interactions between organizational stakeholders and technology that helped to shape the system and influence its acceptance and adoption. The EMR clearly emerged as a central 'actor' within this network. The results illustrate how important it is to plan innovative and complex information systems with reference to (i) the expressed needs and involvement of different actors, starting from the initial introductory phase; (ii) promoting commitment to the system and adopting a participative approach; (iii) defining and resourcing new roles within the organization capable of supporting and sustaining the change and (iv) assessing system impacts in order to mobilize the network around a common goal. The paper highlights the organizational, cultural, technological, and financial considerations that should be taken into account when planning strategies for the implementation of EMR systems in hospital settings. It also demonstrates how ANT may be usefully deployed in evaluating such projects.

  9. A mixed methods study of individual and organizational factors that affect implementation of interventions for children with autism in public schools.

    PubMed

    Locke, Jill; Beidas, Rinad S; Marcus, Steven; Stahmer, Aubyn; Aarons, Gregory A; Lyon, Aaron R; Cannuscio, Carolyn; Barg, Frances; Dorsey, Shannon; Mandell, David S

    2016-10-10

    The significant lifelong impairments associated with autism spectrum disorder (ASD), combined with the growing number of children diagnosed with ASD, have created urgency in improving school-based quality of care. Although many interventions have shown efficacy in university-based research, few have been effectively implemented and sustained in schools, the primary setting in which children with ASD receive services. Individual- and organizational-level factors have been shown to predict the implementation of evidence-based interventions (EBIs) for the prevention and treatment of other mental disorders in schools, and may be potential targets for implementation strategies in the successful use of autism EBIs in schools. The purpose of this study is to examine the individual- and organizational-level factors associated with the implementation of EBIs for children with ASD in public schools. We will apply the Domitrovich and colleagues (2008) framework that examines the influence of contextual factors (i.e., individual- and organizational-level factors) on intervention implementation in schools. We utilize mixed methods to quantitatively test whether the factors identified in the Domitrovich and colleagues (2008) framework are associated with the implementation of autism EBIs, and use qualitative methods to provide a more comprehensive understanding of the factors associated with successful implementation and sustainment of these interventions with the goal of tailoring implementation strategies. The results of this study will provide an in-depth understanding of individual- and organizational-level factors that influence the successful implementation of EBIs for children with ASD in public schools. These data will inform potential implementation targets and tailoring of strategies that will help schools overcome barriers to implementation and ultimately improve the services and outcomes for children with ASD.

  10. An evaluation of factors which can affect the implementation of a health promotion programme under the Schools for Health in Europe framework.

    PubMed

    Bennett, Annemarie E; Cunningham, Cara; Johnston Molloy, Charlotte

    2016-08-01

    The Health Promoting Schools concept helps schools to promote health in a sustainable and long-term fashion. However, developing the capacity to promote health in this way can be challenging when a busy teaching curriculum must be fulfilled. This study aimed to identify factors which affect the acceptability of health promotion programmes to the everyday school environment. Semi-structured qualitative interviews were audio-taped with primary school teachers in one Irish county and transcribed verbatim. The resulting transcripts were analysed using content analysis. Thirty-one teachers were interviewed. The factors which may adversely affect the acceptability of health promotion programmes include the: attitude of teachers towards an additional extra-curricular workload; lack of confidence amongst teachers to lead health promotion; and different organisational cultures between schools. When health promotion programmes under the Health Promoting Schools concept are being implemented, it's important to consider: the readiness for change amongst teachers; the resources available to increase staff capacity to promote health; and the ability of a programme to adapt to the different organisational cultures between schools. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Critical factors of implementing Industrialised Building System in Sarawak: A research on SMEs

    NASA Astrophysics Data System (ADS)

    Hadi, N. A.; Muhamad, W. M. N. W.; Othman, M. K. F.

    2017-05-01

    Industrialised Building System (IBS) have been adopted in Malaysia for over five decades and is expected to grow consistent with Malaysia's economic development. In promoting the adoption of IBS in construction projects, the government has taken several steps such as levy exemption for contractors and developers. Despite its numerous advantages and efforts pulled by the government, the implementation and adoption of IBS are still below the expected figure. Many researchers investigated readiness, setbacks and issues related to the implementation of IBS in Malaysia's construction projects. However, most of the research mainly for projects located in urban areas of West Malaysia. Therefore, this paper aims to close the gap on factors affecting the implementation of IBS for SMEs in Sarawak, where the level urbanisation is low. A semi-structured interview was conducted with 10 SME's contractors to get better insight view. The study found that logistics and infrastructure problems, a limited number of the manufacturer, lack of incentive, conventional payment methods, lack of financial supports are among critical factors affecting the implementation of IBS. Therefore, it was concluded that government plays major role in providing supports, incentives and facilitating the improvement of infrastructure to successfully implementing IBS in Sarawak.

  12. Review of critical factors for SEA implementation

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

    Zhang Jie, E-mail: jasmine@plan.aau.dk; Christensen, Per; Kornov, Lone

    The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure in implementation theory. Firstly, we introduce implementation theory, and then use it inmore » practice to establish a more comprehensive model related to the stages in the implementation process. Secondly, we identify the critical factors in order to see how they are related to the different stages of SEA or are more general in character. Finally we map the different critical factors and how they influence the overall results of an SEA. Based on a literature review, we present a comprehensive picture of the critical factors and where they are found in the process. We conclude that most of the critical factors identified are of a more general character influencing the SEA process as such, while only one out of four of these factors relates to the specific stages of the SEA. Based on this mapping we can sketch a picture of the totality of critical factors. In this study 266 notions of critical factors were identified. Seen at the level of notions of critical factors, only 24% of these relate to specific stages while for 76% the critical factors are of a more general nature. These critical factors interact in complex ways and appear in different combinations in different stages of the implementation process so tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice

  13. Factors affecting sustainability of rural water schemes in Swaziland

    NASA Astrophysics Data System (ADS)

    Peter, Graciana; Nkambule, Sizwe E.

    The Millennium Development Goal (MDG) target to reduce the proportion of people without sustainable access to safe drinking water by the year 2015 has been met as of 2010, but huge disparities exist. Some regions, particularly Sub-Saharan Africa are lagging behind it is also in this region where up to 30% of the rural schemes are not functional at any given time. There is need for more studies on factors affecting sustainability and necessary measures which when implemented will improve the sustainability of rural water schemes. The main objective of this study was to assess the main factors affecting the sustainability of rural water schemes in Swaziland using a Multi-Criteria Analysis Approach. The main factors considered were: financial, social, technical, environmental and institutional. The study was done in Lubombo region. Fifteen functional water schemes in 11 communities were studied. Data was collected using questionnaires, checklist and focused group discussion guide. A total of 174 heads of households were interviewed. Statistical Package for Social Sciences (SPSS) was used to analyse the data and to calculate sustainability scores for water schemes. SPSS was also used to classify sustainability scores according to sustainability categories: sustainable, partially sustainable and non-sustainable. The averages of the ratings for the different sub-factors studied and the results on the sustainability scores for the sustainable, partially sustainable and non-sustainable schemes were then computed and compared to establish the main factors influencing sustainability of the water schemes. The results indicated technical and social factors as most critical while financial and institutional, although important, played a lesser role. Factors which contributed to the sustainability of water schemes were: functionality; design flow; water fetching time; ability to meet additional demand; use by population; equity; participation in decision making on operation and

  14. The Integration of Technology into School Curriculum in Saudi Arabia: Factors Affecting Technology Implementation in the Classroom

    ERIC Educational Resources Information Center

    Barri, Moatasim A.

    2013-01-01

    There are a number of factors that influence technology implementation in the classroom including teachers' concerns; barriers; and intrinsic incentives. These factors give classroom teachers a chance to make a shift in their thinking and practice to help them properly integrate technology across the curriculum. This study was designed to assess:…

  15. Factors Affecting the Full Use of Library and Information Management Systems by Library Personnel

    ERIC Educational Resources Information Center

    Skretas, Georgios

    2005-01-01

    Purpose: To provide a general list of factors that affects and determines the full use of library information management systems (LIMS) by library staff. Design/methodology/approach: The factors, which were identified mainly during participation in the implementation of automation projects in Greece, are listed and briefly analysed in categories…

  16. Genetic factors affecting dental caries risk.

    PubMed

    Opal, S; Garg, S; Jain, J; Walia, I

    2015-03-01

    This article reviews the literature on genetic aspects of dental caries and provides a framework for the rapidly changing disease model of caries. The scope is genetic aspects of various dental factors affecting dental caries. The PubMed database was searched for articles with keywords 'caries', 'genetics', 'taste', 'diet' and 'twins'. This was followed by extensive handsearching using reference lists from relevant articles. The post-genomic era will present many opportunities for improvement in oral health care but will also present a multitude of challenges. We can conclude from the literature that genes have a role to play in dental caries; however, both environmental and genetic factors have been implicated in the aetiology of caries. Additional studies will have to be conducted to replicate the findings in a different population. Identification of genetic risk factors will help screen and identify susceptible patients to better understand the contribution of genes in caries aetiopathogenesis. Information derived from these diverse studies will provide new tools to target individuals and/or populations for a more efficient and effective implementation of newer preventive measures and diagnostic and novel therapeutic approaches in the management of this disease. © 2015 Australian Dental Association.

  17. 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

  18. 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

  19. Factors affecting sign retroreflectivity

    DOT National Transportation Integrated Search

    2001-01-01

    This study was undertaken to better understand the factors that may affect road sign retroreflectivity, specifically age and physical orientation. A better understanding of these factors could provide guidance to ODOT in managing its inventory of roa...

  20. Attitudes Affecting Online Learning Implementation in Higher Education Institutions

    ERIC Educational Resources Information Center

    Mitchell, Betty; Geva-May, Iris

    2009-01-01

    This study explores attitudes towards and affecting online learning implementation (OLI). In recent years there has been greater acceptance of online learning (OL) by institutional decision-makers, as evidenced by higher levels of institutional involvement; nevertheless, the increase in faculty acceptance lags behind. This gap affects the…

  1. Factors affecting scholastic performances of adolescents.

    PubMed

    Shashidhar, Saraswati; Rao, Chandrika; Hegde, Radhakrishna

    2009-05-01

    The present study aims at recognizing the social influence, study habits and health factors affecting scholastic performances of adolescents and to compare these factors among the adolescents between two categories of school. A total of 1230 adolescents (13-18 yrs) were screened. Data was collected by personal interview, using the teenage screening questionnaire, Trivandrum, between May 2004 and November 2005. A total 615 students from corporation and private schools were studied. 39.76% (489) were high achievers, 13.5% (166) were low achievers with p < 0.001. In the low achievers, 12.03% were from the corporation schools and 1.46% from private schools. The incidence of poor study habits and social factors were increased in low achievers of corporation schools. On multivariate analysis, the predictor variables for poor scholastic performance were adolescent having refractory error, not having help for study at home, not doing home work regularly, not solving question bank papers and reading only before examinations. It is feasible and worthwhile to identify the determinants of scholastic performance and plan intervention strategies at each school. The results of this study highlight the importance of implementing newer strategies, focusing on strict study patterns and creating the conducive school and home environment for study, so as to achieve better scholastic performances.

  2. Succesful Lean Manufacturing Implementation: Internal Key Influencing Factors

    NASA Astrophysics Data System (ADS)

    Virginia, Iuga; Claudiu, Kifor

    2015-09-01

    Manufacturing sectors and companies all over the world are successfully implementing lean principles within their processes. Nowadays, lean has become an indispensable part of global players. Companies worldwide need to be aware of multiple factors which weigh heavily on the success or failure of lean implementation. This paper focuses on giving a brief and structured overview over the fundamental organizational factors which play a substantial role for the lean manufacturing (LM) implementation process. The study below focuses on internal factors which are indispensable for a successful LM implementation within organizations. It is imperative that these internal factors are known, recognized and taken into consideration during the whole LM implementation process. Ignoring their influence on the process's implementation may lead to endangering the expected results or to making the process more difficult which could result in much higher human resource consumption.

  3. Business process re-engineering in the logistics industry: a study of implementation, success factors, and performance

    NASA Astrophysics Data System (ADS)

    Shen, Chien-wen; Chou, Ching-Chih

    2010-02-01

    As business process re-engineering (BPR) is an important foundation to ensure the success of enterprise systems, this study would like to investigate the relationships among BPR implementation, BPR success factors, and business performance for logistics companies. Our empirical findings show that BPR companies outperformed non-BPR companies, not only on information processing, technology applications, organisational structure, and co-ordination, but also on all of the major logistics operations. Comparing the different perceptions of the success factors for BPR, non-BPR companies place greater emphasis on the importance of employee involvement while BPR companies are more concerned about the influence of risk management. Our findings also suggest that management attitude towards BPR success factors could affect performance with regard to technology applications and logistics operations. Logistics companies which have not yet implemented the BPR approach could refer to our findings to evaluate the advantages of such an undertaking and to take care of those BPR success factors affecting performance before conducting BPR projects.

  4. Factors Affecting Medical Service Quality.

    PubMed

    Mosadeghrad, Ali Mohammad

    2014-02-01

    A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

  5. [Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses].

    PubMed

    Citolino, Clairton Marcos Filho; Santos, Eduesley Santana; Silva, Rita de Cassia Gengo E; Nogueira, Lilia de Souza

    2015-12-01

    To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR) in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. The majority of nurses reported that the high number of professionals in the scenario (75.5%), the lack of harmony (77.6%) or stress of any member of staff (67.3%), lack of material and/or equipment failure (57.1%), lack of familiarity with the emergency trolleys (98.0%) and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1%) are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units.

  6. Dynamic Synchronization of Teacher-Students Affection in Affective Instruction

    ERIC Educational Resources Information Center

    Zhang, Wenhai; Lu, Jiamei

    2011-01-01

    Based on Bower's affective network theory, the article links the dynamic analysis of affective factors in affective instruction, and presents affective instruction strategic of dynamic synchronization between teacher and students to implement the best ideal mood that promotes students' cognition and affection together. In the process of teaching,…

  7. Factors affecting the implementation of green specifications in construction.

    PubMed

    Lam, Patrick T I; Chan, Edwin H W; Poon, C S; Chau, C K; Chun, K P

    2010-01-01

    Green specifications constitute one of the important elements in green construction. New sustainability requirements and changing priorities in construction management have spurred the emerging green specifications to a faster pace of development. A cross-sectional survey has been conducted in Hong Kong in 2007 to identify principal factors leading to the success of preparing green specifications. Based on extensive construction management literature, 20 variables concerning sustainable construction were summarized. Using the Mann-Whitney U-test, the subtle differences between stakeholders in specifying construction work have been detected even with the high consistency of the responses among the groups. Moreover, five independent factors for successful specification of green construction have been categorized by factor analysis. They are related to (1) green technology and techniques, (2) reliability and quality of specification, (3) leadership and responsibility, (4) stakeholder involvement, and (5) guide and benchmarking systems. Whilst the first and fourth factors are generally more important, different stakeholder groups have different emphases. The results of the survey have been validated against established principles. 2009 Elsevier Ltd. All rights reserved.

  8. Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

    PubMed

    Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

    2008-01-01

    To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p < .001). However, interdepartmental coordination for patient care was inversely related with antibiotic use in contrast to antimicrobial resistance spread prevention and control (p < .0001). Formalization and standardization may eliminate staff role conflict, whereas centralized authority may minimize ambiguity. Culture and communication likely promote internal trust, whereas information technology use

  9. Implementing human factors in clinical practice

    PubMed Central

    Timmons, Stephen; Baxendale, Bryn; Buttery, Andrew; Miles, Giulia; Roe, Bridget; Browes, Simon

    2015-01-01

    Objectives To understand whether aviation-derived human factors training is acceptable and useful to healthcare professionals. To understand whether and how healthcare professionals have been able to implement human factors approaches to patient safety in their own area of clinical practice. Methods Qualitative, longitudinal study using semi-structured interviews and focus groups, of a multiprofessional group of UK NHS staff (from the emergency department and operating theatres) who have received aviation-derived human factors training. Results The human factors training was evaluated positively, and thought to be both acceptable and relevant to practice. However, the staff found it harder to implement what they had learned in their own clinical areas, and this was principally attributed to features of the informal organisational cultures. Conclusions In order to successfully apply human factors approaches in hospital, careful consideration needs to be given to the local context and informal culture of clinical practice. PMID:24631959

  10. Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity.

    PubMed

    Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne

    2008-01-18

    Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as

  11. Evaluating factors affecting the implementation of evidence based medicine in primary healthcare centers in Dubai.

    PubMed

    Albarrak, Ahmed I; Ali Abbdulrahim, Suhair Aqil; Mohammed, Rafiuddin

    2014-07-01

    To assess the current evidence based medicine (EBM) knowledge, attitude and perceptions of physicians at Dubai Primary Health Care Sector (PHCS). Further to evaluate barrier and facilitator factors toward implementing the EBM practice. A cross-sectional study, at Dubai PHCS, UAE between June and August 2010. The survey was composed of two phases. The first phase was a self administrated questionnaire employed for data collection and the second phase was qualitative method, which was in the form of individual interviews. Statistical Package for Social Sciences (SPSS) was used for data analysis. In total 48 participants responded to the survey questionnaire and 13 responded to individual interviews. The response rate was 70.0%. Mean age was 42.18 (SD 10.46). The majority were females (64.6%). The physicians who attended EBM courses reported 70.30% using EBM and showed statistical significance (p = 0.002) from those who did not attend the EBM courses. 65.0% believe that 50-75% of the patients are capable of participating in clinical decision while 71.8% disagreed that the concept of EBM is not applicable to their culture. In addition they showed significance (p = 0.03) between physician beliefs with regard to patient capacity to take decision. About 67.0% of the family physicians were knowledgeable and followed systematic review as the strongest evidence. They had no access to the EBM resources (37.0%) and had no time to practice the EBM (38.0%). Nearly 40.0% interviewees reported lack of encouragement to attend EBM courses. EBM activities (22.0%) and active audit (18.0%) were top rated facilitating factors. EBM is not fully utilized by indefinite physicians in the Dubai PHC sector. Factors associated with non-utilization of EBM in the PHCS are lack of encouragement to attend EBM courses, senior physicians resist adoption of EBM, lack of time and insufficient dissemination process for implementing the clinical guideline.

  12. Evaluating factors affecting the implementation of evidence based medicine in primary healthcare centers in Dubai

    PubMed Central

    Albarrak, Ahmed I.; Ali Abbdulrahim, Suhair Aqil; Mohammed, Rafiuddin

    2013-01-01

    Objectives To assess the current evidence based medicine (EBM) knowledge, attitude and perceptions of physicians at Dubai Primary Health Care Sector (PHCS). Further to evaluate barrier and facilitator factors toward implementing the EBM practice. Methodology A cross-sectional study, at Dubai PHCS, UAE between June and August 2010. The survey was composed of two phases. The first phase was a self administrated questionnaire employed for data collection and the second phase was qualitative method, which was in the form of individual interviews. Statistical Package for Social Sciences (SPSS) was used for data analysis. Results In total 48 participants responded to the survey questionnaire and 13 responded to individual interviews. The response rate was 70.0%. Mean age was 42.18 (SD 10.46). The majority were females (64.6%). The physicians who attended EBM courses reported 70.30% using EBM and showed statistical significance (p = 0.002) from those who did not attend the EBM courses. 65.0% believe that 50–75% of the patients are capable of participating in clinical decision while 71.8% disagreed that the concept of EBM is not applicable to their culture. In addition they showed significance (p = 0.03) between physician beliefs with regard to patient capacity to take decision. About 67.0% of the family physicians were knowledgeable and followed systematic review as the strongest evidence. They had no access to the EBM resources (37.0%) and had no time to practice the EBM (38.0%). Nearly 40.0% interviewees reported lack of encouragement to attend EBM courses. EBM activities (22.0%) and active audit (18.0%) were top rated facilitating factors. Conclusions EBM is not fully utilized by indefinite physicians in the Dubai PHC sector. Factors associated with non-utilization of EBM in the PHCS are lack of encouragement to attend EBM courses, senior physicians resist adoption of EBM, lack of time and insufficient dissemination process for implementing the clinical guideline

  13. Factors Influencing Implementation of a Physical Activity Intervention in Residential Children's Homes.

    PubMed

    Lau, Erica Y; Saunders, Ruth P; Pate, Russell R

    2016-11-01

    The Environmental Intervention in Children's Homes (ENRICH) study was the first published physical activity intervention undertaken in residential children's homes (RCHs). The study revealed differences in implementation across the homes, which may be a key factor that affects program effectiveness. The purpose of this study was to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation of the ENRICH intervention. This study analyzed the ENRICH process evaluation data collected from 24 RCHs. Bayesian Path analysis was used to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation. Level of implementation across RCHs was variable, ranging from 38 to 97 % (M = 68.3, SD = 14.45). Results revealed that organizational capacity and provider characteristics had significant direct associations with level of implementation. Neither direct nor indirect associations between quality of prevention support system and level of implementation reached statistical significance. Conducting formative assessments on organizational capacity and provider characteristics and incorporating such information in implementation planning may increase the likelihood of achieving higher levels of implementation in future studies.

  14. Causes and remedies for the dominant risk factors in Enterprise System implementation projects: the consultants' perspective.

    PubMed

    Lech, Przemysław

    2016-01-01

    The purpose of this research was to investigate the causes of the dominant risk factors, affecting Enterprise System implementation projects and propose remedies for those risk factors from the perspective of implementation consultants. The study used a qualitative research strategy, based on e-mail interviews, semi-structured personal interviews with consultants and participant observation during implementation projects. The main contribution of this paper is that it offers viable indications of how to mitigate the dominant risk factors. These indications were grouped into the following categories: stable project scope, smooth communication supported by the project management, dedicated, competent and decision-making client team, competent and engaged consultant project manager, schedule and budget consistent with the project scope, use of methodology and procedures, enforced and enabled by the project managers, competent and dedicated consultants. A detailed description is provided for each category.

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

    PubMed Central

    2013-01-01

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

  16. Factors affecting the implementation of health legislation and its impact on the rural poor in China: a case study of implementation of the maternal and infant health care law in two poor counties.

    PubMed

    Tolhurst, Rachel; Zhang, Tuohong; Yang, Hui; Gao, Jun; Tang, Shenglan

    2004-01-01

    This paper presents and discusses a case study of health legislation in China. In the transition to a market economy, legislation has been developed to offset the weakening in the central planning mechanism and political control that have historically influenced the behaviour of institutions and individuals in the Ministry of Health. There has been relatively little empirical examination of the implementation and impact of legislation as a tool for influencing health service provision in low-income countries. The study aimed to contribute towards filling this gap by exploring the factors affecting the implementation and impact of the Maternal and Infant Health Care Law, through a case study of two poor, rural counties in Chongqing municipality, China. The study found that key local actors perceive health legislation to be an important tool for safeguarding access to essential health care. However, the implementation of health legislation is inevitably a political process. The study illustrates the difficulties involved in efforts to influence provider behaviour through a national level legislative framework in a situation of decentralization of control over those providers, due to extreme regional variation in economic situations and limited resource inputs from the centre. Lessons are drawn for Chinese and international policy makers.

  17. Motivational Factors Affecting Athletes in Selecting the Sport Branches of Athletics, Ski and Tennis

    ERIC Educational Resources Information Center

    Akyüz, Murat; Agar, Muharrem; Akyüz, Öznur; Dogru, Yeliz

    2016-01-01

    The aim of this study is to research the motivational factors affecting athletes to select the branches of athletics, ski and tennis. Within the scope of the research, the survey developed by H. Sunay in 1996 was implemented and solution for the problem of the research was searched through the findings that were obtained from the survey. SPSS…

  18. Factors Affecting Tocopherol Concentrations in Soybean Seeds.

    PubMed

    Carrera, Constanza S; Seguin, Philippe

    2016-12-21

    Soybean seeds contain several health-beneficial compounds, including tocopherols, which are used by the nutraceutical and functional food industries. Soybean tocopherol concentrations are, however, highly variable. Large differences observed in tocopherol concentrations among soybean genotypes together with the relatively simple biosynthetic pathway involving few genes support the feasibility of selecting for high-tocopherol soybean. Tocopherol concentrations are also highly influenced by environmental factors and field management. Temperature during seed filling and soil moisture appear to be the main factors affecting tocopherol concentrations; other factors such as soil fertility and solar radiation also affect concentrations and composition. Field management decisions including seeding date, row spacing, irrigation, and fertilization also affect tocopherols. Knowledge of factors affecting soybean tocopherols is essential to develop management strategies that will lead to the production of seeds with consistent target concentrations that will meet the needs of the nutraceutical and functional food industries.

  19. Web-based Factors Affecting Online Purchasing Behaviour

    NASA Astrophysics Data System (ADS)

    Ariff, Mohd Shoki Md; Sze Yan, Ng; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Jusoh, Ahmad

    2013-06-01

    The growing use of internet and online purchasing among young consumers in Malaysia provides a huge prospect in e-commerce market, specifically for B2C segment. In this market, if E-marketers know the web-based factors affecting online buyers' behaviour, and the effect of these factors on behaviour of online consumers, then they can develop their marketing strategies to convert potential customers into active one, while retaining existing online customers. Review of previous studies related to the online purchasing behaviour in B2C market has point out that the conceptualization and empirical validation of the online purchasing behaviour of Information and Communication Technology (ICT) literate users, or ICT professional, in Malaysia has not been clearly addressed. This paper focuses on (i) web-based factors which online buyers (ICT professional) keep in mind while shopping online; and (ii) the effect of web-based factors on online purchasing behaviour. Based on the extensive literature review, a conceptual framework of 24 items of five factors was constructed to determine web-based factors affecting online purchasing behaviour of ICT professional. Analysis of data was performed based on the 310 questionnaires, which were collected using a stratified random sampling method, from ICT undergraduate students in a public university in Malaysia. The Exploratory factor analysis performed showed that five factors affecting online purchase behaviour are Information Quality, Fulfilment/Reliability/Customer Service, Website Design, Quick and Details, and Privacy/Security. The result of Multiple Regression Analysis indicated that Information Quality, Quick and Details, and Privacy/Security affect positively online purchase behaviour. The results provide a usable model for measuring web-based factors affecting buyers' online purchase behaviour in B2C market, as well as for online shopping companies to focus on the factors that will increase customers' online purchase.

  20. Implementing human factors in clinical practice.

    PubMed

    Timmons, Stephen; Baxendale, Bryn; Buttery, Andrew; Miles, Giulia; Roe, Bridget; Browes, Simon

    2015-05-01

    To understand whether aviation-derived human factors training is acceptable and useful to healthcare professionals. To understand whether and how healthcare professionals have been able to implement human factors approaches to patient safety in their own area of clinical practice. Qualitative, longitudinal study using semi-structured interviews and focus groups, of a multiprofessional group of UK NHS staff (from the emergency department and operating theatres) who have received aviation-derived human factors training. The human factors training was evaluated positively, and thought to be both acceptable and relevant to practice. However, the staff found it harder to implement what they had learned in their own clinical areas, and this was principally attributed to features of the informal organisational cultures. In order to successfully apply human factors approaches in hospital, careful consideration needs to be given to the local context and informal culture of clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Electronic health records: critical success factors in implementation.

    PubMed

    Safdari, Reza; Ghazisaeidi, Marjan; Jebraeily, Mohamad

    2015-04-01

    EHR implementation results in the improved quality of care, customer-orientation and timely access to complete information. Despite the potential benefits of EHR, its implementation is a difficult and complex task whose success depends on many factors. The purpose of this research is indeed to identify the key success factors of EHR. This is a cross-sectional survey conducted with participation of 340 work forces from different types of job from Hospitals of TUMS in 2014. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS software descriptive statistics and analytical statistics. 58.2% of respondents were female and their mean age and work experience were 37.7 and 11.2 years, respectively and most respondents (52.5%) was bachelor. In terms of job, the maximum rate was related to nursing (33 %) and physician (21 %). the main category of critical success factors in Implementation EHRs, the highest rate related to Project Management (4.62) and lowest related to Organizational factors (3.98). success in implementation EHRs requirement more centralization to project management and human factors. Therefore must be Creating to EHR roadmap implementation, establishment teamwork to participation of end-users and select prepare leadership, users obtains sufficient training to use of system and also prepare support from maintain and promotion system.

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

    PubMed

    Echebiri, Vitalis C

    2015-06-01

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

  3. Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation.

    PubMed

    Vancampfort, Davy; Stubbs, Brendon

    2017-12-15

    One in ten and one in three of people with affective disorders experience diabetes and metabolic syndrome respectively. Physical activity (PA) and sedentary behaviour (SB) are key risk factors that can ameliorate the risk of metabolic disease among this population. However, PA is often seen as luxury and/or a secondary component within the management of people with affective disorders. The current article provides a non-systematic best-evidence synthesis of the available literature, detailing a number of suggestions for the implementation of PA into clinical practice. Whilst the evidence is unequivocal for the efficacy of PA to prevent and manage metabolic disease in the general population, it is in its infancy in this patient group. Nonetheless, action must be taken now to ensure that PA and reducing SB are given a priority to prevent and manage metabolic diseases and improve wider health outcomes. PA should be treated as a vital sign and all people with affective disorders asked about their activity levels and if appropriate advised to increase this. There is a need for investment in qualified exercise specialists in clinical practice such as physiotherapists to undertake and oversee PA in practice. Behavioural strategies such as the self-determined theory should be employed to encourage adherence. Funding is required to develop the evidence base and elucidate the optimal intervention characteristics. PA interventions should form an integral part of the multidisciplinary management of people with affective disorders and our article outlines the evidence and strategies to implement this in practice. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Factors Affecting Wound Healing

    PubMed Central

    Guo, S.; DiPietro, L.A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds. PMID:20139336

  5. Factors affecting wound healing.

    PubMed

    Guo, S; Dipietro, L A

    2010-03-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds.

  6. Bio-psycho-social factors affecting sexual self-concept: A systematic review

    PubMed Central

    Potki, Robabeh; Ziaei, Tayebe; Faramarzi, Mahbobeh; Moosazadeh, Mahmood; Shahhosseini, Zohreh

    2017-01-01

    Background Nowadays, it is believed that mental and emotional aspects of sexual well-being are the important aspects of sexual health. Sexual self-concept is a major component of sexual health and the core of sexuality. It is defined as the cognitive perspective concerning the sexual aspects of ‘self’ and refers to the individual’s self-perception as a sexual creature. Objective The aim of this study was to assess the different factors affecting sexual self-concept. Methods English electronic databases including PubMed, Scopus, Web of Science and Google Scholar as well as two Iranian databases including Scientific Information Database and Iranmedex were searched for English and Persian-language articles published between 1996 and 2016. Of 281 retrieved articles, 37 articles were finally included for writing this review article. Results Factors affecting sexual self-concept were categorized to biological, psychological and social factors. In the category of biological factors, age gender, marital status, race, disability and sexual transmitted infections are described. In the psychological category, the impact of body image, sexual abuse in childhood and mental health history are present. Lastly, in the social category, the roles of parents, peers and the media are discussed. Conclusion As the development of sexual self-concept is influenced by multiple events in individuals’ lives, to promotion of sexual self-concept, an integrated implementation of health policies is recommended. PMID:29038693

  7. Bio-psycho-social factors affecting sexual self-concept: A systematic review.

    PubMed

    Potki, Robabeh; Ziaei, Tayebe; Faramarzi, Mahbobeh; Moosazadeh, Mahmood; Shahhosseini, Zohreh

    2017-09-01

    Nowadays, it is believed that mental and emotional aspects of sexual well-being are the important aspects of sexual health. Sexual self-concept is a major component of sexual health and the core of sexuality. It is defined as the cognitive perspective concerning the sexual aspects of 'self' and refers to the individual's self-perception as a sexual creature. The aim of this study was to assess the different factors affecting sexual self-concept. English electronic databases including PubMed, Scopus, Web of Science and Google Scholar as well as two Iranian databases including Scientific Information Database and Iranmedex were searched for English and Persian-language articles published between 1996 and 2016. Of 281 retrieved articles, 37 articles were finally included for writing this review article. Factors affecting sexual self-concept were categorized to biological, psychological and social factors. In the category of biological factors, age gender, marital status, race, disability and sexual transmitted infections are described. In the psychological category, the impact of body image, sexual abuse in childhood and mental health history are present. Lastly, in the social category, the roles of parents, peers and the media are discussed. As the development of sexual self-concept is influenced by multiple events in individuals' lives, to promotion of sexual self-concept, an integrated implementation of health policies is recommended.

  8. Implementation factors affecting the large-scale deployment of digital health and well-being technologies: A qualitative study of the initial phases of the 'Living-It-Up' programme.

    PubMed

    Agbakoba, Ruth; McGee-Lennon, Marilyn; Bouamrane, Matt-Mouley; Watson, Nicholas; Mair, Frances S

    2016-12-01

    Little is known about the factors which facilitate or impede the large-scale deployment of health and well-being consumer technologies. The Living-It-Up project is a large-scale digital intervention led by NHS 24, aiming to transform health and well-being services delivery throughout Scotland. We conducted a qualitative study of the factors affecting the implementation and deployment of the Living-It-Up services. We collected a range of data during the initial phase of deployment, including semi-structured interviews (N = 6); participant observation sessions (N = 5) and meetings with key stakeholders (N = 3). We used the Normalisation Process Theory as an explanatory framework to interpret the social processes at play during the initial phases of deployment.Initial findings illustrate that it is clear - and perhaps not surprising - that the size and diversity of the Living-It-Up consortium made implementation processes more complex within a 'multi-stakeholder' environment. To overcome these barriers, there is a need to clearly define roles, tasks and responsibilities among the consortium partners. Furthermore, varying levels of expectations and requirements, as well as diverse cultures and ways of working, must be effectively managed. Factors which facilitated implementation included extensive stakeholder engagement, such as co-design activities, which can contribute to an increased 'buy-in' from users in the long term. An important lesson from the Living-It-Up initiative is that attempting to co-design innovative digital services, but at the same time, recruiting large numbers of users is likely to generate conflicting implementation priorities which hinder - or at least substantially slow down - the effective rollout of services at scale.The deployment of Living-It-Up services is ongoing, but our results to date suggest that - in order to be successful - the roll-out of digital health and well-being technologies at scale requires a delicate and pragmatic trade

  9. Factors Affecting Sign Retroreflectivity : final report.

    DOT National Transportation Integrated Search

    2001-01-01

    This study was undertaken to better understand the factors that may affect road sign retroreflectivity, specifically age and physical orientation. A better understanding of these factors could provide guidance to ODOT in managing its inventory of roa...

  10. Factors affecting the stability of reverse shoulder arthroplasty: a biomechanical study.

    PubMed

    Clouthier, Allison L; Hetzler, Markus A; Fedorak, Graham; Bryant, J Tim; Deluzio, Kevin J; Bicknell, Ryan T

    2013-04-01

    Despite the success of reverse shoulder arthroplasty (RSA) in treating patients with painful pseudoparalytic shoulders, instability is a common complication and currently the factors affecting stability are not well understood. The objective of this study was to investigate a number of factors as well as the interactions between factors to determine how they affect the stability of the prosthesis. These factors included: active arm posture (abduction and abduction plane angles), loading direction, glenosphere diameter and eccentricity, and humeral socket constraint. Force required to dislocate the joint, determined using a biomechanical shoulder simulator, was used as a measure of stability. A factorial design experiment was implemented to examine the factors and interactions. Actively increasing the abduction angle by 15° leads to a 30% increase in stability and use of an inferior-offset rather than a centered glenosphere improved stability by 17%. Use of a more constrained humeral socket also increased stability; but the effect was dependent on loading direction, with a 88% improvement for superior loading, 66% for posterior, 36% for anterior, and no change for inferior loading. Abduction plane angle and glenosphere diameter had no effect on stability. Increased glenohumeral abduction and the use of an inferior-offset glenosphere were found to increase the stability of RSA. Additionally, use of a more constrained humeral socket increased stability for anterior, posterior, and superior loading. These identified factor effects have the potential to decrease the risk of dislocation following RSA. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  11. Factors affecting student achievement in science: A study of teacher beliefs

    NASA Astrophysics Data System (ADS)

    Hayes, Jonathan

    This study employed a mixed methods and mixed model research design to explore secondary science teachers' beliefs. Specifically, this study focused on factors that secondary science teachers believe affect student achievement in science, and the extent to which teacher beliefs transfer to teacher practice. This study is significant because the outcomes may inform professional development and policy decisions at the school, district, and provincial level. Results from self-reporting data of 82 secondary science teachers indicate that teacher beliefs in each of the fourteen topics surveyed (Classroom Management, Learning Styles, Inclusion, Equity, Science-Technology-Society (STS), Formative Assessment, Summative Assessment, Constructivism, Thematic Approach, Hands-On/Minds-On Activities, The Nature of Science, Science Subject Matter, Electronic Learning and Cooperative Learning) are positive for most Prince Edward Island (P.E.I.) secondary science teachers. Furthermore, secondary science teachers reported having strong beliefs in their ability to affect student learning (self-efficacy beliefs). However, it is apparent from the survey and interview data that teachers believe there are other influential factors that are preventing some students from learning despite the teachers' best efforts and ability. Regarding implementation, this study indicates that beliefs and the enactment of beliefs in classroom practice are positively correlated. The data also shows that at least seventy percent of teachers reported that they implement practices consistent with all but two topics -- The Nature of Science and Electronic Learning -- at least once a week. The findings of this study are discussed in the context of the P.E.I. secondary science setting. Limitations and implications of this study are also addressed.

  12. Implementing complex innovations: factors influencing middle manager support.

    PubMed

    Chuang, Emmeline; Jason, Kendra; Morgan, Jennifer Craft

    2011-01-01

    Middle manager resistance is often described as a major challenge for upper-level administrators seeking to implement complex innovations such as evidence-based protocols or new skills training. However, factors influencing middle manager support for innovation implementation are currently understudied in the U.S. health care literature. This article examined the factors that influence middle managers' support for and participation in the implementation of work-based learning, a complex innovation adopted by health care organizations to improve the jobs, educational pathways, skills, and/or credentials of their frontline workers. We conducted semistructured interviews and focus groups with 92 middle managers in 17 health care organizations. Questions focused on understanding middle managers' support for work-based learning as a complex innovation, facilitators and barriers to the implementation process, and the systems changes needed to support the implementation of this innovation. Factors that emerged as influential to middle manager support were similar to those found in broader models of innovation implementation within the health care literature. However, our findings extend previous research by developing an understanding about how middle managers perceived these constructs and by identifying specific strategies for how to influence middle manager support for the innovation implementation process. These findings were generally consistent across different types of health care organizations. Study findings suggest that middle manager support was highest when managers felt the innovation fit their workplace needs and priorities and when they had more discretion and control over how it was implemented. Leaders seeking to implement innovations should consider the interplay between middle managers' control and discretion, their narrow focus on the performance of their own departments or units, and the dedication of staff and other resources for empowering their

  13. Toward Digital Citizenship: Examining Factors Affecting Participation and Involvement in the Internet Society among Higher Education Students

    ERIC Educational Resources Information Center

    Al-Zahrani, Abdulrahman

    2015-01-01

    The current study aims to understand digital citizenship, based on the assumptions of Ribble (2014), by examining factors affecting participation and involvement in the Internet virtual societies among higher education students. A quantitative approach using a survey questionnaire was implemented. The participants were 174 students from the…

  14. Electronic health records implementation: an evaluation of information system impact and contingency factors.

    PubMed

    Nguyen, Lemai; Bellucci, Emilia; Nguyen, Linh Thuy

    2014-11-01

    This paper provides a review of EHR (electronic health record) implementations around the world and reports on findings including benefits and issues associated with EHR implementation. A systematic literature review was conducted from peer-reviewed scholarly journal publications from the last 10 years (2001-2011). The search was conducted using various publication collections including: Scopus, Embase, Informit, Medline, Proquest Health and Medical Complete. This paper reports on our analysis of previous empirical studies of EHR implementations. We analysed data based on an extension of DeLone and McLean's information system (IS) evaluation framework. The extended framework integrates DeLone and McLean's dimensions, including information quality, system quality, service quality, intention of use and usage, user satisfaction and net benefits, together with contingent dimensions, including systems development, implementation attributes and organisational aspects, as identified by Van der Meijden and colleagues. A mix of evidence-based positive and negative impacts of EHR was found across different evaluation dimensions. In addition, a number of contingent factors were found to contribute to successful implementation of EHR. This review does not include white papers or industry surveys, non-English papers, or those published outside the review time period. This review confirms the potential of this technology to aid patient care and clinical documentation; for example, in improved documentation quality, increased administration efficiency, as well as better quality, safety and coordination of care. Common negative impacts include changes to workflow and work disruption. Mixed observations were found on EHR quality, adoption and satisfaction. The review warns future implementers of EHR to carefully undertake the technology implementation exercise. The review also informs healthcare providers of contingent factors that potentially affect EHR development and

  15. Contextual factors related to implementation of classroom physical activity breaks.

    PubMed

    Carlson, Jordan A; Engelberg, Jessa K; Cain, Kelli L; Conway, Terry L; Geremia, Carrie; Bonilla, Edith; Kerner, Jon; Sallis, James F

    2017-09-01

    Brief structured physical activity in the classroom is effective for increasing student physical activity. The present study investigated the association between implementation-related contextual factors and intervention implementation after adoption of a structured classroom physical activity intervention. Six elementary-school districts adopted structured classroom physical activity programs in 2013-2014. Implementation contextual factors and intervention implementation (structured physical activity provided in past week or month, yes/no) were assessed using surveys of 337 classroom teachers from 24 schools. Mixed-effects models accounted for the nested design. Availability of resources (yes/no, ORs = 1.91-2.93) and implementation climate z-scores (ORs = 1.36-1.47) were consistently associated with implementation. Teacher-perceived classroom behavior benefits (OR = 1.29) but not student enjoyment or health benefits, and time (OR = 2.32) and academic (OR = 1.63) barriers but not student cooperation barriers were associated with implementation (all z-scores). Four implementation contextual factor composites had an additive association with implementation (OR = 1.64 for each additional favorable composite). Training and technical assistance alone may not support a large proportion of teachers to implement structured classroom physical activity. In addition to lack of time and interference with academic lessons, school climate related to whether administrators and other teachers were supportive of the intervention were key factors explaining whether teachers implemented the intervention. Evidence-based implementation strategies are needed for effectively communicating the benefits of classroom physical activity on student behavior and improving teacher and administrator climate/attitudes around classroom physical activity.

  16. Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review.

    PubMed

    Francke, Anneke L; Smit, Marieke C; de Veer, Anke J E; Mistiaen, Patriek

    2008-09-12

    Nowadays more and more clinical guidelines for health care professionals are being developed. However, this does not automatically mean that these guidelines are actually implemented. The aim of this meta-review is twofold: firstly, to gain a better understanding of which factors affect the implementation of guidelines, and secondly, to provide insight into the "state-of-the-art" regarding research within this field. A search of five literature databases and one website was performed to find relevant existing systematic reviews or meta-reviews. Subsequently, a two-step inclusion process was conducted: (1) screening on the basis of references and abstracts and (2) screening based on full-text papers. After that, relevant data from the included reviews were extracted and the methodological quality of the reviews was assessed by using the Quality Assessment Checklist for Reviews. Twelve systematic reviews met our inclusion criteria. No previous systematic meta-reviews meeting all our inclusion criteria were found. Two of the twelve reviews scored high on the checklist used, indicating only "minimal" or "minor flaws". The other ten reviews scored in the lowest of middle ranges, indicating "extensive" or "major" flaws. A substantial proportion (although not all) of the reviews indicates that effective strategies often have multiple components and that the use of one single strategy, such as reminders only or an educational intervention, is less effective. Besides, characteristics of the guidelines themselves affect actual use. For instance, guidelines that are easy to understand, can easily be tried out, and do not require specific resources, have a greater chance of implementation. In addition, characteristics of professionals - e.g., awareness of the existence of the guideline and familiarity with its content - likewise affect implementation. Furthermore, patient characteristics appear to exert influence: for instance, co-morbidity reduces the chance that guidelines

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

    PubMed Central

    2013-01-01

    Background An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of “context”, “process”, and “content”. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities? Methods We conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption. Results Of the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers’ findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the changes in ownership required

  18. Factors influencing the implementation of evidence in Chinese nursing practice.

    PubMed

    Cheng, Lei; Broome, Marion E; Feng, Sheng; Hu, Yan

    2017-12-01

    To explore the influencing factors from staff nurses, nurse managers, nursing directors and a physician involved in nursing evidence implementation in Mainland China. Although the need for evidence-based nursing is well recognised, continuous efforts are needed to strive for closing the gap from evidence to action. Previous studies have explored influencing factors from individual and organisational perspectives in Western countries. However, it remains unclear what the influences (i.e., context and culture) in the developing countries as China. A grounded theory design using in-depth individual interviews was conducted. Interviews with 56 participants from 24 evidence-based nursing implementation projects were conducted in Mainland China. Constant comparative analysis was used to discover the concepts describing the influencing factors during the implementation process. Factors that influenced implementation of evidence-based practice in the Chinese context were identified. These included the leaders of the projects, the nature of the evidence, practising nurses, patients involved in the projects, the system where the projects were implemented, as well as the influence from outside of the system. A variety of factors influencing evidence implementation in Chinese nursing context were identified and further explored from the perspective of different project leaders and culture influence. There is apparently a strong demand for a supportive system, targeted strategies to facilitate various evidence implementations and integrated core elements of evidence-based practice at the point care. The blurred boundaries and complexity of influencing factors call for a systematic and dynamic perspective during implementation. The competitive priorities emphasise the importance of integration between clinical nursing care and evidence-based practice. © 2017 John Wiley & Sons Ltd.

  19. Age Learning Factors Affecting Pilot Education.

    ERIC Educational Resources Information Center

    Torbert, Brison

    This document, intended for pilot education and flight safety specialists, consists chiefly of a review of the literature on physiological factors that affect pilot education and an examination of environmental factors that should be scrutinized in order to improve the effectiveness of aviation learning facilities. The physiological factors…

  20. Factors Affecting Husband Participation in Antenatal Care Attendance and Delivery

    NASA Astrophysics Data System (ADS)

    Rumaseuw, R.; Berliana, S. M.; Nursalam, N.; Efendi, F.; Pradanie, R.; Rachmawati, P. D.; Aurizki, G. E.

    2018-02-01

    The government has implemented several programs to prevent and reduce a mother’s mortality rate by enhancing active role of the family. The most responsible family member on maintaining the pregnancy and delivery process is the husband. The husband must be active to take care of his wife. Active participation of the husband in accompanying his wife during pregnancy and the delivery process is one of the substantial factors, which helps the husband to take decisions related to the health of his wife. This study aimed to identify variables and its trends, which significantly affect a husband’s participation in accompanying his wife during pregnancy and the delivery process. The data used in this study was from an Indonesian Demographic Health Survey 2012. The study used binary logistic regression as the analysis method. The result showed as many as 8,237 husbands accompanied their wife in antenatal care and the delivery process. The significant variables affecting the husband participation are the age of the wife, the education of wife, the education of the husband, the occupational status of the wife and the husband, the number of children, pregnancy status, and residency region. The possibility for a husband to accompany his wife is larger in several factors, such as the wife being between the ages of 21 - 35 years old, a husband who minimally graduated from junior high school, a working husband, as well as a wife, and the number of children less than and equal to two and the expected pregnancy. The government should consider those factors to create policy related women’s health and integrate the factors into various sectors.

  1. Factors Supporting Implementation among CDSMP Organizations.

    PubMed

    Paone, Deborah

    2014-01-01

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

  2. Factors Supporting Implementation among CDSMP Organizations

    PubMed Central

    Paone, Deborah

    2015-01-01

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

  3. Factors affecting registered nurses' use of medication administration technology in acute care settings: A systematic review.

    PubMed

    San, Tay Hui; Lin, Serena Koh Siew; Fai, Chan Moon

    Information technology to aid reduction in medication errors has been encouraged over the years and one of them is the medication administration technology. It consists of the electronic Medication Administration Record, Bar-Code Medication Administration system and Automated Medication Dispensing system. Studies had examined the effectiveness and impact of this technology to reduce medication error. However, user's acceptance towards this technology has often been neglected. To date, no systematic review has been undertaken to examine the possible factors that affect nurses' use of this technology in the acute care settings. The objective of this systematic review was to explore and determine the factors that affect nurses' use of medication administration technology in the acute care settings. All quantitative studies published in English which examined factors affecting nurses' use of the medication administration technology were considered.Primary focus was on registered nurses with experience of operating medication administration technology in the acute care settings. Other healthcare personnel were excluded.This review considered studies that evaluated factors affecting nurses' use of the medication administration technology.The outcome measures of interest were the factors that affect nurses' use of the medication administration technology in the acute care settings. The search was conducted across published and unpublished databases. A search was conducted in JBI Library of Systematic Reviews, The Cochrane Library, CINAHL, MEDLINE, Scopus, ScienceDirect, Wiley InterScience, SpringerLink, PsycINFO (ovid), Web of science, ProQuest Dissertations and Theses, and MedNar. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review, using the standardised critical appraisal instruments developed by the Joanna Briggs Institute. Quantitative data were extracted from papers included in the

  4. Implementation evaluation of the Telephone Lifestyle Coaching (TLC) program: organizational factors associated with successful implementation.

    PubMed

    Damschroder, Laura J; Reardon, Caitlin M; Sperber, Nina; Robinson, Claire H; Fickel, Jacqueline J; Oddone, Eugene Z

    2017-06-01

    The Telephone Lifestyle Coaching (TLC) program provided telephone-based coaching for six lifestyle behaviors to 5321 Veterans at 24 Veterans Health Administration (VHA) medical facilities. The purpose of the study was to conduct an evaluation of the TLC program to identify factors associated with successful implementation. A mixed-methods study design was used. Quantitative measures of organizational readiness for implementation and facility complexity were used to purposively select a subset of facilities for in-depth evaluation. Context assessments were conducted using interview transcripts. The Consolidated Framework for Implementation Research (CFIR) was used to guide qualitative data collection and analysis. Factors most strongly correlated with referral rates included having a skilled implementation leader who used effective multi-component strategies to engage primary care clinicians as well as general clinic structures that supported implementation. Evaluation findings pointed to recommendations for local and national leaders to help anticipate and mitigate potential barriers to successful implementation.

  5. Environmental Factors Affecting Preschoolers' Motor Development

    ERIC Educational Resources Information Center

    Venetsanou, Fotini; Kambas, Antonis

    2010-01-01

    The process of development occurs according to the pattern established by the genetic potential and also by the influence of environmental factors. The aim of the present study was to focus on the main environmental factors affecting motor development. The review of the literature revealed that family features, such as socioeconomic status,…

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

    PubMed

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

    2017-05-22

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

  7. Critical Success Factor for Implementing Vocational Blended Learning

    NASA Astrophysics Data System (ADS)

    Dewi, K. C.; Ciptayani, P. I.; Surjono, H. D.; Priyanto

    2018-01-01

    Blended learning provides many benefits to the flexibility of time, place and situation constraints. The research’s objectives was describing the factors that determine the successful implementation of blended learning in vocational higher education. The research used a qualitative approach, data collected through observations and interviews by questionnare based on the CSFs indicators refers to TAM and Kliger. Data analysis was inductive method. The result provided an illustration that the success of vocational blended learning implementation was largely determined by the selection of instructional models that are inline with learning achievement target. The effectiveness of blended learning required the existence of policy support, readiness of IT infrastructure. Changing lecturer’s culture by utilizing ICT can also encourage the accelerated process of successful implementation. It can concluded that determinant factor of successful implementation of blended learning in vocational education is determined by teacher’s ability in mastering the pedagogical knowledge of designing instructional models.

  8. Nutritional Factors Affecting Adult Neurogenesis and Cognitive Function.

    PubMed

    Poulose, Shibu M; Miller, Marshall G; Scott, Tammy; Shukitt-Hale, Barbara

    2017-11-01

    Adult neurogenesis, a complex process by which stem cells in the hippocampal brain region differentiate and proliferate into new neurons and other resident brain cells, is known to be affected by many intrinsic and extrinsic factors, including diet. Neurogenesis plays a critical role in neural plasticity, brain homeostasis, and maintenance in the central nervous system and is a crucial factor in preserving the cognitive function and repair of damaged brain cells affected by aging and brain disorders. Intrinsic factors such as aging, neuroinflammation, oxidative stress, and brain injury, as well as lifestyle factors such as high-fat and high-sugar diets and alcohol and opioid addiction, negatively affect adult neurogenesis. Conversely, many dietary components such as curcumin, resveratrol, blueberry polyphenols, sulforaphane, salvionic acid, polyunsaturated fatty acids (PUFAs), and diets enriched with polyphenols and PUFAs, as well as caloric restriction, physical exercise, and learning, have been shown to induce neurogenesis in adult brains. Although many of the underlying mechanisms by which nutrients and dietary factors affect adult neurogenesis have yet to be determined, nutritional approaches provide promising prospects to stimulate adult neurogenesis and combat neurodegenerative diseases and cognitive decline. In this review, we summarize the evidence supporting the role of nutritional factors in modifying adult neurogenesis and their potential to preserve cognitive function during aging. © 2017 American Society for Nutrition.

  9. Critical factors for EIA implementation: literature review and research options.

    PubMed

    Zhang, Jie; Kørnøv, Lone; Christensen, Per

    2013-01-15

    After decades of development, the gap between expectations of Environment Impact Assessments (EIA) and their practical performance remains significant. Research has been done to identify the critical factors for an effective implementation of EIA. However, this research, to a large extent, has not been cumulated and analysed comprehensively according to the stages of the EIA process. This paper contributes to the critical review of the literature on EIA implementation and effectiveness by cumulating mainly empirical findings in an implementation theoretical perspective. It focuses on the links between different critical factors and how they relate to different stages in the EIA and thus influence the decision making process. After reviewing 33 refereed journal articles published between 1999 and 2011, we identified 203 notions of critical factors. Of these, 102 related to different stages defined in our comprehensive EIA implementation model, and 101 were identified as general factors related to the whole EIA system. The number of notions of stage factors and general factors is thus about equal. An overlap between stage factors and general factors was found, which demonstrates that critical factors function differently in different cases. The function of the critical factors is complex and it is difficult to determine contingencies and causations. In the sources we examined, there is evidently an imbalance between in-depth empirical research and general knowledge, and the paper offers some suggestions for future research. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Factors affecting dignity of patients with multiple sclerosis.

    PubMed

    Sharifi, Simin; Borhani, Fariba; Abbaszadeh, Abbas

    2016-12-01

    MS is one of the most common chronic diseases of the nervous system. Apart from disease progression, other complications such as unemployment, separation and divorce could potentially threat patients' dignity. Most of the previous studies have been done of maintaining patients' dignity in interaction with healthcare team, but studies on affecting factors of dignity in chronic patients in the society and in interaction with usual people are scarce. We aimed to investigate factors affecting dignity of Iranian patients with MS in daily living and in interaction of them with the society. In this qualitative study, 13 patients with multiple sclerosis were chosen by purposive sampling and semi-structured interviews were conducted until data saturation. The study was done in Tehran, the capital city of Iran. Factors affecting dignity were classified as 'personal factors' and 'social factors'. Personal factors consist of the following subcategories: patients' communication with self, patients' knowledge, patients' values and beliefs and patients' resources. Social factors include others' communication with patients, social knowledge, social values and beliefs and social resources. Multiple personal and social factors interfere in perceived patient dignity. In fact, interaction between personal and social factors can be influential in final perceived dignity. By focusing on whole aspects of the patients' lives, we can identify dignity-promoting or dignity-threatening factors and help patients maintain their dignity by taking appropriate measures for moderating threatening factors and improving dignity enhancing ones. © 2016 Nordic College of Caring Science.

  11. Eating habits and factors affecting food choice of adolescents living in rural areas.

    PubMed

    Bargiota, Alexandra; Pelekanou, Maria; Tsitouras, Andreas; Koukoulis, Georgios N

    2013-01-01

    To establish factors that affect food choices among adolescents living in rural areas and to identify their food choices. A random sample of adolescents living in a Greek rural area (n=382) aged 12-18 years were individually interviewed. Food consumption was assessed by a semi-quantitative food-frequency questionnaire and adherence to the Mediterranean diet was evaluated using the KIDMED questionnaire. Information was collected regarding self-perceived body size, dieting, dietary knowledge, parental control, meal and snack frequency, eating out of home, eating takeaways and precooked meals, eating from the school canteen. Body image concerns, dieting, education about food, parental control, maternal education level and eating with family and peers are factors that were found to affect food choices in this group of Greek adolescents. The adherence to the Mediterranean diet was low (KIDMED index was 4.5±2.7). Regular family meals at home were frequent in this group and 99% of the adolescents ate lunch daily at home. Eating out with peers and eating from the school canteen was related with higher consumption of 'junk type of food'. Girls and younger adolescents and those whose mothers had a higher education level seem to make healthier choices. Factors such as personal issues, family and peer pressure significantly affect food choices among adolescents living in a Greek rural area and highlight the importance of implementing multilevel strategies to promote healthy eating among adolescents.

  12. Federal Programs Supporting Educational Change, Vol. VII: Factors Affecting Implementation and Continuation.

    ERIC Educational Resources Information Center

    Berman, Paul; And Others

    This report is one of three volumes that describe the second phase of a study that examined the implementation of four federal change agent programs related to education. Phase 2 of the study focused on what happens to local projects in the two largest change agent programs--ESEA Title III and ESEA Title VII--when federal funding stops. This…

  13. Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): a study protocol.

    PubMed

    Stahmer, Aubyn C; Suhrheinrich, Jessica; Schetter, Patricia L; McGee Hassrick, Elizabeth

    2018-01-08

    This study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for the positive effects of EBPs for ASD, these practices are not consistently or effectively used in schools. Although special education programs are mandated to use EBPs, there are very few evidence-based methods for selecting, implementing, and sustaining EBPs. Research focuses primarily on teacher training, without attention to contextual factors (e.g., implementation climate, attitudes toward EBPs, resource allocation, and social networks) that may impact outcomes. Using an implementation science framework, this project will prospectively examine relations between system-wide factors and teachers' use of EBPs and student education outcomes. Survey data will be collected from approximately 85 regional special education directors, 170 regional program specialists, 265 district special education directors, 265 behavior specialists, 925 school principals, 3538 special education teachers, and 2700 paraprofessionals. Administrative data for the students with ASD served by participating teachers will be examined. A total of 79 regional-, district-, and school-level personnel will also participate in social network interviews. Mixed methods, including surveys, administrative data, and observational checklists, will be used to gather in-depth information about system-wide malleable factors that relate to positive teacher implementation of EBPs and student outcomes. Multi-level modeling will be used to assess system-wide malleable factors related to EBP implementation which will be linked to the trainer, teacher, and student outcomes and examined based on moderators (e.g., district size, Special Education Local Plan Area structure

  14. Policy Implementation: Implications for Evaluation

    ERIC Educational Resources Information Center

    DeGroff, Amy; Cargo, Margaret

    2009-01-01

    Policy implementation reflects a complex change process where government decisions are transformed into programs, procedures, regulations, or practices aimed at social betterment. Three factors affecting contemporary implementation processes are explored: networked governance, sociopolitical context and the democratic turn, and new public…

  15. Staff development and secondary science teachers: Factors that affect voluntary participation

    NASA Astrophysics Data System (ADS)

    Corley, Theresa Roebuck

    2000-10-01

    A researcher-designed survey assessed the perceptions of Alabama secondary science public school teachers toward the need for staff development and toward certain staff development strategies and programs. Factors that encouraged or discouraged attendance at voluntary staff development programs and opinions regarding effective and ineffective features of programs were identified. Data were analyzed using descriptive techniques. Percentages and frequencies were noted. Average rankings were computed for the staff development techniques considered most and least effective and for the preferred designs of future staff development offerings. Chi squares were computed to respond to each of the 4 research hypotheses. Narrative discussions and tables were utilized to report the data and provide clarification. This study related demographic information to the research hypotheses. Analysis of the research hypotheses revealed that experienced teachers agree more strongly about the features of staff development programs that they consider effective and about the factors that may affect participation in staff development programs. Analysis of the research questions revealed that secondary science teachers in Alabama agree that staff development is a personal responsibility but that the school systems are responsible for providing staff development opportunities. Teachers believe that staff development is needed annually in both science content and teaching strategies and favor lengthening the school year for staff development. Teachers identified interest level, graduate credit, ability to implement material, scheduling factors, and the reputation of the organizer as the most important factors in determining participation in voluntary staff development programs. Hands-on workshops were identified as the most effective type of voluntary staff development and teachers requested that future staff development experiences include hands-on workshops, networking, curriculum

  16. Factors that affect implementation of a nurse staffing directive: results from a qualitative multi-case evaluation.

    PubMed

    Robinson, Claire H; Annis, Ann M; Forman, Jane; Krein, Sarah L; Yankey, Nicholas; Duffy, Sonia A; Taylor, Beth; Sales, Anne E

    2016-08-01

    To assess implementation of the Veterans Health Administration staffing methodology directive. In 2010 the Veterans Health Administration promulgated a staffing methodology directive for inpatient nursing units to address staffing and budget forecasting. A qualitative multi-case evaluation approach assessed staffing methodology implementation. Semi-structured telephone interviews were conducted from March - June 2014 with Nurse Executives and their teams at 21 facilities. Interviews focused on the budgeting process, implementation experiences, use of data, leadership support, and training. An implementation score was created for each facility using a 4-point rating scale. The scores were used to select three facilities (low, medium and high implementation) for more detailed case studies. After analysing interview summaries, the evaluation team developed a four domain scoring structure: (1) integration of staffing methodology into budget development; (2) implementation of the Directive elements; (3) engagement of leadership and staff; and (4) use of data to support the staffing methodology process. The high implementation facility had leadership understanding and endorsement of staffing methodology, confidence in and ability to work with data, and integration of staffing methodology results into the budgeting process. The low implementation facility reported poor leadership engagement and little understanding of data sources and interpretation. Implementation varies widely across facilities. Implementing staffing methodology in facilities with complex and changing staffing needs requires substantial commitment at all organizational levels especially for facilities that have traditionally relied on historical levels to budget for staffing. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  17. Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs.

    PubMed

    Main, Chris J; Nicholas, Michael K; Shaw, William S; Tetrick, Lois E; Ehrhart, Mark G; Pransky, Glenn

    2016-12-01

    Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision

  18. Factors influencing implementation of a preschool-based physical activity intervention

    PubMed Central

    Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.

    2017-01-01

    Abstract Examining factors that influence implementation of key program components that underlie an intervention’s success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on implementation levels of a component, called Move Outside (i.e., preschool classroom teachers to provide at least 40 min of outdoor recess per day), that was fundamental to the success of a preschool-based physical activity intervention. Level of implementation, defined as the percent of daily goal met for the Move Outside component, was assessed via direct observation. Items assessing preschool capacity, quality of prevention support system and teacher characteristics were selected from surveys and an environmental checklist completed by preschool directors and teachers. Preschool classroom was used as the unit of analysis (Year 1: n = 19; Year 2: n = 17). Results from Bayesian path analyses showed that the three factors were not significantly associated with level of implementation in Year 1, but preschool capacity was directly associated with level of implementation in Year 2 (β= 0.528, 95% CI: 0.134, 0.827). The current findings suggest that factors that influence level of implementation appear to differ as an intervention evolved over time. PMID:28158420

  19. A Study of the Physiological Factors Affecting the Nature of the Adult Learner in the Phoenix Air National Guard.

    ERIC Educational Resources Information Center

    Torbert, James Brison

    An investigation reviewed current literature in the field of physiological factors affecting the adult learning environment. These findings were compared to the academic learning environment at the Phoenix Air National Guard. The end product was a set of recommendations for management to implement in order to improve the learning climate for the…

  20. Community characteristics and implementation factors associated with effective systems of care.

    PubMed

    Lunn, Laurel M; Heflinger, Craig Anne; Wang, Wei; Greenbaum, Paul E; Kutash, Krista; Boothroyd, Roger A; Friedman, Robert M

    2011-07-01

    How are characteristics of communities associated with the implementation of the principles of systems of care (SOC)? This study uses multilevel modeling with a stratified random sample (N = 225) of US counties to explore community-level predictors of the implementation factors of the System of Care Implementation Survey. A model composed of community-level social indicators fits well with 5 of 14 factors identified as relevant for effective SOCs. As hypothesized, community disadvantage was negatively and residential stability positively associated with the implementation of SOC principles. Designation as a mental health professional shortage area was positively related to some implementation scores, as was the percentage of minority residents, while rurality was not significantly associated with any of the factors. Given the limitations of the study, the results should be interpreted with caution, but suggest that further research is merited to clarify these relationships that could inform efforts directed at promoting SOCs.

  1. Factors affecting implementation of perinatal mental health screening in women of refugee background.

    PubMed

    Nithianandan, Nishani; Gibson-Helm, Melanie; McBride, Jacquie; Binny, Amanda; Gray, Kylie M; East, Christine; Boyle, Jacqueline A

    2016-11-18

    For women of refugee background, the increased risk of mental illness associated with pregnancy is compounded by pre- and post-settlement stressors. In Australia, antenatal screening for depression and anxiety symptoms using the Edinburgh Postnatal Depression Scale is recommended for all women. Despite this, screening is not routinely implemented and little is known about barriers and enablers to implementation for women of refugee background. Semi-structured interviews were conducted with a range of health professionals (n = 28: midwives, obstetricians, perinatal mental health and refugee health experts, interpreters) and women of refugee background (n = 9). Themes generated from thematic analysis were examined in relation to the Theoretical Domains Framework and Cultural Competence Conceptual Framework, followed by identification of effective behaviour change techniques to address the barriers and enablers identified by participants. These techniques formed the basis of recommendations to inform sustainable implementation of screening and referral. Almost all participants perceived perinatal mental health screening to be necessary and most recognised the importance of post-traumatic stress disorder (PTSD) screening. Barriers and enablers were identified and related to eight domains: knowledge, skills, professional roles, beliefs about capabilities and consequences, environmental context, social influences and behavioural regulation. This research clarifies how mental health screening may be integrated into routine antenatal care for women of refugee background, in order to improve provision of recommended care. These theory-informed recommendations include an inter-disciplinary approach, coordinating care within and across services, addition of PTSD screening, and effective communication with women.

  2. Economic and Cultural Factors Affecting University Excellence

    ERIC Educational Resources Information Center

    Jabnoun, Naceur

    2009-01-01

    Purpose: The ranking of top universities in the world has generated increased interest in the factors that enhance university performance. The purpose of this paper is to identify economic and cultural factors that affect the number of top ranking universities in each country. Design/methodology/approach: This paper first identifies the number of…

  3. ENVIRONMENTAL FACTORS AFFECTING BREAST CANCER SUSCEPTIBILITY

    EPA Science Inventory

    Environmental Factors Affecting Breast Cancer Susceptibility
    Suzanne. E. Fenton
    US EPA, ORD, MD-67 NHEERL, Reproductive Toxicology Division, Research Triangle Park, NC 27711.

    Breast cancer is still the most common malignancy afflicting women in the Western world. Alt...

  4. Factors Affecting Radon Concentration in Houses

    NASA Astrophysics Data System (ADS)

    Al-Sharif, Abdel-Latif; Abdelrahman, Y. S.

    2001-03-01

    The dangers to the human health upon exposure to radon and its daughter products is the main motivation behind the vast number of studies performed to find the concentration of radon in our living environment, including our houses. The presence of radon and its daughter products in houses are due to various sources including building materials and the soil under the houses. Many factors affect radon concentration in our houses, the elevation above ground level,ventilation, building materials and room usage being among these factors. In our paper, we discuss the effect of elevation above ground level, room usage and ventilation on the Radon concentration in houses. The faculty residences of the Mu'tah University (Jordan) were chosen in our study. Our results showed that the concentration of radon decreases with elevation. Ventilation rate was also found to affect radon concentration, where low concentrations observed for areas with good ventilation.

  5. Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

    PubMed

    Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

    2014-03-01

    In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  6. Using an interdisciplinary approach to identify factors that affect clinicians' compliance with evidence-based guidelines.

    PubMed

    Gurses, Ayse P; Marsteller, Jill A; Ozok, A Ant; Xiao, Yan; Owens, Sharon; Pronovost, Peter J

    2010-08-01

    Our objective was to identify factors that affect clinicians' compliance with the evidence-based guidelines using an interdisciplinary approach and develop a conceptual framework that can provide a comprehensive and practical guide for designing effective interventions. A literature review and a brainstorming session with 11 researchers from a variety of scientific disciplines were used to identify theoretical and conceptual models describing clinicians' guideline compliance. MEDLINE, EMBASE, CINAHL, and the bibliographies of the papers identified were used as data sources for identifying the relevant theoretical and conceptual models. Thirteen different models that originated from various disciplines including medicine, rural sociology, psychology, human factors and systems engineering, organizational management, marketing, and health education were identified. Four main categories of factors that affect compliance emerged from our analysis: clinician characteristics, guideline characteristics, system characteristics, and implementation characteristics. Based on these findings, we developed an interdisciplinary conceptual framework that specifies the expected interrelationships among these four categories of factors and their impact on clinicians' compliance. An interdisciplinary approach is needed to improve clinicians' compliance with evidence-based guidelines. The conceptual framework from this research can provide a comprehensive and systematic guide to identify barriers to guideline compliance and design effective interventions to improve patient safety.

  7. Which factors affect software projects maintenance cost more?

    PubMed

    Dehaghani, Sayed Mehdi Hejazi; Hajrahimi, Nafiseh

    2013-03-01

    The software industry has had significant progress in recent years. The entire life of software includes two phases: production and maintenance. Software maintenance cost is increasingly growing and estimates showed that about 90% of software life cost is related to its maintenance phase. Extraction and considering the factors affecting the software maintenance cost help to estimate the cost and reduce it by controlling the factors. In this study, the factors affecting software maintenance cost were determined then were ranked based on their priority and after that effective ways to reduce the maintenance costs were presented. This paper is a research study. 15 software related to health care centers information systems in Isfahan University of Medical Sciences and hospitals function were studied in the years 2010 to 2011. Among Medical software maintenance team members, 40 were selected as sample. After interviews with experts in this field, factors affecting maintenance cost were determined. In order to prioritize the factors derived by AHP, at first, measurement criteria (factors found) were appointed by members of the maintenance team and eventually were prioritized with the help of EC software. Based on the results of this study, 32 factors were obtained which were classified in six groups. "Project" was ranked the most effective feature in maintenance cost with the highest priority. By taking into account some major elements like careful feasibility of IT projects, full documentation and accompany the designers in the maintenance phase good results can be achieved to reduce maintenance costs and increase longevity of the software.

  8. Factors affecting student success in a first-year mathematics course: a South African experience

    NASA Astrophysics Data System (ADS)

    Kizito, Rita; Munyakazi, Justin; Basuayi, Clement

    2016-01-01

    In spite of sustained efforts tertiary institutions implement to try and improve student academic performance, the number of students succeeding in first-year mathematics courses remains disturbingly low. For most students, the gap between their mathematical capability and the competencies they are expected and need to develop to function effectively in these courses persists even after course instruction. In this study, an instrument for identifying and examining factors affecting student performance and success in a first-year Mathematics university course was developed and administered to 86 students. The overall Cronbach's Alpha coefficient for the questionnaire was found to be 0.916. Having identified variables from prior research known to affect student performance, factor analysis was used to identify variables exhibiting the greatest impact on student performance. The variables included prior academic knowledge, workload, student approaches to learning, assessment, student support teaching quality, methods and resources. From the analysis, students' perceptions of their workload emerged as the factor having the greatest impact on student's performance, followed by the matriculation examination score. The findings are discussed and strategies that can be used to improve teaching and contribute to student success in a first-year mathematics course in a South African context are presented.

  9. Contextual factors affecting task distribution in two participatory ergonomic interventions: a qualitative study.

    PubMed

    Dixon, Shane Michael; Theberge, Nancy

    2011-11-01

    This article provides an analysis of the evolution of the division of labour in participatory ergonomics (PE) programmes in two worksites. The analysis is based on interviews and field observations in the worksites. In both settings there was meaningful participation by both worker and management members of ergonomic change teams (ECTs) in the hazard assessment and solution identification stages, but as the teams moved to the implementation stage, worker representatives were marginalised and the participatory nature of the programmes was severely curtailed. The removal of workers from the process was the outcome of the interplay among the type of activities pursued in the implementation stage, the skills and knowledge required to carry out those activities, and workers' limited influence in the organisational hierarchies. Findings highlight the salience of the social context in which participatory programmes are located and the importance of examining participatory programmes as they evolve over time. STATEMENT OF RELEVANCE: This article contributes to a growing literature on the process and implementation of PE programmes. The article's focus on social and organisational factors that affect the division of labour and attention to the evolution of involvement over time extend current understandings of participation in ergonomics programmes.

  10. How organizational escalation prevention potential affects success of implementation of innovations: electronic medical records in hospitals.

    PubMed

    Lambooij, Mattijs S; Koster, Ferry

    2016-05-20

    Escalation of commitment is the tendency that (innovation) projects continue, even if it is clear that they will not be successful and/or become extremely costly. Escalation prevention potential (EPP), the capability of an organization to stop or steer implementation processes that do not meet their expectations, may prevent an organization of losing time and money on unsuccessful projects. EPP consists of a set of checks and balances incorporated in managerial practices that safeguard management against irrational (but very human) decisions and may limit the escalation of implementation projects. We study whether successful implementation of electronic medical records (EMRs) relates to EPP and investigate the organizational factors accounting for this relationship. Structural equation modelling (SEM), using questionnaire data of 427 doctors and 631 nurses who had experience with implementation and use of EMRs in hospitals, was applied to study whether formal governance and organizational culture mediate the relationship between EPP and the perceived added value of EMRs. Doctors and nurses in hospitals with more EPP report more successful implementation of EMR (in terms of perceived added value of the EMR). Formal governance mediates the relation between EPP and implementation success. We found no evidence that open or innovative culture explains the relationship between EPP and implementation success. There is a positive relationship between the level of EPP and perceived added value of EMRs. This relationship is explained by formal governance mechanisms of organizations. This means that management has a set of tangible tools to positively affect the success of innovation processes. However, it also means that management needs to be able to critically reflect on its (previous) actions and decisions and is willing to change plans if elements of EPP signal that the implementation process is hampered.

  11. Higher Education Institutional Agents as Policy Implementers: The Case of Policies That Affect Undocumented and DACAmented Students

    ERIC Educational Resources Information Center

    Nienhusser, H. Kenny

    2018-01-01

    This study examines 45 community college institutional agents across four states in their role as implementer of policies that affected undocumented and DACAmented students. The findings delve into the role of changing implementation landscape, policy vagueness, implementation burden, and institutional support in this implementation environment.…

  12. Preslaughter factors affecting poultry meat quality chapter 2.

    USDA-ARS?s Scientific Manuscript database

    Poultry meat quality is affected by numerous antemortem factors, in particular those occurring during the last 24 hours that the bird is alive. These short term factors influence carcass yield (live shrink), carcass defects (bruising, broken/dislocated bones), carcass microbiological contamination, ...

  13. FACTORS ADVERSELY AFFECTING AMPHIBIAN POPULATIONS IN THE US

    EPA Science Inventory

    Factors known or suspected to be adversely affecting native amphibian populations in the US were identified using information from species accounts written in a standardized format by multiple authors in a forthcoming book. Specific adverse factors were identified for 53 (58%) of...

  14. Factors influencing a problem-based learning implementation: A case study of IT courses

    NASA Astrophysics Data System (ADS)

    Darus, Norida Muhd; Mohd, Haslina; Baharom, Fauziah; Saip, Mohamed Ali; Puteh, Nurnasran; Marzuki @ Matt, Zaharin; Husain, Mohd Zabidin; Yasin, Azman

    2016-08-01

    IT students must be trained to work efficiently as teamwork. One of the techniques that can be used to train them is through Problem-Based Learning (PBL) approach. The PBL implementation can be influenced by various factors depending on the ultimate goal of the study. This study is focusing on the IT students' perception of the PBL implementation. The student's perception is important to ensure the successfulness of the PBL implementation. Therefore, it is important to identify the factors that might influence the implementation of PBL of IT courses. This study aims to identify some catalyst factors that may influence the PBL implementation of IT courses. The study involved three (3) main phases: identifying PBL implementation factors, constructing a PBL model, and PBL model validation using statistical analysis. Four main factors are identified: PBL Characteristics, PBL Course Assessment, PBL Practices, and PBL Perception. Based on these four factors, a PBL model is constructed. Then, based on the proposed PBL model, four hypotheses are formulated and analyzed to validate the model. All hypotheses are significantly acceptable. The result shows that the PBL Characteristics and PBL Course Assessment factors are significantly influenced the PBL Practices and indirectly influenced the Students' Perception of the PBL Implementation for IT courses. This PBL model can assist decision makers in enhancing the PBL teaching and learning strategy for IT courses. It is also can be tested to other courses in the future.

  15. Factors affecting radiographers' organizational commitment.

    PubMed

    Akroyd, Duane; Jackowski, Melissa B; Legg, Jeffrey S

    2007-01-01

    A variety of factors influence employees' attitudes toward their workplace and commitment to the organization that employs them. However, these factors have not been well documented among radiologic technologists. To determine the predictive ability of selected organizational, leadership, work-role and demographic variables on organizational commitment for a national sample of radiographers. Three thousand radiographers registered by the American Registry of Radiologic Technologists working full time in clinical settings were surveyed by mail regarding their commitment to their employers, leadership within the organization that employs them, employer support and demographic information. Overall, radiographers were found to have only a moderate level of commitment to their employers. Among the factors that significantly affected commitment were the radiographer's educational level, perceived level of organizational support, role clarity and organizational leadership. The results of this study could provide managers and supervisors with insights on how to empower and challenge radiographers and offer opportunities that will enhance radiographers' commitment to the organization, thus reducing costly turnover and improving employee performance.

  16. Critical success factors for implementing healthcare e-Learning.

    PubMed

    Lee, Te-Shu; Kuo, Mu-Hsing; Borycki, Elizabeth M; Yunyong, David

    2011-01-01

    The use of e-Learning in educational institutes has rapidly increased along with the development of information and communication technology (ICT). In healthcare, more medical educators are using e-Learning to support their curriculum design, delivery and evaluation. However, no systematic work exists on characterizing a collective set of Critical Success Factors (CSFs) for implementing e-Learning in the healthcare education institutions. The aim of this paper is to study the CSFs of implementing healthcare e-Learning.

  17. Factors Affecting Faculty Web Portal Usability

    ERIC Educational Resources Information Center

    Bringula, Rex P.; Basa, Roselle S.

    2011-01-01

    The study investigated the factors that might significantly affect web portal usability. Results of the study were intended to serve as inputs for faculty web portal development of the University of the East-Manila. Descriptive statistics utilized questionnaire data from 82 faculty members. The data showed that most of the respondents were…

  18. Low Calorie Diet Affects Aging-Related Factors

    MedlinePlus

    ... Research News From NIH Low Calorie Diet Affects Aging-Related Factors Past Issues / Summer 2006 Table of ... project sponsored by the NIH's National Institute on Aging (NIA) to learn more about the effects of ...

  19. What Factors Affect Response to Ads? A Perspective.

    ERIC Educational Resources Information Center

    Rotzoll, Kim B.

    The concept of "frame of reference" offers a perspective from which to examine the many factors which affect advertising response. The advertiser is interested in affecting two types of overt behavior. First, the individual is induced to select a particular stimulus (the advertisement) from competing stimuli (such as other people, noise,…

  20. Strengthening decentralized primary healthcare planning in Nigeria using a quality improvement model: how contexts and actors affect implementation.

    PubMed

    Eboreime, Ejemai Amaize; Nxumalo, Nonhlanhla; Ramaswamy, Rohit; Eyles, John

    2018-05-08

    Quality improvement models have been applied across various levels of health systems with varying success leading to scepticisms about effectiveness. Health systems are complex, influenced by contexts and characterized by numerous interests. Thus, a shift in focus from examining whether improvement models work, to understanding why, when and where they work most effectively is essential. Nigeria introduced DIVA (Diagnose-Intervene-Verify-Adjust) as a model to strengthen decentralized PHC planning. However, implementation has been poorly sustained. This article explores the role of actors and context in implementation and sustainability of DIVA in two local government areas (LGAs) in Nigeria. We employed an integrated mixed method approach in which qualitative data was used in conjunction with quantitative to understand effects of actors and contexts on implementation outcomes. We analysed policy documents and conducted interviews with PHC managers. Then using the Model for Understanding Success in Quality (MUSIQ), we measured contextual factors affecting implementation of DIVA in the selected LGAs. The LGAs scored 117.42 and 104.67 out of 168 points on the MUSIQ scale, respectively, indicating contextual barriers exist. Both have strong DIVA team attributes, but these could not independently ensure quality implementation. Although external support accounted for the greatest contextual disparities, the utmost implementation challenges relate to subnational government leadership, management, financial and technical support. Although higher levels of government may set visionary goals for PHC, interventions are potentially skewed towards donor interests at lower (implementation) levels. Thus, subnational political will is a key determinant of quality implementation. Consequently, advocacy for responsible and accountable political governance is essential in comparable decentralized contexts.

  1. Factors affecting science reform: Bridging the gap between reform initiatives and teaching practices

    NASA Astrophysics Data System (ADS)

    Pensak, Karl John

    In response to the perceived deficiencies in science education today, and to the expressed need for research into the culture of schools (due primarily to the failure of many science reforms in the past), this study used a broad based approach to study the gap between science education research and science education practice. This study identified 47 factors that may encourage or inhibit science curriculum reform. A survey was conducted to determine which factors were perceived to be important by local and national K-12 classroom teachers, science supervisors/coordinators, and college/university professors. Continual staff development (scheduled as part of teachers' work day/week/month), funding (for long-term staff development, teacher training and support, science laboratory facilities and materials), teacher motivation and "ownership" of the reform, the need for collaborative opportunities for classroom teachers, teachers' college preparation, textbook reform, community support, and reform initiatives that are "in tune" with assessment, are major factors identified as having a substantial affect on the successful adoption, implementation, and institutionalization of science reforms.

  2. Factors Related to Sustained Implementation of Schoolwide Positive Behavior Support

    ERIC Educational Resources Information Center

    McIntosh, Kent; Mercer, Sterett H.; Hume, Amanda E.; Frank, Jennifer L.; Turri, Mary G.; Mathews, Susanna

    2013-01-01

    The purpose of this study was to identify factors associated with sustainability of school-based interventions and the relative contributions of those factors to predicting sustained implementation of Schoolwide Positive Behavior Support (SWPBS). Participants were respondents from 217 schools across 14 U.S. states. Sustainability factors were…

  3. Affective and Social Factors in a Project-Based Writing Course

    ERIC Educational Resources Information Center

    Kathpalia, Sujata Surinder; Heah, Carmel

    2011-01-01

    Much of the work in academic writing has focused on the cognitive rather than the affective and social aspects involved in project-based writing. Emphasis in past research has been on skills and processes of writing rather than on affective factors such as motivation, attitudes, feelings or social factors involving intrapersonal and interpersonal…

  4. Substrate-Related Factors Affecting Enzymatic Saccharification of Lignocelluloses: Our Recent Understanding

    Treesearch

    Shao-Yuan Leu; J.Y. Zhu

    2013-01-01

    Enzymatic saccharification of cellulose is a key step in conversion of plant biomass to advanced biofuel and chemicals. Many substrate-related factors affect saccharification. Rather than examining the role of each individual factor on overall saccharification efficiency, this study examined how each factor affects the three basic processes of a heterogeneous...

  5. Microbiologic factors affecting Clostridium difficile recurrence.

    PubMed

    Chilton, C H; Pickering, D S; Freeman, J

    2018-05-01

    Recurrent Clostridium difficile infection (rCDI) places a huge economic and practical burden on healthcare facilities. Furthermore, rCDI may affect quality of life, leaving patients in an rCDI cycle and dependant on antibiotic therapy. To discuss the importance of microbiologic factors in the development of rCDI. Literature was drawn from a search of PubMed from 2000 onwards with the search term 'recurrent Clostridium difficile infection' and further references cited within these articles. Meta-analyses and systematic reviews have shown that CDI and rCDI risk factors are similar. Development of rCDI is attendant on many factors, including immune status or function, comorbidities and concomitant treatments. Studies suggest that poor bacterial diversity is correlated with clinical rCDI. Narrow-spectrum gut microflora-sparing antimicrobials (e.g. surotomycin, cadazolid, ridinilazole) are in development for CDI treatment, while microbiota therapeutics (faecal microbiota transplantation, nontoxigenic C. difficile, stool substitutes) are increasingly being explored. rCDI can only occur when viable C. difficile spores are present, either within the gut lumen after infection or when reacquired from the environment. C. difficile spore germination can be influenced by gut environmental factors resulting from dysbiosis, and spore outgrowth may be affected stage by some antimicrobials (e.g. fidaxomicin, ramoplanin, oritavancin). rCDI is a significant challenge for healthcare professionals, requiring a multifaceted approach; optimized infection control to minimize reinfection; C. difficile-targeted antibiotics to minimize dysbiosis; and gut microflora restoration to promote colonization resistance. These elements should be informed by our understanding of the microbiologic factors involved in both C. difficile itself and the gut microbiome. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  6. Factors Affecting the Implementation of Policy 2450, Distance Education and the West Virginia Virtual School, as Perceived by Principals/Assistant Principals, Counselors, and Distance Learning Contacts and/or Course Facilitators

    ERIC Educational Resources Information Center

    Burdette, Keith R.

    2013-01-01

    This study examined the factors important to the implementation of West Virginia Board of Education Policy 2450, Distance Learning and the West Virginia Virtual School. The purpose of this study was to determine the factors that facilitated and impeded implementation of the policy, as perceived by principals/assistant principals, counselors, and…

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

    PubMed Central

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

    2015-01-01

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

  8. How Do Implementation Efforts Relate to Program Adherence? Examining the Role of Organizational, Implementer, and Program Factors

    ERIC Educational Resources Information Center

    Dariotis, Jacinda K.; Bumbarger, Brian K.; Duncan, Larissa G.; Greenberg, Mark T.

    2008-01-01

    Widespread replications of evidence-based prevention programs (EBPPs) prompt prevention scientists to examine program implementation adherence in real world settings. Based on Chen's model (1990), we identified five key factors of the implementation system and assessed which characteristics related to program adherence. The sample included 32…

  9. Exploring paraprofessional and classroom factors affecting teacher supervision.

    PubMed

    Irvin, Dwight W; Ingram, Paul; Huffman, Jonathan; Mason, Rose; Wills, Howard

    2018-02-01

    Paraprofessionals serve a primary role in supporting students with disabilities in the classroom, which necessitates teachers' supervision as a means to improve their practice. Yet, little is known regarding what factors affect teacher supervision. We sought to identify how paraprofessional competence and classroom type affected the levels of teacher direction. We administered an adapted version of the Paraprofessional Needs, Knowledge & Tasks Survey and the Survey for Teachers Supervising Paraprofessionals to teachers supervising paraprofessionals in elementary schools. Structural Equation Modeling was used to examine the link between paraprofessional competence and classroom factors affecting the level of teacher supervision. Our results indicated that when teachers perceived paraprofessionals as being more skilled, they provided more supervision, and when more supervision was provided the less they thought paraprofessionals should be doing their assigned tasks. Additionally, paraprofessionals working in classrooms with more students with mild disabilities received less supervision than paraprofessionals working in classrooms with more students with moderate-to-severe disabilities. Those paraprofessionals in classrooms serving mostly children with mild disabilities were also perceived as having lower levels of skill competence than those serving in classrooms with students with more moderate-to-severe disabilities. By understanding the factors that affect teacher supervision, policy and professional development opportunities can be refined/developed to better support both supervising teachers and paraprofessionals and, in turn, improve the outcomes of children with disabilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Assessing organizational implementation context in the education sector: confirmatory factor analysis of measures of implementation leadership, climate, and citizenship.

    PubMed

    Lyon, Aaron R; Cook, Clayton R; Brown, Eric C; Locke, Jill; Davis, Chayna; Ehrhart, Mark; Aarons, Gregory A

    2018-01-08

    A substantial literature has established the role of the inner organizational setting on the implementation of evidence-based practices in community contexts, but very little of this research has been extended to the education sector, one of the most common settings for the delivery of mental and behavioral health services to children and adolescents. The current study examined the factor structure, psychometric properties, and interrelations of an adapted set of pragmatic organizational instruments measuring key aspects of the organizational implementation context in schools: (1) strategic implementation leadership, (2) strategic implementation climate, and (3) implementation citizenship behavior. The Implementation Leadership Scale (ILS), Implementation Climate Scale (ICS), and Implementation Citizenship Behavior Scale (ICBS) were adapted by a research team that included the original scale authors and experts in the implementation of evidence-based practices in schools. These instruments were then administered to a geographically representative sample (n = 196) of school-based mental/behavioral health consultants to assess the reliability and structural validity via a series of confirmatory factor analyses. Overall, the original factor structures for the ILS, ICS, and ICBS were confirmed in the current sample. The one exception was poor functioning of the Rewards subscale of the ICS, which was removed in the final ICS model. Correlations among the revised measures, evaluated as part of an overarching model of the organizational implementation context, indicated both unique and shared variance. The current analyses suggest strong applicability of the revised instruments to implementation of evidence-based mental and behavioral practices in the education sector. The one poorly functioning subscale (Rewards on the ICS) was attributed to typical educational policies that do not allow for individual financial incentives to personnel. Potential directions for

  11. Prioritizing critical success factors for reverse logistics implementation using fuzzy-TOPSIS methodology

    NASA Astrophysics Data System (ADS)

    Agrawal, Saurabh; Singh, Rajesh K.; Murtaza, Qasim

    2016-03-01

    Electronics industry is one of the fastest growing industries in the world. In India also, there are high turnovers and growing demand of electronics product especially after post liberalization in early nineties. These products generate e-waste which has become big environmental issue. Industries can handle these e-waste and product returns efficiently by developing reverse logistics (RL) system. A thorough study of critical success factors (CSFs) and their ordered implementation is essential for successful RL implementation. The aim of the study is to review the CSFs, and to prioritize them for RL implementation in Indian electronics industry. Twelve CSFs were identified through literature review, and discussion with the experts from the Indian electronics industry. Fuzzy-Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach is proposed for prioritizing these CSFs. Perusal of literature indicates that fuzzy-TOPSIS has not been applied earlier for prioritization of CSFs in Indian electronics industry. Five Indian electronics companies were selected for evaluation of this methodology. Results indicate that most of the identified factors are crucial for the RL implementation. Top management awareness, resource management, economic factors, and contracts terms and conditions are top four prioritized factor, and process capabilities and skilled workers is the least prioritized factor. The findings will be useful for successful RL implementation in Indian electronics industry.

  12. Ranking factors affecting emissions of GHG from incubated agricultural soils.

    PubMed

    García-Marco, S; Ravella, S R; Chadwick, D; Vallejo, A; Gregory, A S; Cárdenas, L M

    2014-07-01

    Agriculture significantly contributes to global greenhouse gas (GHG) emissions and there is a need to develop effective mitigation strategies. The efficacy of methods to reduce GHG fluxes from agricultural soils can be affected by a range of interacting management and environmental factors. Uniquely, we used the Taguchi experimental design methodology to rank the relative importance of six factors known to affect the emission of GHG from soil: nitrate (NO 3 - ) addition, carbon quality (labile and non-labile C), soil temperature, water-filled pore space (WFPS) and extent of soil compaction. Grassland soil was incubated in jars where selected factors, considered at two or three amounts within the experimental range, were combined in an orthogonal array to determine the importance and interactions between factors with a L 16 design, comprising 16 experimental units. Within this L 16 design, 216 combinations of the full factorial experimental design were represented. Headspace nitrous oxide (N 2 O), methane (CH 4 ) and carbon dioxide (CO 2 ) concentrations were measured and used to calculate fluxes. Results found for the relative influence of factors (WFPS and NO 3 - addition were the main factors affecting N 2 O fluxes, whilst glucose, NO 3 - and soil temperature were the main factors affecting CO 2 and CH 4 fluxes) were consistent with those already well documented. Interactions between factors were also studied and results showed that factors with little individual influence became more influential in combination. The proposed methodology offers new possibilities for GHG researchers to study interactions between influential factors and address the optimized sets of conditions to reduce GHG emissions in agro-ecosystems, while reducing the number of experimental units required compared with conventional experimental procedures that adjust one variable at a time.

  13. Ranking factors affecting emissions of GHG from incubated agricultural soils

    PubMed Central

    García-Marco, S; Ravella, S R; Chadwick, D; Vallejo, A; Gregory, A S; Cárdenas, L M

    2014-01-01

    Agriculture significantly contributes to global greenhouse gas (GHG) emissions and there is a need to develop effective mitigation strategies. The efficacy of methods to reduce GHG fluxes from agricultural soils can be affected by a range of interacting management and environmental factors. Uniquely, we used the Taguchi experimental design methodology to rank the relative importance of six factors known to affect the emission of GHG from soil: nitrate (NO3−) addition, carbon quality (labile and non-labile C), soil temperature, water-filled pore space (WFPS) and extent of soil compaction. Grassland soil was incubated in jars where selected factors, considered at two or three amounts within the experimental range, were combined in an orthogonal array to determine the importance and interactions between factors with a L16 design, comprising 16 experimental units. Within this L16 design, 216 combinations of the full factorial experimental design were represented. Headspace nitrous oxide (N2O), methane (CH4) and carbon dioxide (CO2) concentrations were measured and used to calculate fluxes. Results found for the relative influence of factors (WFPS and NO3− addition were the main factors affecting N2O fluxes, whilst glucose, NO3− and soil temperature were the main factors affecting CO2 and CH4 fluxes) were consistent with those already well documented. Interactions between factors were also studied and results showed that factors with little individual influence became more influential in combination. The proposed methodology offers new possibilities for GHG researchers to study interactions between influential factors and address the optimized sets of conditions to reduce GHG emissions in agro-ecosystems, while reducing the number of experimental units required compared with conventional experimental procedures that adjust one variable at a time. PMID:25177207

  14. Sporting programs for inactive population groups: factors influencing implementation in the organized sports setting.

    PubMed

    Ooms, Linda; Veenhof, Cindy; Schipper-van Veldhoven, Nicolette; de Bakker, Dinny H

    2015-01-01

    The organized sports sector has received increased attention as a setting to promote health-enhancing physical activity (HEPA) to the general population. For significant public health impact, it is important that successful HEPA programs are widely adopted, implemented and continued as ongoing practice. The importance of evaluating the context in which programs are implemented has been identified as critical. However, little research has focused on understanding the organized sports implementation context, including factors facilitating and impeding implementation. In this study, the main factors influencing implementation of HEPA programs in the organized sports setting were studied. Fourteen sporting programs in the Netherlands aimed at increasing participation in sports by inactive population groups and funded within the National Action Plan for Sport and Exercise (NAPSE) were investigated. The programs were developed by ten Dutch National Sports Federations (NSFs) and implemented by different sports clubs in the Netherlands over a 3-year implementation period (June 2008-June 2011). The qualitative research component involved yearly face-to-face interviews (i.e. fourteen interviews each year, n = 12 program coordinators) and a group meeting with the program coordinators of the NSFs (n = 8). Cross-case comparisons and thematic analyses were performed to identify and categorize important facilitating and impeding factors respectively. The quantitative research component, used to identify the most important facilitating and impeding factors across all sporting programs, consisted of ranking of factors according to importance by the program coordinators (n = 12). Different factors act during six identified (implementation) phases. When comparing factors across phases, several key learnings were evident. Successful implementation relied, for example, on program design and enthusiastic individuals within sporting organizations. On the other hand, inactive

  15. Reviews on factors affecting fatigue behavior of high-Mn steels

    NASA Astrophysics Data System (ADS)

    Kim, Sangshik; Jeong, Daeho; Sung, Hyokyung

    2018-01-01

    A variety of factors affect the fatigue behavior of high-Mn steels, which include both extrinsic (i.e., loading type, R ratio, specimen type, surface condition, temperature, and environment) and intrinsic (i.e., chemical composition, grain size, microstructure, stacking fault energy) factors. Very often, the influence of extrinsic factors on the fatigue behavior is even greater than that of intrinsic factors, misleading the interpretation of fatigue data. The metallurgical factors influence the initiation and propagation behaviors of fatigue by altering the characteristics of slip that is prerequisite for fatigue damage accumulation. It is however not easy to separate the effect of each factor since they affect the fatigue behavior of high-Mn steels in complex and synergistic way. In this review, the fatigue data of high-Mn steels are summarized and the factors complicating the interpretation are discussed.

  16. Review: Factors affecting fouling in conventional pens for slaughter pigs.

    PubMed

    Larsen, M L V; Bertelsen, M; Pedersen, L J

    2018-02-01

    This review assesses factors affecting fouling in conventional pens for slaughter pigs. Fouling of the pen happens when pigs change their excretory behaviour from occurring in the designated dunging area to the lying area. This can result in a lower hygiene, bad air quality, extra work for the farmer, disturbance of the pigs' resting behaviour and an increase in agonistic interactions. A systematic search was conducted and results narrowed down to 21 articles. Four factors were found to affect fouling directly: insufficient space allowance, the flooring design of the pen, the thermal climate and pigs' earlier experience. Further, these primary factors are affected by secondary factors such as the shape of the pen, the weight of the pigs and especially the heat balance of the pigs, which is affected by several tertiary factors including, for example, temperature, humidity and draught. Results indicate that the most important factor to control when trying to prevent fouling of a pen is the pen climate. An appropriate climate may be accomplished through floor cooling in the designated lying area, sprinklers above the designated dunging area and by ensuring a more optimal ambient temperature curve that also fits the weight of the pigs in different stages of the production. All in all, fouling of the pen in conventional slaughter pigs is a multifactorial problem, but it is important to focus on increasing the comfortability, and especially the climate, of the designated lying area.

  17. Factors associated with physical therapists' implementation of physical activity interventions in The Netherlands.

    PubMed

    Huijg, Johanna M; Dusseldorp, Elise; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; Middelkoop, Barend J C; Duijzer, Geerke; Crone, Mathilde R

    2015-04-01

    Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their implementation behaviors. The study objective was to investigate physical therapists' implementation fidelity regarding PA interventions, including completeness and quality of delivery, and influencing factors with a Theoretical Domains Framework-based questionnaire. The study was based on a cross-sectional design. A total of 268 physical therapists completed the Determinants of Implementation Behavior Questionnaire. Questions about completeness and quality of delivery were based on components and tasks of PA interventions as described by the Royal Dutch Society for Physical Therapy. Multilevel regression analyses were used to identify factors associated with completeness and quality of delivery. High implementation fidelity was found for the physical therapists, with higher scores for completeness of delivery than for quality of delivery. Physical therapists' knowledge, skills, beliefs about capabilities and consequences, positive emotions, behavioral regulation, and the automaticity of PA intervention delivery were the most important predictors of implementation fidelity. Together, the Theoretical Domains Framework accounted for 23% of the variance in both total completeness and total quality scores. The cross-sectional design precluded the determination of causal relationships. Also, the use of a self-report measure to assess implementation fidelity could have led to socially desirable responses, possibly resulting in more favorable ratings for completeness and quality. This study enhances the understanding of how physical therapists implement PA interventions and which factors influence their behaviors. Knowledge about these factors may assist in the development of strategies to

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

    PubMed

    Dong, W; Huang, Z

    2015-01-01

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

  19. Effect of Organizational Factors on Information Security Implementations

    ERIC Educational Resources Information Center

    Perez, Rafael G.

    2013-01-01

    The purpose of this quantitative inferential study is to determine the level of correlation between the organizational factors of information security awareness, balanced security processes, and organizational structure with the size of the estimation gap of information security implementations mediated by the end user intentionality. The study…

  20. The Role of Practitioner Self-Efficacy, Training, Program and Workplace Factors on the Implementation of an Evidence-Based Parenting Intervention in Primary Care

    ERIC Educational Resources Information Center

    Turner, Karen M. T.; Nicholson, Jan M.; Sanders, Matthew R.

    2011-01-01

    This study examines factors affecting the implementation by primary care practitioners (nursing, education, allied health, and medical) of a brief parenting and family support intervention (the Primary Care Triple P--Positive Parenting Program) following professional training. It assesses the impact of prior experience, self-efficacy, program…

  1. Factors affecting the quality of life in childhood epilepsy in China.

    PubMed

    Yong, L; Chengye, J; Jiong, Q

    2006-03-01

    To explore the level of, and factors affecting the quality of life (QOL) in childhood epilepsy in China. At the Peking University First Hospital, we consecutively identified 418 parents whose children were with known epilepsy to complete a questionnaire, which included children's demographic characteristics, clinical message of epilepsy, QOL, familial message, parental symptoms of anxiety/depression. Significant (p<0.05) affecting factors of children's quality of life included current educational degree, mental development, age at diagnosis, age at onset, seizure frequency, duration, AED number; parental significant (p<0.05) affecting factors included anxiety, depression and health. On regression analysis, parental anxiety was the most important factor in explaining lower QOL in childhood epilepsy. AEDs, familial economic state, paternal career, seizure frequency were also significant factors. Parental anxiety outweighed the physical factors in determining QOL in childhood epilepsy. Recognition of this will be helpful for professionals to treat disease and improve the QOL of childhood epilepsy.

  2. Health system factors affecting implementation of integrated management of childhood illness (IMCI): qualitative insights from a South African province.

    PubMed

    Pandya, Himani; Slemming, Wiedaad; Saloojee, Haroon

    2018-03-01

    The Integrated Management of Childhood Illness (IMCI) strategy has been adopted by 102 countries including South Africa, as the preferred primary health care (PHC) delivery strategy for sick children under 5 years. Despite substantial investment to support IMCI in South Africa, its delivery remains sub-optimal, with varied implementation in different settings. There is scarce research globally, and in the local context, examining the effects of health system characteristics on IMCI implementation. This study explored key determinants of IMCI delivery in a South African province, with a specific focus on health system building blocks using a health system dynamics framework. In-depth interviews were conducted with 38 districts, provincial and national respondents involved with IMCI co-ordination and delivery, exploring their involvement in, and perceptions of, IMCI strategy implementation. Identified barriers included poor definition of elements of a service package for children and how IMCI aligned with this, incompetence of trained nurses exacerbated by inappropriate rotation practices, use of inappropriate indicators to track progress, multiple cadres coordinating similar activities with poor role delineation, and fragmented, vertical governance of programmes included within IMCI, such as immunization. Enabling practices in one district included the use of standardized child health records incorporating IMCI activities and stringent practice monitoring through record audits. Using IMCI as a case study, our work highlights critical health system deficiencies affecting service delivery for young children which need to be resolved to reposition IMCI within the broader child 'survive, thrive and transform' agenda. Recommendations for appropriate health system strengthening include the need for redefining IMCI within a broader PHC service package for children, prioritizing post-training supervision and mentoring of practitioners through appropriate duty allocation and

  3. Factors affecting academic leadership in dermatology.

    PubMed

    Martires, Kathryn J; Aquino, Lisa L; Wu, Jashin J

    2015-02-01

    Although prior studies have examined methods by which to recruit and retain academic dermatologists, few have examined factors that are important for developing academic leaders in dermatology. This study sought to examine characteristics of dermatology residency programs that affect the odds of producing department or division chairs/chiefs and program directors (PDs). Data regarding program size, faculty, grants, alumni residency program attended, lectures, and publications for all accredited US dermatology residency programs were collected. Of the 103 programs examined, 46% had graduated at least 1 chair/chief, and 53% had graduated at least 1 PD. Results emphasize that faculty guidance and research may represent modifiable factors by which a dermatology residency program can increase its graduation of academic leaders.

  4. Strengthening organizations to implement evidence-based clinical practices.

    PubMed

    VanDeusen Lukas, Carol; Engle, Ryann L; Holmes, Sally K; Parker, Victoria A; Petzel, Robert A; Nealon Seibert, Marjorie; Shwartz, Michael; Sullivan, Jennifer L

    2010-01-01

    Despite recognition that implementation of evidence-based clinical practices (EBPs) usually depends on the structure and processes of the larger health care organizational context, the dynamics of implementation are not well understood. This project's aim was to deepen that understanding by implementing and evaluating an organizational model hypothesized to strengthen the ability of health care organizations to facilitate EBPs. CONCEPTUAL MODEL: The model posits that implementation of EBPs will be enhanced through the presence of three interacting components: active leadership commitment to quality, robust clinical process redesign incorporating EBPs into routine operations, and use of management structures and processes to support and align redesign. In a mixed-methods longitudinal comparative case study design, seven medical centers in one network in the Department of Veterans Affairs participated in an intervention to implement the organizational model over 3 years. The network was selected randomly from three interested in using the model. The target EBP was hand-hygiene compliance. Measures included ratings of implementation fidelity, observed hand-hygiene compliance, and factors affecting model implementation drawn from interviews. Analyses support the hypothesis that greater fidelity to the organizational model was associated with higher compliance with hand-hygiene guidelines. High-fidelity sites showed larger effect sizes for improvement in hand-hygiene compliance than lower-fidelity sites. Adherence to the organizational model was in turn affected by factors in three categories: urgency to improve, organizational environment, and improvement climate. Implementation of EBPs, particularly those that cut across multiple processes of care, is a complex process with many possibilities for failure. The results provide the basis for a refined understanding of relationships among components of the organizational model and factors in the organizational context

  5. 78 FR 46418 - Proposed Information Collection (Obligation To Report Factors Affecting Entitlement) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... (Obligation To Report Factors Affecting Entitlement) Activity; Comment Request AGENCY: Veterans Benefits... use of other forms of information technology. Title: Obligation to Report Factors Affecting... entitlement factors. Individual factors such as income, marital status, and the beneficiary's number of...

  6. 75 FR 62634 - Proposed Information Collection (Obligation to Report Factors Affecting Entitlement) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... (Obligation to Report Factors Affecting Entitlement) Activity: Comment Request AGENCY: Veterans Benefits... use of other forms of information technology. Title: Obligation to Report Factors Affecting... entitlement factors. Individual factors such as income, marital status, and the beneficiary's number of...

  7. Analysis of factors affecting employee satisfaction: A case study from Pakistan.

    PubMed

    Rukh, Lala; Choudhary, Muhammad Abbas; Abbasi, Saddam Akber

    2015-01-01

    Employee job satisfaction has been a research focal point throughout the world. It is a key factor when measuring the performance of an organization and individuals. A leading engineering goods manufacturing enterprise in Pakistan, has been used in this case study. In Pakistan, very limited research has been done with respect to factors affecting job satisfaction. Some research has been done in medical institutions, banks, universities and the information technology sector but large public sector organizations in Pakistan have not been studied. A theoretical foundation for researching factors affecting job satisfaction in large organizations is outlined. The objective of this research is to analyze various demographic, financial and non-financial factors affecting the satisfaction level of employees and to study the effects across different employee groups. This study is based on quantitative data analysis. The employees of the organization under study have been divided into 10 homogeneous groups based on their departments. Information on job related factors (affecting the satisfaction level) have been collected from subsamples of each group using a self-administered questionnaire. An overall sample of 250 (out of total 1100) employees has been selected. Before conducting the survey, reliability of the questionnaire was measured using Cronbach's alpha. The normality of data was also examined using the Kolmogorov Smirnov test. Hypotheses devised to address the research questions were tested by using non-parametric Spearman correlation and Kruskal-Wallis tests. The response rate was 73.2%. Research findings indicated the significant factors that affect the satisfaction level of employees. Median group differences existed between responses based on age, work experience, salary and designation (i.e. job position/rank) of employees. Job satisfaction was also positively and significantly associated with job related factors such as pay, promotion, relation with employees

  8. Factors Affecting Open-Set Word Recognition in Adults with Cochlear Implants

    PubMed Central

    Holden, Laura K.; Finley, Charles C.; Firszt, Jill B.; Holden, Timothy A.; Brenner, Christine; Potts, Lisa G.; Gotter, Brenda D.; Vanderhoof, Sallie S.; Mispagel, Karen; Heydebrand, Gitry; Skinner, Margaret W.

    2012-01-01

    A monosyllabic word test was administered to 114 postlingually-deaf adult cochlear implant (CI) recipients at numerous intervals from two weeks to two years post-initial CI activation. Biographic/audiologic information, electrode position, and cognitive ability were examined to determine factors affecting CI outcomes. Results revealed that Duration of Severe-to-Profound Hearing Loss, Age at Implantation, CI Sound-field Threshold Levels, Percentage of Electrodes in Scala Vestibuli, Medio-lateral Electrode Position, Insertion Depth, and Cognition were among the factors that affected performance. Knowledge of how factors affect performance can influence counseling, device fitting, and rehabilitation for patients and may contribute to improved device design. PMID:23348845

  9. Factors affecting self-regulated learning in medical students: a qualitative study

    PubMed Central

    Jouhari, Zahra; Haghani, Fariba; Changiz, Tahereh

    2015-01-01

    Introduction Clinical courses are required of all medical students and means that they must develop the key skill of self-regulation during learning. The ability to self-regulate learning strategies is affected by different factors. This study determined the views of medical students on the factors affecting self-regulated learning (SRL). Method This study uses a qualitative approach and the content analysis method. Nineteen medical students in their fourth, fifth, and sixth years of study at Isfahan University of Medical Science participated in semi-structured, in-depth interviews. The students were selected using purposive sampling based on their overall grade point average (GPA). Results Five main themes were found to affect SRL. These themes included family with the two subthemes of family supervisory and supportive roles; peers with the two subthemes of facilitating and inhibiting roles; instructors with the two subthemes of personal and educational instructor's characteristics; educational environment with the two subthemes of facilitator and inhibitor roles; and student with the two subthemes of facilitating and inhibiting personal factors. Conclusion The outcomes of student understanding of the factors affecting self-regulation indicate that facilitating factors should be used on an individual basis to reduce the effect of inhibiting factors to improve self-regulation in students. PMID:26549046

  10. Factors affecting self-regulated learning in medical students: a qualitative study.

    PubMed

    Jouhari, Zahra; Haghani, Fariba; Changiz, Tahereh

    2015-01-01

    Introduction Clinical courses are required of all medical students and means that they must develop the key skill of self-regulation during learning. The ability to self-regulate learning strategies is affected by different factors. This study determined the views of medical students on the factors affecting self-regulated learning (SRL). Method This study uses a qualitative approach and the content analysis method. Nineteen medical students in their fourth, fifth, and sixth years of study at Isfahan University of Medical Science participated in semi-structured, in-depth interviews. The students were selected using purposive sampling based on their overall grade point average (GPA). Results Five main themes were found to affect SRL. These themes included family with the two subthemes of family supervisory and supportive roles; peers with the two subthemes of facilitating and inhibiting roles; instructors with the two subthemes of personal and educational instructor's characteristics; educational environment with the two subthemes of facilitator and inhibitor roles; and student with the two subthemes of facilitating and inhibiting personal factors. Conclusion The outcomes of student understanding of the factors affecting self-regulation indicate that facilitating factors should be used on an individual basis to reduce the effect of inhibiting factors to improve self-regulation in students.

  11. Factors affecting self-regulated learning in medical students: a qualitative study.

    PubMed

    Jouhari, Zahra; Haghani, Fariba; Changiz, Tahereh

    2015-01-01

    Clinical courses are required of all medical students and means that they must develop the key skill of self-regulation during learning. The ability to self-regulate learning strategies is affected by different factors. This study determined the views of medical students on the factors affecting self-regulated learning (SRL). This study uses a qualitative approach and the content analysis method. Nineteen medical students in their fourth, fifth, and sixth years of study at Isfahan University of Medical Science participated in semi-structured, in-depth interviews. The students were selected using purposive sampling based on their overall grade point average (GPA). Five main themes were found to affect SRL. These themes included family with the two subthemes of family supervisory and supportive roles; peers with the two subthemes of facilitating and inhibiting roles; instructors with the two subthemes of personal and educational instructor's characteristics; educational environment with the two subthemes of facilitator and inhibitor roles; and student with the two subthemes of facilitating and inhibiting personal factors. The outcomes of student understanding of the factors affecting self-regulation indicate that facilitating factors should be used on an individual basis to reduce the effect of inhibiting factors to improve self-regulation in students.

  12. 14 CFR Appendix B to Part 1215 - Factors Affecting Standard Charges

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Factors Affecting Standard Charges B Appendix B to Part 1215 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION TRACKING AND DATA RELAY SATELLITE SYSTEM (TDRSS) Pt. 1215, App. B Appendix B to Part 1215—Factors Affecting Standard...

  13. Methods of Combinatorial Optimization to Reveal Factors Affecting Gene Length

    PubMed Central

    Bolshoy, Alexander; Tatarinova, Tatiana

    2012-01-01

    In this paper we present a novel method for genome ranking according to gene lengths. The main outcomes described in this paper are the following: the formulation of the genome ranking problem, presentation of relevant approaches to solve it, and the demonstration of preliminary results from prokaryotic genomes ordering. Using a subset of prokaryotic genomes, we attempted to uncover factors affecting gene length. We have demonstrated that hyperthermophilic species have shorter genes as compared with mesophilic organisms, which probably means that environmental factors affect gene length. Moreover, these preliminary results show that environmental factors group together in ranking evolutionary distant species. PMID:23300345

  14. A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India.

    PubMed

    Travasso, Sandra Mary; Rajaraman, Divya; Heymann, Sally Jody

    2014-02-07

    Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated with negative mental health amongst

  15. A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India

    PubMed Central

    2014-01-01

    Background Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Methods Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Results Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. Conclusion This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated

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

    PubMed

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

    2017-12-01

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

  17. Establishing partnership with traditional birth attendants for improved maternal and newborn health: a review of factors influencing implementation.

    PubMed

    Miller, Tina; Smith, Helen

    2017-10-19

    Recent World Health Organization recommendations recognize the important role Traditional Birth Attendants (TBAs) can play in supporting the health of women and newborns. This paper provides an analysis of key factors that affect the implementation of interventions to develop partnerships with TBAs to promote improved access to skilled care at birth. We conducted a secondary analysis of 20 papers identified through two systematic reviews that examined the effectiveness of interventions to find new roles for TBAs on maternal and newborn health outcomes, as well as papers identified through a systematic mapping of the maternal health literature. The Supporting the Use of Research Evidence framework (SURE) guided the thematic analysis to explore the perceptions of various stakeholders and implementation barriers and facilitators, as well as other contextual issues. This analysis identified countries that have implemented interventions to support the transition from birth with a TBA to birth with a skilled birth attendant. Drawing on the experiences of these countries, the analysis highlights factors that are important to consider when designing and implementing such interventions. Barriers to implementation included resistance to change in more traditional communities, negative attitudes between TBAs and skilled attendants and TBAs concerns about the financial implications of assuming new roles. Facilitating factors included stakeholder involvement in devising and implementing interventions, knowledge sharing between TBAs and skilled birth attendants, and formalised roles and responsibilities and remuneration for TBAs. The implementation barriers identified in this analysis could, if not addressed, prevent or discourage TBAs from carrying out newly defined roles supporting women in pregnancy and childbirth and linking them to the formal health system. This paper also identifies the factors that seem critical to success, which new programmes could consider adopting

  18. Factors Affecting the Implementation of Sheltered Instruction Observation Protocols for English Language Learners

    ERIC Educational Resources Information Center

    Calderon, Carlos Trevino

    2012-01-01

    The purpose of this sequential mixed methods case study was to explore the role of a teacher's attitude towards Sheltered Instruction Observation Protocols (SIOP) and how those attitudes affect the program's effectiveness. SIOP is a program designed to mitigate the effects of limited English proficiency and promote equal access to the curriculum…

  19. Factors Affecting Smoking Tendency and Smoking Intensity

    ERIC Educational Resources Information Center

    David, Nissim Ben; Zion, Uri Ben

    2009-01-01

    Purpose: The purpose of this paper is to measure the relative effect of relevant explanatory variable on smoking tendency and smoking intensity. Design/methodology/approach: Using survey data collected by the Israeli Bureau of Statistics in 2003-2004, a probit procedure is estimated for analyzing factors that affect the probability of being a…

  20. Food Safety Programs Based on HACCP Principles in School Nutrition Programs: Implementation Status and Factors Related to Implementation

    ERIC Educational Resources Information Center

    Stinson, Wendy Bounds; Carr, Deborah; Nettles, Mary Frances; Johnson, James T.

    2011-01-01

    Purpose/Objectives: The objectives of this study were to assess the extent to which school nutrition (SN) programs have implemented food safety programs based on Hazard Analysis and Critical Control Point (HACCP) principles, as well as factors, barriers, and practices related to implementation of these programs. Methods: An online survey was…

  1. Identification of Factors That Affect Software Complexity.

    ERIC Educational Resources Information Center

    Kaiser, Javaid

    A survey of computer scientists was conducted to identify factors that affect software complexity. A total of 160 items were selected from the literature to include in a questionnaire sent to 425 individuals who were employees of computer-related businesses in Lawrence and Kansas City. The items were grouped into nine categories called system…

  2. INTERNATIONAL DIFFERENCES IN FACTORS AFFECTING LABOUR MOBILITY.

    ERIC Educational Resources Information Center

    SELLIER, F.; ZARKA, C.

    THE GEOGRAPHICAL, OCCUPATIONAL, AND INTERFIRM MOBILITY, AND THE FACTORS AFFECTING THESE MOVEMENTS FOR WORKERS IN FRANCE, ITALY, GERMANY, AND SWEDEN IN THE PERIOD SINCE THE SECOND WORLD WAR ARE STUDIED. DATA OBTAINED FROM INDUSTRIAL SURVEYS AND GENERAL CENSUSES WERE USED TO COMPARE THE FOUR COUNTRIES WITH EACH OTHER AND WITH THE UNITED STATES.…

  3. A Metasynthesis of Factors Affecting Self-Management of Chronic Illness

    PubMed Central

    SCHULMAN-GREEN, Dena; JASER, Sarah S.; PARK, Chorong; WHITTEMORE, Robin

    2015-01-01

    Aim To identify factors that may serve as facilitators and barriers to self-management described by adults living with chronic illness by conducting a qualitative metasynthesis. Background Self-management is an individuals’ active management of a chronic illness in collaboration with their family members and clinicians. Design Qualitative metasynthesis. Data Sources We analyzed studies (N=53) published between January 2000–May 2013 that described factors affecting self-management in chronic illness as reported by adults aged over 18 years with chronic illness. Review Methods Sandelowsi and Barroso approach to qualitative metasynthesis: literature search; quality appraisal; analysis; and synthesis of findings. Results Collectively, article authors reported on sixteen chronic illnesses, most commonly diabetes (N=28) and cardiovascular disease (N=20). Participants included men and women (mean age=57, range 18–94) from twenty countries representing diverse races and ethnicities. We identified five categories of factors affecting self-management: Personal/Lifestyle Characteristics; Health Status; Resources; Environmental Characteristics; and Health Care System. Factors may interact to affect self-management and may exist on a continuum of positive (facilitator) to negative (barrier). Conclusion Understanding factors that influence self-management may improve assessment of self-management among adults with chronic illness and may inform interventions tailored to meet individuals’ needs and improve health outcomes. PMID:26781649

  4. Factors affecting post-pubertal penile size in patients with hypospadias.

    PubMed

    Moriya, Kimihiko; Nakamura, Michiko; Nishimura, Yoko; Kitta, Takeya; Kanno, Yukiko; Chiba, Hiroki; Kon, Masafumi; Shinohara, Nobuo

    2016-09-01

    To evaluate actual post-pubertal penile size and factors affecting it in hypospadias patients, we retrospectively reviewed medical charts. Hypospadias patients whose external genitalia were categorized into Tanner stage 5, and whose stretched penile length was evaluated at 15 years old or older from April 2008 to April 2015, were enrolled in the present study. Stretched penile length was measured by a single examiner. Actual post-pubertal stretched penile length and factors affecting the post-pubertal stretched penile length were estimated. Statistical analysis was performed using Mann-Whitney U test and univariate and multivariate linear regression models for the determination of independent factors. Thirty patients met the inclusion criteria. Median age at evaluation was 17.2 years. Thirteen and 17 had mild and severe hypospadias, respectively. Endocrinological abnormality was identified in 5. Multivariate analysis showed that the severity of hypospadias and endocrinological abnormality were significant factors affecting stretched penile length. Stretched penile length in 25 patients without endocrinological abnormality was significantly longer than that in those with endocrinological abnormality (p = 0.036). Among patients without endocrinological abnormality, stretched penile length in 13 with severe hypospadias was significantly shorter than that in 12 with mild hypospadias (p = 0.004). While the severity of hypospadias and endocrinological abnormality at post-pubertal evaluation were factors affecting post-pubertal penile size, stretched penile length in patients with severe hypospadias was shorter even in cases without endocrinological abnormality. These results suggest that severe hypospadias is not only a disorder of urethral development, but also a disorder of penile development.

  5. Factors affecting rotator cuff healing.

    PubMed

    Mall, Nathan A; Tanaka, Miho J; Choi, Luke S; Paletta, George A

    2014-05-07

    Several studies have noted that increasing age is a significant factor for diminished rotator cuff healing, while biomechanical studies have suggested the reason for this may be an inferior healing environment in older patients. Larger tears and fatty infiltration or atrophy negatively affect rotator cuff healing. Arthroscopic rotator cuff repair, double-row repairs, performing a concomitant acromioplasty, and the use of platelet-rich plasma (PRP) do not demonstrate an improvement in structural healing over mini-open rotator cuff repairs, single-row repairs, not performing an acromioplasty, or not using PRP. There is conflicting evidence to support postoperative rehabilitation protocols using early motion over immobilization following rotator cuff repair.

  6. Factors affecting corticosteroid concentrations in yellow-bellied marmots.

    PubMed

    Armitage, K B

    1991-01-01

    1. Bound and total corticosteroid concentrations of yellow-bellied marmots (Marmota flaviventris) were lowest in May after emergence from hibernation and peaked in August prior to immergence. 2. Total corticosteroids were affected by age but not by sex or reproductive status. 3. There was no consistent relationship between measures of population density and concentrations of corticosteroids; when a significant relationship occurred, only 22-34% of the variation was explained. 4. Social status and social behavior were the major factors affecting corticosteroid concentrations.

  7. Factors affecting Iran`s future. Final report

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

    Sinai, J.

    1993-05-28

    This study examines the factors affecting Iran`s future by focusing on the demographic, economic, and military trends in Iran and their impact on the country`s national security objectives in the next decade. The paper also assesses the implications of an economic embargo on Iran and potential Iranian threats to regional and United States national interests.

  8. Are Affective Factors a Good Predictor of Science Achievement? Examining the Role of Affective Factors Based on PISA 2006

    ERIC Educational Resources Information Center

    Ozel, Murat; Caglak, Serdar; Erdogan, Mehmet

    2013-01-01

    This study investigated how affective factors like attitude and motivation contribute to science achievement in PISA 2006 using linear structural modeling. The data set of PISA 2006 collected from 4942 fifteen-year-old Turkish students (2290 females, 2652 males) was used for the statistical analyses. A total of 42 selected items on a four point…

  9. Critical success factors in implementing an e-rostering system in a healthcare organisation.

    PubMed

    Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

    2017-01-01

    Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

  10. Factors associated with the implementation of community-based peer-led health promotion programs: A scoping review.

    PubMed

    Lorthios-Guilledroit, Agathe; Richard, Lucie; Filiatrault, Johanne

    2018-06-01

    Peer education is growing in popularity as a useful health promotion strategy. However, optimal conditions for implementing peer-led health promotion programs (HPPs) remain unclear. This scoping review aimed to describe factors that can influence implementation of peer-led HPPs targeting adult populations. Five databases were searched using the keywords "health promotion/prevention", "implementation", "peers", and related terms. Studies were included if they reported at least one factor associated with the implementation of community-based peer-led HPPs. Fifty-five studies were selected for the analysis. The method known as "best fit framework synthesis" was used to analyze the factors identified in the selected papers. Many factors included in existing implementation conceptual frameworks were deemed applicable to peer-led HPPs. However, other factors related to individuals, programs, and implementation context also emerged from the analysis. Based on this synthesis, an adapted theoretical framework was elaborated, grounded in a complex adaptive system perspective and specifying potential mechanisms through which factors may influence implementation of community-based peer-led HPPs. Further research is needed to test the theoretical framework against empirical data. Findings from this scoping review increase our knowledge of the optimal conditions for implementing peer-led HPPs and thereby maximizing the benefits of such programs. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Lagrangian methods for blood damage estimation in cardiovascular devices--How numerical implementation affects the results.

    PubMed

    Marom, Gil; Bluestein, Danny

    2016-01-01

    This paper evaluated the influence of various numerical implementation assumptions on predicting blood damage in cardiovascular devices using Lagrangian methods with Eulerian computational fluid dynamics. The implementation assumptions that were tested included various seeding patterns, stochastic walk model, and simplified trajectory calculations with pathlines. Post processing implementation options that were evaluated included single passage and repeated passages stress accumulation and time averaging. This study demonstrated that the implementation assumptions can significantly affect the resulting stress accumulation, i.e., the blood damage model predictions. Careful considerations should be taken in the use of Lagrangian models. Ultimately, the appropriate assumptions should be considered based the physics of the specific case and sensitivity analysis, similar to the ones presented here, should be employed.

  12. Lagrangian methods for blood damage estimation in cardiovascular devices - How numerical implementation affects the results

    PubMed Central

    Marom, Gil; Bluestein, Danny

    2016-01-01

    Summary This paper evaluated the influence of various numerical implementation assumptions on predicting blood damage in cardiovascular devices using Lagrangian methods with Eulerian computational fluid dynamics. The implementation assumptions that were tested included various seeding patterns, stochastic walk model, and simplified trajectory calculations with pathlines. Post processing implementation options that were evaluated included single passage and repeated passages stress accumulation and time averaging. This study demonstrated that the implementation assumptions can significantly affect the resulting stress accumulation, i.e., the blood damage model predictions. Careful considerations should be taken in the use of Lagrangian models. Ultimately, the appropriate assumptions should be considered based the physics of the specific case and sensitivity analysis, similar to the ones presented here, should be employed. PMID:26679833

  13. Factors affecting cardiac rehabilitation referral by physician specialty.

    PubMed

    Grace, Sherry L; Grewal, Keerat; Stewart, Donna E

    2008-01-01

    Cardiac rehabilitation (CR) is widely underutilized because of multiple factors including physician referral practices. Previous research has shown CR referral varies by type of provider, with cardiologists more likely to refer than primary care physicians. The objective of this study was to compare factors affecting CR referral in primary care physicians versus cardiac specialists. A cross-sectional survey of a stratified random sample of 510 primary care physicians and cardiac specialists (cardiologists or cardiovascular surgeons) in Ontario identified through the Canadian Medical Directory Online was administered. One hundred four primary care physicians and 81 cardiac specialists responded to the 26-item investigator-generated survey examining medical, demographic, attitudinal, and health system factors affecting CR referral. Primary care physicians were more likely to endorse lack of familiarity with CR site locations (P < .001), lack of standardized referral forms (P < .001), inconvenience (P = .04), program quality (P = .004), and lack of discharge communication from CR (P = .001) as factors negatively impacting CR referral practices than cardiac specialists. Cardiac specialists were significantly more likely to perceive that their colleagues and department would regularly refer patients to CR than primary care physicians (P < .001). Where differences emerged, primary care physicians were more likely to perceive factors that would impede CR referral, some of which are modifiable. Marketing CR site locations, provision of standardized referral forms, and ensuring discharge summaries are communicated to primary care physicians may improve their willingness to refer to CR.

  14. Effects of people-centred factors on enterprise resource planning implementation project success: empirical evidence from Sri Lanka

    NASA Astrophysics Data System (ADS)

    Wickramasinghe, Vathsala; Gunawardena, Vathsala

    2010-08-01

    Extant literature suggests people-centred factors as one of the major areas influencing enterprise resource planning (ERP) implementation project success. Yet, to date, few empirical studies attempted to validate the link between people-centred factors and ERP implementation project success. The purpose of this study is to empirically identify people-centred factors that are critical to ERP implementation projects in Sri Lanka. The study develops and empirically validates a framework for people-centred factors that influence the success of ERP implementation projects. Survey research methodology was used and collected data from 74 ERP implementation projects in Sri Lanka. The people-centred factors of 'project team competence', 'rewards' and 'communication and change' were found to predict significantly the ERP implementation project success.

  15. Implementing e-Learning in the Jordanian Higher Education System: Factors Affecting Impact

    ERIC Educational Resources Information Center

    Al-adwan, Ahmad; Smedley, Jo

    2012-01-01

    The increased involvement of technology in all aspects of our lives places educational institutions under pressure to include these aspects at the heart of their learning. This ensures that they continue to be competitive in a constantly changing market with international and cultural links. This study explores the factors that influenced the…

  16. Social and organizational factors affecting implementation of evidence-informed practice in a public health department in Ontario: a network modelling approach

    PubMed Central

    2014-01-01

    Objective The objective of this study is to develop a statistical model to assess factors associated with information seeking in a Canadian public health department. Methods Managers and professional consultants of a public health department serving a large urban population named whom they turned to for help, whom they considered experts in evidence-informed practice, and whom they considered friends. Multilevel regression analysis and exponential random graph modeling were used to predict the formation of information seeking and expertise-recognition connections by personal characteristics of the seeker and source, and the structural attributes of the social networks. Results The respondents were more likely to recognize the members of the supervisory/administrative division as experts. The extent to which an individual implemented evidence-based practice (EBP) principles in daily practice was a significant predictor of both being an information source and being recognized as expert by peers. Friendship was a significant predictor of both information seeking and expertise-recognition connections. Conclusion The analysis showed a communication network segregated by organizational divisions. Managers were identified frequently as information sources, even though this is not a part of their formal role. Self-perceived implementation of EBP in practice was a significant predictor of being an information source or an expert, implying a positive atmosphere towards implementation of evidence-informed decision making in this public health organization. Results also implied that the perception of accessibility and trust were significant predictors of expertise recognition. PMID:24565228

  17. Factors Affecting Radiologist's PACS Usage.

    PubMed

    Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L

    2016-12-01

    The purpose of this study was to determine if any of the factors radiologist, examination category, time of week, and week effect PACS usage, with PACS usage defined as the sequential order of computer commands issued by a radiologist in a PACS during interpretation and dictation. We initially hypothesized that only radiologist and examination category would have significant effects on PACS usage. Command logs covering 8 weeks of PACS usage were analyzed. For each command trace (describing performed activities of an attending radiologist interpreting a single examination), the PACS usage variables number of commands, number of command classes, bigram repetitiveness, and time to read were extracted. Generalized linear models were used to determine the significance of the factors on the PACS usage variables. The statistical results confirmed the initial hypothesis that radiologist and examination category affect PACS usage and that the factors week and time of week to a large extent have no significant effect. As such, this work provides direction for continued efforts to analyze system data to better understand PACS utilization, which in turn can provide input to enable optimal utilization and configuration of corresponding systems. These continued efforts were, in this work, exemplified by a more detailed analysis using PACS usage profiles, which revealed insights directly applicable to improve PACS utilization through modified system configuration.

  18. Cognitive Factors Affecting Freeze-like Behavior in Humans.

    PubMed

    Alban, Michael W; Pocknell, Victoria

    2017-01-01

    Contemporary research on survival-related defensive behaviors has identified physiological markers of freeze/flight/fight. Our research focused on cognitive factors associated with freeze-like behavior in humans. Study 1 tested if an explicit decision to freeze is associated with the psychophysiological state of freezing. Heart rate deceleration occurred when participants chose to freeze. Study 2 varied the efficacy of freezing relative to other defense options and found "freeze" was responsive to variations in the perceived effectiveness of alternative actions. Study 3 tested if individual differences in motivational orientation affect preference for a "freeze" option when the efficacy of options is held constant. A trend in the predicted direction suggested that naturally occurring cognitions led loss-avoiders to select "freeze" more often than reward-seekers. In combination, our attention to the cognitive factors affecting freeze-like behavior in humans represents a preliminary step in addressing an important but neglected research area.

  19. Factors affecting the use of hardwood flooring in urban rehabilitation

    Treesearch

    Robert L. Jr. Nevel; Robert L. Jr. Nevel

    1973-01-01

    The continued use of hardwood flooring in urban rehabilitation is being threatened. A study of the influences that determine the choice of flooring indicates that economic, physical, or technological factors dominate. Most factors affecting the use of hardwood flooring are related to cost, availability, and compatibility. Of these factors, time and cost of installation...

  20. Factors Affecting Sleep Quality of Patients in Intensive Care Unit

    PubMed Central

    Bihari, Shailesh; Doug McEvoy, R.; Matheson, Elisha; Kim, Susan; Woodman, Richard J.; Bersten, Andrew D.

    2012-01-01

    Introduction: Sleep disturbance is a frequently overlooked complication of intensive care unit (ICU) stay. Aim: To evaluate sleep quality among patients admitted to ICU and investigate environmental and non-environmental factors that affect sleep quality in ICU. Methods: Over a 22-month period, we consecutively recruited patients who spent ≥ 2 nights post-endotracheal extubation in ICU and who were orientated to time, place, and person on the day of discharge. Self-reported sleep quality, according to a modified Freedman questionnaire, which provided data on self-reported ICU sleep quality in ICU and environmental factors affecting sleep quality in the ICU, were collected. We also investigated non-environmental factors, such as severity of illness, ICU interventions, and medications that can affect sleep quality. Results: Fifty males and 50 females were recruited with a mean (± SD) age of 65.1 ± 15.2 years. APACHE II score at admission to ICU was 18.1 ± 7.5 with duration of stay 6.7 ± 6.5days. Self-reported sleep quality score at home (1 = worst; 10 = best) was 7.0 ± 2.2; this decreased to 4.0 ± 1.7 during their stay in ICU (p < 0.001). In multivariate analysis with APACHE III as severity of illness (R2 = 0.25), factors [exp(b)(95% CI), p value] which significantly affected sleep in ICU were sex [0.37(0.19-0.72), p < 0.01], age and sex interaction [1.02(1.01-1.03), p < 0.01], bedside phone [0.92(0.87-0.97), p < 0.01], prior quality of sleep at home [1.30(1.05-1.62), p = 0.02], and use of steroids [0.82(0.69-0.98), p = 0.03] during the stay in ICU. Conclusion: Reduced sleep quality is a common problem in ICU with a multifactorial etiology. Citation: Bihari S; McEvoy RD; Kim S; Woodman RJ; Bersten AD. Factors affecting sleep quality of patients in intensive care unit. J Clin Sleep Med 2012;8(3):301-307. PMID:22701388

  1. An Analysis of Factors That Affect the Educational Performance of Agricultural Students

    ERIC Educational Resources Information Center

    Greenway, Gina

    2012-01-01

    Many factors contribute to student achievement. This study focuses on three areas: how students learn, how student personality type affects performance, and how course format affects performance outcomes. The analysis sought to improve understanding of the direction and magnitude with which each of these factors impacts student success. Improved…

  2. Assessment of Factor Affecting Institutional Performance: The Case of Wolaita Sodo University

    ERIC Educational Resources Information Center

    Shibru, Sintayehu; Bibiso, Mesfin; Ousman, Kedir

    2017-01-01

    The purpose of this study is to explore factors that affect institutional performance of Wolaita Sodo University. The study has identified middle level manager's perceptions toward institutional performance to indicate the key factors that seem to affect the performance of the university. Data were collected using structured questionnaires and…

  3. Individual and School Organizational Factors that Influence Implementation of the PAX Good Behavior Game Intervention.

    PubMed

    Domitrovich, Celene E; Pas, Elise T; Bradshaw, Catherine P; Becker, Kimberly D; Keperling, Jennifer P; Embry, Dennis D; Ialongo, Nicholas

    2015-11-01

    Evidence-based interventions are being disseminated broadly in schools across the USA, but the implementation levels achieved in community settings vary considerably. The current study examined the extent to which teacher and school factors were associated with implementation dosage and quality of the PAX Good Behavior Game (PAX GBG), a universal classroom-based preventive intervention designed to improve student social-emotional competence and behavior. Specifically, dosage (i.e., number of games and duration of games) across the school year and quality (i.e., how well the game is delivered) of PAX GBG implementation across four time points in a school year were examined. Hierarchical linear modeling was used to examine the association between teacher-level factors (e.g., demographics, self-reports of personal resources, attitudes toward the intervention, and workplace perceptions) and longitudinal implementation data. We also accounted for school-level factors, including demographic characteristics of the students and ratings of the schools' organizational health. Findings indicated that only a few teacher-level factors were significantly related to variation in implementation. Teacher perceptions (e.g., fit with teaching style, emotional exhaustion) were generally related to dosage, whereas demographic factors (e.g., teachers' age) were related to quality. These findings highlight the importance of school contextual and proximal teacher factors on the implementation of classroom-based programs.

  4. [Risk factors negatively affecting on the formation of musculoskeletal system in children and adolescents in the present conditions].

    PubMed

    Mirskaya, N B

    2013-01-01

    Identifying risk factors affecting the formation of the musculoskeletal system (MSS) in children and adolescents is considered by the author as a necessary condition for the implementation of prevention, timely diagnosis and adequate correction of the MSS disorders and diseases. Introduction in the educational process developed by the author for the first time a conceptual model of prevention and correction of the MSS disorders and diseases in schoolchildren allowed significantly reduce the prevalence of functional disorders and early forms of the MSS diseases in students of a number of comprehensive schools in Moscow by 50%.

  5. Factors affecting onset of puberty in Denizli province in Turkey.

    PubMed

    Semiz, Serap; Kurt, Funda; Kurt, Devrim Tanil; Zencir, Mehmet; Sevinç, Ozgür

    2009-01-01

    The relationship between the possible factors affecting pubertal onset and pubertal timing was investigated in the Denizli province in Turkey. A total number of 3311 subjects (1562 girls, 1749 boys) aged 6-16.5 years participated in this study. Body mass index (BMI) was calculated. Pubertal stages were assessed according to methods of Marshall and Tanner. Testicular volume was determined using Prader orchidometer. Menarcheal age was recorded. All parents and students completed different questionnaires on demographic variables affecting pubertal timing such as socioeconomic conditions, psychosocial factors, exercise, nutritional status, chronic diseases, migration and birth weight. Using distribution percentiles of pubertal stages according to age, the relation between pubertal timing and factors affecting puberty was investigated. There was no significant association between exercise, birth weight, migration, chronic disease, and socioeconomic status and age of puberty onset. Menarcheal age of overweight and obese girls was significantly lower than that of girls with normal weight. In-family stress was the cause of early puberty in girls and of delayed puberty in boys.

  6. Factors affecting the periapical healing process of endodontically treated teeth.

    PubMed

    Holland, Roberto; Gomes, João Eduardo; Cintra, Luciano Tavares Angelo; Queiroz, Índia Olinta de Azevedo; Estrela, Carlos

    2017-01-01

    Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.

  7. Nurse aide decision making in nursing homes: factors affecting empowerment.

    PubMed

    Chaudhuri, Tanni; Yeatts, Dale E; Cready, Cynthia M

    2013-09-01

    To evaluate factors affecting structural empowerment among nurse aides in nursing homes. Structural empowerment can be defined as the actual rather than perceived ability to make autonomous decisions within an organisation. Given the paucity of research on the subject, this study helps to close the gap by identifying factors that affect nurse aide empowerment, that is, decision-making among nurse aides. The data for the study come from self-administered questionnaires distributed to direct-care workers (nurse aides) in 11 nursing homes in a southern state in the USA. Ordinary least square regression models were estimated to analyse the effects of demographic predictors, personal factors (competency, emotional exhaustion and positive attitude) and structural characteristics (coworker and supervisor support, information availability and shared governance) on nurse aide decision-making. Findings suggest race among demographic predictors, emotional exhaustion among personal characteristics, and supervisor support, and shared governance among structural factors, significantly affect nurse aide decision-making. It is important to explore race as one of the central determinants of structural empowerment among nurse aides. In addition, the nature and type of emotional exhaustion that propels decision-making needs to be further examined. The study shows the importance of shared governance and supervisor support for fostering nurse aide empowerment. © 2013 Blackwell Publishing Ltd.

  8. Nutritional Factors Affecting Adult Neurogenesis and Cognitive Function

    USDA-ARS?s Scientific Manuscript database

    Adult neurogenesis, a complex process by which stem cells in the hippocampal brain region differentiate and proliferate into new neurons and other resident brain cells, is known to be affected by many intrinsic and extrinsic factors, including diet. Neurogenesis plays a critical role in neural plas...

  9. Factors affecting the concussion knowledge of athletes, parents, coaches, and medical professionals

    PubMed Central

    Cusimano, Michael D; Zhang, Stanley; Topolovec-Vranic, Jane; Hutchison, Michael G; Jing, Rowan

    2017-01-01

    Objectives: To determine the predictors of knowledge and awareness of concussion symptoms and outcomes through a survey of athletes, parents of players and coaches in sports settings in Canada. Methods: A cross-sectional survey of athletic communities in Canada was conducted. Respondents’ concussion knowledge score consists of responses to questions about the symptoms, diagnosis, and treatment of a concussion and the timing of return-to-sport post-concussion. The percentage of correct responses was defined as the “identification rate.” The extent to which participant factors affected the scores was examined by univariate and multivariate analyses. Results: Respondents were able to identify a mean of 80.6% of symptoms. Cognitive symptoms were most commonly known, and mental health symptoms associated with concussion were least known, and health professionals, coaches, and those with a personal history of concussion had the highest levels of overall knowledge. Language, age, educational level, annual household income, and traumatic brain injury history were good predictors of better concussion knowledge. Conclusion: Those designing and implementing interventions aimed at concussion management and prevention should ensure that younger, lower income, lower educational, non-English-speaking persons, and those without experience of traumatic brain injury or concussion be specifically accounted for in the design and implementation of interventions to prevent and treat concussion and mild traumatic brain injury. PMID:28540042

  10. The key factors affecting students' individual interest in school science lessons

    NASA Astrophysics Data System (ADS)

    Cheung, Derek

    2018-01-01

    Individual interest in school science lessons can be defined as a relatively stable and enduring personal emotion comprising affective and behavioural reactions to events in the regular science lessons at school. Little research has compared the importance of different factors affecting students' individual interest in school science lessons. The present study aimed to address this gap, using a mixed methods design. Qualitative interview data were collected from 60 Hong Kong junior secondary school students, who were asked to describe the nature of their interest in science lessons and the factors to which they attribute this. Teacher interviews, parent interviews, and classroom observations were conducted to triangulate student interview data. Five factors affecting students' individual interest in school science lessons were identified: situational influences in science lessons, individual interest in science, science self-concept, grade level, and gender. Quantitative data were then collected from 591 students using a questionnaire. Structural equation modelling was applied to test a hypothesised model, which provided an acceptable fit to the student data. The strongest factor affecting students' individual interest in school science lessons was science self-concept, followed by individual interest in science and situational influences in science lessons. Grade level and gender were found to be nonsignificant factors. These findings suggest that teachers should pay special attention to the association between academic self-concept and interest if they want to motivate students to learn science at school.

  11. Pharmaceutic factors affecting pediatric compliance.

    PubMed

    Mattar, M E; Markello, J; Yaffe, S J

    1975-01-01

    Evaluation of treatment given at home was studied in children with otitis media who were seen in an outpatient clinic. Full compliance was present in only 5% of the initial 100 patients (Study A). Practical factors limiting their compliance included inadequate dispensing of medication at drug stores, 15%; incorrect therapy schedule, 36%; early termination, 37%; spilled medicine, 7%; therapy shared, 5%. Because of these findings, a plan was implemented (Study B) in which hospital pharmacy personnel gave patient families verbal and written instructions for administering medications that were dispensed, together with a calibrated measuring device and a calendar to record doses taken. Full compliance was raised to 51% in this pilot group (of 33 patients) as compared with 8.5% in 20 concurrent controls who went to neighborhood drug stores. The importance of detailed therapy instructions is stressed. The potential role of the pharmacist in improving compliance is demonstrated.

  12. Factors Associated With Full Implementation of Scope of Practice.

    PubMed

    Ganz, Freda DeKeyser; Toren, Orly; Fadlon, Yafit

    2016-05-01

    To describe whether nurses fully implement their scope of practice; nurses' perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self-efficacy. A descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post-basic certification from two Israeli university hospitals, from May 2012 to September 2013. Five questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self-Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self-efficacy were the predictors. High levels of professional autonomy, self-efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self-efficacy, and attitudes towards future practice, but not with current implementation. Nurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers. Even though staff nurses with post-basic certification had high levels of professional autonomy and self-efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses

  13. Factors that affect implementation of web-based faculty evaluation forms: residents' perspectives from a developing country.

    PubMed

    Ibrahim, S H; Ali, S K; Sadaf, S

    2010-08-01

    A web-based evaluation system for residents to provide feedback on faculty was piloted in four training programs at the Aga Khan University prior to institution-wide implementation. Of the four programs, less than 50% of forms were submitted by residents of three programs while more than 70% of forms were submitted by the residents of one program. This study was conducted to identify reasons for the varying participation rates of the four programs with a view to improving the system. A qualitative approach was employed using focus group discussions (FGDs). Volunteers were invited and three groups of eight to ten residents each were formed. Participants for FGDs were selected from all residency years. FGDs were used to identify residents' perceptions regarding the web-based faculty evaluation system and to identify residents' problems and concerns with completing the web-based faculty evaluating forms. Technical issues in completing and submitting the forms online were identified to be the main deterrents to completing the evaluation forms. Non-accessibility of a resource person for resolving technical problems with the software and the burden of taking time out to complete the forms were considered as limiting factors by many residents. Residents recommended a focused orientation session to the new system within the departments. Residents' confidence and support are key to promoting adequate participation in web-based evaluations. Focused orientation sessions, reinforcement, reminders, assurances of confidentiality, and removal of technical glitches should help to improve resident participation.

  14. Implementing bicycle improvements at the local level

    DOT National Transportation Integrated Search

    1998-09-01

    This implementational manual is intended for local governments who want to make improvements to existing conditions that affect bicycling. Thirteen of the most typical situations or factors that impact bicycle use are considered.

  15. 75 FR 80114 - Agency Information Collection (Obligation To Report Factors Affecting Entitlement) Activity Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... (Obligation To Report Factors Affecting Entitlement) Activity Under OMB Review AGENCY: Veterans Benefits... Report Factors Affecting Entitlement (38 CFR 3.204(a)(1), 38 CFR 3.256(a) and 38 CFR 3.277(b)). OMB... benefits must report changes in their entitlement factors. Individual factors such as income, marital...

  16. Factors Affecting Students' Grades in Principles of Economics

    ERIC Educational Resources Information Center

    Kara, Orhan; Bagheri, Fathollah; Tolin, Thomas

    2009-01-01

    Factors affecting students' grades in principles of microeconomics and macroeconomics students are analyzed from the data collected in two public universities. Results indicate that gender, number of hours worked, SAT scores, number of missed classes, recommending the course to a friend, instructors, being a junior, number of economics courses…

  17. Systematic review of factors affecting pharmaceutical expenditures.

    PubMed

    Mousnad, Mohamed Awad; Shafie, Asrul Akmal; Ibrahim, Mohamed Izham

    2014-06-01

    To systematically identify the main factors contributing to the increase in pharmaceutical expenditures. A systematic search of published studies was conducted utilising major widely used electronic databases using the search terms 'factors,' 'financing,' 'pharmaceutical,' and 'expenditures.' To be included, the studies needed to: (1) measure at least one of the following outcomes: total growth in pharmaceutical expenditures, price growth or quantity growth; (2) mention a clear method for analysing the impact of factors affecting the increases in drug expenditures; (3) be written in English. Nonprimary articles that were published only as an abstract, a review, a commentary or a letter were excluded. From a total of 2039 studies, only 25 were included in the full review. The main determinant categories that were identified in the review were factors related to price, utilisation, therapeutic choice, demand and health care system. The major cost drivers were found to be changes in drug quantities and therapies as well as new drugs. It is important for policymakers to understand pharmaceutical spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Key factors affecting dying children and their families.

    PubMed

    Hinds, Pamela S; Schum, Lisa; Baker, Justin N; Wolfe, Joanne

    2005-01-01

    The death of a child alters the life and health of others immediately and for the rest of their lives. How a child dies influences parents' abilities to continue their role functions as well as siblings' abilities to make and maintain friendships, and may be the basis for health care providers' decisions to exit direct care roles. Thus, facilitating a "good death"-an obvious care priority for all involved with the dying child-ought also to be a priority for the health of bereaved families and affected health care providers. Making this a care priority is complicated by a serious lack of data, as details of the last hours or weeks of a dying child or adolescent's life are largely unknown. The purpose of this paper is to identify key factors that affect the course of dying children and adolescents and that of their bereaved survivors, and to link those key factors to needed research that could produce clinically relevant findings to improve the care of these patients. Key factors described here include suffering (physical, psychological, and spiritual), communication, decision making, prognostic ambiguities, ability of the seriously ill child to give assent to research participation, and educational preparation of health care providers to give competent end-of-life care.

  19. Factors Affecting Online Groupwork Interest: A Multilevel Analysis

    ERIC Educational Resources Information Center

    Du, Jianxia; Xu, Jianzhong; Fan, Xitao

    2013-01-01

    The purpose of the present study is to examine the personal and contextual factors that may affect students' online groupwork interest. Using the data obtained from graduate students in an online course, both student- and group-level predictors for online groupwork interest were analyzed within the framework of hierarchical linear modeling…

  20. Factors Affecting the Technology Readiness of Health Professionals

    ERIC Educational Resources Information Center

    Myers, Stephanie E.

    2010-01-01

    Federal government policies are promoting diffusion of technologies into the healthcare system. If health professionals reject the new technologies planned for the healthcare system, it could result in costly failures, delays, and workforce problems. There is a lack of knowledge about factors that affect technology readiness (TR), defined as the…

  1. Factors affecting knowledge transfer from continuing professional education to clinical practice: Development and psychometric properties of a new instrument.

    PubMed

    Vasli, Parvaneh; Dehghan-Nayeri, Nahid; Khosravi, Laleh

    2018-01-01

    Despite the emphasis placed on the implementation of continuing professional education programs in Iran, researchers or practitioners have not developed an instrument for assessing the factors that affect the knowledge transfer from such programs to clinical practice. The aim of this study was to design and validate such instrument for the Iranian context. The research used a three-stage mix method. In the first stage, in-depth interviews with nurses and content analysis were conducted, after which themes were extracted from the data. In the second stage, the findings of the content analysis and literature review were examined, and preliminary instrument options were developed. In the third stage, qualitative content validity, face validity, content validity ratio, content validity index, and construct validity using exploratory factor analysis was conducted. The reliability of the instrument was measured before and after the determination of construct validity. Primary tool instrument initially comprised 53 items, and its content validity index was 0.86. In the multi-stage factor analysis, eight questions were excluded, thereby reducing 11 factors to five and finally, to four. The final instrument with 43 items consists of the following dimensions: structure and organizational climate, personal characteristics, nature and status of professionals, and nature of educational programs. Managers can use the Iranian instrument to identify factors affecting knowledge transfer of continuing professional education to clinical practice. Copyright © 2017. Published by Elsevier Ltd.

  2. Factors affecting receipt of chemotherapy in women with breast cancer

    PubMed Central

    Morimoto, Libby; Coalson, Jenna; Mowat, Fionna; O’Malley, Cynthia

    2010-01-01

    Aims: To review literature describing factors associated with receipt of chemotherapy for breast cancer, to better understand what factors are most relevant to women’s health and whether health disparities are apparent, and to assess how these factors might affect observational studies and outcomes research. Patterns of care for metastatic breast cancer, for which no standard-of-care exists, were of particular interest. Methods: Relevant studies written in English, Italian, French, or Spanish, published in 2000 or later, were identified through MEDLINE and reviewed. Review articles and clinical trials were excluded; all observational studies and surveys were considered. Articles were reviewed for any discussion of patient characteristics, hospital/physician/insurance characteristics, psychosocial characteristics, and clinical characteristics affecting receipt of chemotherapy by breast cancer patients. Results: In general, factors associated with increased likelihood of receiving chemotherapy included younger age, being Caucasian, having good general health and few co-morbidities, having more severe clinical disease, having responded well to previous treatment, and having breast cancer that is estrogen- or progesterone-receptor-negative. Many of the clinical factors found to increase the likelihood of receiving chemotherapy were consistent with current oncology guidelines. Of the relevant 19 studies identified, only six (32%) reported data specific to metastatic cancer; most studies aggregated women with stage I–IV for purposes of analysis. Conclusion: Studies of patterns of care in breast cancer treatment can help identify challenges in health care provided to particular subgroups of women and can aid researchers in designing studies that account for such factors in clinical and outcomes research. Although scarce, studies evaluating only women with metastatic breast cancer indicate that factors affecting decisions related to receipt of chemotherapy are similar

  3. Potential safety issues and other factors that may affect the introduction and uptake of rotavirus vaccines

    PubMed Central

    Aliabadi, N.; Tate, J.E.; Parashar, U.D.

    2018-01-01

    Rotavirus vaccines have demonstrated significant impact in reducing the burden of morbidity and mortality from childhood diarrhoea in countries that have implemented routine vaccination to date. Despite this success, in many countries, rotavirus vaccine coverage remains lower than that of other routine childhood vaccines. Several issues may potentially affect vaccine uptake, namely safety concerns related to intussusception with consequent age restrictions on rotavirus vaccination, contamination with porcine circovirus, vaccine-derived reassortant strains and hospitalization in newborn nurseries at time of administration of live oral rotavirus vaccine. In addition to these safety concerns, other factors may also affect uptake, including lower vaccine efficacy in the developing world, potential emergence of strains escaping from vaccine protection resulting in lower overall impact of a vaccination programme and sustainable vaccine financing. Although further work is needed to address some of these concerns, global policy bodies have reaffirmed that the benefits of rotavirus vaccination outweigh the risks, and vaccine use is recommended globally. PMID:27129416

  4. Potential safety issues and other factors that may affect the introduction and uptake of rotavirus vaccines.

    PubMed

    Aliabadi, N; Tate, J E; Parashar, U D

    2016-12-01

    Rotavirus vaccines have demonstrated significant impact in reducing the burden of morbidity and mortality from childhood diarrhoea in countries that have implemented routine vaccination to date. Despite this success, in many countries, rotavirus vaccine coverage remains lower than that of other routine childhood vaccines. Several issues may potentially affect vaccine uptake, namely safety concerns related to intussusception with consequent age restrictions on rotavirus vaccination, contamination with porcine circovirus, vaccine-derived reassortant strains and hospitalization in newborn nurseries at time of administration of live oral rotavirus vaccine. In addition to these safety concerns, other factors may also affect uptake, including lower vaccine efficacy in the developing world, potential emergence of strains escaping from vaccine protection resulting in lower overall impact of a vaccination programme and sustainable vaccine financing. Although further work is needed to address some of these concerns, global policy bodies have reaffirmed that the benefits of rotavirus vaccination outweigh the risks, and vaccine use is recommended globally. Published by Elsevier Ltd.

  5. An analytical hierarchy process-based study on the factors affecting legislation on plastic bags in the USA.

    PubMed

    Li, Zhongguo; Zhao, Fu

    2017-08-01

    Annually, a large number of used plastic shopping bags are released into the environment, posing significant threats to public health and wildlife. Owing to these concerns, many local, regional, and national governments around the world have passed legislation to ban or restrict the use of plastic shopping bags. However, in the USA there are only 18 states that have approved plastic bag bans/fees, and even within these states these regulations do not cover all cities or counties. There are many factors that could affect the development and implementation of these regulations. This article employs an analytical hierarchy process to analyse the factors that could impact the enactment of plastic bag regulations. Five impact factors are identified based on statistical data, that is, geographical location, interest of industry achievable, cost of living, level of economic development, and educational level of population. The weights of the five impact factors are determined and it is found that the possibility of banning or restricting plastic bags in general follows a certain pattern among all states.

  6. Physical activity promotion in schools: which strategies do schools (not) implement and which socioecological factors are associated with implementation?

    PubMed

    Cardon, Greet M; Van Acker, Ragnar; Seghers, Jan; De Martelaer, Kristine; Haerens, Leen L; De Bourdeaudhuij, Ilse M M

    2012-06-01

    We studied the implementation and associated factors of strategies (e.g. sports after school and during lunch break, active schoolyards, active school commuting) and organizational principles (e.g. safe bike racks, pupil involvement) that facilitate the physical activity (PA)-promoting role of schools. Key representatives of 111 elementary and 125 secondary schools filled out an online survey. Less than half of the elementary schools organized sports during lunch-break or after school. In secondary schools the least implemented strategies were the promotion of active school commuting and after-school sports. In general pupil, parental and community involvement scored low. Better knowledge of community schools and having attended in-service training were associated with higher implementation scores in elementary and secondary schools. Better implementation of the strategies was found in larger schools. Participation in activities from the School Sports Association and more perceived interest from parents and the school board were also associated with higher implementation scores. In conclusion, knowledge of community schools and in-service training next to sufficient human resources are potential key factors to promote PA. Efforts are needed to convince and help schools to increase parental and pupil involvement and to build a policy on school-community partnerships.

  7. Factors affecting the periapical healing process of endodontically treated teeth

    PubMed Central

    Holland, Roberto; Gomes, João Eduardo; Cintra, Luciano Tavares Angelo; Queiroz, Índia Olinta de Azevedo; Estrela, Carlos

    2017-01-01

    Abstract Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction. PMID:29069143

  8. User acceptability--a critical success factor for picture archiving and communication system implementation.

    PubMed

    Crivianu-Gaita, D; Babyn, P; Gilday, D; O'Brien, B; Charkot, E

    2000-05-01

    The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

  9. Successful Implementation Factors for Using Computers in Iranian Schools during One Decade (1995-2005)

    ERIC Educational Resources Information Center

    Zamani, Bibi Eshrat

    2010-01-01

    The main purpose of this paper is to identify factors and conditions that are important for successful implementation of computers in Iranian schools during one decade from 1995 to 2005. The second focus of this paper is to examine how these factors relate to models of implementation in other countries such as developed countries. This paper is…

  10. Factors affecting outcome in ocular myasthenia gravis.

    PubMed

    Mazzoli, Marco; Ariatti, Alessandra; Valzania, Franco; Kaleci, Shaniko; Tondelli, Manuela; Nichelli, Paolo F; Galassi, Giuliana

    2018-01-01

    50%-60% of patients with ocular myasthenia gravis (OMG) progress to generalized myasthenia gravis (GMG) within two years. The aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables. We reviewed a cohort of 168 Caucasian patients followed from September 2000 to January 2016. Several independent variables were considered as prognostic factors: gender, age of onset, results on electrophysiological tests, presence and level of antibodies against acetylcholine receptors (AChR Abs), treatments, thymic abnormalities. The primary outcome was the progression to GMG and/or the presence of bulbar symptoms. Secondary outcomes were either achievement of sustained minimal manifestation status or worsening in ocular quantitative MG subscore (O-QMGS) or worsening in total QMG score (T-QMGS), assessed by Myasthenia Gravis Foundation of America (MGFA) quantitative scores. Changes in mental and physical subscores of health-related quality of life (HRQoL) were assessed with SF-36 questionnaire. Variance analysis was used to interpret the differences between AChR Ab titers at different times of follow up among the generalized and non-generalized patients. Conversion to GMG occurred in 18.4% of patients; it was significantly associated with sex, later onset of disease and anti-AChR Ab positivity. Antibody titer above the mean value of 25.8 pmol/mL showed no significant effect on generalization. Sex and late onset of disease significantly affected T-QMGS worsening. None of the other independent variables significantly affected O-QMGS and HRQoL. Sex, later onset and anti-AChR Ab positivity were significantly associated with clinical worsening.

  11. Implementing Cooperative Learning in Australian Primary Schools: Generalist Teachers' Perspectives

    ERIC Educational Resources Information Center

    Hennessey, Angela; Dionigi, Rylee A.

    2013-01-01

    To implement cooperative learning successfully in practice, teachers require knowledge of cooperative learning, its features and terms, and how it functions in classrooms. This qualitative study examined 12 Australian generalist primary teachers', understandings of cooperative learning and perceived factors affecting its implementation. Using…

  12. Factors affecting nutrient trends in major rivers of the Chesapeake Bay Watershed

    USGS Publications Warehouse

    Sprague, Lori A.; Langland, M.J.; Yochum, S.E.; Edwards, R.E.; Blomquist, J.D.; Phillips, S.W.; Shenk, G.W.; Preston, S.D.

    2000-01-01

    Trends in nutrient loads and flow-adjusted concentrations in the major rivers entering Chesapeake Bay were computed on the basis of water-quality data collected between 1985 and 1998 at 29 monitoring stations in the Susquehanna, Potomac, James, Rappahannock, York, Patuxent, and Choptank River Basins. Two computer models?the Chesapeake Bay Watershed Model (WSM) and the U.S. Geological Survey?s 'Spatially Referenced Regressions on Watershed attributes' (SPARROW) Model?were used to help explain the major factors affecting the trends. Results from WSM simulations provided information on temporal changes in contributions from major nutrient sources, and results from SPARROW model simulations provided spatial detail on the distribution of nutrient yields in these basins. Additional data on nutrient sources, basin characteristics, implementation of management practices, and ground-water inputs to surface water were analyzed to help explain the trends. The major factors affecting the trends were changes in nutrient sources and natural variations in streamflow. The dominant source of nitrogen and phosphorus from 1985 to 1998 in six of the seven tributary basins to Chesapeake Bay was determined to be agriculture. Because of the predominance of agricultural inputs, changes in agricultural nutrient sources such as manure and fertilizer, combined with decreases in agricultural acreage and implementation of best management practices (BMPs), had the greatest impact on the trends in flow-adjusted nutrient concentrations. Urban acreage and population, however, were noted to be increasing throughout the Chesapeake Bay Watershed, and as a result, delivered loads of nutrients from urban areas increased during the study period. Overall, agricultural nutrient management, in combination with load decreases from point sources due to facility upgrades and the phosphate detergent ban, led to downward trends in flow-adjusted nutrient concentrations atmany of the monitoring stations in the

  13. Factors affecting sexual function in menopause: A review article.

    PubMed

    Nazarpour, Soheila; Simbar, Masoumeh; Tehrani, Fahimeh Ramezani

    2016-08-01

    This study aimed to systematically review the articles on factors affecting sexual function during menopause. Searching articles indexed in Pubmed, Science Direct, Iranmedex, EMBASE, Scopus, and Scientific Information Database databases, a total number of 42 studies published between 2003 and 2013 were selected. Age, estrogen deficiency, type of menopause, chronic medical problems, partner's sex problems, severity of menopause symptoms, dystocia history, and health status were the physical factors influencing sexual function of menopausal women. There were conflicting results regarding the amount of androgens, hormonal therapy, exercise/physical activity, and obstetric history. In the mental-emotional area, all studies confirmed the impact of depression and anxiety. Social factors, including smoking, alcohol consumption, the quality of relationship with husband, partner's loyalty, sexual knowledge, access to health care, a history of divorce or the death of a husband, living apart from a spouse, and a negative understanding of women's health were found to affect sexual function; however, there were conflicting results regarding the effects of education, occupation, socioeconomic status, marital duration, and frequency of sexual intercourse. Copyright © 2016. Published by Elsevier B.V.

  14. Complementary feeding: clinically relevant factors affecting timing and composition.

    PubMed

    Krebs, Nancy F; Hambidge, K Michael

    2007-02-01

    Exclusive breastfeeding for the first 6 mo of life followed by optimal complementary feeding are critical public health measures for reducing and preventing morbidity and mortality in young children. Clinical factors, such as birth weight, prematurity, and illness, that affect the iron and zinc requirements of younger infants are discussed. Maternal diet and nutritional status do not have a strong effect on the mineral content of human milk, but physiologic changes in milk and the infants' status determine the dependence of the infant on complementary foods in addition to human milk to meet iron and zinc requirements after 6 mo. The nature of zinc absorption, which is suitably characterized by saturation response modeling, dictates that plant-based diets, which are low in zinc, are associated with low absolute daily absorbed zinc, which is inadequate to meet requirements. Foods with a higher zinc content, such as meats, are much more likely to be sufficient to meet dietary requirements. Current plant-based complementary feeding patterns for older fully breastfed infants in both developed and developing countries pose a risk of zinc deficiency. The strong rationale for the potential benefits of providing meat as an early complementary food, and the examples of successful intervention programs, provide potent incentives to pursue broader implementation programs, with concurrent rigorous evaluation of both efficacy and effectiveness.

  15. Analysis on factors affecting consumers decision on purchasing simple-type houses

    NASA Astrophysics Data System (ADS)

    Rumintang, A.; Sholichin, I.

    2018-01-01

    In line with the increase of the population and the need of comfortable houses, as affected by modernization era, the house demand is getting higher. Hence, conducting a research on consumers need and want in buying a house should be seriously attempted to succeed marketing activity. Using an analysis consumers’ behavior, the researcher will know few affecting factors related to consumers’ satisfaction in buying a house. Among other, the factors in question include: house price, house condition, facilities, location and accessability. The sample of this research was drawn from the residents of Graha Asri Housing, Taman Bulang Permai, and Sukodono Permai. Based on the analysis and discussion, some conclusions are made as follow: the factors and variables affecting the consumers’ decision on each choice of house is different and also the same variables on three sources of data include housing atmosphere, cleaning service, ease of access to shopping center, health clinics or hospitals, tourism spot, schools, and the bus station.

  16. Specifying an implementation framework for Veterans Affairs antimicrobial stewardship programmes: using a factor analysis approach.

    PubMed

    Chou, Ann F; Graber, Christopher J; Zhang, Yue; Jones, Makoto; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew; Glassman, Peter A

    2018-06-04

    Inappropriate antibiotic use poses a serious threat to patient safety. Antimicrobial stewardship programmes (ASPs) may optimize antimicrobial use and improve patient outcomes, but their implementation remains an organizational challenge. Using the Promoting Action on Research Implementation in Health Services (PARiHS) framework, this study aimed to identify organizational factors that may facilitate ASP design, development and implementation. Among 130 Veterans Affairs facilities that offered acute care, we classified organizational variables supporting antimicrobial stewardship activities into three PARiHS domains: evidence to encompass sources of knowledge; contexts to translate evidence into practice; and facilitation to enhance the implementation process. We conducted a series of exploratory factor analyses to identify conceptually linked factor scales. Cronbach's alphas were calculated. Variables with large uniqueness values were left as single factors. We identified 32 factors, including six constructs derived from factor analyses under the three PARiHS domains. In the evidence domain, four factors described guidelines and clinical pathways. The context domain was broken into three main categories: (i) receptive context (15 factors describing resources, affiliations/networks, formalized policies/practices, decision-making, receptiveness to change); (ii) team functioning (1 factor); and (iii) evaluation/feedback (5 factors). Within facilitation, two factors described facilitator roles and tasks and five captured skills and training. We mapped survey data onto PARiHS domains to identify factors that may be adapted to facilitate ASP uptake. Our model encompasses mostly mutable factors whose relationships with performance outcomes may be explored to optimize antimicrobial use. Our framework also provides an analytical model for determining whether leveraging existing organizational processes can potentially optimize ASP performance.

  17. A Systemic Approach to Implementing a Protective Factors Framework

    ERIC Educational Resources Information Center

    Parsons, Beverly; Jessup, Patricia; Moore, Marah

    2014-01-01

    The leadership team of the national Quality Improvement Center on early Childhood ventured into the frontiers of deep change in social systems by funding four research projects. The purpose of the research projects was to learn about implementing a protective factors approach with the goal of reducing the likelihood of child abuse and neglect. In…

  18. 14 CFR Appendix B to Part 1215 - Factors Affecting Standard Charges

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... DATA RELAY SATELLITE SYSTEM (TDRSS) Pt. 1215, App. B Appendix B to Part 1215—Factors Affecting Standard Charges Charges for services shall be determined by multiplying the factors below by the base rates for...

  19. Other Factors That Affect Heart Disease: Birth Control Pills

    MedlinePlus

    ... Heart Handbook for Women Other Factors That Affect Heart Disease Birth Control Pills Studies show that women who ... t had any more complications because of my heart disease." — Diane Pay attention to diabetes. Levels of glucose, ...

  20. Reappraising factors affecting mourning dove perch coos

    USGS Publications Warehouse

    Sayre, M.W.; Atkinson, R.D.; Baskett, T.S.; Haas, G.H.

    1978-01-01

    Results confirmed pairing as the primary factor influencing perch-cooing rates of wild mourning doves (Zenaida macroura). Marked unmated males cooed at substantially higher rates (6.2x) than mated males, had greater probability of cooing (2.3x) during 3-minute periods, and continued cooing longer each morning than mated males. Population density was not a major factor affecting cooing. Unmated males cooed more frequently in the presence of other cooing doves (P < 0.05) than when alone, but the number of additional doves above 1 was unimportant. Cooing rates of both mated and unmated males on areas with dissimilar dove densities were not significantly different. Within limits of standard call-count procedure, weather exerted no detectable influence on cooing.

  1. Analysis of factors that inhibiting implementation of Information Security Management System (ISMS) based on ISO 27001

    NASA Astrophysics Data System (ADS)

    Tatiara, R.; Fajar, A. N.; Siregar, B.; Gunawan, W.

    2018-03-01

    The purpose of this research is to determine multi factors that inhibiting the implementation of the ISMS based on ISO 2700. It is also to propose a follow-up recommendation on the factors that inhibit the implementation of the ISMS. Data collection is derived from questionnaires to 182 respondents from users in data center operation (DCO) at bca, Indonesian telecommunication international (telin), and data centre division at Indonesian Ministry of Health. We analysing data collection with multiple linear regression analysis and paired t-test. The results are multiple factors which inhibiting the implementation of the ISMS from the three organizations which has implement and operate the ISMS, ISMS documentation management, and continual improvement. From this research, we concluded that the processes of implementation in ISMS is the necessity of the role of all parties in succeeding the implementation of the ISMS continuously.

  2. Organisational Factors Affecting Policy and Programme Decision Making in a Public Health Policy Environment

    ERIC Educational Resources Information Center

    Zardo, Pauline; Collie, Alex; Livingstone, Charles

    2015-01-01

    Organisational factors can affect the success of interventions aimed at increasing research use. Research is needed to identify organisational factors affecting research use in specific public health policy contexts. Qualitative interviews with decision makers from a specific public health context identified a range of organisational factors that…

  3. Factors affecting dental service quality.

    PubMed

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia

    2015-01-01

    Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.

  4. Exploring Factors that Affect Purchase Intention of Athletic Team Merchandise

    ERIC Educational Resources Information Center

    Lee, Donghun; Trail, Galen T.; Lee, Cindy; Schoenstedt, Linda J.

    2013-01-01

    The purpose of this study was to test a structural model to determine which psychosocial constructs affected the purchase intention of athletic team merchandise (ATM). Results from the analyses indicated that the twelve-factor ATM model fit the data from collegiate athletic events well, explaining the various impact factors that lead to purchase…

  5. The School Counseling Program Implementation Survey: Initial Instrument Development and Exploratory Factor Analysis

    ERIC Educational Resources Information Center

    Clemens, Elysia V.; Carey, John C.; Harrington, Karen M.

    2010-01-01

    This article details the initial development of the School Counseling Program Implementation Survey and psychometric results including reliability and factor structure. An exploratory factor analysis revealed a three-factor model that accounted for 54% of the variance of the intercorrelation matrix and a two-factor model that accounted for 47% of…

  6. 29 CFR 784.118 - The exemption is intended for work affected by natural factors.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false The exemption is intended for work affected by natural...(a)(5) Exemption § 784.118 The exemption is intended for work affected by natural factors. As... that are controlled or materially affected by natural factors or elements, such as the vicissitudes of...

  7. 29 CFR 784.118 - The exemption is intended for work affected by natural factors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false The exemption is intended for work affected by natural...(a)(5) Exemption § 784.118 The exemption is intended for work affected by natural factors. As... that are controlled or materially affected by natural factors or elements, such as the vicissitudes of...

  8. Factors Influencing Implementation of a Preschool-Based Physical Activity Intervention

    ERIC Educational Resources Information Center

    Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.

    2017-01-01

    Examining factors that influence implementation of key program components that underlie an intervention's success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on…

  9. Drug use prevention: factors associated with program implementation in Brazilian urban schools.

    PubMed

    Pereira, Ana Paula Dias; Sanchez, Zila M

    2018-03-07

    A school is a learning environment that contributes to the construction of personal values, beliefs, habits and lifestyles, provide convenient settings for the implementation of drug use prevention programs targeting adolescents, who are the population group at highest risk of initiating drug use. The objective of the present study was to investigate the prevalence of factors associated with implementing drug use prevention programs in Brazilian public and private middle and high urban schools. The present population-based cross-sectional survey was conducted with a probability sample of 1151 school administrators stratified by the 5 Brazilian administrative divisions, in 2014. A close-ended, self-reported online questionnaire was used. Logistic regression analysis was used to identify factors associated with implementing drug use prevention programs in schools. A total of 51.1% of the schools had adopted drug use prevention programs. The factors associated with program implementation were as follows: belonging to the public school network; having a library; development of activities targeting sexuality; development of "Health at School Program" activities; offering extracurricular activities; and having an administrator that participated in training courses on drugs. The adoption of drug use prevention practices in Brazilian schools may be expanded with greater orchestration of schools through specialized training of administrators and teachers, expansion of the School Health Program and concomitant development of the schools' structural and curricular attributes.

  10. Affecting Factors on Local Waste Management in Penyangkringan Village, Weleri: an Identification

    NASA Astrophysics Data System (ADS)

    Puspita Adriyanti, Nadia; Candra Dewi, Ova; Gamal, Ahmad; Joko Romadhon, Mohammad; Raditya

    2018-03-01

    Villages in Indonesia usually does not have proper waste management and it is affecting the environmental and social condition in those places. Local governments have been trying to implement many kinds of solid waste management systems and yet many of them does not bear fruit. We argue that the failure of the waste management implementation in Indonesian villages is due to several aspects: the geographic condition of the villages, the social conditions, and the availability of facilities and infrastructures in those villages. Waste management should be modeled in accordance to those three aspects.

  11. Formal Classroom Observations: Factors That Affect Their Success

    ERIC Educational Resources Information Center

    Zaidi, Zeba

    2017-01-01

    Formal class room observation is a very delicate topic in any educational institution. It involves a series of emotions and sentiments that come with the package. In this paper, the researcher will attempt to analyze the factors that affect the process in a relatively significant manner and thereby contribute greatly to the success or failure of…

  12. Factors affecting patient compliance with compressive brace therapy for pectus carinatum.

    PubMed

    Kang, Du-Young; Jung, Junho; Chung, Sangho; Cho, Jinkyung; Lee, Sungsoo

    2014-12-01

    The aim of this study was to identify factors affecting patient compliance with brace therapy for pectus carinatum. Eighty-six pectus carinatum patients who started brace therapy from August 2008 to November 2011 were included in this study. Patients were divided into two groups: patients who wore the brace for ≥6 months (compliance group) or patients who wore the brace for <6 months (non-compliance group). Factors affecting patient compliance were assessed at the last day of follow-up with a multiple-choice questionnaire. The questionnaire comprised seven items: pain at compression site, skin problems on compression area, confidence in brace treatment, shame, discomfort, initial result of bracing treatment and total number of factors affecting patient compliance. Eighty-six patients completed the survey, including seven (8.1%) female patients and 79 (91.9%) male patients, with a mean age of 12.0 years at the time of treatment (range, 3-20 years). The initial result of the compression period (P <0.001) and total number of factors affecting patient compliance (P <0.05) were significant predictors of patient compliance. An initial successful result of the compression period may increase patient compliance during treatment for pectus carinatum. Additional efforts to decrease pain, skin problems, shame and discomfort, and to give confidence may be beneficial in increasing compliance with bracing treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  13. [Factors affecting the control of blood pressure and lipid levels in patients with cardiovascular disease: the PREseAP Study].

    PubMed

    Orozco-Beltrán, Domingo; Brotons, Carlos; Moral, Irene; Soriano, Nuria; Del Valle, María A; Rodríguez, Ana I; Pepió, Josep M; Pastor, Ana

    2008-03-01

    The aim of this observational study was to identify factors influencing the control of blood pressure (i.e., <140/90 mmHg, or <130/80 mmHg in diabetic patients) and low-density lipoprotein (LDL) cholesterol level (<100 mg/dL) in 1223 patients with cardiovascular disease. Overall, 70.2% of patients were men, and their mean age was 66.4 years. Blood pressure was poorly controlled in 50.9% (95% confidence interval [CI], 46.9%-54.8%) and the LDL cholesterol level was poorly controlled in 60.1% (95% CI, 56.3%-63.9%). Determinants of poor blood pressure control were diabetes, hypertension, no previous diagnosis of heart failure, previous diagnosis of peripheral artery disease or stroke, obesity, and no lipid-lowering treatment. Determinants of poor LDL cholesterol control were no lipid-lowering treatment, no previous diagnosis of ischemic heart disease, no antihypertensive treatment, and dyslipidemia. The factors affecting blood pressure control were different from those affecting LDL cholesterol control, an observation that should be taken into account when implementing treatment recommendations for achieving therapeutic objectives in secondary prevention.

  14. Factors affecting the academic performance of optometry students in Mozambique.

    PubMed

    Shah, Kajal; Naidoo, Kovin; Bilotto, Luigi; Loughman, James

    2015-06-01

    The Mozambique Eyecare Project is a higher education partnership for the development, implementation, and evaluation of a model of optometry training at UniLúrio in Mozambique. There are many composite elements to the development of sustainable eye health structures, and appropriate education for eye health workers remains a key determinant of successful eye care development. However, from the first intake of 16 students, only 9 students graduated from the program, whereas only 6 graduated from the second intake of 24 students. This low graduation rate is attributable to a combination of substandard academic performance and student dropout. The aim of this article was to identify factors affecting the academic performance of optometry students in Mozambique. Nine lecturers (the entire faculty) and 15 students (9 from the first intake and 6 from the second) were recruited to the study. Clinical competency assessments were carried out on the students, semistructured individual interviews were conducted with the course lecturers, and a course evaluation questionnaire was completed by students. The results were combined to understand the complexities surrounding the optometry student training and performance. One student out of nine from the first intake and three students out of six from the second were graded as competent in all the elements of the refraction clinical competency examination. Analysis of data from the interviews and questionnaire yielded four dominant themes that were viewed as important determinants of student refraction competencies: student learning context, teaching context, clinic conditions and assessment, and the existing operating health care context. The evaluations have helped the university and course partners to better structure the teaching and adapt the learning environments by recommending a preparatory year and a review of the curriculum and clinic structure, implementing more transparent entry requirements, increasing awareness of

  15. Factors affecting maintenance overlay ride quality : 1996 rideability status.

    DOT National Transportation Integrated Search

    1997-01-01

    In early 1996, the Virginia Transportation Research Council initiated a formal analysis of the factors affecting overlay ride quality. As part of that effort, a statewide, multi-year survey of the ride quality for both new overlays and pavement await...

  16. Project BEST-PAL (Basic Education Skills Through-Parenting Affective Learning): Process Manual for Program Implementation.

    ERIC Educational Resources Information Center

    Brevard Community Coll., Cocoa, FL.

    This manual describes and evaluates the implementation of Project BEST-PAL (Basic Education Skills Through-Parent Affective Learning), Brevard Community College's special demonstration training project intended to return adults who have dropped out of the educational system back into the learning environment by bringing them to parenting classes…

  17. External factors affecting data acquisition during corneal topography examination.

    PubMed

    González-Méijome, José Manuel; Queirós, Antonio; Jorge, Jorge; Fernandes, Paulo; Cerviño, Alejandro; de Almeida, José Borges

    2007-03-01

    To analyze the factors affecting data acquisition during corneal topography examination with the Medmont E-300 videokeratoscope and to provide strategies to minimize their effects. Sixty eyes from thirty young adults were examined. A second observer registered incidences with the potential to affect data acquisition. Those factors were correlated with the difficulty of measurements as judged subjectively by the practitioner who performed the examination. Measurements of axial curvature were analyzed to evaluate the variability expressed as intrasession and intersession coefficient of variation and the standard error of the mean (SEM). The level of difficulty rated by the practitioner was in general low, with 70% of the eyes being easy or very easy to measure. For the remaining 30% of the eyes, corneal topography measurements were considered to be difficult (27%) or very difficult (3%). Of the external parameters investigated, only fixation instability (P<0.001, chi2) and the need for head repositioning (P=0.024, chi2) were associated significantly with a higher level of difficulty, as rated subjectively by the practitioner. Further analysis showed that some external factors, including those previously mentioned and others related to tear instability, affect the variability of measurements at certain corneal locations, particularly in the vertical meridian when related to tear instability and in the horizontal meridian when related to the need for head repositioning on the chin rest owing to physiognomy interferences with the keratoscope cone. Intersession SEM improved when three readings from each session were considered. The level of subjective difficulty found during videokeratoscopy examination is correlated strongly with fixation instability and the need for head reorientation in the chin rest, whereas tear-related events seem to be less relevant in the practitioner perception of test ease or difficulty. Those factors have relevance in measurement variability.

  18. Factors affecting 30-month survival in lung cancer patients.

    PubMed

    Mahesh, P A; Archana, S; Jayaraj, B S; Patil, Shekar; Chaya, S K; Shashidhar, H P; Sunitha, B S; Prabhakar, A K

    2012-10-01

    Age adjusted incidence rate of lung cancer in India ranges from 7.4 to 13.1 per 100,000 among males and 3.9 to 5.8 per 100,000 among females. The factors affecting survival in lung cancer patients in India are not fully understood. The current study was undertaken to evaluate the factors affecting survival in patients diagnosed with lung cancer attending a tertiary care cancer institute in Bangalore, Karnataka, India. Consecutive patients with primary lung cancer attending Bangalore Institute of Oncology, a tertiary care centre at Bangalore, between 2006 and 2009 were included. Demographic, clinical, radiological data were collected retrospectively from the medical records. A total of 170 consecutive subjects (128 males, 42 females) diagnosed to have lung cancer; 151 non-small cell lung cancer (NSCLC) and 19 small cell lung cancer (SCLC) were included. A higher proportion of never-smokers (54.1%) were observed, mostly presenting below the age of 60 yr. Most subjects were in stage IV and III at the time of diagnosis. More than 50 per cent of patients presented with late stage lung cancer even though the duration of symptoms is less than 2 months. The 30-month overall survival rates for smokers and never-smokers were 32 and 49 per cent, respectively. No significant differences were observed in 30 month survival based on age at presentation, gender and type of lung cancer. Cox proportional hazards model identified never-smokers and duration of symptoms less than 1 month as factors adversely affecting survival. Our results showed that lung cancer in Indians involved younger subjects and associated with poorer survival as compared to other ethnic population. Studies on large sample need to be done to evaluate risk factors in lung cancer patients.

  19. Factors affecting 30-month survival in lung cancer patients

    PubMed Central

    Mahesh, P.A.; Archana, S.; Jayaraj, B.S.; Patil, Shekar; Chaya, S.K.; Shashidhar, H.P.; Sunitha, B.S.; Prabhakar, A.K.

    2012-01-01

    Background & objectives: Age adjusted incidence rate of lung cancer in India ranges from 7.4 to 13.1 per 100,000 among males and 3.9 to 5.8 per 100,000 among females. The factors affecting survival in lung cancer patients in India are not fully understood. The current study was undertaken to evaluate the factors affecting survival in patients diagnosed with lung cancer attending a tertiary care cancer institute in Bangalore, Karnataka, India. Methods: Consecutive patients with primary lung cancer attending Bangalore Institute of Oncology, a tertiary care centre at Bangalore, between 2006 and 2009 were included. Demographic, clinical, radiological data were collected retrospectively from the medical records. Results: A total of 170 consecutive subjects (128 males, 42 females) diagnosed to have lung cancer; 151 non-small cell lung cancer (NSCLC) and 19 small cell lung cancer (SCLC) were included. A higher proportion of never-smokers (54.1%) were observed, mostly presenting below the age of 60 yr. Most subjects were in stage IV and III at the time of diagnosis. More than 50 per cent of patients presented with late stage lung cancer even though the duration of symptoms is less than 2 months. The 30-month overall survival rates for smokers and never-smokers were 32 and 49 per cent, respectively. No significant differences were observed in 30 month survival based on age at presentation, gender and type of lung cancer. Cox proportional hazards model identified never-smokers and duration of symptoms less than 1 month as factors adversely affecting survival. Interpretation & conclusions: Our results showed that lung cancer in Indians involved younger subjects and associated with poorer survival as compared to other ethnic population. Studies on large sample need to be done to evaluate risk factors in lung cancer patients. PMID:23168702

  20. Factors affecting preparedness and capacity to manage pandemic influenza: perceptions of healthcare managers.

    PubMed

    Adini, B; Laor, D; Aharonson-Daniel, L

    2014-08-01

    Numerous interventions seeking to increase preparedness for pandemic influenza have been implemented, but low compliance of healthcare providers has been reported in many instances. The aim of this study was to identify factors that affect preparedness for pandemic influenza by examining: hospital managers' perceptions of measures implemented to promote preparedness for pandemic influenza; hospital managers' assessments of the readiness and capability of their hospitals to manage pandemic influenza; and the effectiveness of a national pandemic preparedness programme in Israel over time. A quasi-experiment was conducted following implementation of a national pandemic preparedness programme in Israel. A survey assessed hospital managers' perceptions of the effectiveness of the programme, and the preparedness and capacity of their hospitals to manage pandemic influenza. Two independent evaluations of preparedness for biological threats were conducted, based on a validated tool that included 60 objective parameters. Correlations between perceived preparedness and capacity and components of the preparedness programme were analysed using Statistical Package for the Social Sciences Version 17. Stepwise logistic regression was used to determine the components that influence preparedness and capability to manage pandemic influenza. All general hospital managers in Israel were approached twice (first and second evaluations). Ninety-one percent rated themselves as highly/very highly prepared for pandemic influenza, and 87% rated themselves as highly/very highly capable of dealing with pandemic influenza. Strong correlation was found between hospital managers' perceived preparedness and capacity to manage pandemic influenza (rho = 0.761, P = 0.000), and between perceived preparedness and familiarity with the disease (rho = 0.605, P = 0.003). Familiarity with guidelines accounted for 35% of the variance in perceived capability (adjusted R(2) = 0.346, P = 0.002). Inclusion of

  1. Factors affecting medication-order processing time.

    PubMed

    Beaman, M A; Kotzan, J A

    1982-11-01

    The factors affecting medication-order processing time at one hospital were studied. The order processing time was determined by directly observing the time to process randomly selected new drug orders on all three work shifts during two one-week periods. An order could list more than one drug for an individual patient. The observer recorded the nature, location, and cost of the drugs ordered, as well as the time to process the order. The time and type of interruptions also were noted. The time to process a drug order was classified as six dependent variables: (1) total time, (2) work time, (3) check time, (4) waiting time I--time from arrival on the dumbwaiter until work was initiated, (5) waiting time II--time between completion of the work and initiation of checking, and (6) waiting time III--time after the check was completed until the order left on the dumbwaiter. The significant predictors of each of the six dependent variables were determined using stepwise multiple regression. The total time to process a prescription order was 58.33 +/- 48.72 minutes; the urgency status of the order was the only significant determinant of total time. Urgency status also significantly predicted the three waiting-time variables. Interruptions and the number of drugs on the order were significant determinants of work time and check time. Each telephone interruption increased the work time by 1.72 minutes. While the results of this study cannot be generalized to other institutions, pharmacy managers can use the method of determining factors that affect medication-order processing time to identify problem areas in their institutions.

  2. Factors Affecting the Implementation of Communicative Language Teaching in Taiwanese College English Classes

    ERIC Educational Resources Information Center

    Chang, Ming; Goswami, Jaya S.

    2011-01-01

    Foreign language teaching in many Asian-Pacific countries in recent decades has shifted toward communicative-focused instruction. However, researchers have reported a gap between policy and practice. To incorporate teachers' voices in adopting the communicative approach in the curriculum, this study explores factors that promote or hinder EFL…

  3. Teaching the Factors Affecting Resistance Using Pencil Leads

    ERIC Educational Resources Information Center

    Küçüközer, Asuman

    2015-01-01

    The aim of this paper is to provide a way of teaching the factors that affect resistance using mechanical pencil leads and the brightness of the light given out by a light bulb connected to an electrical circuit. The resistance of a conductor is directly proportional to its length (L) and inversely proportional to its cross-sectional area (A).…

  4. Technical issues affecting the implementation of US Environmental Protection Agency's proposed fish tissue-based aquatic criterion for selenium.

    PubMed

    Lemly, A Dennis; Skorupa, Joseph P

    2007-10-01

    The US Environmental Protection Agency is developing a national water quality criterion for selenium that is based on concentrations of the element in fish tissue. Although this approach offers advantages over the current water-based regulations, it also presents new challenges with respect to implementation. A comprehensive protocol that answers the "what, where, and when" is essential with the new tissue-based approach in order to ensure proper acquisition of data that apply to the criterion. Dischargers will need to understand selenium transport, cycling, and bioaccumulation in order to effectively monitor for the criterion and, if necessary, develop site-specific standards. This paper discusses 11 key issues that affect the implementation of a tissue-based criterion, ranging from the selection of fish species to the importance of hydrological units in the sampling design. It also outlines a strategy that incorporates both water column and tissue-based approaches. A national generic safety-net water criterion could be combined with a fish tissue-based criterion for site-specific implementation. For the majority of waters nationwide, National Pollution Discharge Elimination System permitting and other activities associated with the Clean Water Act could continue without the increased expense of sampling and interpreting biological materials. Dischargers would do biotic sampling intermittently (not a routine monitoring burden) on fish tissue relative to the fish tissue criterion. Only when the fish tissue criterion is exceeded would a full site-specific analysis including development of intermedia translation factors be necessary.

  5. Culture and affect: the factor structure of the affective style questionnaire and its relation with depression and anxiety among Japanese.

    PubMed

    Ito, Masaya; Hofmann, Stefan G

    2014-09-02

    Affective styles are assumed to be one of the underlying processes of depression and anxiety maintenance. However, little is known about the effect of depression and anxiety and the cultural influence of the factor structure. Here, we examined the cross-cultural validity of the Affective Style Questionnaire and its incremental validity for the influence on depression and anxiety. Affective Style Questionnaire was translated into Japanese using standard back-translation procedure. Japanese university students (N = 1,041) served as participants. Emotion Regulation Questionnaire, Acceptance and Action Questionnaire-II, Toronto Alexithymia Scale, Rumination and Reflection Questionnaire, Brief COPE, Self-Construal Scale, and Hospital Anxiety and Depression Scale were administered. Exploratory and confirmatory factor analyses showed that the Affective Style Questionnaire comprised four factors: Concealing, Adjusting, Holding and Tolerating (CFI = .92, TLI = .90, RMSEA = .07). The measure's convergent and discriminant validity was substantiated by its association with various emotion regulation measures. Regression analyses showed that negative influence of Adjusting, Holding, Reappraisal (β = -.17, -.19, -.30) and positive influence of Suppression (β = .23) were observed on depression. For anxiety, Adjusting and Reappraisal was negatively influenced (β = -.29, and -.18). Reliability and validity of the Affective Style Questionnaire was partly confirmed. Further study is needed to clarify the culturally dependent aspects of affective styles.

  6. Reducing eating disorder risk factors: A pilot effectiveness trial of a train-the-trainer approach to dissemination and implementation.

    PubMed

    Greif, Rebecca; Becker, Carolyn Black; Hildebrandt, Tom

    2015-12-01

    Impediments limit dissemination and implementation of evidence-based interventions (EBIs), including lack of sufficient training. One strategy to increase implementation of EBIs is the train-the-trainer (TTT) model. The Body Project is a peer-led body image program that reduces eating disorder (ED) risk factors. This study examined the effectiveness of a TTT model at reducing risk factors in Body Project participants. Specifically, this study examined whether a master trainer could train a novice trainer to train undergraduate peer leaders to administer the Body Project such that individuals who received the Body Project (i.e., participants) would evidence comparable outcomes to previous trials. We hypothesized that participants would evidence reductions in ED risk factors, with effect sizes similar to previous trials. Utilizing a TTT model, a master trainer trained a novice trainer to train undergraduate peer leaders to administer the Body Project to undergraduate women. Undergraduate women aged 18 years or older who received the Body Project intervention participated in the trial and completed measures at baseline, post-treatment, and five-month follow-up. Primary outcomes included body dissatisfaction, thin ideal internalization, negative affect, and ED pathology. Participants demonstrated significant reductions in thin ideal internalization, ED pathology and body dissatisfaction at post-treatment and 5-month follow-up. At 5 months, using three different strategies for managing missing data, effect sizes were larger or comparable to earlier trials for 3 out of 4 variables. Results support a TTT model for Body Project implementation and the importance of utilizing sensitivity analyses for longitudinal datasets with missing data. © 2015 Wiley Periodicals, Inc.

  7. Factors That Affect the Academic Success of Foreign Students at Cardinal Stritch University

    ERIC Educational Resources Information Center

    Annor, Peter

    2010-01-01

    There are limited studies in the literature on the factors that affect the academic success of foreign students in the United States. This ex post facto mixed method study investigated the factors that affect the academic success of foreign students at Cardinal Stitch University (CSU), a medium size, private university located in the Midwestern…

  8. Looking under the Bonnet: Factors Affecting Student Adoption of E-Learning Systems in Jordan

    ERIC Educational Resources Information Center

    Abbad, Muneer Mahmood; Morris, David; de Nahlik, Carmel

    2009-01-01

    The primary questions addressed in this paper are the following: what are the factors that affect students' adoption of an e-learning system and what are the relationships among these factors? This paper investigates and identifies some of the major factors affecting students' adoption of an e-learning system in a university in Jordan. E-learning…

  9. Institutional and Managerial Factors Affecting International Student Recruitment Management

    ERIC Educational Resources Information Center

    Ross, Mitchell; Heaney, Joo-Gim; Cooper, Maxine

    2007-01-01

    Purpose: The purpose of this paper is to investigate international student recruitment from an institutional perspective and to consider institutional factors that may affect recruitment. Design/methodology/approach: A qualitative study is undertaken in which education marketing practitioners are interviewed regarding aspects of international…

  10. Financial factors and the implementation of medications for treating opioid use disorders.

    PubMed

    Knudsen, Hannah K; Roman, Paul M

    2012-12-01

    Despite the established effectiveness of pharmacotherapies for treating opioid use disorders, implementation of medications for addiction treatment (MAT) by specialty treatment programs is limited. This research examined relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources. Face-to-face structured interviews were conducted in 2008 to 2009 with administrators of 154 community-based treatment programs affiliated with the National Institute on Drug Abuse's Clinical Trials Network; none of these programs exclusively dispensed methadone without offering other levels of care. Implementation of MAT was measured by summing the percentages of opioid patients receiving buprenorphine maintenance, methadone maintenance, and tablet naltrexone. Financial factors included the percentages of revenues received from Medicaid, private insurance, criminal justice, the Federal block grant, state government, and county government. Organizational structure and workforce characteristics were also measured. Implementation of MAT for opioid use disorders was low. Greater reliance on Medicaid was positively associated with implementation after controlling for organizational structure and workforce measures, whereas the association for reliance on criminal justice revenues was negative. The implementation of MAT for opioid use disorders by specialty addiction treatment programs may be facilitated by Medicaid but may be impeded by reliance on funding from the criminal justice system. These findings point to the need for additional research that considers the impact of organizational dependence on different types of funding on patterns of addiction treatment practice.

  11. Psychological factors affecting medical condition: a new proposal for DSM-V.

    PubMed

    Fava, Giovanni A; Fabbri, Stefania; Sirri, Laura; Wise, Thomas N

    2007-01-01

    The DSM category of "psychological factors affecting medical condition" had virtually no impact on clinical practice. However, several clinically relevant psychosomatic syndromes have been described in the literature: disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, and irritable mood. These syndromes, in addition to the DSM definition of hypochondriasis, can yield clinical specification in the category of "psychological factors affecting medical condition" and eliminate the need for the highly criticized DSM classification of somatoform disorders. This new classification is supported by a growing body of research evidence and is in line with psychosomatic medicine as a recognized subspecialty.

  12. Success factors for implementation of the balanced scorecard in a NHS multi-agency setting.

    PubMed

    Radnor, Zoe; Lovell, Bill

    2003-01-01

    Even though the balanced scorecard (BSC) has become a highly popular performance management tool, usage in local public sector National Health Service (NHS) organisations is still rare. This paper conditionally outlines some grounds in supporting such usage. In particular underlying conceptual concerns with the BSC system and its implementation pitfalls require full consideration. This paper then outlines some factors to be taken into account for "successful" BSC implementation in a NHS multi-agency setting. These findings emerged from a series of focus groups that took place with contributors drawn from all the key organisations within the Bradford Health Action Zone. Finally, this paper argues that if key criteria are met, successful implementation of the BSC may then proceed. However, "blind" BSC implementation without consideration of these factors may result in potential "failure".

  13. Factors affecting general practitioners' decisions about plain radiography for back pain: implications for classification of guideline barriers--a qualitative study.

    PubMed

    Espeland, Ansgar; Baerheim, Anders

    2003-03-24

    General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such factors. Focus group interviews regarding factors affecting ordering decisions were carried out on a diverse sample of Norwegian general practitioners and were analysed qualitatively. Results of this study and two qualitative studies from the Netherlands and USA on use of spine radiography were interpreted for barriers to guideline adherence. These were compared with an existing barrier classification system described by Dr Cabana's group. The factors which Norwegian general practitioners considered might affect their decisions about ordering plain radiography for back pain concerned the following broader issues: clinical ordering criteria, patients' wishes for radiography and the general practitioner's response, uncertainty, professional dignity, access to radiology services, perception of whether the patient really was ill, sense of pressure from other health care providers/social security, and expectations about the consequences of ordering radiography. The three studies suggested several attitude-related and external barriers as classified in a previously reported system described by Dr Cabana in another study. Identified barriers not listed in this system were: lack of expectancy that guideline adherence will lead to desired health care process, emotional difficulty with adherence, improper access to actual/alternative health care services, and pressure from health care providers/organisations. Our findings may help implement spine radiography guidelines. They also indicate that Cabana et al.'s barrier classification system needs extending. A revised system is proposed.

  14. Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

    PubMed

    Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

    2016-08-01

    Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

  15. Development of hospital information systems: user participation and factors affecting it.

    PubMed

    Rahimi, Bahlol; Safdari, Reza; Jebraeily, Mohamad

    2014-12-01

    Given the large volume of data generated in hospitals, in order to efficiently management them; using hospital information system (HIS) is critical. User participation is one of the major factors in the success of HIS that in turn leads Information needs and processes to be correctly predicted and also their commitment to the development of HIS to be augmented. The purpose of this study is to investigate the participation rate of users in different stages of HIS development as well as to identify the factors affecting it. This is a descriptive-cross sectional study which was inducted in 2014. The study population consists of 140 HIS users (from different types of job including physicians, nurses, laboratory, radiology and HIM staffs) from Teaching Hospitals Affiliated to Urmia University of Medical Sciences. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS software descriptive statistics and analytical statistics (t-test and chi-square). The highest participation rate of users in the four-stage development of the HIS was related to the implementation phase (2.88) and the lowest participation rate was related to analysis (1.23). The test results showed that the rate of user participation was not satisfactory in none of the stages of development (P< 0.05). The most important factors in increasing user participation include established teamwork from end-users and the support of top managers from HIS development. According to the results obtained from the study, it seems that health care administrators must have a detailed plan for user participation prior to the development and purchase of HIS so that they identify the real needs as well as increase their commitment and motivations to develop, maintain and upgrade the system, and in this way, the success of the system will be assured.

  16. Demographic and obstetric factors affecting women's sexual functioning during pregnancy.

    PubMed

    Abouzari-Gazafroodi, Kobra; Najafi, Fatemeh; Kazemnejad, Ehsan; Rahnama, Parvin; Montazeri, Ali

    2015-08-19

    Sexual desire and frequency of sexual relationships during pregnancy remains challenging. This study aimed to assess factors that affect women's sexual functioning during pregnancy. This was a cross sectional study carried out at prenatal care clinics of public health services in Iran. An author-designed structured questionnaire including items on socio-demographic characteristics, obstetric history, the current pregnancy, and women's sexual functioning during pregnancy was used to collect data. The generalized linear model was performed in order to find out factors that affect women's sexual functioning during pregnancy. In all, 518 pregnant women participated in the study. The mean age of participants was 26.4 years (SD = 4.7). Overall 309 women (59.7%) scored less than mean on sexual functioning. The results obtained from generalized linear model demonstrated that that lower education, unwanted pregnancy, earlier stage of pregnancy, older age, and longer duration of marriage were the most important factors contributing to disturbed sexual functioning among couples. The findings suggest that sexual function during pregnancy might be disturbed due to several factors. Indeed issues on sexual relationship should be included as part of prenatal care and reproductive health programs for every woman.

  17. Motivating factors for small and midsized businesses to implement worksite health promotion.

    PubMed

    Witt, Laurel B; Olsen, Delane; Ablah, Elizabeth

    2013-11-01

    This study explores the decision-making process, including motivating factors, for small and midsized businesses in the Midwest to implement health promotion initiatives. This a replication of a study conducted in the Pacific Northwest. Semistructured qualitative interviews were conducted with key informants from 12 Midwestern metropolitan employers with fewer than 1,000 employees. Informants were interviewed regarding their companies' policies and practices around workplace health promotion programming adoption and valuation. Workplace health promotion adoption at these small and midsized businesses was motivated by three goals: to lower health care costs, to address human relations objectives, and to improve productivity. Low upfront cost was the most frequently considered criterion in choosing which workplace health promotion program to offer. Barriers to implementation included lack of employee buy-in, prohibitive costs, and personnel or time constraints. Aids to implementation included employee buy-in and affordability. This study suggests that cost considerations predominate in the workplace health promotion decision-making process at small to midsized businesses. Furthermore, employee buy-in cannot be underestimated as a factor in successful program implementation or longevity. Employees, along with executives and human resources management, must be appropriately targeted by health promotion practitioners in workplace health promotion efforts.

  18. Affect and Health Behavior Co-Occurrence: The Emerging Roles of Transdiagnostic Factors and Sociocultural Factors.

    PubMed

    Zvolensky, Michael J; Leventhal, Adam M

    2016-01-01

    The majority of scientific work addressing relations among affective states and health correlates has focused primarily on their co-occurrence and a limited range of health conditions. We have developed a Special Issue to highlight recent advances in this emerging field of work that addresses the nature and interplay between affective states and disorders, in terms of their impact and consequences from health status and behavior. This Special Issue is organized into three parts classified as (a) co-occurrence and interplay between (b) transdiagnostic factors and (c) sociocultural factors. It is hoped that this issue will (a) alert readers to the significance of this work at different levels of analysis, (b) illustrate the many domains currently being explored via innovative approaches, and (c) identify fecund areas for future systematic study. © The Author(s) 2016.

  19. Prevalence, pathophysiological mechanisms and factors affecting urolithiasis.

    PubMed

    Khan, Aslam

    2018-05-01

    The formation of urinary stone, urolithiasis, is one the oldest known disease affecting human throughout different civilizations and times. The exact pathophysiological mechanism of urolithiasis is not yet clear, as these calculi are of various types and too complex for simple understanding. A single theory cannot explain its formation; therefore, different theories are presented in various times for its explanation like free particle, fixed particle, Randall's plaque theory. In addition, various factors and components are identified that play an important role in the formation of these urinary calculi. In this review, composition of kidney stones, its prevalence/incidence, explanation of pathophysiological mechanisms and role of various factors; urinary pH, uric acid, parathyroid hormone, citrate, oxalate, calcium and macromolecules; osteopontin, matrix Gla protein, kidney injury molecules, urinary prothrombin fragment-1, Tamm-Horsfall protein, inter-α-inhibitors, have been discussed in detail.

  20. Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics.

    PubMed

    Or, Calvin; Tong, Ellen; Tan, Joseph; Chan, Summer

    2018-05-29

    The health care reform initiative led by the Hong Kong government's Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients' health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users' and organizations' needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users' information technology literacy; training and technical support; and social and organizational influences. The

  1. Factors that affect the development of nurses' competencies: a systematic review.

    PubMed

    Rizany, Ichsan; Hariyati, Rr Tutik Sri; Handayani, Hanny

    2018-02-01

    To investigate factors affecting the development of nursing competency based on a review of the literature. A systematic review was utilized. The articles were taken from the databases of Pro-Quest, ScienceDirect, SpringerLink, and Scopus. They were retrieved using the following keywords: nursing competence, nurse competencies and clinical competence. Twenty-one papers were selected. Competence development is a continuous process of improving knowledge, attitudes and skills, and is influenced by a myriad of factors. Six factors were identified that affected the development of nursing competence in our systematic review: (1) work experience, (2) type of nursing environment, (3) educational level achieved, (4) adherence to professionalism, (5) critical thinking, and (6) personal factors. Work experience and education were shown to significantly influence the development of competency of nurses. Nurse managers need to support staffing competence through ongoing education, mentoring-preceptorship training, and case-reflection-discussion teaching programs. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  2. Factors Affecting Recruitment into Child and Adolescent Psychiatry Training

    ERIC Educational Resources Information Center

    Shaw, Jon A.; Lewis, John E.; Katyal, Shalini

    2010-01-01

    Objective: The authors studied the factors affecting the recruitment into child and adolescent psychiatry training in the United States. Methods: Medical students (n = 154) and general and child and adolescent psychiatry residents (n = 111) completed a questionnaire to evaluate career choice in child psychiatry (n = 265). Results: Compared with…

  3. [Factors affecting the recovery in the intensive care unit].

    PubMed

    Turkov, P N; Nikitin, V V; Antsupova, M A; Podkopaev, V N; Panfilova, R P; Ivanova, I N; Nesterova, L I

    2013-01-01

    Urgency of the problem is defined by economical, regulatory and legislative acts, regional social and moral factors. There is critical situation in Russian Pediatric Healthcare system. This situation is due to inadequate funding, high medical technologies inaccessibility for some Russian children, their adverse health state. The article presents a retrospective analysis of intensive therapy and resuscitation outcomes with technical equipment and work environment assessment in the intensive care unit of Tushinskaya city pediatric clinic for the period from 2007 to 2011. Anaesthetic and emergency care quality and safety depend on several factors: permanent equipment improvement, comprehensive analysis of every fatal case and full implementation of "Anti-epidemic (prophylactic) actions plan" and "Program of monitoring compliance with the sanitary norms".

  4. Identification of major factors in Australian primary care pharmacists' practice environment that have a bearing on the implementation of professional models of practice.

    PubMed

    Jackson, John K; Hussainy, Safeera Y; Kirkpatrick, Carl M J

    2017-08-01

    Objective The aim of the present study was to describe an environmental framework for pharmacists in primary care in Australia and determine the major factors within that environment that have the greatest bearing on their capacity to implement patient-focused models of professional practice. Methods A draft framework for pharmacists' practice was developed by allocating structures, systems and related factors known to the researchers or identified from the literature as existing within pharmacists' internal, operational and external environments to one of five domains: Social, Technological, Economic, Environmental or Political [STEEP]. Focus groups of pharmacists used an adapted nominal group technique to assess the draft and add factors where necessary. Where applicable, factors were consolidated into groups to establish a revised framework. The three major factors or groups in each domain were identified. The results were compared with the enabling factors described in the profession's vision statement. Results Seventy-eight individual factors were ultimately identified, with 86% able to be grouped. The three dominant groups in each of the five domains that had a bearing on the implementation of professional models of practice were as follows: (1) Social: the education of pharmacists, their beliefs and the capacity of the pharmacist workforce; (2) Technological: current and future practice models, technology and workplace structures; (3) Economic: funding of services, the viability of practice and operation of the Pharmaceutical Benefits Scheme; (4) Environmental: attitudes and expectations of stakeholders, including consumers, health system reform and external competition; and (5) Political: regulation of practice, representation of the profession and policies affecting practice. Conclusions The three dominant groups of factors in each of the five STEEP environmental domains, which have a bearing on pharmacists' capacity to implement patient-focused models of

  5. Implementation of health promotion programmes in schools: an approach to understand the influence of contextual factors on the process?

    PubMed

    Darlington, Emily Joan; Violon, Nolwenn; Jourdan, Didier

    2018-01-22

    Implementing complex and multi-level public health programmes is challenging in school settings. Discrepancies between expected and actual programme outcomes are often reported. Such discrepancies are due to complex interactions between contextual factors. Contextual factors relate to the setting, the community, in which implementation occurs, the stakeholders involved, and the characteristics of the programme itself. This work uses realist evaluation to understand how contextual factors influence the implementation process, to result in variable programme outcomes. This study focuses on identifying contextual factors, pinpointing combinations of contextual factors, and understanding interactions and effects of such factors and combinations on programme outcomes on different levels of the implementation process. Schools which had participated in a school-based health promotion programme between 2012 and 2015 were included. Two sets of qualitative data were collected: semi-structured interviews with school staff and programme coordinators; and written documents about the actions implemented in a selection of four schools. Quantitative data included 1553 questionnaires targeting pupils aged 8 to 11 in 14 schools to describe the different school contexts. The comparison between what was expected from the programme (programme theory) and the outcomes identified in the field data, showed that some of the mechanisms expected to support the implementation of the programme, did not operate as anticipated (e.g. inclusion of training, initiation by decision-maker). Key factors which influenced the implementation process included, amongst other factors, the mode of introduction of the programme, home/school relationship, leadership of the management team, and the level of delegated power. Five types of interactions between contextual factors were put forward: enabling, hindering, neutral, counterbalancing and moderating effects. Recurrent combinations of factors were

  6. A review of affecting factors on sexual satisfaction in women.

    PubMed

    Shahhosseini, Zohreh; Gardeshi, Zeinab Hamzeh; Pourasghar, Mehdi; Salehi, Fariba

    2014-12-01

    Sex is a complex, important and sensitive issue in human being and interwoven with the whole of human existence. Given the serious changes in attitude, function and behavior in sex, the need to address sexual function, especially sexual satisfaction, is felt completely. Sexual satisfaction has a very important role in creating marital satisfaction and any defect in sexual satisfaction is significantly associated with risky sexual behaviors, serious mental illness, social crimes and ultimately divorce. The aim of this study was to explore affecting factors on sexual satisfaction in women based on an overview in scientific database. In this narrative review the researchers searched MEDLINE database, Google Scholar and Science Direct as well as Persian database like Scientific Information Database with search terms of sexual satisfaction and sexual function, restricted to English/ Persian language, during the 20 years ago. Then those articles written by renowned experts were selected. In this regard, 57 articles have been reviewed, which 30 articles related to this research have been extracted. The findings were divided in to four categories including: Demographic factors, Pathophysiological factors, Psychological factors and Sociocultural factors. Sexuality, especially sexual intimacy is sophisticated and yet elegant affair that the other persons has different definitions and different functions. Discrepancies in the results of the studies show that analysis of factors affecting sexual satisfaction regardless of the women's' sociocultural context, religious beliefs, and personal attitudes is undoubtedly inefficient, unscientific and irrational.

  7. Factors affecting yearly and monthly visits to Taipei Zoo

    NASA Astrophysics Data System (ADS)

    Su, Ai-Tsen; Lin, Yann-Jou

    2018-02-01

    This study investigated factors affecting yearly and monthly numbers of visits to Taipei Zoo. Both linear and nonlinear regression models were used to estimate yearly visits. The results of both models showed that the "opening effect" and "animal star effect" had a significantly positive effect on yearly visits, while a SARS outbreak had a negative effect. The number of years had a significant influence on yearly visits. Results showed that the nonlinear model had better explanatory power and fitted the variations of visits better. Results of monthly model showed that monthly visits were significantly influenced by time fluctuations, weather conditions, and the animal star effect. Chinese New Year, summer vacation, numbers of holidays, and animal star exhibitions increased the number of monthly visits, while the number of days with temperatures at or below 15 °C, the number of days with temperatures at or above 30 °C, and the number of rainy days had significantly negative effects. Furthermore, the model of monthly visits showed that the animal star effect could last for over two quarters. The results of this study clarify the factors affecting visits to an outdoor recreation site and confirm the importance of meteorological factors to recreation use.

  8. A Qualitative Study of Factors Affecting Morale in Psychiatry Residency Training.

    PubMed

    Caravella, Rachel A; Robinson, Lee A; Wilets, Ilene; Weinberg, Michael; Cabaniss, Deborah L; Cutler, Janis L; Kymissis, Carisa; Arbuckle, Melissa R

    2016-10-01

    Resident morale is an important yet poorly understood aspect of the residency training experience. Despite implications for program quality, resident satisfaction, patient care, and recruitment, little is known about the variables influencing this complex phenomenon. This study sought to identify important factors affecting morale in psychiatry residency training. The authors conducted four semi-structured focus groups at a moderately sized, urban, psychiatry residency program during the 2013-2014 academic year. They used qualitative data analysis techniques, including grounded theory and content analysis, to identify key themes affecting resident morale across training levels. Twenty-seven residents participated in the focus groups with equal distribution across post-graduate years (PGY) 1-4. Five major conceptual categories affecting resident morale emerged: Sense of Community, Individual Motivators, Clinical Work, Feeling Cared For, and Trust in the Administration. Morale is an important topic in residency education. The qualitative results suggest that factors related to a Sense of Community and Individual Motivators generally enhanced resident morale whereas factors related to a lack of Feeling Cared For and Trust in the Administration tended to contribute to lower morale. The authors describe the possible interventions to promote stronger program morale suggested by these findings.

  9. Factors affecting the overcrowding in outpatient healthcare

    PubMed Central

    Bahadori, Mohammadkarim; Teymourzadeh, Ehsan; Ravangard, Ramin; Raadabadi, Mehdi

    2017-01-01

    Background: The expansion of outpatient services and the desire to provide more outpatient care than inpatient care create some problems such as the overcrowding in the outpatient clinics. Given the importance of overcrowding in the outpatient clinics, this qualitative study aimed to determine the factors influencing the overcrowding in the specialty and subspecialty clinic of a teaching hospital. Materials and Methods: This was a qualitative study conducted in the specialty and subspecialty clinic of a hospital using content analysis method in the period of January to March 2014. The study population was all managers and heads of the outpatient wards. The studied sample consisted of 22 managers of the clinic wards who were selected using the purposive sampling method. The required data was collected using semi-structured interviews. The collected data was analyzed using conventional content analysis and the MAXQDA 10.0 software. Results: Three themes were identified as the main factors affecting the overcrowding including the internal positive factors, internal negative factors, and external factors. Conclusions: Despite the efforts made to eliminate overcrowding, and reduce waiting times and increase access to the services for patients, the problem of overcrowding still has remained unresolved. In addition, the use of some strategies such as clarifying the working processes of the clinic for staff and patients and the relationships between the clinic and other wards especially emergency department, as well as using a simple triage system on the patients’ arrival at the clinic are recommended. PMID:28546986

  10. Recruitment and retention: factors that affect pericyte migration

    PubMed Central

    Aguilera, Kristina Y.

    2013-01-01

    Pericytes are critical for vascular morphogenesis and contribute to several pathologies, including cancer development and progression. The mechanisms governing pericyte migration and differentiation are complex and have not been fully established. Current literature suggests that platelet-derived growth factor/platelet-derived growth factor receptor-β, sphingosine 1-phosphate/endothelial differentiation gene-1, angiopoietin-1/tyrosine kinase with immunoglobulin-like and EGF-like domains 2, angiopoietin-2/tyros-ine kinase with immunoglobulin-like and EGF-like domains 2, transforming growth factor β/activin receptor-like kinase 1, transforming growth factor β/activin receptor-like kinase 5, Semaphorin-3A/Neuropilin, and matrix metalloproteinase activity regulate the recruitment of pericytes to nascent vessels. Interestingly, many of these pathways are directly affected by secreted protein acidic and rich in cysteine (SPARC). Here, we summarize the function of these factors in pericyte migration and discuss if and how SPARC might infuence these activities and thus provide an additional layer of control for the recruitment of vascular support cells. Additionally, the consequences of targeted inhibition of pericytes in tumors and the current understanding of pericyte recruitment in pathological environments are discussed. PMID:23912898

  11. Factors Affecting Time to Sputum Culture Conversion in Adults with Pulmonary Tuberculosis: A Historical Cohort Study without Censored Cases.

    PubMed

    Kanda, Rie; Nagao, Taishi; Tho, Nguyen Van; Ogawa, Emiko; Murakami, Yoshitaka; Osawa, Makoto; Saika, Yoshinori; Doi, Kenji; Nakano, Yasutaka

    2015-01-01

    In patients with pulmonary tuberculosis (TB), shortening the time to sputum culture conversion is desirable to reduce the likelihood of mycobacterial transmission. A persistent positive sputum culture after 2 months of treatment is reported to be associated with the presence of cavitation and the extent of disease on chest X-ray, high colony count, diabetes mellitus, and smoking. However, little is known about factors affecting the time to sputum culture conversion. This study was conducted to evaluate factors affecting the time to sputum culture conversion throughout the course of treatment in adults with pulmonary TB. This study was performed using a database of the medical records of patients with active pulmonary TB who were treated at Hirakata Kohsai Hospital in Hirakata City, Osaka, Japan, from October 2000 to October 2002. Cox proportional-hazards analysis was used to evaluate factors affecting the time to sputum culture conversion after adjusting for potential confounders. The data of 86 patients with pulmonary TB were analyzed. The median time to sputum culture conversion was 39 days, and the maximum time was 116 days. The Cox proportional-hazards analysis showed that a higher smear grading (HR, 0.40; 95%CI, 0.23-0.71) and a history of ever smoking (HR, 0.48; 95%CI, 0.25-0.94) were associated with delayed sputum culture conversion. High smear grading and smoking prolonged the time to sputum culture conversion in adults with pulmonary TB. To effectively control TB, measures to decrease the cigarette smoking rate should be implemented, in addition to early detection and timely anti-TB treatment.

  12. Direct access: factors that affect physical therapist practice in the state of Ohio.

    PubMed

    McCallum, Christine A; DiAngelis, Tom

    2012-05-01

    Direct access to physical therapist services is permitted by law in the majority of states and across all practice settings. Ohio enacted such legislation in 2004; however, it was unknown how direct access had affected actual clinical practice. The purpose of this study was to describe physical therapist and physical therapist practice environment factors that affect direct access practice. A 2-phase, mixed-method descriptive study was conducted. In the first phase, focus group interviews with 32 purposively selected physical therapists were completed, which resulted in 8 themes for an electronically distributed questionnaire. In the second phase, survey questionnaires were distributed to physical therapists with an e-mail address on file with the Ohio licensing board. An adjusted return rate of 23% was achieved. Data were analyzed for descriptive statistics. A constant comparative method assessed open-ended questions for common themes and patterns. Thirty-one percent of the respondents reported using direct access in physical therapist practice; however, 80% reported they would practice direct access if provided the opportunity. Physical therapists who practiced direct access were more likely to be in practice 6 years or more and hold advanced degrees beyond the entry level, were American Physical Therapy Association members, and had supportive management and organizational practice policies. The direct access physical therapist practice was generally a locally owned suburban private practice or a school-based clinic that saw approximately 6% to 10% of its patients by direct access. The majority of patients treated were adults with musculoskeletal or neuromuscular impairments. Nonresponse from e-mail may be associated with sample frame bias. Implementation of a direct access physical therapist practice model is evident in Ohio. Factors related to reimbursement and organizational policy appear to impede the process.

  13. Factors Affecting Role Stress and Burnout among School Counselors

    ERIC Educational Resources Information Center

    Willingham, Wendy Elizabeth

    2009-01-01

    The purpose of this study is to determine factors affecting role stress and burnout among practicing school counselors as measured by the Maslach Burnout Inventory-Educators Survey (MBI-ES) and the Role Conflict and Ambiguity Scale. The MBI-ES utilizes three subscales to measure burnout: emotional exhaustion, depersonalization, and personal…

  14. Factors affecting species distribution predictions: A simulation modeling experiment

    Treesearch

    Gordon C. Reese; Kenneth R. Wilson; Jennifer A. Hoeting; Curtis H. Flather

    2005-01-01

    Geospatial species sample data (e.g., records with location information from natural history museums or annual surveys) are rarely collected optimally, yet are increasingly used for decisions concerning our biological heritage. Using computer simulations, we examined factors that could affect the performance of autologistic regression (ALR) models that predict species...

  15. Motivational Factors Affecting Online Learning by Japanese MBA Students

    ERIC Educational Resources Information Center

    Kikuchi, Hisayo

    2006-01-01

    In Japan, Internet based learning is still at an early stage. However, adult learners in Japanese society expect the development of flexible e-learning programs. This case study examines motivational factors affecting online learning in a Japanese and Australian MBA program, using observations, interviews and a questionnaire survey. The data were…

  16. Analysis of extrinsic and intrinsic factors affecting event related desynchronization production.

    PubMed

    Takata, Yohei; Kondo, Toshiyuki; Saeki, Midori; Izawa, Jun; Takeda, Kotaro; Otaka, Yohei; It, Koji

    2012-01-01

    Recently there has been an increase in the number of stroke patients with motor paralysis. Appropriate re-afferent sensory feedback synchronized with a voluntary motor intention would be effective for promoting neural plasticity in the stroke rehabilitation. Therefore, BCI technology is considered to be a promising approach in the neuro-rehabilitation. To estimate human motor intention, an event-related desynchronization (ERD), a feature of electroencephalogram (EEG) evoked by motor execution or motor imagery is usually used. However, there exists various factors that affect ERD production, and its neural mechanism is still an open question. As a preliminary stage, we evaluate mutual effects of intrinsic (voluntary motor imagery) and extrinsic (visual and somatosensory stimuli) factors on the ERD production. Experimental results indicate that these three factors are not always additively interacting with each other and affecting the ERD production.

  17. New strategies in the assessment of psychological factors affecting medical conditions.

    PubMed

    Sirri, Laura; Fabbri, Stefania; Fava, Giovanni A; Sonino, Nicoletta

    2007-12-01

    In this article, we examine research that may lead to a better assessment of psychological factors affecting medical conditions. We performed a review of the psychosomatic literature using both Medline and manual searches. We selected papers that were judged to be relevant to new strategies of assessment, with particular reference to the use of the Diagnostic Criteria for Psychosomatic Research. We assessed 8 areas concerned with the assessment of psychological factors in the setting of medical disease: hypochondriasis, disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, irritable mood, and Type A behavior. A new subclassification of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-V]; not yet published) category of psychological factors affecting physical conditions appears to be feasible and may provide the clinician with better tools for identifying psychological distress.

  18. Sustainability of teacher implementation of school-based mental health programs.

    PubMed

    Han, Susan S; Weiss, Bahr

    2005-12-01

    Evidence-based prevention and intervention programs are increasingly being implemented in schools and it therefore is becoming increasingly important to understand the complexities of program implementation under real-world conditions. Much research has focused on the contextual factors that influence program implementation but less work has attempted to provide an integrated understanding of mechanisms (e.g., teacher-training processes) that affect teachers' program implementation. In this paper, we review literature on factors related to teachers' implementation of school-based prevention and intervention programs, then from this review abstract what we believe are four basic ingredients that characterize potentially sustainable teacher-implemented classroom programs. Finally, we present a sequential model, based on these ingredients, of the naturalistic processes underlying sustainability of teachers' program implementation and describe how this sustainability can be enhanced through provision of teacher training and performance feedback from a classroom consultant.

  19. Multifactorial analysis of factors affecting recurrence of stroke in Japan.

    PubMed

    Omori, Toyonori; Kawagoe, Masahiro; Moriyama, Michiko; Yasuda, Takeshi; Ito, Yasuhiro; Hyakuta, Takeshi; Nagatsuka, Kazuyuki; Matsumoto, Masayasu

    2015-03-01

    Data on factors affecting stroke recurrence are relatively limited. The authors examined potential factors affecting stroke recurrence, retrospectively. The study participants were 1087 patients who were admitted to stroke centers suffering from first-ever ischemic stroke and returned questionnaires with usable information after discharge. The authors analyzed the association between clinical parameters of the patients and their prognosis. Recurrence rate of during an average of 2 years after discharge was 21.3%, and there were differences among stroke subtypes. It was found that the disability level of the patients after discharge correlated well with the level at discharge (r s = 0.66). Multivariate logistic regression analysis of the data shows that modified Rankin Scale score, National Institute of Health Stroke Scale score, gender, age, and family history had statistically significant impacts on stroke recurrence, and the impact was different depending on subtypes. These findings suggest that aggressive and persistent health education for poststroke patients and management of risk factors are essential to reduce stroke recurrence. © 2012 APJPH.

  20. Affective Outcomes of Schooling: Full-Information Item Factor Analysis of a Student Questionnaire.

    ERIC Educational Resources Information Center

    Muraki, Eiji; Engelhard, George, Jr.

    Recent developments in dichotomous factor analysis based on multidimensional item response models (Bock and Aitkin, 1981; Muthen, 1978) provide an effective method for exploring the dimensionality of questionnaire items. Implemented in the TESTFACT program, this "full information" item factor analysis accounts not only for the pairwise joint…

  1. Making Sense, Making Do: Local District Implementation of a New State Induction Policy

    ERIC Educational Resources Information Center

    Ellis, Chad D.

    2016-01-01

    Connecticut's Teacher Education and Mentoring (TEAM) program is in its early stages of implementation. This study examined how local school districts implemented TEAM and identified factors that affected implementation. It was based on interviews with twenty-two participants at the state, district, and local school levels. The intentions of the…

  2. Understanding influential factors on implementing green supply chain management practices: An interpretive structural modelling analysis.

    PubMed

    Agi, Maher A N; Nishant, Rohit

    2017-03-01

    In this study, we establish a set of 19 influential factors on the implementation of Green Supply Chain Management (GSCM) practices and analyse the interaction between these factors and their effect on the implementation of GSCM practices using the Interpretive Structural Modelling (ISM) method and the "Matrice d'Impacts Croisés Multiplication Appliquée à un Classement" (MICMAC) analysis on data compiled from interviews with supply chain (SC) executives based in the Gulf countries (Middle East region). The study reveals a strong influence and driving power of the nature of the relationships between SC partners on the implementation of GSCM practices. We especially found that dependence, trust, and durability of the relationship with SC partners have a very high influence. In addition, the size of the company, the top management commitment, the implementation of quality management and the employees training and education exert a critical influence on the implementation of GSCM practices. Contextual elements such as the industry sector and region and their effect on the prominence of specific factors are also highlighted through our study. Finally, implications for research and practice are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Mathematics Performance and the Role Played by Affective and Background Factors

    ERIC Educational Resources Information Center

    Grootenboer, Peter; Hemmings, Brian

    2007-01-01

    In this article, we report on a study examining those factors which contribute to the mathematics performance of a sample of children aged between 8 and 13 years. The study was designed specifically to consider the potency of a number of mathematical affective factors, as well as background characteristics (viz., gender, ethnicity, and…

  4. Factors Affecting Career Decision Making of Mexican and Mexican-American Students.

    ERIC Educational Resources Information Center

    Newlon, Betty J.; Borboa, Roman

    The purpose of this research was to identify the self-reported factors affecting the career decision making of Mexican and Mexican-American students. It was hypothesized that the factor clusters would differ between the two sample populations, Mexican and Mexican-American. It was also hypothesized that these clusters would differ from six clusters…

  5. Industry Training: The Factors that Affect Demand. Discussion Paper.

    ERIC Educational Resources Information Center

    Smith, A.; Roberts, P.; Noble, C.; Hayton, G.; Thorne, E.

    A study was conducted in Australia, to determine the factors that affect demand for job training. The study consisted of 30 detailed industry case studies, an industry analysis, and a literature review. Each case study examined current training practices, training decision making in the business, and the determinants of training for the…

  6. Implementation and Performance of Factorized Back projection on Low-Cost Commercial-Off-the-Shelf Hardware

    DTIC Science & Technology

    performance on a low cost, low size, weight, and power (SWAP) computer : a Raspberry Pi Model B. For a comparison of performance, a baseline implementation...improvement factor of 2-3 compared to filtered backprojection. Execution on a single Raspberry Pi is too slow for real-time imaging. However, factorized...backprojection is easily parallelized, and we include a discussion of parallel implementation across multiple Pis .

  7. An Analysis of Factors Affecting Community College Students' Expectations on E-Learning

    ERIC Educational Resources Information Center

    Kilic-Cakmak, Ebru; Karatas, Sercin; Ocak, Mehmet Akif

    2009-01-01

    There are many factors that affect the e-learning process. Instructor, assessment and evaluation, communication, and technical support are among the leading factors. It is obvious that these factors influence the effectiveness of e-learning and may be related to different expectations of e-learners. Therefore, this study focuses on examining the…

  8. Factors That Affect a School District's Ability to Successfully Implement the Use of Data Warehouse Applications in the Data Driven Decision Making Process

    ERIC Educational Resources Information Center

    DeLoach, Robin

    2012-01-01

    The purpose of this study was to explore the factors that influence the ability of teachers and administrators to use data obtained from a data warehouse to inform instruction. The mixed methods study was guided by the following questions: 1) What data warehouse application features affect the ability of an educator to effectively use the…

  9. Lengths of Orthologous Prokaryotic Proteins Are Affected by Evolutionary Factors

    PubMed Central

    Tatarinova, Tatiana; Dien Bard, Jennifer; Cohen, Irit

    2015-01-01

    Proteins of the same functional family (for example, kinases) may have significantly different lengths. It is an open question whether such variation in length is random or it appears as a response to some unknown evolutionary driving factors. The main purpose of this paper is to demonstrate existence of factors affecting prokaryotic gene lengths. We believe that the ranking of genomes according to lengths of their genes, followed by the calculation of coefficients of association between genome rank and genome property, is a reasonable approach in revealing such evolutionary driving factors. As we demonstrated earlier, our chosen approach, Bubble-sort, combines stability, accuracy, and computational efficiency as compared to other ranking methods. Application of Bubble Sort to the set of 1390 prokaryotic genomes confirmed that genes of Archaeal species are generally shorter than Bacterial ones. We observed that gene lengths are affected by various factors: within each domain, different phyla have preferences for short or long genes; thermophiles tend to have shorter genes than the soil-dwellers; halophiles tend to have longer genes. We also found that species with overrepresentation of cytosines and guanines in the third position of the codon (GC3 content) tend to have longer genes than species with low GC3 content. PMID:26114113

  10. Lengths of Orthologous Prokaryotic Proteins Are Affected by Evolutionary Factors.

    PubMed

    Tatarinova, Tatiana; Salih, Bilal; Dien Bard, Jennifer; Cohen, Irit; Bolshoy, Alexander

    2015-01-01

    Proteins of the same functional family (for example, kinases) may have significantly different lengths. It is an open question whether such variation in length is random or it appears as a response to some unknown evolutionary driving factors. The main purpose of this paper is to demonstrate existence of factors affecting prokaryotic gene lengths. We believe that the ranking of genomes according to lengths of their genes, followed by the calculation of coefficients of association between genome rank and genome property, is a reasonable approach in revealing such evolutionary driving factors. As we demonstrated earlier, our chosen approach, Bubble-sort, combines stability, accuracy, and computational efficiency as compared to other ranking methods. Application of Bubble Sort to the set of 1390 prokaryotic genomes confirmed that genes of Archaeal species are generally shorter than Bacterial ones. We observed that gene lengths are affected by various factors: within each domain, different phyla have preferences for short or long genes; thermophiles tend to have shorter genes than the soil-dwellers; halophiles tend to have longer genes. We also found that species with overrepresentation of cytosines and guanines in the third position of the codon (GC3 content) tend to have longer genes than species with low GC3 content.

  11. Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

    PubMed

    Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

    2013-10-01

    The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

  12. Factors Influencing Implementation of OHSAS 18001 in Indian Construction Organizations: Interpretive Structural Modeling Approach

    PubMed Central

    Rajaprasad, Sunku Venkata Siva; Chalapathi, Pasupulati Venkata

    2015-01-01

    Background Construction activity has made considerable breakthroughs in the past two decades on the back of increases in development activities, government policies, and public demand. At the same time, occupational health and safety issues have become a major concern to construction organizations. The unsatisfactory safety performance of the construction industry has always been highlighted since the safety management system is neglected area and not implemented systematically in Indian construction organizations. Due to a lack of enforcement of the applicable legislation, most of the construction organizations are forced to opt for the implementation of Occupational Health Safety Assessment Series (OHSAS) 18001 to improve safety performance. Methods In order to better understand factors influencing the implementation of OHSAS 18001, an interpretive structural modeling approach has been applied and the factors have been classified using matrice d'impacts croises-multiplication appliqué a un classement (MICMAC) analysis. The study proposes the underlying theoretical framework to identify factors and to help management of Indian construction organizations to understand the interaction among factors influencing in implementation of OHSAS 18001. Results Safety culture, continual improvement, morale of employees, and safety training have been identified as dependent variables. Safety performance, sustainable construction, and conducive working environment have been identified as linkage variables. Management commitment and safety policy have been identified as the driver variables. Conclusion Management commitment has the maximum driving power and the most influential factor is safety policy, which states clearly the commitment of top management towards occupational safety and health. PMID:26929828

  13. A Study of the Technological, Instructional, and Motivational Factors Affecting PHR Certification Exam Outcomes

    ERIC Educational Resources Information Center

    Bonner, David M.

    2012-01-01

    Although previous studies have considered the factors affecting other certification exam outcomes, they have not examined those that are related to performance on the Professional in Human Resources (PHR) exam. In response to that need, this study specifically investigates technology and training factors that affect self-efficacy and self-set…

  14. A real world dissemination and implementation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.

    PubMed

    Gros, Daniel F; Szafranski, Derek D; Shead, Sarah D

    2017-03-01

    Dissemination and implementation of evidence-based psychotherapies is challenging in real world clinical settings. Transdiagnostic Behavior Therapy (TBT) for affective disorders was developed with dissemination and implementation in clinical settings in mind. The present study investigated a voluntary local dissemination and implementation effort, involving 28 providers participating in a four-hour training on TBT. Providers completed immediate (n=22) and six-month follow-up (n=12) training assessments and were encouraged to collect data on their TBT patients (delivery fidelity was not investigated). Findings demonstrated that providers endorsed learning of and interest in using TBT after the training. At six-months, 50% of providers reported using TBT with their patients and their perceived effectiveness of TBT to be very good to excellent. Submitted patient outcome data evidenced medium to large effect sizes. Together, these findings provide preliminary support for the effectiveness of a real world dissemination and implementation of TBT. Published by Elsevier Ltd.

  15. [Factors affecting residual stones after percutaneous nephrolithotomy in patients with renal calculus].

    PubMed

    Qiao, Mingzhou; Zhang, Haifang; Zhou, Chenlong

    2015-11-24

    To explore the factors affecting the residual stones after percutaneous nephrolithotomy (PCNL) in patients with renal calculus. A retrospective analysis was performed for 1 200 patients who were affected by renal calculus and treated with PCNL between Jan 2008 and May 2014 in People's Hospital of Anyang City. Among those patients, 16 were diagnosed as bilateral renal stone and had two successive operations. The size, location and number of stones, previous history of surgery, the degree of hydronephrosis, urinary infection were included in the univariate analysis. Significant factors in univariate analysis were included in the multivariate analysis to determine factors affecting stone residual. A total of 385 cases developed stone residual after surgery. The overall residual rate was 31.7%. In univariate analysis, renal pelvis combined with caliceal calculus (P=0.006), stone size larger than 4 cm (P=0.005), stone number more than 4 (P=0.002), the amount of bleeding more than 200 ml (P=0.025), operation time longer than 120 minutes (P=0.028) were associated with an increased rate of stone residual. When subjected to the Cox multivariate analysis, the independent risk factors for residual stones were renal pelvis combined with caliceal calculus (P=0.049), stone size larger than 4 cm (P=0.038) and stone number more than 4 (P=0.018). Factors affecting the incidence of residual stones after PCNL are the size, location and number of stones. Larger size stone and the presence of renal pelvis combined with caliceal calculus are significantly associated with residual stones. Nevertheless, stone number less than 4 indicates an increased stone clearance rate.

  16. Barriers and facilitators for the implementation of primary prevention and health promotion activities in primary care: a synthesis through meta-ethnography.

    PubMed

    Rubio-Valera, Maria; Pons-Vigués, Mariona; Martínez-Andrés, María; Moreno-Peral, Patricia; Berenguera, Anna; Fernández, Ana

    2014-01-01

    Evidence supports the implementation of primary prevention and health promotion (PP&HP) activities but primary care (PC) professionals show resistance to implementing these activities. The aim was to synthesize the available qualitative research on barriers and facilitators identified by PC physicians and nurses in the implementation of PP&HP in adults. A systematic search of three databases was conducted and supported by manual searches. The 35 articles included were translated into each other and a new interpretation of the concepts extracted was generated. The factors affecting the implementation of PP&HP activities in PC according to professionals were fitted into a five-level ecological model: intrapersonal factors, interpersonal processes, institutional factors, community factors and public policy. At the intrapersonal level we find professionals' beliefs about PP&HP, experiences, skills and knowledge, and selfconcept. The attitudes and behavior towards PP&HP of patients, specialists, practice managers and colleagues (interpersonal factors) affect the feasibility of implementing PP&HP. Institutional level: PC is perceived as well-placed to implement PP&HP but workload, lack of time and referral resources, and the predominance of the biomedical model (which prioritizes disease treatment) hamper the implementation of PP&HP. The effectiveness of financial incentives and tools such as guidelines and alarms/reminders is conditioned by professionals' attitudes to them. Community factors include patients' social and cultural characteristics (religion, financial resources, etc.), local referral resources, mass-media messages and pharmaceutical industry campaigns, and the importance given to PP&HP in the curriculum in university. Finally, policies affect the distribution of resources, thus affecting the implementation of PP&HP. Research on barriers and facilitators in the implementation of PP&HP activities in multirisk management is scarce. The conceptual overview

  17. Factors affecting decision-making of patients choosing acupuncture in a public hospital.

    PubMed

    Sayampanathan, Andrew Arjun; Koh, Thean Howe Bryan; Kong, Keng He; Low, Yin Peng

    2015-11-01

    With increasing evidence to support its practice, acupuncture has been integrated within many hospitals around the world. The purpose of this study is to understand the factors affecting decision making of patients as they select acupuncture treatment for their medical conditions and symptoms within a public hospital. A qualitative study consisting of in depth interviews with 14 patients was conducted. All patients attended an acupuncture clinic within a public hospital. Data collected was analysed via thematic analysis. Four main factor groups affecting decision making of patients were identified- factors affecting the level and value of patient-centric care, the confidence and trust patients place within the acupuncture service, the presence of collaborative efforts between acupuncturists and Western medicine practitioners, and the knowledge, culture and belief society has regarding the role of acupuncture and Western medicine. All participants interviewed had more than one factor group present as enablers toward their eventual selection of acupuncture for ailment management. It was also noted that although the majority of participants had sufficient knowledge regarding acupuncture, there were a select few who had misperceptions or no knowledge regarding certain aspects of acupuncture. There may be certain patterns in the way patients choose to utilise acupuncture services in public hospitals. Further studies should also be carried out in other public hospitals to analyse the factor groups identified further.

  18. Factors that Affect Poverty Areas in North Sumatera Using Discriminant Analysis

    NASA Astrophysics Data System (ADS)

    Nasution, D. H.; Bangun, P.; Sitepu, H. R.

    2018-04-01

    In Indonesia, especially North Sumatera, the problem of poverty is one of the fundamental problems that become the focus of government both central and local government. Although the poverty rate decreased but the fact is there are many people who are poor. Poverty happens covers several aspects such as education, health, demographics, and also structural and cultural. This research will discuss about several factors such as population density, Unemployment Rate, GDP per capita ADHK, ADHB GDP per capita, economic growth and life expectancy that affect poverty in Indonesia. To determine the factors that most influence and differentiate the level of poverty of the Regency/City North Sumatra used discriminant analysis method. Discriminant analysis is one multivariate analysis technique are used to classify the data into a group based on the dependent variable and independent variable. Using discriminant analysis, it is evident that the factor affecting poverty is Unemployment Rate.

  19. Silage review: Factors affecting dry matter and quality losses in silages.

    PubMed

    Borreani, G; Tabacco, E; Schmidt, R J; Holmes, B J; Muck, R E

    2018-05-01

    An overview was made of dry matter (DM) and quality losses that occur during the ensiling process from the field through the feeding phase. The aim was to review the relevant published literature of the last 15 yr focusing on developments achieved after the publication of the book Silage Science and Technology. This review discusses the factors affecting DM and quality losses in terms of field and pre-ensiling conditions, respiration and temperature at ensiling, fermentation patterns, methods of covering and weighting the silage cover, and management of aerobic deterioration. The possibility of reducing DM and quality losses during the ensiling process requires knowledge of how to measure losses on farm and establish the status of the silage during the feed-out phase, implementing the most effective management practices to avoid air exposure during conservation and reduce silage aerobic deterioration during feeding. The paper concludes with future perspectives and recommended management practices to reduce losses and increase efficiency over the whole ensiling process in view of increasing sustainability of the livestock production chain. The Authors. Published by FASS Inc. and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

  20. Factors Other than GFR Affecting Serum Cystatin C Levels

    PubMed Central

    Stevens, Lesley A; Schmid, Christopher H.; Greene, Tom; Li, Liang; Beck, Gerald J; Joffe, Marshall; Froissart, Marc; Kusek, John; Zhang, Yaping (Lucy); Coresh, Josef; Levey, Andrew S

    2015-01-01

    Cystatin C is gaining acceptance as an endogenous filtration marker. Factors other than glomerular filtration rate (GFR) that affect the serum level have not been carefully studied. In a cross-sectional analysis of a pooled dataset of participants from clinical trials and a clinical population with chronic kidney disease (N=3418), we related serum levels of cystatin C and creatinine to clinical and biochemical variables after adjustment for GFR using errors-in-variables models to account for GFR measurement error. GFR was measured as urinary clearance of 125I-iothalamate and 15Cr-EDTA. Cystatin C was assayed at a single laboratory and creatinine was standardized to reference methods. Mean (SD) creatinine and cystatin C were 2.1 (1.1) mg/dL and 1.8 (0.8) mg/L, respectively. After adjustment for GFR, cystatin C was 4.3% lower for every 20 years of age, 9.2% lower for female sex but only 1.9% lower in blacks. Diabetes was associated with 8.5% higher levels of cystatin C and 3.9% lower levels of creatinine. Higher C-reactive protein and white blood cell count and lower serum albumin were associated with higher levels of cystatin C and lower levels of creatinine. Adjustment for age, sex and race had a greater effect on association of factors with creatinine than cystatin C. In conclusion, cystatin C is affected by factors other than GFR. Clinicians should consider these factors when interpreting the serum levels or GFR estimates from cystatin C. PMID:19119287

  1. Hospital Views of Factors Affecting Telemedicine Use.

    PubMed

    Merchant, Kimberly A S; Ward, Marcia M; Mueller, Keith J

    2015-04-01

    Telemedicine (also known as telehealth) is a means to increase access to care, one of the foundations of the Triple Aim. However, the expansion of telemedicine services in the United States has been relatively slow. We previously examined the extent of uptake of hospital based telemedicine using the 2013 HIMSS (Healthcare Information and Management Systems Society) Analytics national database of 4,727 non-specialty hospitals. Our analysis indicated that the largest percentage of operational telemedicine implementations (15.7 percent) was in radiology departments, with a substantial number in emergency/trauma care (7.5 percent) and cardiology/stroke/heart attack programs (6.8 percent). However, existing databases are limited because they do not identify whether a respondent hospital is a "hub" (providing telemedicine services) or a "spoke" (receiving telemedicine services). Therefore, we used data from interviews with hospital representatives to deepen the research and understanding of telemedicine use and the factors affecting that use. Interviews were conducted with key informants at 18 hub hospitals and 18 spoke hospitals to explore their perceptions of barriers and motivators to telemedicine adoption and expansion. Key Findings. (1) Respondents from both hub and spoke hospitals reported that telemedicine helps them meet their mission, enhances access, keeps lower-acuity patients closer to home, and helps head off competition. (2) Respondents from both hub and spoke hospitals reported licensing and credentialing to be significant barriers to telemedicine expansion. Thus, half of hubs provide services only within their state. (3) A variety of one-time funding sources have been used to initiate and grow telemedicine services among hubs and spokes. However, reimbursement issues have impeded the development of workable business models for sustainability. Hub hospitals shoulder the responsibility for identifying sustainable business models. (4) Although respondents

  2. Validating YouTube Factors Affecting Learning Performance

    NASA Astrophysics Data System (ADS)

    Pratama, Yoga; Hartanto, Rudy; Suning Kusumawardani, Sri

    2018-03-01

    YouTube is often used as a companion medium or a learning supplement. One of the educational places that often uses is Jogja Audio School (JAS) which focuses on music production education. Music production is a difficult material to learn, especially at the audio mastering. With tutorial contents from YouTube, students find it easier to learn and understand audio mastering and improved their learning performance. This study aims to validate the role of YouTube as a medium of learning in improving student’s learning performance by looking at the factors that affect student learning performance. The sample involves 100 respondents from JAS at audio mastering level. The results showed that student learning performance increases seen from factors that have a significant influence of motivation, instructional content, and YouTube usefulness. Overall findings suggest that YouTube has a important role to student learning performance in music production education and as an innovative and efficient learning medium.

  3. Beyond Negative Pain-Related Psychological Factors: Resilience Is Related to Lower Pain Affect in Healthy Adults.

    PubMed

    Hemington, Kasey S; Cheng, Joshua C; Bosma, Rachael L; Rogachov, Anton; Kim, Junseok A; Davis, Karen D

    2017-09-01

    Resilience, a characteristic that enhances adaptation in response to stressful events, is a positive psychological factor that can predict and modulate health outcomes. However, resilience is rarely considered in pain research. Conversely, negative psychological factors (eg, anxiety, depression) are known to be related to the affective dimension of pain. It is critical to understand all potential psychological drivers of pain affect, a prominent component of chronic pain. We tested the hypothesis that higher resilience is associated with lower pain affect, above and beyond the predictive value of negative psychological factors. Healthy adults underwent psychophysical testing to acquire ratings of heat pain intensity and unpleasantness and completed the Resilience Scale, the State-Trait Anxiety Inventory (trait form), Beck Depression Inventory, Pain Catastrophizing Scale, and the Pain Vigilance and Attention Questionnaire. Multiple regression modeling (n = 68) showed resilience to be a negatively associated with pain affect (unpleasantness). Furthermore, in individuals with higher anxiety scores, resilience was protective against higher pain affect. This highlights the importance of resilience, a positive psychological factor, in the affective dimension of pain. This study is the first to assess a positive psychological factor and experimental pain affect, and has the potential to improve prediction of and treatment strategies for clinical pain. We report that resilience, a positive psychological factor, interacts with anxiety and is associated with heat pain affect (unpleasantness) in healthy individuals. Resilience may provide predictive value of chronic pain affect and treatment outcomes, and could be a target for behavioral therapy. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  4. Designing Caregiver-Implemented Shared-Reading Interventions to Overcome Implementation Barriers

    PubMed Central

    Logan, Jessica R.; Damschroder, Laura

    2015-01-01

    Purpose This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. Methods A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Results Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. Conclusions A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders. PMID:26262941

  5. Designing Caregiver-Implemented Shared-Reading Interventions to Overcome Implementation Barriers.

    PubMed

    Justice, Laura M; Logan, Jessica R; Damschroder, Laura

    2015-12-01

    This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders.

  6. A study of the factors affecting the range of airplanes

    NASA Technical Reports Server (NTRS)

    Biermann, David

    1937-01-01

    A study was made of the most important factors affecting the range of airplanes. Numerical examples are given showing the effects of different variables on the range of a two-engine airplane. The takeoff problems of long-range airplanes are analyzed.

  7. An Empirically Derived Taxonomy of Factors Affecting Physicians' Willingness to Disclose Medical Errors

    PubMed Central

    Kaldjian, Lauris C; Jones, Elizabeth W; Rosenthal, Gary E; Tripp-Reimer, Toni; Hillis, Stephen L

    2006-01-01

    BACKGROUND Physician disclosure of medical errors to institutions, patients, and colleagues is important for patient safety, patient care, and professional education. However, the variables that may facilitate or impede disclosure are diverse and lack conceptual organization. OBJECTIVE To develop an empirically derived, comprehensive taxonomy of factors that affects voluntary disclosure of errors by physicians. DESIGN A mixed-methods study using qualitative data collection (structured literature search and exploratory focus groups), quantitative data transformation (sorting and hierarchical cluster analysis), and validation procedures (confirmatory focus groups and expert review). RESULTS Full-text review of 316 articles identified 91 impeding or facilitating factors affecting physicians' willingness to disclose errors. Exploratory focus groups identified an additional 27 factors. Sorting and hierarchical cluster analysis organized factors into 8 domains. Confirmatory focus groups and expert review relocated 6 factors, removed 2 factors, and modified 4 domain names. The final taxonomy contained 4 domains of facilitating factors (responsibility to patient, responsibility to self, responsibility to profession, responsibility to community), and 4 domains of impeding factors (attitudinal barriers, uncertainties, helplessness, fears and anxieties). CONCLUSIONS A taxonomy of facilitating and impeding factors provides a conceptual framework for a complex field of variables that affects physicians' willingness to disclose errors to institutions, patients, and colleagues. This taxonomy can be used to guide the design of studies to measure the impact of different factors on disclosure, to assist in the design of error-reporting systems, and to inform educational interventions to promote the disclosure of errors to patients. PMID:16918739

  8. More than just a question of technology: factors related to hospitals' adoption and implementation of health information exchange.

    PubMed

    Vest, Joshua R

    2010-12-01

    The provisions of the American Recovery & Reinvestment Act increased the likelihood of more widespread health information exchange (HIE), the electronic transfer of patient-level information between organizations, by essentially mandating the use of electronic health record systems. While important, the sparse body of research on HIE efforts and anecdotal reports indicate the barriers to HIE adoption and implementation include factors beyond simply the presence or absence of a specific technology. This paper examines those technological, organizational, and environmental factors that are associated with both HIE adoption and implementation in a sample of 4830 U.S. hospitals. Factors associated with adoption and implementation were modeled using random-intercept logistic regression. Consistent with a perspective that adoption and implementation are different phenomena, many factors associated with an increased odds of adoption, were unassociated with implementation and vice versa. Non-profit status, public hospitals, more live and operation applications, more emergency room visits, network membership, and the presence of physician portals all increased hospitals' odds of HIE adoption. However, only network membership increased the odds of HIE implementation, whereas competition decreased those odds significantly. This study agreed with earlier case-studies and anecdotal reports that factors beyond technology were important to both adoption and implementation. While current U.S. policy on healthcare information technology adoption focuses on technological barriers, many other non-technological factors may ultimately hinder effective HIE. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies.

    PubMed

    O'Connor, Siobhan; Hanlon, Peter; O'Donnell, Catherine A; Garcia, Sonia; Glanville, Julie; Mair, Frances S

    2016-09-15

    Numerous types of digital health interventions (DHIs) are available to patients and the public but many factors affect their ability to engage and enrol in them. This systematic review aims to identify and synthesise the qualitative literature on barriers and facilitators to engagement and recruitment to DHIs to inform future implementation efforts. PubMed, MEDLINE, CINAHL, Embase, Scopus and the ACM Digital Library were searched for English language qualitative studies from 2000 - 2015 that discussed factors affecting engagement and enrolment in a range of DHIs (e.g. 'telemedicine', 'mobile applications', 'personal health record', 'social networking'). Text mining and additional search strategies were used to identify 1,448 records. Two reviewers independently carried out paper screening, quality assessment, data extraction and analysis. Data was analysed using framework synthesis, informed by Normalization Process Theory, and Burden of Treatment Theory helped conceptualise the interpretation of results. Nineteen publications were included in the review. Four overarching themes that affect patient and public engagement and enrolment in DHIs emerged; 1) personal agency and motivation; 2) personal life and values; 3) the engagement and recruitment approach; and 4) the quality of the DHI. The review also summarises engagement and recruitment strategies used. A preliminary DIgital Health EnGagement MOdel (DIEGO) was developed to highlight the key processes involved. Existing knowledge gaps are identified and a number of recommendations made for future research. Study limitations include English language publications and exclusion of grey literature. This review summarises and highlights the complexity of digital health engagement and recruitment processes and outlines issues that need to be addressed before patients and the public commit to digital health and it can be implemented effectively. More work is needed to create successful engagement strategies and better

  10. Factors Affecting Teen Involvement in Pennsylvania 4-H Programming

    ERIC Educational Resources Information Center

    Gill, Bart E.; Ewing, John C.; Bruce, Jacklyn A.

    2010-01-01

    The study reported here determined the factors that affect teen involvement in 4-H programming. The design of the study was descriptive and correlational in nature. Using a purposive sampling procedure, a survey questionnaire was distributed to all (N=214) 4-H members attending the 4-H State Leadership Conference. The major findings of the study…

  11. Factors affecting dance exercise performance in students at a special needs school.

    PubMed

    Ito, Yukiko; Hiramoto, Izumi; Kodama, Hideya

    2017-09-01

    In Japan, dance exercise has been introduced as a compulsory element of health and physical education, but there is a considerable discrepancy in the levels of performance among students with intellectual disability (ID) at special needs schools. The aim of this study was therefore to identify the factors affecting the performance of dance exercise in students with ID. A 4 month dance exercise program was implemented for junior high school students at a special needs school, and the performance of 32 students at 22 sessions was assessed quantitatively according to calorie use during exercise and performance proficiency score. The measures were compared according to gender, age, body mass index, diagnosis, and development quotient (DQ) score. Performance in many students improved with repetition and reached the highest attainment level at around the third month. Male gender and older age had a significant positive impact on calorie use, whereas diagnosis of Down syndrome and higher DQ score had a significant positive impact on proficiency score. Four students with poor performance were all female students with autism. This study provides some possible explanations for differences in the levels of dance performance among students with ID. © 2017 Japan Pediatric Society.

  12. Factors Affecting Zebra Mussel Kill by the Bacterium Pseudomonas fluorescens

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

    Daniel P. Molloy

    2004-02-24

    The specific purpose of this research project was to identify factors that affect zebra mussel kill by the bacterium Pseudomonas fluorescens. Test results obtained during this three-year project identified the following key variables as affecting mussel kill: treatment concentration, treatment duration, mussel siphoning activity, dissolved oxygen concentration, water temperature, and naturally suspended particle load. Using this latter information, the project culminated in a series of pipe tests which achieved high mussel kill inside power plants under once-through conditions using service water in artificial pipes.

  13. Psychological Factor Affecting English Speaking Performance for the English Learners in Indonesia

    ERIC Educational Resources Information Center

    Haidara, Youssouf

    2016-01-01

    In every learning situation or environment, human psychology plays a significant role. English speaking is a language skill that is highly affected by human psychology. This research aimed at describing the psychological factor that affects negatively the English speaking performance for the English learners in Indonesia. A descriptive qualitative…

  14. The Key Factors Affecting Students' Individual Interest in School Science Lessons

    ERIC Educational Resources Information Center

    Cheung, Derek

    2018-01-01

    Individual interest in school science lessons can be defined as a relatively stable and enduring personal emotion comprising affective and behavioural reactions to events in the regular science lessons at school. Little research has compared the importance of different factors affecting students' individual interest in school science lessons. The…

  15. Factors Affecting the Use of an E-Learning Portal at University

    ERIC Educational Resources Information Center

    Cegarra-Navarro, Juan-Gabriel; Rodriguez, Francisco Javier Canovas

    2012-01-01

    Electronic learning (e-learning) portals can be defined as websites that store and present materials for online learning, training, performance assessment, and certification. Few, if any, studies have investigated the factors that might contribute to the integration or implementation of e-learning portals in universities. With the development of…

  16. Affective changes during the postpartum period: Influences of genetic and experiential factors.

    PubMed

    Agrati, Daniella; Lonstein, Joseph S

    2016-01-01

    This article is part of a Special Issue "Parental Care". The postpartum period involves some truly transformational changes in females' socioemotional behaviors. For most female laboratory rodents and women, these changes include an improvement in their affective state, which has positive consequences for their ability to sensitively care for their offspring. There is heterogeneity among females in the likelihood of this positive affective change, though, and some women experience elevated anxiety or depression (or in rodents anxiety- or depression-related behaviors) after giving birth. We aim to contribute to the understanding of this heterogeneity in maternal affectivity by reviewing selected components of the scientific literatures on laboratory rodents and humans examining how mothers' physical contact with her infants, genetics, history of anxiety and depression and early-life and recent-life experiences contribute to individual differences in postpartum affective states. These studies together indicate that multiple biological and environmental factors beyond female maternal state shape affective responses during the postpartum period, and probably do so in an interactive manner. Furthermore, the similar capacity of some of these factors to modulate anxiety and depression in human and rodent mothers suggests cross-species conservation of mechanisms regulating postpartum affectivity. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Factors Affecting Soil Microbial Community Structure in Tomato Cropping Systems

    USDA-ARS?s Scientific Manuscript database

    Soil and rhizosphere microbial communities in agroecosystems may be affected by soil, climate, plant species, and management. We identified some of the most important factors controlling microbial biomass and community structure in an agroecosystem utilizing tomato plants with the following nine tre...

  18. Evaluating the impact of implementation factors on family-based prevention programming: methods for strengthening causal inference.

    PubMed

    Crowley, D Max; Coffman, Donna L; Feinberg, Mark E; Greenberg, Mark T; Spoth, Richard L

    2014-04-01

    Despite growing recognition of the important role implementation plays in successful prevention efforts, relatively little work has sought to demonstrate a causal relationship between implementation factors and participant outcomes. In turn, failure to explore the implementation-to-outcome link limits our understanding of the mechanisms essential to successful programming. This gap is partially due to the inability of current methodological procedures within prevention science to account for the multitude of confounders responsible for variation in implementation factors (i.e., selection bias). The current paper illustrates how propensity and marginal structural models can be used to improve causal inferences involving implementation factors not easily randomized (e.g., participant attendance). We first present analytic steps for simultaneously evaluating the impact of multiple implementation factors on prevention program outcome. Then, we demonstrate this approach for evaluating the impact of enrollment and attendance in a family program, over and above the impact of a school-based program, within PROSPER, a large-scale real-world prevention trial. Findings illustrate the capacity of this approach to successfully account for confounders that influence enrollment and attendance, thereby more accurately representing true causal relations. For instance, after accounting for selection bias, we observed a 5% reduction in the prevalence of 11th grade underage drinking for those who chose to receive a family program and school program compared to those who received only the school program. Further, we detected a 7% reduction in underage drinking for those with high attendance in the family program.

  19. Factors affecting the reproductive success of dominant male meerkats.

    PubMed

    Spong, Göran F; Hodge, Sarah J; Young, Andrew J; Clutton-Brock, Tim H

    2008-05-01

    Identifying traits that affect the reproductive success of individuals is fundamental for our understanding of evolutionary processes. In cooperative breeders, a dominant male typically restricts mating access to the dominant female for extended periods, resulting in pronounced variation in reproductive success among males. This may result in strong selection for traits that increase the likelihood of dominance acquisition, dominance retention and reproductive rates while dominant. However, despite considerable research on reproductive skew, few studies have explored the factors that influence these three processes among males in cooperative species. Here we use genetic, behavioural and demographic data to investigate the factors affecting reproductive success in dominant male meerkats (Suricata suricatta). Our data show that dominant males sire the majority of all offspring surviving to 1 year. A male's likelihood of becoming dominant is strongly influenced by age, but not by weight. Tenure length and reproductive rate, both important components of dominant male reproductive success, are largely affected by group size and composition, rather than individual traits. Dominant males in large groups have longer tenures, but after this effect is controlled, male tenure length also correlates negatively to the number of adult females in the group. Male reproductive rate also declines as the number of intra- and extra-group competitors increases. As the time spent in the dominant position and reproductive rate while dominant explain > 80% of the total variance in reproductive success, group composition thus has major implications for male reproductive success.

  20. Factors affecting the employability in people with epilepsy.

    PubMed

    Wo, Monica Chen Mun; Lim, Kheng Seang; Choo, Wan Yuen; Tan, Chong Tin

    2016-12-01

    People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE. This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio ≥90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS). Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE. Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family

  1. Characteristics and critical success factors for implementing problem-based learning in a human resource-constrained country.

    PubMed

    Giva, Karen R N; Duma, Sinegugu E

    2015-08-31

    Problem-based learning (PBL) was introduced in Malawi in 2002 in order to improve the nursing education system and respond to the acute nursing human resources shortage. However, its implementation has been very slow throughout the country. The objectives of the study were to explore and describe the goals that were identified by the college to facilitate the implementation of PBL, the resources of the organisation that facilitated the implementation of PBL, the factors related to sources of students that facilitated the implementation of PBL, and the influence of the external system of the organisation on facilitating the implementation of PBL, and to identify critical success factors that could guide the implementation of PBL in nursing education in Malawi. This is an ethnographic, exploratory and descriptive qualitative case study. Purposive sampling was employed to select the nursing college, participants and documents for review.Three data collection methods, including semi-structured interviews, participant observation and document reviews, were used to collect data. The four steps of thematic analysis were used to analyse data from all three sources. Four themes and related subthemes emerged from the triangulated data sources. The first three themes and their subthemes are related to the characteristics related to successful implementation of PBL in a human resource-constrained nursing college, whilst the last theme is related to critical success factors that contribute to successful implementation of PBL in a human resource-constrained country like Malawi. This article shows that implementation of PBL is possible in a human resource-constrained country if there is political commitment and support.

  2. Personal Factors that Affect the Satisfaction of Female Patients Undergoing Esthetic Suture after Typical Thyroidectomy.

    PubMed

    Kim, Hyo Young; Kim, Jung Won; Park, Jin Hyung; Kim, Jung Hun; Han, Yea Sik

    2013-07-01

    In esthetic surgery, understanding the factors that influence patient satisfaction is important for successful practice. We hypothesize that the factors that influence patient satisfaction include not only aesthetic and functional outcomes, but also personal factors such as the level of familiarity with factors affecting wound healing and expectations regarding aesthetic outcome. One hundred patients who underwent esthetic closure after thyroidectomy were included in this study. In order to evaluate the individual characteristics of the patients, a preoperative survey was administered to the patients. We estimated the patient satisfaction six months postoperatively and assessed the aesthetic and functional outcomes using the Patient and Observer Scar Assessment Scale. According to the results of correlation analysis, level of familiarity with wound healing factors had a positive correlation with satisfaction. High expectations, pain, itching, and high observer scale score had negative correlations with satisfaction. The factors that were correlated with satisfaction were included in the multiple regression analysis. Level of familiarity with wound healing factors was found to have a positive relationship with satisfaction, while itching and observer scale were found to have a negative relationship with satisfaction. After excluding 10 patients who had hypertrophic scars, only level of familiarity with wound healing factors and expectations affected satisfaction. The level of familiarity with factors affecting wound healing and expectations were found to independently affect satisfaction. Improving patients' level of familiarity with wound healing factors and reducing their expectations by providing suitable preoperative education has the potential to improve patient satisfaction.

  3. Arsenic in Drinking Water in Bangladesh: Factors Affecting Child Health

    PubMed Central

    Aziz, Sonia N.; Aziz, Khwaja M. S.; Boyle, Kevin J.

    2014-01-01

    The focus of this paper is to present an empirical model of factors affecting child health by observing actions households take to avoid exposure to arsenic in drinking water. Millions of Bangladeshis face multiple health hazards from high levels of arsenic in drinking water. Safe water sources are either expensive or difficult to access, affecting people’s individuals’ time available for work and ultimately affecting the health of household members. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, parental actions linking child health outcomes is used in the empirical model. Empirical results suggest that child health is significantly affected by the age and gender of the household water procurer. Adults with a high degree of concern for children’s health risk from arsenic contamination, and who actively mitigate their arsenic contaminated water have a positive effect on child health. PMID:24982854

  4. Factors affecting physical therapists’ job satisfaction: questionnaire survey targeting first-year physical therapists

    PubMed Central

    Kota, Munetsugu; Kudo, Hiroyuki; Okita, Kazuhiko

    2018-01-01

    [Purpose] The survey aimed to clarify the factors that affect physiotherapists’ job satisfaction. [Subjects and Methods] To examine factors affecting physical therapists’ job satisfaction using a cross-sectional study with a questionnaire survey. Subjects were 193 first-year physical therapists who participated in a newcomer orientation at Hiroshima Prefectural Physical Therapy Association. The questionnaire comprised items concerning physical therapists’ satisfaction with their work, motives for becoming physical therapists, education in school, internships, the workplace, and comfort in the workplace. [Results] Subjects were divided into two groups according to their satisfaction with their occupation. The “high satisfaction” group included 157 subjects, and the group “low satisfaction” group included 36 subjects. Using logistic regression analysis, items concerning comfort in the workplace, motives for becoming physical therapists, and learning in school were analysed. [Conclusion] Factors affecting physical therapists’ job satisfaction were primarily influenced by previous experience and working conditions. PMID:29706706

  5. Factors affecting physical therapists' job satisfaction: questionnaire survey targeting first-year physical therapists.

    PubMed

    Kota, Munetsugu; Kudo, Hiroyuki; Okita, Kazuhiko

    2018-04-01

    [Purpose] The survey aimed to clarify the factors that affect physiotherapists' job satisfaction. [Subjects and Methods] To examine factors affecting physical therapists' job satisfaction using a cross-sectional study with a questionnaire survey. Subjects were 193 first-year physical therapists who participated in a newcomer orientation at Hiroshima Prefectural Physical Therapy Association. The questionnaire comprised items concerning physical therapists' satisfaction with their work, motives for becoming physical therapists, education in school, internships, the workplace, and comfort in the workplace. [Results] Subjects were divided into two groups according to their satisfaction with their occupation. The "high satisfaction" group included 157 subjects, and the group "low satisfaction" group included 36 subjects. Using logistic regression analysis, items concerning comfort in the workplace, motives for becoming physical therapists, and learning in school were analysed. [Conclusion] Factors affecting physical therapists' job satisfaction were primarily influenced by previous experience and working conditions.

  6. Factors affecting wood energy consumption by U.S. households

    Treesearch

    Nianfu Song; Francisco X. Aguilar; Stephen R. Shifley; Michael E. Goerndt

    2012-01-01

    About 23% of energy derived from woody sources in the U.S. was consumed by households, of which 70% was used by households in rural areas in 2005. We investigated factors affecting household-level wood energy consumption in the four continental U.S. regions using data from the U.S. Residential Energy Consumption Survey. To account for a large number of zero...

  7. [Implementation of Telemedicine in Cape Verde: Influencing Factors].

    PubMed

    Correia, Artur; Azevedo, Vanda; Lapão, Luís Velez

    2017-04-28

    Telemedicine is the provision of health services, where distance is a critical factor, using information and communication technologies. Cape Verde has bet on using this tool to increase access of the population of its islands to specialized care. Qualitative study, covering the period between 2013 and 2014. It uses document analysis, semi-structured interviews and focus groups to collect data and analysis of content for their analysis. The participant population includes doctors, nurses and professionals from some institutions related to telemedicine. The priorities of the National Telemedicine Program are set, the cores and reference centers are operational, with trained personnel and equipment installed. Several other policy instruments and conditioning factors and facilitators of the program have been identified. Telemedicine is contributing to the reduction of inequalities in access to health, in Cape Verde. However, the full adoption of a service based on a new technology depends on conditioning factors and facilitators, and several success factors of telemedicine, identified in the literature, are not observed and in conjunction with other existing weaknesses affect the overall development of the National Telemedicine Program. However the strengths and capabilities are highlighted opportunities to act. Despite the progress, some telemedicine success factors highlighted on the literature are not seen in the country.

  8. Some Key Factors in Policy Implementation.

    ERIC Educational Resources Information Center

    Rowen, Henry

    Business policy texts identify numerous steps that make up the policy implementation process for private firms. On the surface, these steps also appear applicable to the implementation of public policies. However, the problems of carrying out these implementing steps in the public sector are significantly different than in the private sector due…

  9. Initial investigation of organisational factors associated with the implementation of active support.

    PubMed

    Fyffe, Chris; McCubbery, Jeffrey; Reid, Katharine J

    2008-09-01

    Active support (AS) has been shown to increase the amount of time that residents in shared residential settings are involved in purposeful activities. The organisational processes required to implement AS have been less well researched. Staff in community houses answered questions about the occurrence of organisational activities and processes thought to assist AS implementation (e.g., training and teamwork), their understanding of engagement, and their experience of changes in staff practice consistent with AS (including implementation problems). Non-house-based managers were also interviewed about their role in AS implementation. Reported occurrence of organisational activities and processes (e.g., training and teamwork) and understanding of engagement were associated with more reports of changes in staff practice and fewer staff reports of implementation problems. Staff reports on the role of non-house-based managers were not associated with reports of changes in staff practice or with reports of fewer AS implementation problems. Non-house-based managers' reports overestimated their role in AS implementation when compared with reports from house-based staff groups. While there are limitations in the research design (including the reliance on staff reports), the findings support the importance of wider organisational factors (beyond training programs for direct support staff) as integral to the implementation of AS. There is a need for further research on AS implementation.

  10. Factors related to leader implementation of a nationally disseminated community-based exercise program: a cross-sectional study

    PubMed Central

    Seguin, Rebecca A; Palombo, Ruth; Economos, Christina D; Hyatt, Raymond; Kuder, Julia; Nelson, Miriam E

    2008-01-01

    Background The benefits of community-based health programs are widely recognized. However, research examining factors related to community leaders' characteristics and roles in implementation is limited. Methods The purpose of this cross-sectional study was to use a social ecological framework of variables to explore and describe the relationships between socioeconomic, personal/behavioral, programmatic, leadership, and community-level social and demographic characteristics as they relate to the implementation of an evidence-based strength training program by community leaders. Eight-hundred fifty-four trained program leaders in 43 states were invited to participate in either an online or mail survey. Corresponding community-level characteristics were also collected. Programmatic details were obtained from those who implemented. Four-hundred eighty-seven program leaders responded to the survey (response rate = 57%), 78% online and 22% by mail. Results Of the 487 respondents, 270 implemented the program (55%). One or more factors from each category – professional, socioeconomic, personal/behavioral, and leadership characteristics – were significantly different between implementers and non-implementers, determined by chi square or student's t-tests as appropriate. Implementers reported higher levels of strength training participation, current and lifetime physical activity, perceived support, and leadership competence (all p < 0.05). Logistic regression analysis revealed a positive association between implementation and fitness credentials/certification (p = 0.003), program-specific self-efficacy (p = 0.002), and support-focused leadership (p = 0.006), and a negative association between implementation and educational attainment (p = 0.002). Conclusion Among this sample of trained leaders, several factors within the professional, socioeconomic, personal/behavioral, and leadership categories were related to whether they implemented a community-based exercise

  11. The main factor affecting the competitiveness of Contractor Company

    NASA Astrophysics Data System (ADS)

    Nurisra; Malahayati, Nurul; Mahmuddin

    2018-05-01

    Contractor companies must have the competitive advantage to compete in maintaining the survival of the company. Problems arise because quite a lot of advantages can be used and these advantages must be used appropriately to produce competitiveness for the company to continue to compete and to win the competition. This study aims to determine the main factors affecting the competitiveness of medium-class contractors in Banda Aceh. Data collection was obtained through questionnaires distributed to 31 middle-class contractors in Banda Aceh. Data processing and analysis is done by using descriptive analysis. Based on the result of descriptive analysis, it can be concluded that the most important competitiveness factor with a mean score value 4.52 is the relationship, and the factor that has the highest mean score value is the relationship with the government of 4.97, while the result of the ranking analysis is obtained 25 factor that is critical to the competitiveness of medium-class contractors in Banda Aceh.

  12. Factors Affecting the Formation of Food Preferences in Preschool Children.

    ERIC Educational Resources Information Center

    Alles-White, Monica L.; Welch, Patricia

    1985-01-01

    Identifies and discusses factors that affect the development of food preferences in preschool children, including familiarity, age, parents, peers, teachers, and programs designed to influence food habits. Makes recommendations to preschool and day care programs for creating an atmosphere conducive to trying new foods. (Author/DST)

  13. Risk factors for injuries in landslide- and flood-affected populations in Uganda.

    PubMed

    Agrawal, Shreya; Gopalakrishnan, Tisha; Gorokhovich, Yuri; Doocy, Shannon

    2013-08-01

    The frequency of occurrence of natural disasters has increased over the past several decades, which necessitates a better understanding of human vulnerability, particularly in low-resource settings. This paper assesses risk factors for injury in the March 2010 floods and landslides in Eastern Uganda, and compares the effects of location, injury type, and severity. A stratified cluster survey of the disaster-affected populations was conducted five months after onset of the disasters. Probability proportional to size sampling was used to sample 800 households, including 400 affected by floods in Butaleja District and 400 affected by landslides in Bududa District. Flood- and landslide-affected populations were surveyed in July 2010 using a stratified cluster design. The odds of injury were 65% higher in the flood-affected groups than the landslide-affected groups in a logistic regression (OR = 0.35; 95% CI, 0.24-0.52; P < .001). The injury rate was greater in individuals under 42 years of age, and location of injury was a contributing factor. More people were injured in the flood-affected population as compared with the landslide-affected population, and injuries were more severe. This study illustrates differences between populations injured by flood and landslide disasters that occurred simultaneously in Eastern Uganda in 2010. In areas where landslides are prone to occur due to massive rainfalls or floods, preventative measures, such as early warning systems and evacuation, are more likely to increase the likelihood of people surviving, while for areas with massive floods, immediate and effective medical attention can save lives and improve injury outcomes.

  14. Exploring Local Level Factors Shaping the Implementation of a Blended Learning Module for Information and Geospatial Literacy in Ontario

    ERIC Educational Resources Information Center

    Vine, Michelle M.; Chiappetta-Swanson, Catherine; Maclachlan, John; Brodeur, Jason J.; Bagg, Julianne

    2016-01-01

    The objectives of this research study were to examine local level factors shaping the implementation of a blended pedagogical approach for geospatial- and information-literacy, and to understand implementer satisfaction. As such, we addressed the following research questions: What local-level factors shape the implementation of the blended…

  15. Factors affecting smoking in schizophrenia.

    PubMed

    Beratis, S; Katrivanou, A; Gourzis, P

    2001-01-01

    There is an increased frequency of smoking among patients with schizophrenia. However, it is unknown whether the smoking behavior of the patients is similar in all schizophrenia subtypes, as well as which is the relationship between smoking initiation and disease onset. Four hundred six patients with DSM-IV schizophrenia were interviewed to determine the smoking status in relationship to gender and schizophrenic subtype, and to other factors that could affect or be affected by smoking. The frequency of smoking among patients (58%) was significantly greater than in subjects from the general population (42%) (P =.000005). Male patients smoked significantly more frequently (70%) than the corresponding control subjects (50%) (P =.000006), whereas the difference failed to reach significance between female patients (41%) and control subjects (32%). Among male patients, the number of smokers was significantly greater than in the controls in the paranoid (77%), undifferentiated (72%), and residual (78%) subtypes, whereas there was no significant difference in the disorganized (44%) and catatonic (22%) subtypes. The findings show that the frequency of smoking in schizophrenia patients increases with increasing positive symptoms and decreases with increasing negative symptoms. Male and female smoking patients consumed approximately 10 cigarettes per day more than the corresponding control subjects (P <.000001). In 86% of the patients, smoking initiation occurred before the disease onset. Among patients who smoked, smoking initiation and disease onset occurred at age 18.7 +/- 4.4 and 24.1 +/- 6.1 years, respectively (P <.000001). It appears that smoking in schizophrenia is influenced by gender and subtype. However, the nature of this association remains uncertain because in the vast majority of the patients smoking initiation occurs earlier than the disease onset. Copyright 2001 by W.B. Saunders Company

  16. Understanding and avoiding potential problems in implementing automation

    NASA Astrophysics Data System (ADS)

    Rouse, W. B.; Morris, N. M.

    1985-11-01

    Technology-driven efforts to implement automation often encounter problems due to lack of acceptance or begrudging acceptance by the personnel involved. It is argued in this paper that the level of automation perceived by an individual heavily influences whether or not the automation is accepted by that individual. The factors that appear to affect perceived level of automation are discussed. Issues considered include the impact of automation on the system and the individual, correlates of acceptance, problems and risks of automation, and factors influencing alienation. Based on an understanding of these issues, a set of eight guidelines is proposed as a possible means of avoiding problems in implementing automation.

  17. Understanding and avoiding potential problems in implementing automation

    NASA Technical Reports Server (NTRS)

    Rouse, W. B.; Morris, N. M.

    1985-01-01

    Technology-driven efforts to implement automation often encounter problems due to lack of acceptance or begrudging acceptance by the personnel involved. It is argued in this paper that the level of automation perceived by an individual heavily influences whether or not the automation is accepted by that individual. The factors that appear to affect perceived level of automation are discussed. Issues considered include the impact of automation on the system and the individual, correlates of acceptance, problems and risks of automation, and factors influencing alienation. Based on an understanding of these issues, a set of eight guidelines is proposed as a possible means of avoiding problems in implementing automation.

  18. Factors affecting general practitioners' decisions about plain radiography for back pain: implications for classification of guideline barriers – a qualitative study

    PubMed Central

    Espeland, Ansgar; Baerheim, Anders

    2003-01-01

    Background General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such factors. Methods Focus group interviews regarding factors affecting ordering decisions were carried out on a diverse sample of Norwegian general practitioners and were analysed qualitatively. Results of this study and two qualitative studies from the Netherlands and USA on use of spine radiography were interpreted for barriers to guideline adherence. These were compared with an existing barrier classification system described by Dr Cabana's group. Results The factors which Norwegian general practitioners considered might affect their decisions about ordering plain radiography for back pain concerned the following broader issues: clinical ordering criteria, patients' wishes for radiography and the general practitioner's response, uncertainty, professional dignity, access to radiology services, perception of whether the patient really was ill, sense of pressure from other health care providers/social security, and expectations about the consequences of ordering radiography. The three studies suggested several attitude-related and external barriers as classified in a previously reported system described by Dr Cabana in another study. Identified barriers not listed in this system were: lack of expectancy that guideline adherence will lead to desired health care process, emotional difficulty with adherence, improper access to actual/alternative health care services, and pressure from health care providers/organisations. Conclusions Our findings may help implement spine radiography guidelines. They also indicate that Cabana et al.'s barrier classification system needs extending. A revised system is proposed. PMID:12659640

  19. Evaluating the Impact of Implementation Factors on Family-Based Prevention Programming: Methods for Strengthening Causal Inference

    PubMed Central

    Crowley, D. Max; Coffman, Donna L.; Feinberg, Mark; Greenberg, Mark; Spoth, Richard

    2013-01-01

    Despite growing recognition of the important role implementation plays in successful prevention efforts, relatively little work has sought to demonstrate a causal relationship between implementation factors and participant outcomes. In turn, failure to explore the implementation-to-outcome link limits our understanding of the mechanisms essential to successful programming. This gap is partially due to the inability of current methodological procedures within prevention science to account for the multitude of confounders responsible for variation in implementation factors (i.e., selection bias). The current paper illustrates how propensity and marginal structural models can be used to improve causal inferences involving implementation factors not easily randomized (e.g., participant attendance). We first present analytic steps for simultaneously evaluating the impact of multiple implementation factors on prevention program outcome. Then we demonstrate this approach for evaluating the impact of enrollment and attendance in a family program, over and above the impact of a school-based program, within PROSPER, a large scale real-world prevention trial. Findings illustrate the capacity of this approach to successfully account for confounders that influence enrollment and attendance, thereby more accurately representing true causal relations. For instance, after accounting for selection bias, we observed a 5% reduction in the prevalence of 11th grade underage drinking for those who chose to receive a family program and school program compared to those who received only the school program. Further, we detected a 7% reduction in underage drinking for those with high attendance in the family program. PMID:23430578

  20. Ergonomics in the development and implementation of organisational strategy for sustainability.

    PubMed

    Ryan, Brendan; Wilson, John R

    2013-01-01

    This is the first phase of an ergonomics study of sustainability in a rail organisation, particularly environmental sustainability. The main emphasis has been on the use of a qualitative approach to carry out in-depth consultation with those in influential and policy setting roles in the organisation, collecting and analysing perceptions on sustainability policy and related business processes. The study identified factors affecting implementation of policy on sustainability and these have been developed to produce a list of requirements for implementing the policy. The findings are valuable in understanding the range of attitudes, aspirations and perceived constraints, from the perspective of those in senior roles in the company, and development of a sustainability strategy for a rail infrastructure owner. There is need for wider consultation, both within the organisation and externally, to validate and refine the understanding of barriers to the implementation of the policy. The role of ergonomics in supporting the work on sustainability is discussed. The study collects in-depth views from senior managers on the challenges of implementing a policy on sustainability in a rail organisation. Outputs include a list of factors affecting implementation of policy and requirements for better implementation of policy in this area. Potential contributions of ergonomics to sustainability in organisational contexts are discussed.

  1. The Synergistic Effect of Affective Factors on Student Learning Outcomes

    ERIC Educational Resources Information Center

    Jack, Brady Michael; Lin, Huann-shyang; Yore, Larry D.

    2014-01-01

    This study investigates how affective and self-related factors impact participation in science learning and environmental awareness and responsibility. Using PISA 2006 datasets from Taiwan and Canada having similar level of science competency, the model for this study verifies and expands an earlier model by examining the relationships among…

  2. Factors Affecting Educational Innovation with in Class Electronic Response Systems

    ERIC Educational Resources Information Center

    Freeman, Mark; Bell, Amani; Comerton-Forde, Carole; Pickering, Joanne; Blayney, Paul

    2007-01-01

    This paper reports the use of Rogers' diffusion of innovation perspective to understand the factors affecting educational innovation decisions, specifically in regard to in class electronic response systems. Despite decreasing costs and four decades of research showing strong student support, academic adoption is limited. Using data collected from…

  3. Scrutinizing the Factors Affecting Fluency of English among Arab Learners

    ERIC Educational Resources Information Center

    Al Ghazali, Fawzi

    2017-01-01

    This research study investigates the cognitive, psychological and personal factors affecting the accuracy and fluency of English language usage among Arab learners. Early research led by Chomsky (1965) and Krashen (1981) suggested that an individual's Language Acquisition Device once triggered at the appropriate time and supported with adequate…

  4. Factors Affecting the Acceptability of Microforms as a Reading Medium.

    ERIC Educational Resources Information Center

    Spencer, Herbert; Reynolds, Linda

    Based on visits to representative microform users and an extensive survey of relevant literature, a study was undertaken to assess the relative importance of factors affecting the acceptability of microforms as reading mediums. The following variables were considered: (1) microform characteristics; (2) equipment design; (3) work station design;…

  5. Environmental factors affecting understory diversity in second-growth deciduous forests

    Treesearch

    Cynthia D. Huebner; J.C. Randolph; G.R. Parker

    1995-01-01

    The purpose of this study was to determine the most important nonanthropogenic factors affecting understory (herbs, shrubs and low-growing vines) diversity in forested landscapes of southern Indiana. Fourteen environmental variables were measured for 46 sites. Multiple regression analysis showed significant positive correlation between understory diversity and tree...

  6. Factors Affecting School Choice: What Do Malaysian Chinese Parents Want?

    ERIC Educational Resources Information Center

    Siah, Poh Chua; Christina Ong, Sook Beng; Tan, Swee Mee; Sim, Chzia Poaw; Xian Thoo, Raphael Yi

    2018-01-01

    Aiming to explore factors affecting Malaysian Chinese parents in sending their children to either national secondary schools or Chinese independent schools, 494 parents were surveyed using a questionnaire. Results showed that parents who sent their children to Chinese independent schools have different priorities compared to those who sent theirs…

  7. Risk factors affecting human traumatic tympanic membrane perforation regeneration therapy using fibroblast growth factor-2.

    PubMed

    Lou, Zhengcai; Yang, Jian; Tang, Yongmei; Xiao, Jian

    2015-01-01

    The use of growth factors to achieve closure of human traumatic tympanic membrane perforations (TMPs) has recently been demonstrated. However, pretreatment factors affecting healing outcomes have seldom been discussed. The objective of this study was to evaluate pretreatment factors contributing to the success or failure of healing of TMPs using fibroblast growth factor-2 (FGF-2). A retrospective cohort study of 99 patients (43 males, 56 females) with traumatic TMPs who were observed for at least 6 months after FGF-2 treatment between March 2011 and December 2012. Eleven factors considered likely to affect the outcome of perforation closure were evaluated statistically using univariate and multivariate logistic regression analysis. Each traumatic TMP was treated by direct application of FGF-2. Complete closure versus failure to close. In total, 99 patients were analyzed. The total closure rate was 92/99 (92.9%) at 6 months; the mean closure time was 10.59 ±  6.81 days. The closure rate did not significantly differ between perforations with or without inverted edges (100.0% vs. 91.4%, p = 0.087), among different size groups (p = 0.768), or among different periods of exposure to injury (p = 0.051). However, the closure rate was significantly different between the high- and low-dose FGF-2 groups (85.0% vs. 98.3%, p = 0.010) and between perforations where the umbo or malleus was or was not involved in perforation (85.4% vs. 98.3%, p = 0.012). Additionally, univariate logistic regression analysis tests showed that it was difficult to achieve healing of these perforations with a history of chronic otitis media or residual TM calcification (p = 0.006), the umbo or malleus was involved in perforation (p = 0.038), and with a high dose of FGF-2 (p = 0.035) compared with control groups. Multivariate logistic regression analysis showed that only a history of chronic otitis media and residual TM calcification and perforation close to the

  8. Factors affecting alkali jarosite precipitation

    NASA Astrophysics Data System (ADS)

    Dutrizac, J. E.

    1983-12-01

    Several factors affecting the precipitation of the alkali jarosites (sodium jarosite, potassium jarosite, rubidium jarosite, and ammonium jarosite) have been studied systematically using sodium jarosite as the model. The pH of the reacting solution exercises a major influence on the amount of jarosite formed, but has little effect on the composition of the washed product. Higher temperatures significantly increase the yield and slightly raise the alkali content of the jarosites. The yield and alkali content both increase greatly with the alkali concentration to about twice the stoichiometric requirement but, thereafter, remain nearly constant. At 97 °C, the amount of product increases with longer retention times to about 15 hours, but more prolonged reaction times are without significant effect on the amount or composition of the jarosite. Factors such as the presence of seed or ionic strength have little effect on the yield or jarosite composition. The amount of precipitate augments directly as the iron concentration of the solution increases, but the product composition is nearly independent of this variable. A significant degree of agitation is necessary to suspend the product and to prevent the jarosite from coating the apparatus with correspondingly small yields. Once the product is adequately suspended, however, further agitation is without significant effect. The partitioning of alkali ions during jarosite precipitation was ascertained for K:Na, Na:NH4, K:NH4, and K:Rb. Potassium jarosite is the most stable of the alkali jarosites and the stability falls systematically for lighter or heavier congeners; ammonium jarosite is slightly more stable than the sodium analogue. Complete solid solubility among the various alkali jarosite-type compounds was established.

  9. [Phosphorus availability in cropland soils of China and related affecting factors].

    PubMed

    Wang, Yong-Zhuang; Chen, Xin; Shi, Yi

    2013-01-01

    Soil phosphorus (P) availability directly determines cropland productivity. Based on the long-term fertilization experiments in different climatic zones of China, this paper summarized the P content, its availability, and the factors affecting the P transformation in China cropland soils. The total and available P contents in different types of China cropland soils were 0.31-1.72 g x kg(-1) and 0.1-228.8 mg x kg(-1), respectively. Soil parent material, soil physical and chemical prosperities, and fertilization practices were the main factors affecting the soil P availability. It was suggested that more attentions should be paid on the mixed application of organic manure and chemical fertilizers to improve the P availability of cropland soils and on the potential environmental impacts of this fertilization.

  10. Factors affecting workplace bullying and lateral violence among clinical nurses in Korea: descriptive study.

    PubMed

    Oh, Hyunjin; Uhm, Dong Choon; Yoon, Young Joo

    2016-04-01

    Workplace bullying and lateral violence are serious issues affecting the work life of hospital nurses. The purpose of this study was to identify the selected individual and institutional characteristics for workplace bullying and lateral violence using a conceptual framework. A descriptive survey design was used. A convenience sample of 255 nurses in tertiary hospitals, who had a minimum of 6 months clinical experience, completed the survey. Regression analysis was used to determine factors significantly associated with workplace bullying and lateral violence. The Negative Acts Questionnaire-Revised and the Lateral Violence scale were used to measure workplace bullying and lateral violence. A negative affect, individualism and working in hospital specialty units predicted workplace bullying. Individualism, a negative affect, affiliated hospital and working hours predicted verbal abuse whereas the place of employment was significantly associated with lateral violence. The results of this study identified factors that are associated with bullying and violence but did not fully support the conceptual framework. The individual characteristic negative affect was significantly associated with most types of workplace bullying and lateral violence bully whereas the place of employment was an important factor in lateral violence. Nurse managers need to be aware that both individual and institutional factors may impact levels of workplace bullying and lateral violence in their hospitals and need to prepare specific strategies to address these multiple factors. © 2015 John Wiley & Sons Ltd.

  11. Factors affecting length of stay in teaching hospitals of a middle-income country

    PubMed Central

    Khosravizadeh, Omid; Vatankhah, Soudabeh; Bastani, Peivand; Kalhor, Rohollah; Alirezaei, Samira; Doosty, Farzane

    2016-01-01

    Introduction The length of stay (LOS) in hospitals is a widely used and important criteria for evaluating hospital performance. The aim of this study was to determine factors affecting LOS in teaching hospitals of Qazvin Providence. Methods In this cross-sectional study, patients’ health records were randomly selected from archives in teaching hospitals of Qazvin in 2013. Data were collected through a data entry form and were analyzed using Kolmogorov–Smirnov, Kruskal–Wallis, and Mann–Whitney U tests at the significant level of 0.05. Results The mean of hospital LOS was 5.45 ± 6.14 days. Age, employment, marital status, history of previous admission, patient condition at discharge, method of payment, and type of treatment had an impact on LOS (p<0.05). Other factors, including gender, place of residence, and type of admission, did not affect LOS. Conclusion Because hospitals consume a perceptible part of resources in a health system, controlled and optimized use of its resources help to save a lot. Therefore, this study showed many clinical and nonclinical factors affect LOS in evaluating these factors, which may reduce inappropriate hospital stays and decrease costs. PMID:27957301

  12. Analysis of usability factors affecting purchase intention in online e-commerce sites

    NASA Astrophysics Data System (ADS)

    Perdana, R. A.; Suzianti, A.

    2017-03-01

    The growing number of internet users plays a significant role in the emergence of a variety of online e-commerce sites to meet the needs of Indonesians. However, there are still some problems faced by the users in using e-commerce sites. Therefore, a research related to user experience on their purchase intention to foster e-commerce sites is required. This study is conducted to find out the relationship between usability factors on e-commerce users’ purchase intention using a case study by using SEM to analyse the usability of the website. The result of this study shows that credibility, readability and telepresence are usability factors that directly affect purchase intention, while simplicity, consistency and interactivity are usability factors that indirectly affect purchase intention. Therefore, we can conclude that Indonesian consumers are on the Early Majority phase in adopting Company A.

  13. The Internal Structure of Positive and Negative Affect: A Confirmatory Factor Analysis of the PANAS

    ERIC Educational Resources Information Center

    Tuccitto, Daniel E.; Giacobbi, Peter R., Jr.; Leite, Walter L.

    2010-01-01

    This study tested five confirmatory factor analytic (CFA) models of the Positive Affect Negative Affect Schedule (PANAS) to provide validity evidence based on its internal structure. A sample of 223 club sport athletes indicated their emotions during the past week. Results revealed that an orthogonal two-factor CFA model, specifying error…

  14. Factors affecting midwives' confidence in intrapartum care: a phenomenological study.

    PubMed

    Bedwell, Carol; McGowan, Linda; Lavender, Tina

    2015-01-01

    midwives are frequently the lead providers of care for women throughout labour and birth. In order to perform their role effectively and provide women with the choices they require midwives need to be confident in their practice. This study explores factors which may affect midwives' confidence in their practice. hermeneutic phenomenology formed the theoretical basis for the study. Prospective longitudinal data collection was completed using diaries and semi-structured interviews. Twelve midwives providing intrapartum care in a variety of settings were recruited to ensure a variety of experiences in different contexts were captured. the principal factor affecting workplace confidence, both positively and negatively, was the influence of colleagues. Perceived autonomy and a sense of familiarity could also enhance confidence. However, conflict in the workplace was a critical factor in reducing midwives' confidence. Confidence was an important, but fragile, phenomenon to midwives and they used a variety of coping strategies, emotional intelligence and presentation management to maintain it. this is the first study to highlight both the factors influencing midwives' workplace confidence and the strategies midwives employed to maintain their confidence. Confidence is important in maintaining well-being and workplace culture may play a role in explaining the current low morale within the midwifery workforce. This may have implications for women's choices and care. Support, effective leadership and education may help midwives develop and sustain a positive sense of confidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Discovery of Implementation Factors That Lead to Technology Adoption in Long-Term Care.

    PubMed

    Schoville, Rhonda R

    2017-10-01

    The current exploratory, qualitative study discovered and clarified implementation factors that led to technology adoption in long-term care (LTC). The Integrated Technology Implementation model guided the study of an electronic health record used in three LTC settings. Thirty key stakeholders (i.e., directors of nursing, nurses, and certified nurse aides) participated in focus groups or interviews. Findings indicated experiences were more similar than different among groups and facilities. Five major implementation themes supported by a variety of minor themes were identified. Implications for nursing include that leaders must be knowledgeable and committed to the change and engage staff throughout the implementation process. In addition, various communication and education strategies are required. [Journal of Gerontological Nursing, 43(10), 21-26.]. Copyright 2017, SLACK Incorporated.

  16. Specifying the non-specific factors underlying opioid analgesia: Expectancy, attention, and affect

    PubMed Central

    Atlas, Lauren Y.; Wielgosz, Joseph; Whittington, Robert A.; Wager, Tor D.

    2013-01-01

    Rationale Psychological processes such as expectancy, attention, and affect directly influence clinical outcomes. These factors are grouped together as “nonspecific” factors, or placebo effects, in the medical literature, and their individual contributions are rarely considered. The pain-reducing effects of analgesic treatments may reflect changes in these psychological factors, rather than pure drug effects on pain. Furthermore, drug effects may not be isolated by drug vs. placebo comparisons if drugs interact with relevant psychological processes. Objectives To determine whether the analgesic effects of opioid and placebo treatment are mediated by changes in attention, expectancy, or affect. Methods We crossed intravenous administration of a potent opioid analgesic, remifentanil, with information about drug delivery (treatment expectancy, or placebo) using a balanced placebo design. We measured drug and treatment expectancy effects on pain, attention, and responses to emotional images. We also examined interactions with cue-based expectations about noxious stimulation, or stimulus expectancy. Results Pain was additively influenced by treatment expectancy, stimulus expectancy, and drug concentration. Attention performance showed a small but significant interaction between drug and treatment expectancy. Finally, remifentanil enhanced responses to both positive and negative emotional images. Conclusions The pain-relieving effects of opioid drugs are unlikely to be mediated by changes in threat or affective processing. Standard open-label opioid administration influences multiple clinically relevant cognitive and emotional processes. Psychological factors can combine with drug effects to influence multiple outcomes in distinct ways. The influence of specific psychological factors should be considered when developing and testing pharmacological treatments. PMID:24096537

  17. Study on the factors affecting the quality of public bus transportation service in Bali Province using factor analysis

    NASA Astrophysics Data System (ADS)

    Susilawati, M.; Nilakusmawati, D. P. E.

    2017-06-01

    The volume of mobility flows are increasing day by day and the condition of the number of people using private transport modes contribute to traffic congestion. With the limited capacity of the road, one of the alternatives solution to reduce congestion is to optimize the use of public transport. The purposes of this study are to determine the factors that influence user’s satisfaction on the quality of public bus transportation service and determine variables that became identifier on the dominant factor affecting user’s satisfaction. The study was conducted for the public bus transportation between districts in the province of Bali, which is among the eight regencies and one municipality, using a questionnaire as a data collection instrument. Service variables determinant of user’s satisfaction in this study, described in 25 questions, which were analyzed using factor analysis. The results showed there were six factors that explain the satisfaction of users of public transport in Bali, with a total diversity of data that can be parsed by 61.436%. These factors are: Safety and comfort, Responsiveness, Capacity, Tangible, Safety, Reliability. The dominant factor affecting public transport user satisfaction is the safety and comfort, with the most influential variable is feeling concerned about the personal safety of users when on the bus.

  18. A study of factors affecting the adoption of server virtualization technology

    NASA Astrophysics Data System (ADS)

    Lu, Hsin-Ke; Lin, Peng-Chun; Chiang, Chang-Heng; Cho, Chien-An

    2018-04-01

    It has become a trend that worldwide enterprises and organizations apply new technologies to improve their operations; besides, it has higher cost and less flexibility to construct and manage traditional servers, therefore the current mainstream is to use server virtualization technology. However, from these new technology organizations will not necessarily get the expected benefits because each one has its own level of organizational complexity and abilities to accept changes. The researcher investigated key factors affecting the adoption of virtualization technology through two phases. In phase I, the researcher reviewed literature and then applied the dimensions of "Information Systems Success Model" (ISSM) to generalize the factors affecting the adoption of virtualization technology to be the preliminary theoretical framework and develop a questionnaire; in phase II, a three-round Delphi Method was used to integrate the opinions of experts from related fields which were then gradually converged in order to obtain a stable and objective questionnaire of key factors so that these results were expected to provide references for organizations' adoption of server virtualization technology and future studies.

  19. Factors Affecting Environmental Knowledge and Attitudes among Lebanese College Students

    ERIC Educational Resources Information Center

    Oweini, Ahmad; Houri, Ahmad

    2006-01-01

    This exploratory study aimed at assessing the variables that would positively affect the knowledge and attitude of a group of Lebanese college students regarding the environment, namely such factors as gender, age, previous hiking experience and living abroad. A purposeful sample of students attending the Lebanese American University, was asked to…

  20. Factors Affecting Performance of Undergraduate Students in Construction Related Disciplines

    ERIC Educational Resources Information Center

    Olatunji, Samuel Olusola; Aghimien, Douglas Omoregie; Oke, Ayodeji Emmanuel; Olushola, Emmanuel

    2016-01-01

    Academic performance of students in Nigerian institutions has been of much concern to all and sundry hence the need to assess the factors affecting performance of undergraduate students in construction related discipline in Nigeria. A survey design was employed with questionnaires administered on students in the department of Quantity Surveying,…

  1. Factors Affecting Resilience and Development of Posttraumatic Stress Disorder in Critical Care Nurses.

    PubMed

    Mealer, Meredith; Jones, Jacqueline; Meek, Paula

    2017-05-01

    Job stress and cumulative exposure to traumatic events experienced by critical care nurses can lead to psychological distress and the development of burnout syndrome and posttraumatic stress disorder. Resilience can mitigate symptoms associated with these conditions. To identify factors that affect resilience and to determine if the factors have direct or indirect effects on resilience in development of posttraumatic stress disorder. Data from 744 respondents to a survey mailed to 3500 critical care nurses who were members of the American Association of Critical-Care Nurses were analyzed. Mplus was used to analyze a mediation model. Nurses who worked in any type of intensive care unit other than the medical unit and had high scores for resilience were 18% to 50% less likely to experience post-traumatic stress disorder than were nurses with low scores. Nurses with a graduate degree in nursing were 18% more likely to experience posttraumatic stress disorder than were nurses with a bachelor's degree. Because of their effects on resilience, working in a medical intensive care unit and having a graduate degree may influence the development of posttraumatic stress disorder. Future research is needed to better understand the impact of resilience on health care organizations, development of preventive therapies and treatment of posttraumatic stress disorder for critical care nurses, and the most appropriate mechanism to disseminate and implement strategies to address posttraumatic stress disorder. ©2017 American Association of Critical-Care Nurses.

  2. Health care professionals implementing a smoke-free policy at inpatient psychiatric units.

    PubMed

    Grant, Lyle G; Oliffe, John L; Johnson, Joy L; Bottorff, Joan L

    2014-12-01

    Smoke-free grounds policies (SFGPs) were introduced to inpatient psychiatric hospital settings to improve health among patients, staff, and visitors. We conducted an ethnographic study in Northern British Columbia, Canada, to describe how the implementation of SFGPs is affected by institutional cultures. Data reported here included participant observation, document review, informal discussions (n = 11), and interviews with health care professionals (HCPs; n = 19) and staff (n = 2) at two hospitals. We used iterative and inductive processes to derive thematic findings. Findings related to HCPs illustrate how local contexts and cultural factors affect SFGP implementation. These factors included individual beliefs and attitudes, the influence of group norms, leadership and consensus building, and locale-specific norms. Strong, consultative leadership, in which leaders solicited input from and long-term support of people most directly responsible for policy implementation, was key to success. © The Author(s) 2014.

  3. Factors Influencing Teachers' Implementation of an Innovative Tobacco Prevention Curriculum for Multiethnic Youth: Project SPLASH

    ERIC Educational Resources Information Center

    Sy, Angela; Glanz, Karen

    2008-01-01

    Background: The effectiveness of school-based tobacco use prevention programs depends on proper implementation. This study examined factors associated with teachers' implementation of a smoking prevention curriculum in a cluster randomized trial called Project SPLASH (Smoking Prevention Launch Among Students in Hawaii). Methods: A process…

  4. Barriers and Facilitators for the Implementation of Primary Prevention and Health Promotion Activities in Primary Care: A Synthesis through Meta-Ethnography

    PubMed Central

    Rubio-Valera, Maria; Pons-Vigués, Mariona; Martínez-Andrés, María; Moreno-Peral, Patricia; Berenguera, Anna; Fernández, Ana

    2014-01-01

    Background Evidence supports the implementation of primary prevention and health promotion (PP&HP) activities but primary care (PC) professionals show resistance to implementing these activities. The aim was to synthesize the available qualitative research on barriers and facilitators identified by PC physicians and nurses in the implementation of PP&HP in adults. Methods and Findings A systematic search of three databases was conducted and supported by manual searches. The 35 articles included were translated into each other and a new interpretation of the concepts extracted was generated. The factors affecting the implementation of PP&HP activities in PC according to professionals were fitted into a five-level ecological model: intrapersonal factors, interpersonal processes, institutional factors, community factors and public policy. At the intrapersonal level we find professionals' beliefs about PP&HP, experiences, skills and knowledge, and selfconcept. The attitudes and behavior towards PP&HP of patients, specialists, practice managers and colleagues (interpersonal factors) affect the feasibility of implementing PP&HP. Institutional level: PC is perceived as well-placed to implement PP&HP but workload, lack of time and referral resources, and the predominance of the biomedical model (which prioritizes disease treatment) hamper the implementation of PP&HP. The effectiveness of financial incentives and tools such as guidelines and alarms/reminders is conditioned by professionals' attitudes to them. Community factors include patients' social and cultural characteristics (religion, financial resources, etc.), local referral resources, mass-media messages and pharmaceutical industry campaigns, and the importance given to PP&HP in the curriculum in university. Finally, policies affect the distribution of resources, thus affecting the implementation of PP&HP. Conclusions Research on barriers and facilitators in the implementation of PP&HP activities in multirisk

  5. Innovation implementation in the public sector: an integration of institutional and collective dynamics.

    PubMed

    Choi, Jin Nam; Chang, Jae Yoon

    2009-01-01

    The present study integrates institutional factors and employee-based collective processes as predictors of 2 key implementation outcomes: implementation effectiveness and innovation effectiveness (Klein, Conn, & Sorra, 2001). Specifically, the authors proposed that institutional factors shape employees' collective implementation efficacy and innovation acceptance. The authors further hypothesized that these employee-based collective processes mediate the effects of institutional factors on implementation outcomes. This integrative framework was examined in the context of 47 agencies and ministries of the Korean Government that were implementing a process innovation called E-Government. Three-wave longitudinal data were collected from 60 external experts and 1,732 government employees. The results reveal the importance of management support for collective implementation efficacy, which affected employees' collective acceptance of the innovation. As hypothesized, these collective employee dynamics mediated the effects of institutional enablers on successful implementation as well as the amount of long-term benefit that accrued to the agencies and ministries. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

  6. Factors affecting early and long-term outcomes after completion pneumonectomy.

    PubMed

    Chataigner, Olivier; Fadel, Elie; Yildizeli, Bedrettin; Achir, Abdallah; Mussot, Sacha; Fabre, Dominique; Mercier, Olaf; Dartevelle, Philippe G

    2008-05-01

    To identify factors that affect operative mortality and morbidity and long-term survival after completion pneumonectomy. We retrospectively reviewed the charts of consecutive patients who underwent completion pneumonectomy at our cardiothoracic surgery department from January 1996 to December 2005. We identified 69 patients, who accounted for 17.8% of all pneumonectomies during the study period; 22 had benign disease and 47 malignant disease (second primary lung cancer, n=19; local recurrence, n=17; or metastasis, n=11). There were 50 males and 19 females with a mean age of 60 years (range, 29-80 years). Postoperative mortality was 12% and postoperative morbidity 41%. Factors associated with postoperative mortality included obesity (p=0.005), coronary artery disease (p=0.03), removal of the right lung (p=0.02), advanced age (p=0.02), and renal failure (p<0.0001). Preoperative renal failure was the only significant risk factor for mortality by multivariate analysis (p=0.036). Bronchopleural fistula developed in seven patients (10%), with risk factors being removal of the right lung (p=0.04) and mechanical stump closure (p=0.03). Overall survival was 65% after 3 years and 46% after 5 years. Long-term survival was not affected by the reason for completion pneumonectomy. Although long-term survival was acceptable, postoperative mortality and morbidity rates remained high, confirming the reputation of completion pneumonectomy as a challenging procedure. Significant comorbidities and removal of the right lung were the main risk factors for postoperative mortality. Improved patient selection and better management of preoperative renal failure may improve the postoperative outcomes of this procedure, which offers a chance for prolonged survival.

  7. Contextual Factors Related to Implementation and Reach of a Pragmatic Multisite Trial– The My Own Health Report (MOHR) Study

    PubMed Central

    Balasubramanian, Bijal A.; Heurtin-Roberts, Suzanne; Krasny, Sarah; Rohweder, Catherine; Fair, Kayla; Olmos, Tanya; Stange, Kurt C.; Gorin, Sherri Sheinfeld

    2018-01-01

    Background Contextual factors relevant to health care improvement studies are important for translating findings to other settings; however, these are rarely collected systematically and reported. This study articulates a prospective method for assessing contextual factors and describes factors related to implementation and patient reach of a pragmatic multisite trial conducted in nine primary care practices. Methods In a qualitative case-series, contextual factors were assessed from the My Own Health Report (MOHR) study, focused on systematically conducting health risk assessments and goal setting for unhealthy behaviors and behavioral health in primary care. Data were collected prospectively at baseline, mid-point, and end of intervention using a template that guided conduct of interviews and observations at practice sites. A multidisciplinary team used an iterative process to summarize themes describing contextual factors related to intervention implementation and patient reach, calculated by dividing the number of patients who completed the MOHR assessment by the number of patients offered MOHR. Results Contextual factors operational both within and external to the practice environment influenced implementation and patient reach over time. These included practice members’ motivations towards the MOHR intervention, practice staff capacity to take on additional responsibilities for implementation, practice information system capacity, external resources to support quality improvement, linkages with community resources, and fit of implementation strategy to patient populations. Conclusions Systematic assessment of contextual factors throughout implementation of quality improvement initiatives is needed to meaningfully interpret findings and translate lessons learned to other health care settings. Thus, knowledge of contextual factors is essential for scaling up of effective improvement strategies. PMID:28484066

  8. Factors affecting electronic health record adoption in long-term care facilities.

    PubMed

    Cherry, Barbara; Carter, Michael; Owen, Donna; Lockhart, Carol

    2008-01-01

    Electronic health records (EHRs) hold the potential to significantly improve the quality of care in long-term care (LTC) facilities, yet limited research has been done on how facilities decide to adopt these records. This study was conducted to identify factors that hinder and facilitate EHR adoption in LTC facilities. Study participants were LTC nurses, administrators, and corporate executives. Primary barriers identified were costs, the need for training, and the culture change required to embrace technology. Primary facilitators were training programs, well-defined implementation plans, government assistance with implementation costs, evidence that EHRs will improve care outcomes, and support from state regulatory agencies. These results offer a framework of action for policy makers, LTC Leaders, and researchers.

  9. Factors Critical to the Implementation of Self-Paced Instruction: A Background Review.

    DTIC Science & Technology

    1984-08-01

    tailored and adapted to specific user needs during the implementation process. Factors related to the user group’s ability to take a flexible...Manager and Learning Facilitator. The seven roles are Planner (at classroom operations), Inplementor/Monitor, Evaluator, fDiagnostician , Remediator

  10. Factors Affecting 25-Hydroxyvitamin D Concentration in Response to Vitamin D Supplementation

    PubMed Central

    Mazahery, Hajar; von Hurst, Pamela R.

    2015-01-01

    Sun exposure is the main source of vitamin D. Due to many lifestyle risk factors vitamin D deficiency/insufficiency is becoming a worldwide health problem. Low 25(OH)D concentration is associated with adverse musculoskeletal and non-musculoskeletal health outcomes. Vitamin D supplementation is currently the best approach to treat deficiency and to maintain adequacy. In response to a given dose of vitamin D, the effect on 25(OH)D concentration differs between individuals, and it is imperative that factors affecting this response be identified. For this review, a comprehensive literature search was conducted to identify those factors and to explore their significance in relation to circulating 25(OH)D response to vitamin D supplementation. The effect of several demographic/biological factors such as baseline 25(OH)D, aging, body mass index(BMI)/body fat percentage, ethnicity, calcium intake, genetics, oestrogen use, dietary fat content and composition, and some diseases and medications has been addressed. Furthermore, strategies employed by researchers or health care providers (type, dose and duration of vitamin D supplementation) and environment (season) are other contributing factors. With the exception of baseline 25(OH)D, BMI/body fat percentage, dose and type of vitamin D, the relative importance of other factors and the mechanisms by which these factors may affect the response remains to be determined. PMID:26121531

  11. Factors Affecting Aerosol Radiative Forcing

    NASA Astrophysics Data System (ADS)

    Wang, Jingxu; Lin, Jintai; Ni, Ruijing

    2016-04-01

    Rapid industrial and economic growth has meant a large amount of aerosols in the atmosphere with strong radiative forcing (RF) upon the climate system. Over parts of the globe, the negative forcing of aerosols has overcompensated for the positive forcing of greenhouse gases. Aerosol RF is determined by emissions and various chemical-transport-radiative processes in the atmosphere, a multi-factor problem whose individual contributors have not been well quantified. In this study, we analyze the major factors affecting RF of secondary inorganic aerosols (SIOAs, including sulfate, nitrate and ammonium), primary organic aerosol (POA), and black carbon (BC). We analyze the RF of aerosols produced by 11 major regions across the globe, including but not limited to East Asia, Southeast Asia, South Asia, North America, and Western Europe. Factors analyzed include population size, per capita gross domestic production (GDP), emission intensity (i.e., emissions per unit GDP), chemical efficiency (i.e., mass per unit emissions) and radiative efficiency (i.e., RF per unit mass). We find that among the 11 regions, East Asia produces the largest emissions and aerosol RF, due to relatively high emission intensity and a tremendous population size. South Asia produce the second largest RF of SIOA and BC and the highest RF of POA, in part due to its highest chemical efficiency among all regions. Although Southeast Asia also has large emissions, its aerosol RF is alleviated by its lowest chemical efficiency. The chemical efficiency and radiative efficiency of BC produced by the Middle East-North Africa are the highest across the regions, whereas its RF is lowered by a small per capita GDP. Both North America and Western Europe have low emission intensity, compensating for the effects on RF of large population sizes and per capita GDP. There has been a momentum to transfer industries to Southeast Asia and South Asia, and such transition is expected to continue in the coming years. The

  12. Factors Affecting Aerosol Radiative Forcing

    NASA Astrophysics Data System (ADS)

    Wang, J.; Lin, J.; Ni, R.

    2016-12-01

    Rapid industrial and economic growth has meant large amount of aerosols in the atmosphere with strong radiative forcing (RF) upon the climate system. Over parts of the globe, the negative forcing of aerosols has overcompensated for the positive forcing of greenhouse gases. Aerosol RF is determined by emissions and various chemical-transport-radiative processes in the atmosphere, a multi-factor problem whose individual contributors have not been well quantified. In this study, we analyze the major factors affecting RF of secondary inorganic aerosols (SIOAs, including sulfate, nitrate and ammonium), primary organic aerosol (POA), and black carbon (BC). We analyze the RFof aerosols produced by 11 major regions across the globe, including but not limited to East Asia, Southeast Asia, South Asia, North America, and Western Europe. Factors analyzed include population size, per capita gross domestic production (GDP), emission intensity (i.e., emissionsper unit GDP), chemical efficiency (i.e., mass per unit emissions) and radiative efficiency (i.e., RF per unit mass). We find that among the 11 regions, East Asia produces the largest emissions and aerosol RF, due to relatively high emission intensity and a tremendous population size.South Asia produce the second largest RF of SIOA and BC and the highest RF of POA, in part due to its highest chemical efficiency among all regions. Although Southeast Asia also has large emissions,its aerosol RF is alleviated by its lowest chemical efficiency.The chemical efficiency and radiative efficiency of BC produced by the Middle East-North Africa are the highest across the regions, whereas its RF is loweredbyasmall per capita GDP.Both North America and Western Europe have low emission intensity, compensating for the effects on RF of large population sizes and per capita GDP. There has been a momentum to transfer industries to Southeast Asia and South Asia, and such transition is expected to continue in the coming years. The resulting

  13. Mothers recovering from cocaine addiction: factors affecting parenting skills.

    PubMed

    Coyer, S M

    2001-01-01

    To identify factors that may influence parenting by mothers who are recovering from cocaine addiction. Exploratory descriptive, with in-depth unstructured interviews. Interviews were conducted in the woman's home or in a treatment center. A convenience sample of 11 women recovering from cocaine addiction who were mothers of children 3 years of age and younger. A content analysis was used to analyze the interview data. Two themes, personal/psychologic factors and environmental/contextual factors, and four subthemes emerged. They identify issues that may affect parenting by mothers being treated for cocaine addiction. Subthemes included low self-esteem, difficulty developing a maternal identity, isolation from friends and family, and chronic life stress. This study provides a better understanding of the sources contributing to vulnerability in the parenting role for mothers recovering from cocaine addiction and will assist nurses in providing care for these mothers and their children.

  14. Factors Affecting the Interest of Israeli Social Work Students in Working with Different Client Groups

    ERIC Educational Resources Information Center

    Krumer-Nevo, Michal; Weiss, Idit

    2006-01-01

    Employing a large-scale sample of 521 BSW students from 4 Israeli schools of social work, this research examines the factors affecting social work students' interest in working with a wide range of client groups. The results suggest that student interest in working with specific client groups is affected by factors related to desire for…

  15. Factors Affecting English Language Teaching and Learning in Higher Education

    ERIC Educational Resources Information Center

    Nguyen, Hong Thi; Warren, Wendy; Fehring, Heather

    2014-01-01

    This paper reports part of a study that aims to explore factors affecting the efficacy of non-major English teaching and learning in Vietnamese higher education through an investigation of classroom practices. Eight non-participant class observations were conducted at HUTECH University, Ho Chi Minh City, Vietnam. The study's findings show that…

  16. The Impact of CLIL on Affective Factors and Vocabulary Learning

    ERIC Educational Resources Information Center

    Heras, Arantxa; Lasagabaster, David

    2015-01-01

    The aim of this article is twofold: to assess the effectiveness of a CLIL (content and language integrated learning) module on affective factors (motivation and self-esteem), and to test the purported blurring effect of CLIL on gender differences in foreign language learning. Forty-six students in their fourth year of compulsory secondary…

  17. The Perspective of Gozitan Teachers on Factors Affecting Students' Achievement

    ERIC Educational Resources Information Center

    Xuereb, Lorna; De Giovanni, Katya Sarah

    2016-01-01

    This study aims at exploring the impact of factors at pupil, teacher and school levels on students? academic achievement. Moreover, the main purpose was that of investigating which one of the three levels is most likely to affect students? educational accomplishment. A questionnaire was administered to 100 Gozitan teachers. Results were analysed…

  18. 77 FR 18862 - Brazil: Competitive Factors Affecting U.S. and Brazilian Agricultural Sales in Selected Third...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 332-524] Brazil: Competitive Factors Affecting U.S. and Brazilian Agricultural Sales in Selected Third Country Markets AGENCY: United States... Committee in investigation No. 332-524, Brazil: Competitive Factors In Brazil Affecting U.S. and Brazilian...

  19. Physical Activity Promotion in Schools: Which Strategies Do Schools (Not) Implement and Which Socioecological Factors Are Associated with Implementation?

    ERIC Educational Resources Information Center

    Cardon, Greet M.; Van Acker, Ragnar; Seghers, Jan; De Martelaer, Kristine; Haerens, Leen L.; De Bourdeaudhuij, Ilse M. M.

    2012-01-01

    We studied the implementation and associated factors of strategies (e.g. sports after school and during lunch break, active schoolyards, active school commuting) and organizational principles (e.g. safe bike racks, pupil involvement) that facilitate the physical activity (PA)-promoting role of schools. Key representatives of 111 elementary and 125…

  20. Review of factors affecting sustainability in the universities

    NASA Astrophysics Data System (ADS)

    Ajilian, Hosna

    Understanding the factors which influence adopting sustainability practices in IHE is an important issue to develop more effective sustainability's methods and policies. The focus of this research is to find out a meaningful relationship between adopting sustainability practices and some of the characteristics of institutions of higher education (IHE). IHE can be considered as the best place to promote sustainability and develop the culture of sustainability in society. Thus, this research is conducted to help developing sustainability in IHE which have significant direct and indirect impact on society and the environment. First, the sustainability letter grades were derived from "Greenreportcard.org" which have been produced based on an evaluation of each school in nine main categories including: Administration, Climate Change & Energy, Food & Recycling, etc. In the next step, the characteristics of IHE as explanatory variables were chosen from "The Integrated Postsecondary Education Data System" (IPEDS) and respective database was implemented in STATA Software. Finally, the "ordered-Probit Model" is used through STATA to analyze the impact of some IHE's factor on adopting sustainability practices on campus. The results of this analysis indicate that variables related to "Financial support" category are the most influential factors in determining the sustainability status of the university. "The university features" with two significant variables for "Selectivity" and "Top 50 LA" can be classified as the second influential category in this table, although the "Student influence" is also eligible to be ranked as the second important factor. Finally, the "Location feature" of university was determined with the least influential impact on the sustainability of campuses.

  1. Making the Connection--Factors Influencing Implementation of Evidence Supported and Non-Evaluated Lifestyle Interventions in Healthcare: A Multiple Case Study

    ERIC Educational Resources Information Center

    van de Glind, Irene; Heinen, Maud; Geense, Wytske; Mesters, Ilse; Wensing, Michel; van Achterberg, Theo

    2015-01-01

    Many implementation barriers relate to lifestyle interventions (LIs) being developed by scientists. Exploring whether implementation of non-evaluated LIs is less complicated, might offer insight how to improve the use of effective interventions. This study aimed to identify influencing factors for implementation and compare factors between…

  2. Factors affecting the palpability of breast lesion by self-examination.

    PubMed

    Lam, W W M; Chan, C P; Chan, C F; Mak, C C C; Chan, C F; Chong, K W H; Leung, M H J; Tang, M H

    2008-03-01

    This study aims to assess the accuracy of detection of breast lesion by breast self-examination and to assess different factors affecting the accuracy. All consecutive Chinese female patients, who attended our breast imaging unit in 2001, completed our questionnaire, had retrievable hard copy films, and had more than three years clinical follow-up, were recruited for this study. Different factors, such as age, menopausal status, previous experience of breastfeeding, family history of breast cancer, previous history of mastectomy or lumpectomy, hormonal therapy, oral contraceptive pills and previous history of mammography, were correlated with accuracy in self-detection of breast lesions retrospectively. The nature, size and location of the lesion, and breast size based on imaging, were also correlated with the accuracy in self-detection of breast lesions. A total of 163 questionnaires were analysed. 111 patients detected a breast lesion themselves and 24 of these lesions were false-positives. A total of 173 lesions (27 cancerous, 146 benign lesions) were documented by either ultrasonography and/or mammography, and confirmed by either histology or three-year clinical follow-up. The overall sensitivity in detecting both benign and malignant breast lesions was 71% when number of breast lesions was used as the denominator, and up to 78% sensitivity was achieved when number of patients was used as the denominator. History of mastectomy, and size and nature of the lesions were found to affect the accuracy of self-detection of breast lesions. Overall, breast self-examinations were effective in the detection of breast lesions and factors such as size of lesion, nature of the lesion and history of mastectomy affect the accuracy of the detections. Breast self-examination should be promoted for early detection of breast cancer.

  3. Factors Affecting the Effectiveness and Use of Moodle: Students' Perception

    ERIC Educational Resources Information Center

    Damnjanovic, Vesna; Jednak, Sandra; Mijatovic, Ivana

    2015-01-01

    The purpose of this research paper is to identify the factors affecting the effectiveness of Moodle from the students' perspective. The research hypotheses derived from the suggested extended Seddon model have been empirically validated using the responses to a survey on e-learning usage among 255 users. We tested the model across higher education…

  4. Implementing quality initiatives in healthcare organizations: drivers and challenges.

    PubMed

    Abdallah, Abdallah

    2014-01-01

    Various quality initiatives seem to have successful implementation in some healthcare organizations yet fail in others. This paper sets out to study the literature trying to understand drivers and challenges facing quality initiatives implementation in healthcare organizations then compare findings from literature with those of a structured questionnaire answered by 60 representatives from 18 hospitals. Finally it proposes a framework that mitigates challenges and utilizes drivers to ensure best implementation results. Literature regarding implementing various quality initiatives in the healthcare sector was reviewed. Representatives from several healthcare organizations were surveyed. Results from both approaches are compared to highlight the key challenges and drivers facing implementers. This research reveals that internal factors related to leadership and employees greatly affect quality initiative success or failure. Design and relevance play a major role in successful implementation. PRACTICAL IMPLICATIONs: This research offers healthcare professionals greater success when implementing certain quality initiatives by taking success/failure factors into consideration. A general framework for successful implementation in the healthcare sector is provided. This article uncovers reasons behind success or failure in a comprehensive and practical way. It also explores how most popular quality initiatives are applied in hospitals.

  5. A retrospective content analysis of studies on factors constraining the implementation of health sector reform in Ghana.

    PubMed

    Sakyi, E Kojo

    2008-01-01

    Ghana has undertaken many public service management reforms in the past two decades. But the implementation of the reforms has been constrained by many factors. This paper undertakes a retrospective study of research works on the challenges to the implementation of reforms in the public health sector. It points out that most of the studies identified: (1) centralised, weak and fragmented management system; (2) poor implementation strategy; (3) lack of motivation; (4) weak institutional framework; (5) lack of financial and human resources and (6) staff attitude and behaviour as the major causes of ineffective reform implementation. The analysis further revealed that quite a number of crucial factors obstructing reform implementation which are particularly internal to the health system have either not been thoroughly studied or overlooked. The analysis identified lack of leadership; weak communication and consultation; lack of stakeholder participation, corruption and unethical professional behaviour as some of the missing variables in the literature. The study, therefore, indicated that there are gaps in the literature that needed to be filled through rigorous reform evaluation based on empirical research particularly at district, sub-district and community levels. It further suggested that future research should be concerned with the effects of both systems and structures and behavioural factors on reform implementation.

  6. Association of School Characteristics and Implementation in the X:IT Study--A School-Randomized Smoking Prevention Program

    ERIC Educational Resources Information Center

    Bast, Lotus S.; Due, Pernille; Ersbøll, Annette K.; Damsgaard, Mogens T.; Andersen, Anette

    2017-01-01

    Background: Assessment of implementation is essential for the evaluation of school-based preventive activities. Interventions are more easily implemented in schools if detailed instructional manuals, lesson plans, and materials are provided; however, implementation may also be affected by other factors than the intervention itself--for example,…

  7. Free for All: A Case Study Examining Implementation Factors of One-to-One Device Programs

    ERIC Educational Resources Information Center

    Howard, Sarah K.; Rennie, Ellie

    2013-01-01

    Despite significant investment in school one-to-one device programs, little is known about which aspects of program implementation work and why. Through a comparison of two implementation models, adopter-diffusion and saturation, and using existing data from the One Laptop per Child Australia laptop program, we explored how factors of…

  8. Factors Affecting Conservation Practice Behavior of CRP Participants in Alabama

    Treesearch

    Okwudili Onianwa; Gerald Wheelock; Shannon Hendrix

    1999-01-01

    This study examines the factors that affect conservation practice choices of CRP farmers in Alabama. From over 9,000 contracts enrolled in the state between 1986 and 1995, 594 were randomly selected for the study. A multiple-regression analysis was employed to analyze the data. Results indicate that education, ratio ofcropland in CRP, farm size, gender, prior crop...

  9. Factors Affecting the Retention Decisions of Female Surface Warfare Officers

    DTIC Science & Technology

    2003-03-01

    NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS Approved for public release; distribution is unlimited. FACTORS AFFECTING THE RETENTION...Warfare Officers 6. AUTHOR(S) Clifton, Elizabeth A. 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School ...for the degree of MASTER OF SCIENCE IN LEADERSHIP AND HUMAN RESOURCE DEVELOPMENT from the NAVAL POSTGRADUATE SCHOOL March 2003

  10. Factors Affecting Lactoferrin Concentration in Human Milk: How Much Do We Know?

    PubMed Central

    Villavicencio, Aasith; Rueda, Maria S.; Turin, Christie G.; Ochoa, Theresa J.

    2017-01-01

    Lactoferrin (LF) is a breast milk glycoprotein with antimicrobial and anti-inflammatory effects. Its beneficial properties in infants, especially in those born preterm, are currently being studied in clinical trials. However, the maternal and nursing infant factors that may affect the concentration of LF in breast milk are still not clear. We conducted a systematic review to investigate the factors that may affect LF concentration. We used a 2-step approach to identify the eligible studies according to inclusion/exclusion criteria and to determine which studies would be considered. We included 70 qualified articles from 29 countries with publication dates ranging from 1976 to 2015. We described the correlation between LF concentration in breast milk and lactation stage; 10 maternal factors, such as race, parity, among others; and 2 infant factors, infections and prematurity. Colostrum has the highest LF levels, but they decrease with days postpartum. No other factor has been consistently associated with LF concentration. A major limitation of the majority of the published studies is the small sample size and the different methods used to measure LF concentration. Therefore, there is a need for large, multicenter studies with standardized study design, sample collection, and LF measurement methods to identify clinically significant factors associated with LF expression in breast milk, which will help promote exclusive breastfeeding in preterm infants. PMID:28075610

  11. Factors affecting assertiveness among student nurses.

    PubMed

    Ibrahim, Sanaa Abd El Azim

    2011-05-01

    This study aimed to investigate the factors affecting assertiveness among student nurses. The study was carried out at Faculty of Nursing, Port-Said University, on 207 student nurses from four different grades. Rathus Assertiveness Schedule, consisted of 30 items, was used to measure the students' assertiveness level and a 12-item scale developed by Spreitzer was used to measure students' psychological empowerment. The study results showed that 60.4% of the students were assertive, while about half of the students were empowered. A positive relation between student assertiveness and psychological empowerment was detected. Moreover, positive relations regarding family income and students' assertiveness and psychological empowerment were determined. The study recommended introduction of specific courses aiming at enhancing the acquisition of assertiveness skills, in addition, nurse educators must motivate their students to express their opinion and personal rights and also they must pay attention for students' empowerment and enhance students' autonomy. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Barriers and Facilitating Factors for Implementation of Genetic Services: A Public Health Perspective.

    PubMed

    Cornel, Martina C; van El, Carla G

    2017-01-01

    More than 15 years after the publication of the sequence of the human genome, the resulting changes in health care have been modest. At the same time, some promising examples in genetic services become visible, which contribute to the prevention of chronic disease such as cancer. These are discussed to identify barriers and facilitating factors for the implementation of genetic services. Examples from oncogenetics illustrate a high risk of serious disease where prevention is possible, especially in relatives. Some 5% of breast cancers and colorectal cancers are attributable to an inherited predisposition. These cancers occur at a relatively young age. DNA testing of relatives of affected patients may facilitate primary and secondary prevention. Training of non-genetic health care workers and health technology assessment are needed, as is translational research in terms of bringing genomics to health care practice while monitoring and evaluating. Stratified screening programs could include cascade screening and risk assessment based on family history. New roles and responsibilities will emerge. A clear assessment of the values implied is needed allowing to balance the pros and cons of interventions to further the responsible innovation of genetic services.

  13. Factors Affecting Regional Per-Capita Carbon Emissions in China Based on an LMDI Factor Decomposition Model

    PubMed Central

    Dong, Feng; Long, Ruyin; Chen, Hong; Li, Xiaohui; Yang, Qingliang

    2013-01-01

    China is considered to be the main carbon producer in the world. The per-capita carbon emissions indicator is an important measure of the regional carbon emissions situation. This study used the LMDI factor decomposition model–panel co-integration test two-step method to analyze the factors that affect per-capita carbon emissions. The main results are as follows. (1) During 1997, Eastern China, Central China, and Western China ranked first, second, and third in the per-capita carbon emissions, while in 2009 the pecking order changed to Eastern China, Western China, and Central China. (2) According to the LMDI decomposition results, the key driver boosting the per-capita carbon emissions in the three economic regions of China between 1997 and 2009 was economic development, and the energy efficiency was much greater than the energy structure after considering their effect on restraining increased per-capita carbon emissions. (3) Based on the decomposition, the factors that affected per-capita carbon emissions in the panel co-integration test showed that Central China had the best energy structure elasticity in its regional per-capita carbon emissions. Thus, Central China was ranked first for energy efficiency elasticity, while Western China was ranked first for economic development elasticity. PMID:24353753

  14. Factors affecting regional per-capita carbon emissions in China based on an LMDI factor decomposition model.

    PubMed

    Dong, Feng; Long, Ruyin; Chen, Hong; Li, Xiaohui; Yang, Qingliang

    2013-01-01

    China is considered to be the main carbon producer in the world. The per-capita carbon emissions indicator is an important measure of the regional carbon emissions situation. This study used the LMDI factor decomposition model-panel co-integration test two-step method to analyze the factors that affect per-capita carbon emissions. The main results are as follows. (1) During 1997, Eastern China, Central China, and Western China ranked first, second, and third in the per-capita carbon emissions, while in 2009 the pecking order changed to Eastern China, Western China, and Central China. (2) According to the LMDI decomposition results, the key driver boosting the per-capita carbon emissions in the three economic regions of China between 1997 and 2009 was economic development, and the energy efficiency was much greater than the energy structure after considering their effect on restraining increased per-capita carbon emissions. (3) Based on the decomposition, the factors that affected per-capita carbon emissions in the panel co-integration test showed that Central China had the best energy structure elasticity in its regional per-capita carbon emissions. Thus, Central China was ranked first for energy efficiency elasticity, while Western China was ranked first for economic development elasticity.

  15. [Factors affecting infant mortality (author's transl)].

    PubMed

    Chackiel, J

    1982-04-01

    The purpose of this paper is to analyze the differentials and detect factors affecting infant mortality on the basis of data obtained from the fertility surveys from those countries participating in the World Fertility Survey. In particular, this includes the surveys carried out in Colombia, Peru, Costa Rica, Panama, and the Dominican Republic. 3 types of explanatory variables may be considered from the information available: 1) context variables related to the mother's environment; 2) socioeconomic variables based on the educational and economic characteristics of the mother and her last husband; and 3) biological factors (from each woman's pregnancy history) such as mother's age at birth of the child, order of birth, interbirth interval, etc. The countries, whether high or low mortality, present great differences in child mortality in most of the variables considered. In Panama and Costa Rica there are population sectors with infant mortality rates of around 100/1000 live births, whereas in Peru these are over 150/1000 (children from mothers without education, low agricultural strata, etc.). Besides presenting the differentials, a methodological test is made through the application to Costa Rica and Peru of the Proportional Hazards Model which permits analysis of the effects of variables when acting simultaneously upon mortality in early childhood. The variables which show the highest disparity in mortality level are: natural region among the context variables, education of mother among the socioeconomic variables, and interbirth interval and maternal age at birth of their children among the biological ones.

  16. Factors affecting rotator cuff healing after arthroscopic repair: osteoporosis as one of the independent risk factors.

    PubMed

    Chung, Seok Won; Oh, Joo Han; Gong, Hyun Sik; Kim, Joon Yub; Kim, Sae Hoon

    2011-10-01

    The prognostic factors associated with structural outcome after arthroscopic rotator cuff repair have not yet been fully determined. The hypothesis of this study was that bone mineral density (BMD) is an important prognostic factor affecting rotator cuff healing after arthroscopic cuff repair. Cohort study; Level of evidence, 3. Among 408 patients who underwent arthroscopic repair for full-thickness rotator cuff tear between January 2004 and July 2008, 272 patients were included whose postoperative cuff integrity was verified by computed tomography arthrography (CTA) or ultrasonography (USG) and simultaneously who were evaluated by various functional outcome instruments. The mean age at the time of operation was 59.5 ± 7.9 years. Postoperative CTA or USG was performed at a mean 13.0 ± 5.1 months after surgery, and the mean follow-up period was 37.2 ± 10.0 months (range, 24-65 months). The clinical, structural, and surgery-related factors affecting cuff integrity including BMD were analyzed using both univariate and multivariate analysis. Evaluation of postoperative cuff integrity was performed by musculoskeletal radiologists who were unaware of the present study. The failure rate of rotator cuff healing was 22.8% (62 of 272). The failure rate was significantly higher in patients with lower BMD (P < .001); older age (P < .001); female gender (P = .03); larger tear size (P < .001); higher grade of fatty infiltration (FI) of the supraspinatus, infraspinatus, and subscapularis (all P < .001); diabetes mellitus (P = .02); shorter acromiohumeral distance (P < .001); and associated biceps procedure (P < .001). However, in the multivariate analysis, only BMD (P = .001), FI of the infraspinatus (P = .01), and the amount of retraction (P = .03) showed a significant relationship with cuff healing failure following arthroscopic rotator cuff repair. Bone mineral density, as well as FI of the infraspinatus and amount of retraction, was an independent determining factor

  17. Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

    PubMed Central

    Kim, Yong Byum; Sung, Tae-Yun

    2017-01-01

    Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action. Factors that affect the onset time include the potency of the NMBDs, the rate of NMBDs reaching the effect site, the onset time by dose control, metabolism and elimination of NMBDs, buffered diffusion to the effect site, nicotinic acetylcholine receptor subunit affinity, drugs that affect acetylcholine (ACh) production and release at the neuromuscular junction, drugs that inhibit plasma cholinesterase, presynaptic receptors responsible for ACh release at the neuromuscular junction, anesthetics or drugs that affect muscle contractility, site and methods for monitoring neuromuscular function, individual variability, and coexisting disease. NMBDs with rapid onset without major adverse events are expected in the next few years, and the development of lower potency NMBDs will continue. Anesthesiologists should be aware of the use of NMBDs in the management of anesthesia. The choice of NMBD and determination of the appropriate dosage to modulate neuromuscular blockade characteristics such as onset time and duration of neuromuscular blockade should be considered along with factors that affect the effects of the NMBDs. In this review, we discuss the factors that affect the onset time of NMBDs. PMID:29046769

  18. Clinical trials involving cats: what factors affect owner participation?

    PubMed

    Gruen, Margaret E; Jiamachello, Katrina N; Thomson, Andrea; Lascelles, B Duncan X

    2014-09-01

    Clinical trials are frequently hindered by difficulties in recruiting eligible participants, increasing the timeline and limiting generalizability of results. In veterinary medicine, where proxy enrollment is required, no studies have detailed what factors influence owner participation in clinical trials involving cats. We aimed to investigate these factors through a survey of owners at first opinion practices. The survey was designed using feedback from a pilot study and input from clinical researchers. Owners were asked demographic questions and whether they would, would not, or were unsure about participating in a clinical trial with their cat. They then ranked the importance and influence of various factors on participation using a five-point Likert-type scale, and incentives from most to least encouraging. A total of 413 surveys were distributed to cat owners at four hospitals, two feline-only and two multi-species; 88.6% were completed. Data for importance and influence factors as well as incentive rankings were analyzed overall, and by hospital type, location and whether owners would consider participating. The most influential factors were trust in the organization, benefit to the cat and veterinarian recommendation. Importance and influence factors varied by willingness to participate. Ranked incentives were not significantly different across groups, with 'Free Services' ranked highest. This study provides a first look at what factors influence participation in clinical trials with cats. Given the importance placed in the recommendation of veterinarians, continued work is needed to determine veterinarian-related factors affecting clinical trial participation. The results provide guidance towards improved clinical trial design, promotion and education. © ISFM and AAFP 2014.

  19. Factors affecting smartphone adoption for accessing information in medical settings.

    PubMed

    Tahamtan, Iman; Pajouhanfar, Sara; Sedghi, Shahram; Azad, Mohsen; Roudbari, Masoud

    2017-06-01

    This study aimed to acquire knowledge about the factors affecting smartphone adoption for accessing information in medical settings in Iranian Hospitals. A qualitative and quantitative approach was used to conduct this study. Semi-structured interviews were conducted with 21 medical residents and interns in 2013 to identify determinant factors for smartphone adoption. Afterwards, nine relationships were hypothesised. We developed a questionnaire to test these hypotheses and to evaluate the importance of each factor. Structural equation modelling was used to analyse the causal relations between model parameters and to accurately identify determinant factors. Eight factors were identified in the qualitative phase of the study, including perceived usefulness, perceived ease of use, training, internal environment, personal experience, social impacts, observability and job related characteristics. Among the studied factors, perceived usefulness, personal experience and job related characteristics were significantly associated with attitude to use a smartphone which accounted for 64% of the variance in attitude. Perceived usefulness had the strongest impact on attitude to use a smartphone. The factors that emerged from interviews were consistent with the Technology Acceptance Model (TAM) and some previous studies. TAM is a reliable model for understanding the factors of smartphone acceptance in medical settings. © 2017 Health Libraries Group.

  20. Factors affecting mortality in elderly patients who underwent surgery for gastric cancer.

    PubMed

    Kayılıoglu, Selami Ilgaz; Göktug, Ufuk Utku; Dinc, Tolga; Sozen, Isa; Yavuz, Zeynep; Coskun, Faruk

    2018-03-05

    The aim of this study was to determine factors affecting overall mortality in patients over 60 years of age who underwent surgery for gastric cancer in our clinic. Data on histopathological diagnosis (tumor size, lymph node status, and number), pathological stage, serum albumin level, tumor markers, complete blood count, and demographic information of 109 patients over 60 years of age who had surgery for gastric cancer between January 2011 and July 2016 were obtained retrospectively from the patient files. In addition, the survival status of all patients were examined and recorded. Metastatic lymph node ratio (MLR), red cell distribution width platelet ratio (RPR), neutrophil-lymphocyte ratio (NLR), plateletlymphocyte ratio (PLR), and prognostic nutritional index (PNI) were calculated. On univariate analysis of independent parameters, pathological LN number (p = 0.001), MLR (p <0.001), T3 (p = 0.001) or T4 (p = 0,006) tumor stage according to TNM system, the presence of metastasis (p = 0.063), and male gender (p = 0.066) were found to affect overall mortality (OM). On multivariable Cox regression analysis of these results, MLR (p = 0.005) and T stage (p = 0.006) was determined to be a statistically significant and independent prognostic value. In patients over 60 years of age who underwent surgery for gastric cancer, the factors affecting mortality were determined to be the presence of metastases, number of pathological lymph nodes, and male gender. Metastatic lymph node ratio and T1&T2 stage were determined to be independent prognostic factors. Elderly, Gastric cancer, Mortality, Prognostic factor.

  1. Control of exogenous factors affecting plasma homovanillic acid concentration.

    PubMed

    Davidson, M; Giordani, A B; Mohs, R C; Mykytyn, V V; Platt, S; Aryan, Z S; Davis, K L

    1987-04-01

    Measurements of plasma homovanillic acid (pHVA) concentrations appear to be a valid research strategy in psychiatric disorders in which a central dopamine (DA) abnormality has been implicated. This study provides guidance about the control of some of the exogenous factors affecting pHVA concentrations. Fasting for 14 hours eliminates the dietary effects on pHVA in healthy human subjects. Changing position, walking for 30 minutes, or smoking two cigarettes has no effect on pHVA concentrations.

  2. Motor experience with a sport-specific implement affects motor imagery

    PubMed Central

    Zhu, Hua; Shen, Cheng; Zhang, Jian

    2018-01-01

    The present study tested whether sport-specific implements facilitate motor imagery, whereas nonspecific implements disrupt motor imagery. We asked a group of basketball players (experts) and a group of healthy controls (novices) to physically perform (motor execution) and mentally simulate (motor imagery) basketball throws. Subjects produced motor imagery when they were holding a basketball, a volleyball, or nothing. Motor imagery performance was measured by temporal congruence, which is the correspondence between imagery and execution times estimated as (imagery time minus execution time) divided by (imagery time plus execution time), as well as the vividness of motor imagery. Results showed that experts produced greater temporal congruence and vividness of kinesthetic imagery while holding a basketball compared to when they were holding nothing, suggesting a facilitation effect from sport-specific implements. In contrast, experts produced lower temporal congruence and vividness of kinesthetic imagery while holding a volleyball compared to when they were holding nothing, suggesting the interference effect of nonspecific implements. Furthermore, we found a negative correlation between temporal congruence and the vividness of kinesthetic imagery in experts while holding a basketball. On the contrary, the implement manipulation did not modulate the temporal congruence of novices. Our findings suggest that motor representation in experts is built on motor experience associated with specific-implement use and thus was subjected to modulation of the implement held. We conclude that sport-specific implements facilitate motor imagery, whereas nonspecific implements could disrupt motor representation in experts. PMID:29719738

  3. Factors Affecting Differential Equation Problem Solving Ability of Students at Pre-University Level: A Conceptual Model

    ERIC Educational Resources Information Center

    Aisha, Bibi; Zamri, Sharifa NorulAkmar Syed; Abdallah, Nabeel; Abedalaziz, Mohammad; Ahmad, Mushtaq; Satti, Umbreen

    2017-01-01

    In this study, different factors affecting students' differential equations (DEs) solving abilities were explored at pre university level. To explore main factors affecting students' differential equations problem solving ability, articles for a 19-year period, from 1996 to 2015, were critically reviewed and analyzed. It was revealed that…

  4. Merriam's turkey nest survival and factors affecting nest predation by mammals

    Treesearch

    Chad P. Lehman; Mark A. Rumble; Lester D. Flake; Daniel J. Thompson

    2008-01-01

    Nest success is an important parameter affecting population fluctuations of wild turkeys (Meleagris gallopavo). Factors influencing mammalian predation on turkey nests are complicated and not well understood. Therefore, we assessed nest hazard risk by testing competing hypotheses of Merriam's turkey (M. g. merriami) nest...

  5. Factors that affect coseismic folds in an overburden layer

    NASA Astrophysics Data System (ADS)

    Zeng, Shaogang; Cai, Yongen

    2018-03-01

    Coseismic folds induced by blind thrust faults have been observed in many earthquake zones, and they have received widespread attention from geologists and geophysicists. Numerous studies have been conducted regarding fold kinematics; however, few have studied fold dynamics quantitatively. In this paper, we establish a conceptual model with a thrust fault zone and tectonic stress load to study the factors that affect coseismic folds and their formation mechanisms using the finite element method. The numerical results show that the fault dip angle is a key factor that controls folding. The greater the dip angle is, the steeper the fold slope. The second most important factor is the overburden thickness. The thicker the overburden is, the more gradual the fold. In this case, folds are difficult to identify in field surveys. Therefore, if a fold can be easily identified with the naked eye, the overburden is likely shallow. The least important factors are the mechanical parameters of the overburden. The larger the Young's modulus of the overburden is, the smaller the displacement of the fold and the fold slope. Strong horizontal compression and vertical extension in the overburden near the fault zone are the main mechanisms that form coseismic folds.

  6. Multi-Level Family Factors and Affective and Behavioral Symptoms of Oppositional Defiant Disorder in Chinese Children

    PubMed Central

    Tang, Yixin; Lin, Xiuyun; Chi, Peilian; Zhou, Qing; Hou, Xiangning

    2017-01-01

    Given the important role of family environment in children's psychological development, the objective of this study was to examine the linkages between family factors at the whole, dyadic, and individual levels and two dimensions (affective and behavioral) of Oppositional Defiant Disorder (ODD) symptoms in Chinese children. Participants comprised of 80 father-child dyads and 169 mother-child dyads from families with ODD children. The results indicated that multilevel family factors were differently associated with children's affective and behavioral ODD symptoms. All the family factors at the dyadic and individual levels were significantly associated with child affective ODD symptoms. However, only the most proximal factors (parent-child relationship and child emotion regulation, which were directly related to child) were significantly related to child behavioral ODD symptoms. The present study extends the current knowledge regarding the relationships between family factors and two dimensions of child ODD symptoms by testing the comprehensive multilevel family factors model. This study also recommends that future interventions for ODD children should consider the multi-level family factors to enhance intervention efficacy. PMID:28713321

  7. Factors affecting compliance with measles vaccination in Lao PDR.

    PubMed

    Phimmasane, Maniphet; Douangmala, Somthana; Koffi, Paulin; Reinharz, Daniel; Buisson, Yves

    2010-09-24

    In line with WHO objectives, the Lao Government is committed to eliminate measles by 2012. Yet from 1992 to 2007, the annual incidence of measles remained high while the vaccination coverage showed a wide diversity across provinces. A descriptive study was performed to determine factors affecting compliance with vaccination against measles, which included qualitative and quantitative components. The qualitative study used a convenience sample of 13 persons in charge of the vaccination program, consisting of officials from different levels of the health care structure and members of vaccination teams. The quantitative study performed on the target population consisted of a matched, case-control survey conducted on a stratified random sample of parents of children aged 9-23 months. Overall, 584 individuals (292 cases and 292 controls) were interviewed in the three provinces selected because of low vaccination coverage. On the provision of services side (supply), the main problems identified were a lack of vaccine supply and diluent, a difficulty in maintaining the cold chain, a lack of availability and competence among health workers, a lack of coordination and a limited capacity to assess needs and make coherent decisions. In the side of the consumer (demand), major obstacles identified were poor knowledge about measles immunization and difficulties in accessing vaccination centers because of distance and cost. In multivariate analysis, a low education level of the father was a factor of non-immunization while the factors of good compliance were high incomes, spacing of pregnancies, a feeling that children must be vaccinated, knowledge about immunization age, presenting oneself to the hospital rather than expecting the mobile vaccination teams and last, immunization of other family members or friends' children. The main factors affecting the compliance with vaccination against measles in Laos involve both the supply side and the demand side. Obtaining an effective

  8. Factors affecting sexual life during pregnancy in eastern Turkey.

    PubMed

    Eryilmaz, Gülşen; Ege, Emel; Zincir, Handan

    2004-01-01

    This is a descriptive and cross-sectional study aiming to determine the factors affecting sexual life in pregnant women. The study was carried out in 238 women in Malatya, Turkey. It was found that 61.4% regarded coitus as a risk during pregnancy, 31.9% did not have any knowledge about this matter. In 81.5% sexual life was affected during pregnancy. The mean frequency of intercourse was 2.02 +/- 0.7/week before pregnancy and decreased to 1.51 +/- 0.6/week during pregnancy. The reasons for this decline are: exhaustion and fatigue (64.3%); waning of sexual desire (55.9%); harmful to the fetus (49.2%); causing abortions in early pregnancy (45%), and inducing preterm labor (34%). There was a significant relationship between changes in sexual life during pregnancy and the duration of marriage (chi2=10.8, p<0.05), education level (chi2=18.1, p<0.05), parity (chi2=11.1, p<0.05), and gravidity (chi2=6.8, p<0.05). The variables such as age, employment status, and number of abortions did not affect sexual life during pregnancy. Copyright 2004 S. Karger AG, Basel

  9. Milking performance evaluation and factors affecting milking claw vacuum levels with flow simulator.

    PubMed

    Enokidani, Masafumi; Kawai, Kazuhiro; Shinozuka, Yasunori; Watanabe, Aiko

    2017-08-01

    Milking performance of milking machines that matches the production capability of dairy cows is important in reducing the risk of mastitis, particularly in high-producing cows. This study used a simulated milking device to examine the milking performance of the milking system of 73 dairy farms and to analyze the factors affecting claw vacuum. Mean claw vacuum and range of fluctuation of claw vacuum (claw vacuum range) were measured at three different flow rates: 5.7, 7.6 and 8.7 kg/min. At the highest flow rate, only 16 farms (21.9%) met both standards of mean claw vacuum ≥35 kPa and claw vacuum range ≤ 7 kPa, showing that milking systems currently have poor milking performance. The factors affecting mean claw vacuum were claw type, milk-meter and vacuum shut-off device; the factor affecting claw vacuum range was claw type. Examination of the milking performance of the milking system using a simulated milking device allows an examination of the performance that can cope with high producing cows, indicating the possibility of reducing the risk of mastitis caused by inappropriate claw vacuum. © 2016 Japanese Society of Animal Science.

  10. Factors that Affect Emergent Literacy Development When Engaging with Electronic Books

    ERIC Educational Resources Information Center

    Salmon, Lynda G.

    2014-01-01

    This article reviews extant literature with the purpose of identifying factors that affect the potential efficacy of electronic books to support literacy development during early childhood. Selection criteria include experimental, quasi-experimental, and observational studies from peer-reviewed journals from 2000 to 2013 with a target population…

  11. How has the economic downturn affected communities and implementation of science-based prevention in the randomized trial of communities that care?

    PubMed

    Kuklinski, Margaret R; Hawkins, J David; Plotnick, Robert D; Abbott, Robert D; Reid, Carolina K

    2013-06-01

    This study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science-based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science-based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science-based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science-based prevention were also relatively low in both periods.

  12. How Has the Economic Downturn Affected Communities and Implementation of Science-Based Prevention in the Randomized Trial of Communities That Care?

    PubMed Central

    Kuklinski, Margaret R.; Hawkins, J. David; Plotnick, Robert D.; Abbott, Robert D.; Reid, Carolina K.

    2013-01-01

    This study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science-based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science-based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science-based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science-based prevention were also relatively low in both periods. PMID:23054169

  13. Catchment process affecting drinking water quality, including the significance of rainfall events, using factor analysis and event mean concentrations.

    PubMed

    Cinque, Kathy; Jayasuriya, Niranjali

    2010-12-01

    To ensure the protection of drinking water an understanding of the catchment processes which can affect water quality is important as it enables targeted catchment management actions to be implemented. In this study factor analysis (FA) and comparing event mean concentrations (EMCs) with baseline values were techniques used to asses the relationships between water quality parameters and linking those parameters to processes within an agricultural drinking water catchment. FA found that 55% of the variance in the water quality data could be explained by the first factor, which was dominated by parameters usually associated with erosion. Inclusion of pathogenic indicators in an additional FA showed that Enterococcus and Clostridium perfringens (C. perfringens) were also related to the erosion factor. Analysis of the EMCs found that most parameters were significantly higher during periods of rainfall runoff. This study shows that the most dominant processes in an agricultural catchment are surface runoff and erosion. It also shows that it is these processes which mobilise pathogenic indicators and are therefore most likely to influence the transport of pathogens. Catchment management efforts need to focus on reducing the effect of these processes on water quality.

  14. Motivating Factors that Affect Enrolment and Student Performance in an ODL Engineering Program

    ERIC Educational Resources Information Center

    Dadigamuwa, P. R.; Senanayake, Samans

    2012-01-01

    The present study was carried out to determine the motivating factors for enrolling in an engineering study programme in open and distance learning (ODL) and the factors that affect the students' performance. The study was conducted with two convenient samples of students following distance learning courses in engineering technology, conducted by…

  15. Human factors for capacity building: lessons learned from the OpenMRS implementers network.

    PubMed

    Seebregts, C J; Mamlin, B W; Biondich, P G; Fraser, H S F; Wolfe, B A; Jazayeri, D; Miranda, J; Blaya, J; Sinha, C; Bailey, C T; Kanter, A S

    2010-01-01

    The overall objective of this project was to investigate ways to strengthen the OpenMRS community by (i) developing capacity and implementing a network focusing specifically on the needs of OpenMRS implementers, (ii) strengthening community-driven aspects of OpenMRS and providing a dedicated forum for implementation-specific issues, and; (iii) providing regional support for OpenMRS implementations as well as mentorship and training. The methods used included (i) face-to-face networking using meetings and workshops; (ii) online collaboration tools, peer support and mentorship programmes; (iii) capacity and community development programmes, and; (iv) community outreach programmes. The community-driven approach, combined with a few simple interventions, has been a key factor in the growth and success of the OpenMRS Implementers Network. It has contributed to implementations in at least twenty-three different countries using basic online tools; and provided mentorship and peer support through an annual meeting, workshops and an internship program. The OpenMRS Implementers Network has formed collaborations with several other open source networks and is evolving regional OpenMRS Centres of Excellence to provide localized support for OpenMRS development and implementation. These initiatives are increasing the range of functionality and sustainability of open source software in the health domain, resulting in improved adoption and enterprise-readiness. Social organization and capacity development activities are important in growing a successful community-driven open source software model.

  16. Implementation Science for the Environment.

    PubMed

    Hering, Janet G

    2018-05-15

    The establishment of the field of implementation science was motivated by the understanding that medical and health research alone is insufficient to generate better health outcomes. With strong support from funding agencies for medical research, implementation science promotes the application of a structured framework or model in the implementation of research-based results, specifically evidence-based practices (EBPs). Furthermore, explicit consideration is given to the context of EBP implementation (i.e., socio-economic, political, cultural, and institutional factors that could affect the implementation process). Finally, implementation is monitored in a robust and rigorous way. Today, the field of implementation science supports conferences and professional societies as well as one dedicated journal and numerous others with related content. The goal of these various activities is to reduce the estimated, average "bench to bedside" time lag of 17 years for uptake of EBPs from health research into routine practice. Despite similar time lags and impediments to uptake in the environmental domain, a parallel field of implementation science for the environment has not (yet) emerged. Although some parallels in needs and opportunities can easily be drawn between the health and environmental domains, a detailed mapping exercise is needed to understand which aspects of implementation science could be applied in the environmental domain either directly or in a modified form. This would allow an accelerated development of implementation science for the environment.

  17. A review of genetic, biological, pharmacological, and clinical factors that affect carbohydrate-deficient transferrin levels.

    PubMed

    Fleming, Michael F; Anton, Raymond F; Spies, Claudia D

    2004-09-01

    Carbohydrate-deficient transferrin (CDT) is an alcohol biomarker recently approved by the U.S. Food and Drug Administration. This test is increasingly being used to detect and monitor alcohol use in a variety of health care, legal, and industrial settings. The goal of this study is to review the genetic, biological, pharmacological, and clinical factors that may affect CDT levels. A review of the literature identified 95 research articles that met the authors' criteria and reported potential interactions of a variety of factors on percent and total CDT levels. The review established 12 categories of variables that may affect CDT levels. These categories include (1) alcohol use, (2) genetic factors, (3) race, (4) gender, (5) age, (6) liver disease, (7) iron levels, (8) tobacco use, (9) medication such as estrogen and anticonvulsants, (10) metabolic factors such as body mass index and total body water, (11) chronic medical conditions such as rheumatoid arthritis, and (12) surgical patients. There is evidence that %CDT levels are affected by alcohol use, end-stage liver disease, and genetic variants. In addition to these three factors, total CDT levels (CDTect) are also affected by factors that raise transferrin levels such as iron deficiency, chronic illnesses, and menopausal status. Other potential factors such as tobacco and age appear to be confounded by alcohol use. The roles of female gender, low body mass index, chronic inflammatory diseases, and medication on CDT levels require further study. False negatives are associated with female gender, episodic lower level alcohol use, and acute trauma with blood loss. This review suggests that a number of factors are associated with false-positive CDTect and %CDT levels. CDT offers great promise to assist physicians in the care of patients to detect and monitor heavy alcohol use.

  18. Factors Affecting Teachers' Adoption of Educational Computer Games: A Case Study

    ERIC Educational Resources Information Center

    Kebritchi, Mansureh

    2010-01-01

    Even though computer games hold considerable potential for engaging and facilitating learning among today's children, the adoption of modern educational computer games is still meeting significant resistance in K-12 education. The purpose of this paper is to inform educators and instructional designers on factors affecting teachers' adoption of…

  19. Factors Affecting Participation of Displaced Workers in Retraining: A Literature Review.

    ERIC Educational Resources Information Center

    Dean, Gary J.

    This document offers a selected review of literature relevant to retraining displaced workers. A description of the economic conditions leading to the displacement of workers, the nature and scope of the displaced worker problem, and factors potentially affecting displaced workers' participation in adult education and training programs is…

  20. Factors Affecting Student Retention in Online Courses: Overcoming This Critical Problem

    ERIC Educational Resources Information Center

    Gaytan, Jorge

    2013-01-01

    The purpose of this study was to determine what a panel of 15 experts would identify as critical factors affecting student retention in online courses that will serve as implications for educational leaders to guide their student retention strategies, online organizational structures, institutional policies, and online instructional activities. A…

  1. Factors Affecting Bachelor's Degree Completion among Black Males with Prior Attrition

    ERIC Educational Resources Information Center

    Matthews-Whetstone, Rayna; Scott, Joyce A.

    2015-01-01

    Black males lag behind their female counterparts in bachelor's degree completion. This study examined why Black males leave higher education, eventually return, and complete their degrees. Researchers are aware of some of the challenges that Black males encounter in higher education, but there is little information factors affecting successful…

  2. Factors Affecting Career Choice among Speech-Language Pathology and Audiology Students

    ERIC Educational Resources Information Center

    Stone, Larissa; Pellowski, Mark W.

    2016-01-01

    This investigation assessed the factors affecting career choice among 474 current undergraduate and graduate speech-language pathology and audiology students (from four universities). A 14-item questionnaire was developed that included questions related to general influence of career choice and whether or not the participants had previously been,…

  3. Research Implementation.

    ERIC Educational Resources Information Center

    Trochim, William M. K.

    Investigated is the topic of research implementation and how it can affect evaluation results. Even when evaluations are well planned, the obtained results can be misleading if the conscientiously-constructed research plan is not correctly implemented in practice. In virtually every research arena, one finds major difficulties in implementing the…

  4. Factors affecting the decision to pursue glaucoma fellowship training.

    PubMed

    Gedde, Steven J; Budenz, Donald L; Haft, Payman; Lee, Yunhee; Quigley, Harry A

    2007-01-01

    To identify factors associated with the choice to pursue glaucoma fellowship training by graduating ophthalmology residents. An anonymous survey was sent to each graduating ophthalmology resident in the United States in February 2003. Demographic data and information relating to residency training, career goals, and factors influencing career choices were collected from the surveys. Surveys were completed by 215 (49.2%) residents, including 135 (62.8%) who were pursuing fellowships. Among residents undertaking fellowship training, 17 (12.6%) selected glaucoma and 118 (87.4%) chose other subspecialties. Residents entering glaucoma fellowships performed more glaucoma filtering procedures (P=0.006), and they were less likely to publish a paper (P=0.05) and have time allocated for research (P=0.04) than residents seeking fellowships in other subspecialties. Factors that were rated as less important to those choosing glaucoma fellowships included interest in challenging diagnostic problems (P=0.009), types of patient problems (P=0.015), an academic career (P=0.03), and working with new technology (P=0.04). The decision to pursue fellowship training was made later by residents entering glaucoma compared with those choosing other subspecialties (P=0.001). A variety of factors affect the decision to pursue fellowship training. There are differences in how these factors are weighed among residents seeking fellowships in glaucoma and other subspecialties.

  5. An Analysis of Multiple Factors Affecting Retention in Web-Based Community College Courses

    ERIC Educational Resources Information Center

    Doherty, William

    2006-01-01

    The current study examined four factors affecting retention in Web-based community college courses. Analyses were conducted on student demographics, student learning styles, course communication and external factors. The results suggest that Web-based courses are more attractive to busy students who are also more likely to fail or drop the course.…

  6. Some factors affecting skin and wound healing.

    PubMed

    Winter, G D

    2006-05-01

    The domestic pig is the preferred animal for studying the effects of environmental factors on skin and wound because its integument is more like that of man than any other. The three factors that most drastically affect the pattern, speed and quality of healing are dehydration of exposed tissues, the status of the blood supply bringing oxygen and nutrients to the area and sepsis. Wounds exposed to the air lose water vapour, the upper dermis dries and healing takes place beneath a dry scab. Covering a wound with an occlusive dressing prevents scab formation and radically alters the pattern of epidermal wound healing. Blowing on wounds creates a scab within three hours instead of the normal 24 hours but more tissue is sacrificed in the process. This may only be justified if it can be shown that rapid artificial scab formation significantly cuts down the incidence of severe infections, i.e. in large burns. Less serious wounds heal faster when covered with a suitable occlusive dressing. Indolent wounds are characterised by a rim of infected, necrotic tissue in which leucocytes and macrophages are unable to function effectively through lack of oxygen. A suitable dressing changed frequently can bring about mild debridement and re-establish the conditions for healing.

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

    ERIC Educational Resources Information Center

    Shamas-Brandt, Ellen

    2012-01-01

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

  8. A Study on Factors Affecting Navy Officers’ Decisions to Pursue Funded Graduate Education: A Qualitative Approach

    DTIC Science & Technology

    2017-06-01

    Distribution is unlimited. A STUDY ON FACTORS AFFECTING NAVY OFFICERS’ DECISIONS TO PURSUE FUNDED GRADUATE EDUCATION: A QUALITATIVE APPROACH ...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. A STUDY ON FACTORS...REPORT DATE June 2017 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE A STUDY ON FACTORS AFFECTING NAVY OFFICERS

  9. Analysis of various factors affecting pupil size in patients with glaucoma.

    PubMed

    Park, Ji Woong; Kang, Bong Hui; Kwon, Ji Won; Cho, Kyong Jin

    2017-09-16

    Pupil size is an important factor in predicting post-operative satisfaction. We assessed the correlation between pupil size, measured by Humphrey static perimetry, and various affecting factors in patients with glaucoma. In total, 825 eyes of 415 patients were evaluated retrospectively. Pupil size was measured with Humphrey static perimetry. Comparisons of pupil size according to the presence of glaucoma were evaluated, as were correlations between pupil size and various factors, including age, logMAR best corrected visual acuity (BCVA), retinal nerve fiber layer (RNFL) thickness, spherical equivalent, intraocular pressure, axial length, central corneal thickness, white-to-white, and the kappa angle. Pupil size was significantly smaller in glaucoma patients than in glaucoma suspects (p < 0.001) or the normal group (p < 0.001). Pupil size decreased significantly as age (p < 0.001) and central cornea thickness (p = 0.007) increased, and increased significantly as logMAR BCVA (p = 0.02) became worse and spherical equivalent (p = 0.007) and RNFL thickness (p = 0.042) increased. In patients older than 50 years, pupil size was significantly larger in eyes with a history of cataract surgery. Humphrey static perimetry can be useful in measuring pupil size. Pupil size was significantly smaller in eyes with glaucoma. Other factors affecting pupil size can be used in a preoperative evaluation when considering cataract surgery or laser refractive surgery.

  10. FACTORS AFFECTING SENSITIVITY OF CHEMICAL AND ECOLOGICAL RESPONSES OF MARINE EMBAYMEMTS TO NITROGEN LOADING

    EPA Science Inventory

    This paper summarizes an ongoing examination of the primary factors that affect sensitivity of marine embayment responses to nitrogen loading. Included is a discussion of two methods for using these factors: classification of embayments into discrete sensitivity classes and norma...

  11. Strategic implementation of integrated water resources management in Mozambique: An A’WOT analysis

    NASA Astrophysics Data System (ADS)

    Gallego-Ayala, Jordi; Juízo, Dinis

    The Integrated Water Resources Management (IWRM) paradigm has become an important framework in development and management of water resources. Many countries in the Southern Africa region have begun water sector reforms to align the sector with the IWRM concepts. In 2007 the Mozambican Government started to update the policy and the legal framework of the water sector to foster the application of IWRM concept as a basis for achieving sustainable development. However the steps towards the implementation of this national framework are still in preparation. This research aims to identify and establish a priority ranking of the fundamental factors likely to affect the outcome of the IWRM reforms in Mozambique. This study uses the hybrid multi-criteria decision method A’WOT, a methodology coined by Kurttila et al. (2000). This method relies on the combination of the Strengths, Weaknesses, Opportunities, and Threats (SWOT) technique and the Analytic Hierarchy Process (AHP) technique. Using this procedure it is possible to identify and rank the factors affecting the functioning of a system. The key factors affecting the implementation of the IWRM, analysed in this study, were identified through an expert group discussion. These factors have been grouped into different categories of SWOT. Subsequently, the AHP methodology was applied to obtain the relative importance of each factor captured in the SWOT analysis; to this end the authors interviewed a panel of water resources management experts and practitioners. As a result, of this study and the application of the A’WOT methodology, the research identified and ranked the fundamental factors for the success of the IWRM strategy in Mozambique. The results of this study suggest that in Mozambique a planning strategy for the implementation of the IWRM should be guided mainly by combination of interventions in factors falling under opportunity and weakness SWOT groups.

  12. Evaluation of factors that affect hip moment impulse during gait: A systematic review.

    PubMed

    Inai, Takuma; Takabayashi, Tomoya; Edama, Mutsuaki; Kubo, Masayoshi

    2018-03-01

    Decreasing the daily cumulative hip moments in the frontal and sagittal planes may lower the risk of hip osteoarthritis. Therefore, it may be important to evaluate factors that affect hip moment impulse during gait. It is unclear what factors affect hip moment impulse during gait. This systematic review aimed to evaluate different factors that affect hip moment impulse during gait in healthy adults and patients with hip osteoarthritis. Four databases (Scopus, ScienceDirect, PubMed, and PEDro) were searched up to August 2017 to identify studies that examined hip moment impulse during gait. Data extracted for analysis included the sample size, age, height, body mass, type of intervention, and main findings. After screening, 10 of the 975 studies identified were included in our analysis. Several factors, including a rocker bottom shoe, FitFlop™ sandals, ankle push-off, posture, stride length, body-weight unloading, a rollator, walking poles, and a knee brace, were reviewed. The main findings were as follows: increasing ankle push-off decreased both the hip flexion and extension moment impulses; body-weight unloading decreased both the hip extension and adduction moment impulses; the FitFlop™ sandal increased the sum of the hip flexion and extension moment impulses; long strides increased the hip extension moment impulse; and the use of a knee brace increased hip flexion moment impulse. Of note, none of the eligible studies included patients with hip osteoarthritis. The hip moment impulses can be modified by person-specific factors (ankle push-off and long strides) and external factors (body-weight unloading and use of the FitFlop™ sandals and a knee brace). Effects on the progression of hip osteoarthritis remain to be evaluated. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Factors Affecting University Students' Intention to Use Cloud Computing in Jordan

    ERIC Educational Resources Information Center

    Rababah, Khalid Ali; Khasawneh, Mohammad; Nassar, Bilal

    2017-01-01

    The aim of this study is to examine the factors affecting students' intention to use cloud computing in the Jordanian universities. To achieve this purpose, a quantitative research approach which is a survey-based was deployed. Around 400 questionnaires were distributed randomly to Information Technology (IT) students at four universities in…

  14. Factors Affecting Early Services for Children Who Are Hard of Hearing

    ERIC Educational Resources Information Center

    Harrison, Melody; Page, Thomas A.; Oleson, Jacob; Spratford, Meredith; Berry, Lauren Unflat; Peterson, Barbara; Welhaven, Anne; Arenas, Richard M.; Moeller, Mary Pat

    2016-01-01

    Purpose: To describe factors affecting early intervention (EI) for children who are hard of hearing, we analyzed (a) service setting(s) and the relationship of setting to families' frequency of participation, and (b) provider preparation, caseload composition, and experience in relation to comfort with skills that support spoken language for…

  15. Factors Affecting Training Transfer: Participants' Motivation to Transfer Training, Literature Review

    ERIC Educational Resources Information Center

    Alawneh, Muhammad K.

    2008-01-01

    This article investigates factors that motivate participants in learning and training activities to transfer skills, knowledge and attitude from the learning setting to the workplace. Based on training transfer theories hypothesized by Holton (1996), one of the major theories that affect an organization's learning is motivation to transfer theory.…

  16. Demand-side financing for maternal and newborn health: what do we know about factors that affect implementation of cash transfers and voucher programmes?

    PubMed

    Hunter, Benjamin M; Murray, Susan F

    2017-08-31

    Demand-side financing (DSF) interventions, including cash transfers and vouchers, have been introduced to promote maternal and newborn health in a range of low- and middle-income countries. These interventions vary in design but have typically been used to increase health service utilisation by offsetting some financial costs for users, or increasing household income and incentivising 'healthy behaviours'. This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health. A secondary analysis (using an adapted Supporting the Use of Research Evidence framework - SURE) was performed on studies that had previously been identified in a systematic review of evidence on DSF interventions in maternal and newborn health. The article draws on findings from 49 quantitative and 49 qualitative studies. The studies give insights on difficulties with exclusion of migrants, young and multiparous women, with demands for informal fees at facilities, and with challenges maintaining quality of care under increasing demand. Schemes experienced difficulties if communities faced long distances to reach participating facilities and poor access to transport, and where there was inadequate health infrastructure and human resources, shortages of medicines and problems with corruption. Studies that documented improved care-seeking indicated the importance of adequate programme scope (in terms of programme eligibility, size and timing of payments and voucher entitlements) to address the issue of concern, concurrent investments in supply-side capacity to sustain and/or improve quality of care, and awareness generation using community-based workers, leaders and women's groups. Evaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social, geographical and health systems factors as barriers to accessing care. Careful design of DSF

  17. Recovery after local extinction: factors affecting re-establishment of alpine lake zooplankton.

    PubMed

    Knapp, Roland A; Sarnelle, Orlando

    2008-12-01

    The introduction of fishes into naturally fishless mountain lakes often results in the extirpation of large-bodied zooplankton species. The ability to predict whether or not particular species will recover following fish removal is critically important for the design and implementation of lake restoration efforts but is currently not possible because of a lack of information on what factors affect recovery. The objective of this study was to identify the factors influencing recovery probability in two large-bodied zooplankton species following fish removal. We predicted that (1) Daphnia melanica would have a higher probability of recovery than Hesperodiaptomus shoshone due to differences in reproductive mode (D. melanica is parthenogenetic, H. shoshone is obligately sexual), (2) recovery probability would be a decreasing function of fish residence time due to the negative relationship between fish residence time and size of the egg bank, and (3) recovery probability would be an increasing function of lake depth as a consequence of a positive relationship between lake depth and egg bank size. To test these predictions, we sampled contemporary zooplankton populations and collected paleolimnological data from 44 naturally fishless lakes that were stocked with trout for varying lengths of time before reverting to a fishless condition. D. melanica had a significantly higher probability of recovery than did H. shoshone (0.82 vs. 0.54, respectively). The probability of recovery for H. shoshone was also significantly influenced by lake depth, fish residence time, and elevation, but only elevation influenced the probability of recovery in D. melanica. These results are consistent with between-species differences in reproductive mode combined with the much greater longevity of diapausing eggs in D. melanica than in H. shoshone. Our data also suggest that H. shoshone will often fail to recover in lakes with fish residence times exceeding 50 years.

  18. Stage is a prognostic factor for surgically treated patients with early-stage lip cancer for whom a 'wait and see' policy in terms of neck status has been implemented.

    PubMed

    Eskiizmir, G; Ozgur, E; Karaca, G; Temiz, P; Yanar, N Hacioglu; Ozyurt, B Cengiz

    2017-10-01

    To determine the locoregional control and survival rates (in terms of risk factors) of patients who underwent surgical resection of early-stage lip cancer and for whom a 'wait and see' policy in terms of neck status had been implemented. The sociodemographic data, tumour stage, tumour characteristics and histopathological features of 41 patients with early-stage lip cancer were evaluated. Factors predictive of survival and locoregional recurrence were analysed. The five-year overall survival and disease-free survival rates were determined, and the prognostic risk factors were compared. The mean follow-up period was 60.5 months (range, 4-92 months). Age, sex, tumour stage, tumour thickness and volume, and perineural involvement were not predictive of locoregional recurrence or survival. Pathological tumour stage (T1 vs T2) was a prognostic factor for both five-year overall survival (87.3 vs 65.6 per cent, p = 0.042) and disease-free survival (88.6 vs 65.6 per cent, p = 0.037). Tumour stage was clearly a major factor affecting the prognosis of surgically treated patients with early-stage lip cancer for whom a 'wait and see' policy in terms of neck status had been implemented.

  19. The Factors that Affect Science Teachers' Participation in Professional Development

    NASA Astrophysics Data System (ADS)

    Roux, Judi Ann

    Scientific literacy for our students and the possibilities for careers available in Science, Technology, Engineering, and Mathematics (STEM) areas are important topics for economic growth as well as global competitiveness. The achievement of students in science learning is dependent upon the science teachers' effectiveness and experienced science teachers depend upon relevant professional development experiences to support their learning. In order to understand how to improve student learning in science, the learning of science teachers must also be understood. Previous research studies on teacher professional development have been conducted in other states, but Minnesota science teachers comprised a new and different population from those previously studied. The purpose of this two-phase mixed methods study was to identify the current types of professional development in which experienced, Minnesota secondary science teachers participated and the factors that affect their participation in professional development activities. The mixed-methods approach s utilized an initial online survey followed by qualitative interviews with five survey respondents. The results of the quantitative survey and the qualitative interviews indicated the quality of professional development experiences and the factors which affected the science teachers' participation in professional development activities. The supporting and inhibiting factors involved the availability of resources such as time and money, external relationships with school administrators, teacher colleagues, and family members, and personal intrinsic attributes such as desires to learn and help students. This study also describes implications for science teachers, school administrators, policymakers, and professional development providers. Recommendations for future research include the following areas: relationships between and among intrinsic and extrinsic factors, science-related professional development activities

  20. 'It is not a quick fix' structural and contextual issues that affect implementation of integrated health and well-being services: a qualitative study from North East England.

    PubMed

    Cheetham, M; Visram, S; Rushmer, R; Greig, G; Gibson, E; Khazaeli, B; Wiseman, A

    2017-11-01

    The objective of this article is to examine the factors affecting the design, commissioning and delivery of integrated health and well-being services (IHWSs), which seek to address multiple health-related behaviours, improve well-being and tackle health inequalities using holistic approaches. Qualitative studies embedded within iterative process evaluations. Semi-structured interviews conducted with 16 key informants as part of two separate evaluations of IHWSs in North East England, supplemented by informal observations of service delivery. Transcripts and fieldnotes were analysed thematically. The study findings identify a challenging organisational context in which to implement innovative service redesign, as a result of budget cuts and changes in NHS and local authority capacity. Pressures to demonstrate outcomes affected the ability to negotiate the practicalities of joint working. Progress is at risk of being undermined by pressures to disinvest before the long-term benefits to population health and well-being are realised. The findings raise important questions about contract management and relationships between commissioners and providers involved in implementing these new ways of working. These findings provide useful learning in terms of the delivery and commissioning of similar IHWSs, contributing to understanding of the benefits and challenges of this model of working. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Factors affecting the adoption of home-heating energy-conservation measures: a behavioral approach

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

    Macey, S.M.

    1982-01-01

    The basic aim of this research is to better understand homeowners' adoption of home-heating energy-conservation measures by analyzing a number of factors that are thought to be underlying determinants of adoption behavior. The basic approach is behavioral drawing on the knowledge built up in behavioral geography through studies on natural hazards and innovation diffusion, and borrowing from psychological theories of attitude formation and decision making. In particular, six factors (information, environmental personality, socio-economic and demographic factors, dwelling unit characteristics, psychological variables, and past experience) are shown to directly and indirectly affect adoption behavior. By this means, differences between adopters andmore » nonadopters in the underlying cognitive structures and in the situational factors that affect their decisions are identified. The study focuses on the adoption of three measures: reducing winter night-time thermostat settings, changing or cleaning furnace filters, and installing an automatic setback thermostat. Personal interviews with a random sample of 159 homeowners in Decatur, Illinois serve as the main data base. Results indicate that adoption behavior is determined more by past experience, than by intention. Beliefs, attitudes, and social influences affect behavior indirectly through intention. These psychological variables also act as mediators between information, knowledge, environmental personality, situational variables and behavior. In particular, respondent's age, previous home ownership, and length of residence act indirectly on adoption behavior. Each of these reflects the amount of past experience the respondent is likely to have.« less

  2. Dietary factors affecting susceptibility to urinary tract infection.

    PubMed

    Kontiokari, Tero; Nuutinen, Matti; Uhari, Matti

    2004-04-01

    Urinary tract infection (UTI) is usually an ascending infection caused by bacteria derived from stools. Since the bacterial composition of stools is dependent on the diet, it is likely that the risk of UTI will change with changes in the diet. Most data describing diet as a risk factor for UTI come from epidemiological and interventional trials. It has been shown in a case-control setting that frequent consumption of fresh berry or fruit juices and fermented milk products containing probiotic bacteria decreases the risk for UTI recurrence in women. Several interventional trials have found Vaccinium berry products to provide protection from UTI recurrence. Probiotics have not been able to prevent UTI in interventional trials. However, the lack of an effect may be related to too low a dose or to the use of non-optimal products in these trials. Limited data are available on the effects of nutrition on UTI in children. However, there is no reason to expect that children would be different from adults in this respect. In this review, we discuss the dietary factors affecting the susceptibility to UTI.

  3. Factors Influencing the Implementation of Training and Learning in the Workplace.

    ERIC Educational Resources Information Center

    Ridoutt, Lee; Dutneall, Ralph; Hummel, Kevin; Smith, Chris Selby

    The quantitative relationship between factors previously identified as affecting the extent and intensity of training within organizations was explored through a survey of companies in Australia's entertainment and process manufacturing sectors. A self-completion questionnaire was mailed first to a sample of 446 companies across Australia (112 of…

  4. Factors affecting participation decision and amount of physical activity among urban dwellers in Malaysia.

    PubMed

    Cheah, Y K; Azahadi, M; Phang, S N; Hazilah, N

    2017-05-01

    The rapid rise in the prevalence of physical inactivity-related diseases has become a serious public health issue worldwide. The objective of the present study is to examine the factors affecting participation in physical activity among urban dwellers in Malaysia. This cross-sectional study measures physical activity using a rigorous regression model. Data are obtained from the National Health and Morbidity Survey 2011 (NHMS 2011). A lognormal hurdle model is used to analyse the participation decision and the amount decision of physical activity. The results show that income, gender, ethnicity, marital status and employment status are significantly associated with participation decision and amount decision. However, age, insurance and self-rated health only affect participation decision, whereas family size, education and smoking only affect amount decision. It can, thus, be concluded that sociodemographic, insurance, lifestyle and health factors play an important role in determining physical activity behaviour among urban dwellers. When formulating policies, special attention must be paid to these factors. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. Factors affecting songbird nest survival in riparian forests in a Midwestern agricultural landscape

    Treesearch

    Rebecca G. Peak; Frank R. Thompson; Terry L. Shaffer

    2004-01-01

    We investigated factors affecting nest success of songbirds in riparian forest and buffers in northeastern Missouri. We used an information-theoretic approach to determine support for hypotheses concerning effects of nest-site, habitat-patch, edge, and temporal factors on nest success of songbirds in three narrow (55-95 m) and three wide (400-530 m) riparian forests...

  6. Factors motivating and affecting health information exchange usage

    PubMed Central

    Zhao, Hongwei; Jaspserson, 'Jon; Gamm, Larry D; Ohsfeldt, Robert L

    2011-01-01

    Objective Health information exchange (HIE) is the process of electronically sharing patient-level information between providers. However, where implemented, reports indicate HIE system usage is low. The aim of this study was to determine the factors associated with different types of HIE usage. Design Cross-sectional analysis of clinical data from emergency room encounters included in an operational HIE effort linked to system user logs using crossed random-intercept logistic regression. Measurements Independent variables included factors indicative of information needs. System usage was measured as none, basic usage, or a novel pattern of usage. Results The system was accessed for 2.3% of all encounters (6142 out of 271 305). Novel usage patterns were more likely for more complex patients. The odds of HIE usage were lower in the face of time constraints. In contrast to expectations, system usage was lower when the patient was unfamiliar to the facility. Limitations Because of differences between HIE efforts and the fact that not all types of HIE usage (ie, public health) could be included in the analysis, results are limited in terms of generalizablity. Conclusions This study of actual HIE system usage identifies patients and circumstances in which HIE is more likely to be used and factors that are likely to discourage usage. The paper explores the implications of the findings for system redesign, information integration across exchange partners, and for meaningful usage criteria emerging from provisions of the Health Information Technology for Economic & Clinical Health Act. PMID:21262919

  7. Factors Preventing the Successful Implementation of Information Systems: Case of the Elementary Public Education in Mexico

    ERIC Educational Resources Information Center

    Patiño, Israel

    2015-01-01

    This paper aims to identify the factors that impede the successful implementation of information systems in the case of primary public education for the systematization of administrative and operational processes. Once identified and diagnosed the cause, the proposal is made, in order to ensure that implementation. This aided with scientific…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  9. Factors Affecting the Adoption of Information and Communication Technologies in Teaching

    ERIC Educational Resources Information Center

    Salinas, Álvaro; Nussbaum, Miguel; Herrera, Oriel; Solarte, Mario; Aldunate, Roberto

    2017-01-01

    This study describes the level of adoption of information and communication technologies in teaching in three Latin American countries. It also analyzes factors that affect the process by which teachers incorporate these technologies into their classrooms. In order to do so, an online survey was conducted with 89 teachers. The results show that…

  10. Determination of Factors Affecting Physical Activity Status of University Students on a Health Sciences Campus

    PubMed Central

    Dayi, Ayfer; Acikgoz, Ayla; Guvendi, Guven; Bayrak, Levent; Ersoy, Burcu; Gur, Cagri; Ozmen, Omer

    2017-01-01

    Background Upon graduation, students studying in departments related to health will work in the health sector and will guide and enlighten people with their knowledge and behavior. The purpose of this study was to determine the factors affecting the physical activity (PA) conditions of university students on a health sciences campus. Material/Methods A cross-sectional study was carried out on 706 students in a Turkish university. The data was obtained from a survey prepared by the researchers. The 26-question survey aimed to discover the students’ socio-demographic characteristics and their awareness and practices concerning PA. Results We found that 30% of the students engage in some type of PA during their university education. A relationship was observed concerning their current PA and their family inactivity levels, as well as between inactivity before entering the university and inactivity during their education. The presence of a chronic disease in family members does not affect student PA. A majority of the students believe PA is beneficial (98.7%), 93.9% believe it relieves stress, and 94.5% believe it helps control body weight. Conclusions Although students of medicine and related disciplines are aware of the importance of proper diet and adequate levels of PA in health, they did not implement theory into practice. Thus, it is questionable how young health professionals will promote the positive effects and necessity of regular physical activity if they do not apply these activities to their own lifestyle. PMID:28103207

  11. Implementation of the Better Jobs Better Care Demonstration: Lessons for Long-Term Care Workforce Initiatives

    ERIC Educational Resources Information Center

    Kemper, Peter; Brannon, Diane; Barry, Teta; Stott, Amy; Heier, Brigitt

    2008-01-01

    Purpose: Better Jobs Better Care (BJBC) was a long-term care workforce demonstration that sought to improve recruitment and retention of direct care workers by changing public policy and management practice. The purpose of this article is to document and assess BJBC's implementation, analyze factors affecting implementation, and draw lessons from…

  12. Factors affecting the healing of pressure ulcers in a Korean acute care hospital.

    PubMed

    Sung, Young Hee; Park, Kyung Hee

    2011-01-01

    We sought to determine the factors affecting pressure ulcer (PU) healing in an acute care facility in Korea. Data were collected between October 1, 2006, and September 30, 2007, regarding PU status and factors hypothesized to influence wound healing. We developed a form that queried factors thought to affect PU healing based on literature review. We also administered the Pressure Ulcer Scale for Healing (PUSH) tool to assess healing of PUs and calculated change in PUSH scale as the outcome variable reflecting the magnitude of the healing of PU. One hundred fifty eight patients with a total of 326 PUs in an acute care hospital located in Seoul, Korea, comprised the sample. The variables found to significantly affect PU healing included mean arterial pressure (MAP), serum albumin level, urinary incontinence, consultation with nutritionist, Braden Scale scale, wound size, and exudate amount. Pressure ulcer healing was improved when the MAP was higher (B = 0.034) and the serum albumin level was more than 2.8 g/dL (20.8 grams/liter) (B = 1.107). When managing patients in an acute care setting, PU healing may be improved by maintaining MAP and providing protein supplements to keep serum albumin level greater than 2.8 g/dL (20.8 grams/liter).

  13. Factors Linked to Substance Use Disorder Counselors’ (Non)Implementation Likelihood of Tobacco Cessation 5 A's, Counseling, and Pharmacotherapy

    PubMed Central

    Laschober, Tanja C.; Muilenburg, Jessica L.; Eby, Lillian T.

    2015-01-01

    Study Background Despite efforts to promote the use of tobacco cessation services (TCS), implementation extensiveness remains limited. This study investigated three factors (cognitive, behavioral, environmental) identified by social cognitive theory as predictors of substance use disorder counselors’ likelihood of use versus non-use of tobacco cessation (TC) 5 A's (ask patients about tobacco use, advise to quit, assess willingness to quit, assist in quitting, arrange for follow-up contact), counseling, and pharmacotherapy with their patients who smoke cigarettes. Methods Data were collected in 2010 from 942 counselors working in 257 treatment programs that offered TCS. Cognitive factors included perceived job competence and TC attitudes. Behavioral factors encompassed TC-related skills and general training. External factors consisted of TC financial resource availability and coworker TC attitudes. Data were analyzed using logistic regression models with nested data. Results Approximately 86% of counselors used the 5 A's, 76% used counseling, and 53% used pharmacotherapy. When counselors had greater TC-related skills and greater general training they were more likely to implement the 5 A's. Implementation of counseling was more likely when counselors had more positive attitudes toward TC treatment, greater general training, greater financial resource availability, and when coworkers had more positive attitudes toward TC treatment. Implementation of pharmacotherapy was more likely when counselors had more positive attitudes toward TC treatment, greater general training, and greater financial resource availability. Conclusion Findings indicate that interventions to promote TCS implementation should consider all three factors simultaneously as suggested by social cognitive theory. PMID:26005696

  14. A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems.

    PubMed

    Phansalkar, Shobha; Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

    2010-01-01

    The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decision support. Last, we suggest actionable recommendations for delivering effective clinical decision support using alerts. A review of studies from the medical informatics literature suggests that many basic human factors principles are not followed, possibly contributing to the lack of acceptance of alerts in clinical information systems. We evaluate the limitations of current alerting philosophies and provide recommendations for improving acceptance of alerts by incorporating human factors principles in their design.

  15. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    PubMed Central

    Ludwick, D. A.; Doucette, John

    2009-01-01

    Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation. PMID:19081787

  16. Factors affecting aging cognitive function among community-dwelling older adults.

    PubMed

    Kim, Chun-Ja; Park, JeeWon; Kang, Se-Won; Schlenk, Elizabeth A

    2017-08-01

    The study purpose was to determine factors affecting aging cognitive function of 3,645 community-dwelling older adults in Korea. The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio-metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms. Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities. Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders. © 2017 John Wiley & Sons Australia, Ltd.

  17. Identifying the factors affecting bike-sharing usage and degree of satisfaction in Ningbo, China

    PubMed Central

    Guo, Yanyong; Zhou, Jibiao; Wu, Yao; Li, Zhibin

    2017-01-01

    The boom in bike-sharing is receiving growing attention as societies become more aware of the importance of active non-motorized traffic modes. However, the low usage of this transport mode in China raises concerns. The primary objective of this study is to explore factors affecting bike-sharing usage and satisfaction degree of bike-sharing among the bike-sharing user population in China. Data were collected by a questionnaire survey in Ningbo. A bivariate ordered probit (BOP) model was developed to examine simultaneously those factors associated with both bike-sharing usage and satisfaction degree of bike-sharing among users. Marginal effects for contributory factors were calculated to quantify their impacts on the outcomes. The results showed that the BOP model can account for commonly shared unobserved characteristics within usage and satisfaction of bike-sharing. The BOP model results showed that the usage of bike-sharing was affected by gender, household bicycle/e-bike ownership, trip model, travel time, bike-sharing stations location, and users’ perception of bike-sharing. The satisfaction degree of bike-sharing was affected by household income, bike-sharing stations location, and users’ perception of bike-sharing. It is also found that bike-sharing usage and satisfaction degree are strongly correlated and positive in direction. The results can enhance our comprehension of the factors that affect usage and satisfaction degree of bike-sharing. Based on the results, some suggestions regarding planning, engineering, and public advocacy were discussed to increase the usage of bike-sharing in Ningbo, China. PMID:28934321

  18. Content validity of critical success factors for e-Government implementation in Indonesia

    NASA Astrophysics Data System (ADS)

    Napitupulu, D.; Syafrullah, M.; Rahim, R.; Amar, A.; Sucahyo, YG

    2018-05-01

    The purpose of this research is to validate the Critical Success Factors (CSFs) of e-Government implementation in Indonesia. The e-Government initiative conducted only to obey the regulation but ignoring the quality. Defining CSFs will help government agencies to avoid failure of e-Government projects. A survey with the questionnaire was used to validate the item of CSF based on expert judgment through two round of Delphi. The result showed from 67 subjects in instrument tested; there are 11 invalid items deleted and remain only 56 items that had good content validity and internal reliability. Therefore, all 56 CSFs should be adopted by government agencies in Indonesia to support e-Government implementation.

  19. Effects of organizational context on Lean implementation in five hospital systems.

    PubMed

    Harrison, Michael I; Paez, Kathryn; Carman, Kristin L; Stephens, Jennifer; Smeeding, Lauren; Devers, Kelly J; Garfinkel, Steven

    2016-01-01

    Despite broad agreement among researchers about the value of examining how context shapes implementation of improvement programs and projects, limited attention has been paid to contextual effects on implementation of Lean. To help reduce gaps in knowledge of effects of intraorganizational context, we researched Lean implementation initiatives in five organizations and examined 12 of their Lean rapid improvement projects. All projects aimed at improving clinical care delivery. On the basis of the literature on Lean, innovation, and quality improvement, we developed a framework of factors likely to affect Lean implementation and outcomes. Drawing on the framework, we conducted semistructured interviews and applied qualitative codes to the transcribed interviews. Available documents, data, and observations supplemented the interviews. We constructed case studies of Lean implementation in each organization, compared implementation across organizations, and compared the 12 projects. Intraorganizational characteristics affecting organization-wide Lean initiatives and often also shaping project outcomes included CEO commitment to Lean and active support for it, prior organizational capacity for quality improvement-based performance improvement, alignment of the Lean initiative with the organizational mission, dedication of resources and experts to Lean, staff training before and during projects, establishment of measurable and relevant project targets, planning of project sequences that enhance staff capabilities and commitment without overburdening them, and ensuring communication between project members and other affected staff. Dependence of projects on inputs of new information technology was a barrier to project success. Incremental implementation of Lean produced reported improvements in operational efficiency and occasionally in care quality. However, even under the relatively favorable circumstances prevailing in our study sites, incremental implementation did

  20. Strategic environmental assessment performance factors and their interaction: An empirical study in China

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

    Li, Tianwei, E-mail: li.tianwei@mep.gov.cn; Wang, Huizhi, E-mail: huizhiwangnk@163.com; Deng, Baole, E-mail: dengbaolekobe@126.com

    Strategic Environmental Assessment (SEA) has been seen as a preventive and participatory environmental management tool designed to integrate environmental protection into the decision-making process. However, the debate about SEA performance and effectiveness has increased in recent decades. Two main challenges exist in relation to this issue. The first is identifying the key influencing factors that affect SEA effectiveness, and the second is analyzing the relationship between SEA and these influencing factors. In this study, influencing factors were investigated through questionnaire surveys in the Chinese context, and then a Structural Equation Model (SEM) was developed and tested to identify potential linksmore » and causal relationships among factors. The associations between the independent factors were divided into direct and indirect causal associations. The results indicate that the decision-making process and policy context directly affect SEA implementation, while information and data sharing, public participation, expertise and SEA institutions are indirectly related with SEA. The results also suggest that a lack of cooperation between different sectors is an obstacle to the implementation of SEA. These findings could potentially contribute to the future management and implementation of SEA or enhance existing knowledge of SEA. The results show that the proposed model has a degree of feasibility and applicability. - Highlights: • Influencing factors were identified and investigated through questionnaire surveys. • Structural Equation Model (SEM) was developed and tested to identify potential links and causal relationships among factors. • Decision-making process and policy context directly affect SEA implementation. • Lack of cooperation among different sectors is an obstacle to the implementation of SEA. • The proposed model has a degree of feasibility and applicability.« less

  1. A Concept Mapping Approach to Guide and Understand Dissemination and Implementation

    PubMed Central

    Green, Amy E.; Fettes, Danielle L.; Aarons, Gregory A.

    2013-01-01

    Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping—a mixed method strategy—to study implementation of behavioral health innovations and evidence-based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed. PMID:22892987

  2. A concept mapping approach to guide and understand dissemination and implementation.

    PubMed

    Green, Amy E; Fettes, Danielle L; Aarons, Gregory A

    2012-10-01

    Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping-a mixed method strategy-to study implementation of behavioral health innovations and evidence-based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed.

  3. [An Electroencephalogram-driven Personalized Affective Music Player System: Algorithms and Preliminary Implementation].

    PubMed

    Ma, Yong; Li, Juan; Lu, Bin

    2016-02-01

    In order to monitor the emotional state changes of audience on real-time and to adjust the music playlist, we proposed an algorithm framework of an electroencephalogram (EEG) driven personalized affective music recommendation system based on the portable dry electrode shown in this paper. We also further finished a preliminary implementation on the Android platform. We used a two-dimensional emotional model of arousal and valence as the reference, and mapped the EEG data and the corresponding seed songs to the emotional coordinate quadrant in order to establish the matching relationship. Then, Mel frequency cepstrum coefficients were applied to evaluate the similarity between the seed songs and the songs in music library. In the end, during the music playing state, we used the EEG data to identify the audience's emotional state, and played and adjusted the corresponding song playlist based on the established matching relationship.

  4. [Factors affecting the vegetation restoration after fires in cold temperate wetlands: A review].

    PubMed

    Zhao, Feng-Jun; Wang, Li-Zhong; Shu, Li-Fu; Chen, Peng-Yu; Chen, Li-guang

    2013-03-01

    Cold temperate wetland plays an important role in maintaining regional ecological balance. Fire is an important disturbance factor in wetland ecosystem. Severe burning can induce the marked degradation of the ecological functions of wetland ecosystem. The vegetation restoration, especially the early vegetation restoration, after fires, is the premise and basis for the recovery of the ecological functions of the ecosystem. This paper reviewed the research progress on the factors affecting the vegetation restoration after fires in wetlands. The vegetation restoration after fires in cold temperate wetlands was controlled by the fire intensity, fire size, vegetation types before fires, regeneration characteristics of plant species, and site conditions. It was considered that the long-term monitoring on the post-fire vegetation restoration in cold temperate wetland, the key factors affecting the vegetation restoration, the roles of frozen soil layer on the post-fire vegetation restoration, and the theories and technologies on the vegetation restoration would be the main research directions in the future.

  5. Factors affecting the sustainability of solid waste management system-the case of Palestine.

    PubMed

    Al-Khateeb, Ammar J; Al-Sari, Majed I; Al-Khatib, Issam A; Anayah, Fathi

    2017-02-01

    Understanding the predictors of sustainability in solid waste management (SWM) systems can significantly contribute to eliminate many waste management problems. In this paper, the sustainability elements of SWM systems of interest are (1) attitudes toward separation at the source, (2) behaviour regarding reuse and/or recycling and (3) willingness to pay for an improved service of SWM. The predictors affecting these three elements were studied in two Palestinian cities: Ramallah and Jericho. The data were collected via structured questionnaires and direct interviews with the respondents, and the analysis utilized a logistic regression model. The results showed that the place of residence and dwelling premises are the significant factors influencing attitudes toward separation at the source; the place of residence and age are the significant factors explaining behaviour regarding reuse and/or recycling; while the dwelling premises, gender, level of education and being received education on waste management are the significant factors affecting willingness to pay for an improved service of SWM.

  6. Are inner context factors related to implementation outcomes in cognitive-behavioral therapy for youth anxiety?

    PubMed Central

    Edmunds, Julie; Ditty, Matthew; Watkins, Jessica; Walsh, Lucia; Marcus, Steven; Kendall, Philip

    2013-01-01

    Among the challenges facing the mental health field are the dissemination and implementation of evidence-based practices. The present study investigated the relationships between inner context variables (i.e., adopter characteristics and individual perceptions of intra-organizational factors) and two implementation outcomes – independently rated therapist fidelity on a performance-based role-play (i.e., adherence and skill) and self-reported penetration of cognitive behavioral therapy for youth anxiety following training. A significant relationship was found between inner context variables and fidelity. Specifically, adopter characteristics were associated with adherence and skill; individual perceptions of intra-organizational factors were associated with adherence. Inner context variables were not associated with penetration. Future directions are discussed. PMID:24202067

  7. Factors that affect the flow of patients through triage.

    PubMed

    Lyons, Melinda; Brown, Ruth; Wears, Robert

    2007-02-01

    To use observational methods to objectively evaluate the organisation of triage and what issues may affect the effectiveness of the process. A two-phase study comprising observation of 16 h of triage in a London hospital emergency department and interviews with the triage staff to build a qualitative task analysis and study protocol for phase 2; observation and timing in triage for 1870 min including 257 patients and for 16 different members of the triage staff. No significant difference was found between grades of staff for the average triage time or the fraction of time absent from triage. In all, 67% of the time spent absent from triage was due to escorting patients into the department. The average time a patient waited in the reception before triage was 13 min 34 s; the average length of time to triage for a patient was 4 min 17 s. A significant increase in triage time was found when patients were triaged to a specialty, expected by a specialty, or were actively "seen and treated" in triage. Protocols to prioritise patients with potentially serious conditions to the front of the queue had a significantly positive effect on their waiting time. Supplementary tasks and distractions had varying effects on the timely assessment and triage of patients. The human factors method is applicable to the triage process and can identify key factors that affect the throughput at triage. Referring a patient to a specialty at triage affects significantly the triage workload; hence, alternative methods or management should be suggested. The decision to offer active treatment at triage increases the time taken, and should be based on clinical criteria and the workload determined by staffing levels. The proportion of time absent from triage could be markedly improved by support from porters or other non-qualified staff, as well as by proceduralised handovers from triage to the main clinical area. Triage productivity could be improved by all staff by becoming aware of the effect of

  8. Internal and external environmental factors affecting the performance of hospital-based home nursing care.

    PubMed

    Noh, J-W; Kwon, Y-D; Yoon, S-J; Hwang, J-I

    2011-06-01

    Numerous studies on HNC services have been carried out by signifying their needs, efficiency and effectiveness. However, no study has ever been performed to determine the critical factors associated with HNC's positive results despite the deluge of positive studies on the service. This study included all of the 89 training hospitals that were practising HNC service in Korea as of November 2006. The input factors affecting the performance were classified as either internal or external environmental factors. This analysis was conducted to understand the impact that the corresponding factors had on performance. Data were analysed by using multiple linear regressions. The internal and external environment variables affected the performance of HNC based on univariate analysis. The meaningful variables were internal environmental factors. Specifically, managerial resource (the number of operating beds and the outpatient/inpatient ratio) were meaningful when the multiple linear regression analysis was performed. Indeed, the importance of organizational culture (the passion of HNC nurses) was significant. This study, considering the limited market size of Korea, illustrates that the critical factor for the development of hospital-led HNC lies with internal environmental factors rather than external ones. Among the internal environmental factors, the hospitals' managerial resource-related factors (specifically, the passion of nurses) were the most important contributing element. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  9. An Investigation of Relationships between Internal and External Factors Affecting Technology Integration in Classrooms

    ERIC Educational Resources Information Center

    Hur, Jung Won; Shannon, David; Wolf, Sara

    2016-01-01

    Various factors affecting technology integration have been identified, but little research has examined the relationships between factors, especially internal and external ones, and whether they directly or indirectly influenced each other. To fill this research gap, this study examined the significance and relationships of five factors…

  10. Ontario's emergency department process improvement program: the experience of implementation.

    PubMed

    Rotteau, Leahora; Webster, Fiona; Salkeld, Erin; Hellings, Chelsea; Guttmann, Astrid; Vermeulen, Marian J; Bell, Robert S; Zwarenstein, Merrick; Rowe, Brian H; Nigam, Amit; Schull, Michael J

    2015-06-01

    In recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long-Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital-based teams' experiences during the ED process improvement program implementation and the teams' perceptions of the key factors that influenced the program's success or failure. A qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed. Twenty-four interviews were coded and analyzed. The results are organized according to participants' experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project. Several key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the

  11. Readiness factors for lean implementation in healthcare settings--a literature review.

    PubMed

    Al-Balushi, S; Sohal, A S; Singh, P J; Al Hajri, A; Al Farsi, Y M; Al Abri, R

    2014-01-01

    The purpose of this paper is to determine the readiness factors that are critical to the application and success of lean operating principles in healthcare organizations through a review of relevant literature. A comprehensive review of literature focussing on lean and lean healthcare was conducted. Leadership, organizational culture, communication, training, measurement, and reward systems are all commonly attributed readiness factors throughout general change management and lean literature. However, directly related to the successful implementation of lean in healthcare is that a setting is able to authorize a decentralized management style and undertake an end-to-end process view. These can be particularly difficult initiatives for complex organizations such as healthcare settings. The readiness factors identified are based on a review of the published literature. The external validity of the findings could be enhanced if tested using an empirical study. The readiness factors identified will enable healthcare practitioners to be better prepared as they begin their lean journeys. Sustainability of the lean initiative will be at stake if these readiness factors are not addressed. To the best of the knowledge, this is the first paper that provides a consolidated list of key lean readiness factors that can guide practice, as well as future theory and empirical research.

  12. Identification of key factors affecting the water pollutant concentration in the sluice-controlled river reaches of the Shaying River in China via statistical analysis methods.

    PubMed

    Dou, Ming; Zhang, Yan; Zuo, Qiting; Mi, Qingbin

    2015-08-01

    The construction of sluices creates a strong disturbance in water environmental factors within a river. The change in water pollutant concentrations of sluice-controlled river reaches (SCRRs) is more complex than that of natural river segments. To determine the key factors affecting water pollutant concentration changes in SCRRs, river reaches near the Huaidian Sluice in the Shaying River of China were selected as a case study, and water quality monitoring experiments based on different regulating modes were implemented in 2009 and 2010. To identify the key factors affecting the change rates for the chemical oxygen demand of permanganate (CODMn) and ammonia nitrogen (NH3-N) concentrations in the SCRRs of the Huaidian Sluice, partial correlation analysis, principal component analysis and principal factor analysis were used. The results indicate four factors, i.e., the inflow quantity from upper reaches, opening size of sluice gates, water pollutant concentration from upper reaches, and turbidity before the sluice, which are the common key factors for the CODMn and NH3-N concentration change rates. Moreover, the dissolved oxygen before a sluice is a key factor for the permanganate concentration from CODMn change rate, and the water depth before a sluice is a key factor for the NH3-N concentration change rate. Multiple linear regressions between the water pollutant concentration change rate and key factors were established via multiple linear regression analyses, and the quantitative relationship between the CODMn and NH3-N concentration change rates and key affecting factors was analyzed. Finally, the mechanism of action for the key factors affecting the water pollutant concentration changes was analyzed. The results reveal that the inflow quantity from upper reaches, opening size of sluice gates, permanganate concentration from CODMn from upper reaches and dissolved oxygen before the sluice have a negative influence and the turbidity before the sluice has a positive

  13. FACTORS AFFECTING SUSCEPTIBILITY OF THE CORAL MONTASTRAEA FAVEOLATE TO BLACK-BAND DISEASE

    EPA Science Inventory

    Black-band disease affects many species of tropical reef-building corals, but it is unclear what factors contribute to the disease-susceptibility of individual corals or how the disease is transmitted between colonies. Studies have suggested that the ability of black-band disease...

  14. Commentary on factors affecting transverse vibration using an idealized theoretical equation

    Treesearch

    Joseph F. Murphy

    2000-01-01

    An idealized theoretical equation to calculate flexural stiffness using transverse vibration of a simply end-supported beam is being considered by the American Society of Testing and Materials (ASTM) Wood Committee D07 to determine lumber modulus of elasticity. This commentary provides the user a quantitative view of six factors that affect the accuracy of using the...

  15. Factors Affecting the Identification of Research Problems in Educational Administration Studies

    ERIC Educational Resources Information Center

    Yalçin, Mikail; Bektas, Fatih; Öztekin, Özge; Karadag, Engin

    2016-01-01

    The purpose of this study is to reveal the factors that affect the identification of research problems in educational administration studies. The study was designed using the case study method. Criterion sampling was used to determine the work group; the criterion used to select the participants was that of having a study in the field of…

  16. System-Level Evaluation: Language and Other Background Factors Affecting Mathematics Achievement

    ERIC Educational Resources Information Center

    Howie, Sarah

    2005-01-01

    The aim of this study is to describe and to explore the main factors affecting the performance of South African pupils in the mathematics test of the Third International Mathematics and Science Study-Repeat (TIMSS-R). The first objective was to describe the performance of the pupils in the mathematics test, the pupils' proficiency in English, as…

  17. Factors affecting physicians' responses to patients' requests for antidepressants: focus group study.

    PubMed

    Tentler, Aleksey; Silberman, Jordan; Paterniti, Debora A; Kravitz, Richard L; Epstein, Ronald M

    2008-01-01

    The ways in which patients' requests for antidepressants affect physicians' prescribing behavior are poorly understood. To describe physicians' affective and cognitive responses to standardized patients' (SPs) requests for antidepressants, as well as the attitudinal and contextual factors influencing prescribing behavior. Focus group interviews and brief demographic questionnaires. Twenty-two primary care physicians in 6 focus groups; all had participated in a prior RCT of the influence of patients' requests on physicians' prescribing. Iterative review of interview transcripts, involving qualitative coding and thematic analysis. Physicians participating in the focus groups were frequently unaware of and denied the degree to which their thinking was biased by patient requests, but were able to recognize such biases after facilitated reflection. Common affective responses included annoyance and empathy. Common cognitive reactions resulted in further diagnostic inquiry or in acquiescing to the patient's demands to save time or build the patient-clinician relationship. Patients' requests for medication prompted the participants to err on the side of overtreating versus careful review of clinical indications. Lack of time and participants' attitudes--toward the role of the patient and the pharmaceutical ads--also influenced their responses, prompting them to interpret patient requests as diagnostic clues or opportunities for efficiency. This study provides a taxonomy of affective and cognitive responses to patients' requests for medications and the underlying attitudes and contextual factors influencing them. Improved capacity for moment-to-moment self-awareness during clinical reasoning processes may increase the appropriateness of prescribing.

  18. Patient and disease factors affecting the choice and adherence to active surveillance.

    PubMed

    Dall'Era, Marc A

    2015-05-01

    Treatment decisions for low-risk prostate cancer are arguably some of the most challenging in oncology. Active surveillance has emerged as an important option for many men with tumors estimated to have a low metastatic potential. Multiple complex patient and physician factors affect the recommendation, selection, and adherence to active surveillance. While baseline clinical criteria are used to identify candidates for this approach, it is important to identify and understand other forces that may influence the management of prostate cancer with active surveillance. Patient perceptions and acceptance of active surveillance have improved over time. Treatment decisions for prostate cancer are strongly associated with physician recommendations, and a high-quality relationship between the patient and his healthcare system is critical to successful active surveillance. Patient understanding of prostate cancer and consistency of information received from separate physicians can affect a decision to pursue active surveillance. Psychological symptoms, most notably regarding anxiety and distress, can affect adherence to active surveillance over time. In general, anxiety for men on active surveillance is low, and lifestyle interventions and self-management strategies may be helpful for increasing quality of life and limiting abandonment of active surveillance in the absence of disease progression. Multiple factors may affect the decision for and adherence to active surveillance for prostate cancer. It is important for both physicians and patients to be aware of these issues and work towards individualized approaches and interventions as needed to increase adoption of active surveillance in the future.

  19. Turkish nurses' assessments of their power and the factors that affect it.

    PubMed

    Basaran, Seher; Duygulu, Sergul

    2015-11-01

    To explore nurses' self-assessments of power and their opinions regarding factors affecting power in Turkey using a cross-sectional, descriptive study. In order to safely and cost-effectively care for patients, nurses must perceive themselves as powerful and have the use and control of power resources. The study sample consisted of 297 nurses in six hospitals: two government hospitals, two university hospitals and two private hospitals. Data were collected using the Demographic Data Form and Power Question Form. Nurses regarded themselves as 'quite powerful' regarding persuasion (53.2%) and referent power (43.4%). Many nurses also regarded themselves as having positional power and 'quite powerful' regarding, reward (44.1%) and legitimate power (34.7%). Nurses saw themselves as least powerful in resource power (48.1%). Individual, educational and organisational factors were the main factors affecting personal and positional power sources. Turkish nurses regarded themselves as above average on being powerful in both the personal and positional power base but not in resource power. We recommend that nurses, educators and managers develop strategies to support nurses' power as a way to enhance the patient care outcomes. © 2014 John Wiley & Sons Ltd.

  20. Factors affecting economies of scale in combined sewer systems.

    PubMed

    Maurer, Max; Wolfram, Martin; Anja, Herlyn

    2010-01-01

    A generic model is introduced that represents the combined sewer infrastructure of a settlement quantitatively. A catchment area module first calculates the length and size distribution of the required sewer pipes on the basis of rain patterns, housing densities and area size. These results are fed into the sewer-cost module in order to estimate the combined sewer costs of the entire catchment area. A detailed analysis of the relevant input parameters for Swiss settlements is used to identify the influence of size on costs. The simulation results confirm that an economy of scale exists for combined sewer systems. This is the result of two main opposing cost factors: (i) increased construction costs for larger sewer systems due to larger pipes and increased rain runoff in larger settlements, and (ii) lower costs due to higher population and building densities in larger towns. In Switzerland, the more or less organically grown settlement structures and limited land availability emphasise the second factor to show an apparent economy of scale. This modelling approach proved to be a powerful tool for understanding the underlying factors affecting the cost structure for water infrastructures.

  1. Examining Success Factors Related to ERP Implementations in Higher Education Shared Services Projects

    ERIC Educational Resources Information Center

    Stoyanoff, Dawn Galadriel Pfeiffer

    2012-01-01

    This study examined the enterprise resource planning (ERP) implementations that utilized a shared services model in higher education. The purpose of this research was to examine the critical success factors which were perceived to contribute to project success. This research employed a quantitative non-experimental correlational design and the…

  2. Maternal and Neonatal Birth Factors Affecting the Age of ASD Diagnosis.

    PubMed

    Darcy-Mahoney, Ashley; Minter, Bonnie; Higgins, Melinda; Guo, Ying; Zauche, Lauren Head; Hirst, Jessica

    2016-12-01

    Early diagnosis of autism spectrum disorders (ASD) enables early intervention that improves long term functioning of children with ASD but is often delayed until age of school entry. Few studies have identified factors that affect timely diagnosis. This study addressed how maternal education, race, age, marital status as well as neonatal birth factors affect the age at which a child is diagnosed with ASD. This study involved a retrospective analysis of 664 records of children treated at one of the largest autism treatment centers in the United States from March 1, 2009 to December 30, 2010. Logistic regression and Cox proportional hazards regression were used to identify maternal and neonatal factors associated with age of diagnosis. Infant gender, maternal race, marital status, and maternal age were identified as significant factors for predicting the age of ASD diagnosis. In the Cox proportional hazards regression model, only maternal race and marital status were included. Median survival age till diagnosis of children born to married mothers was 53.4 months compared to 57.8 months and 63.7 months of children born to single and divorced or widowed mothers respectively. Median survival age till diagnosis for children of African American mothers was 53.8 months compared to 57.2 months for children of Caucasian mothers. No statistically significant difference of timing of ASD diagnosis was found for children of varying gestational age. Children born to older or married mothers and mothers of minority races were more likely to have an earlier ASD diagnosis. No statistically significant differences in timing of ASD diagnosis were found for children born at varying gestational ages. Identification of these factors has the potential to inform public health outreach aimed at promoting timely ASD diagnosis. This work could enhance clinical practice for timelier diagnoses of ASD by supporting parents and clinicians around the world in identifying risk factors beyond gender

  3. Factors Influencing Acceptability and Perceived Impacts of a Mandatory ePortfolio Implemented by an Occupational Therapy Regulatory Organization.

    PubMed

    Vachon, Brigitte; Foucault, Marie-Lyse; Giguère, Charles-Édouard; Rochette, Annie; Thomas, Aliki; Morel, Martine

    2018-01-01

    The use of ePortfolios has been implemented in several regulatory organizations to encourage clinicians' engagement in continuing professional development (CPD). However, their use has achieved mixed success, and multiple personal and contextual factors can influence their impacts on practice change. The aim of this study was to identify which factors influence the acceptability and perceived impacts of an ePortfolio implemented by an occupational therapy regulatory organization in one Canadian province. A cross-sectional online survey design was used. The survey was sent to registered occupational therapists in Quebec. Multiple regression analyses were conducted to identify factors influencing acceptability and outcomes: ease of use, satisfaction, impact on implementation of the CPD plan, and competence improvement. The survey was fully completed by 546 participants. Factors significantly influencing the ePortfolio acceptability and perceived impacts were attitude toward and familiarity with the portfolio, confidence in reflective skills, engagement in the CPD plan, and desire for feedback. Time spent completing the ePortfolio and the fact of completing it in teams were negatively associated with the outcomes. Shaping more favorable user attitudes, helping users recognize and experience the tool's benefits for their practice, and fostering confidence in their reflective skills are important factors that can be addressed to improve ePortfolio acceptability and outcomes. Contextual factors, such as time spent completing the ePortfolio and completing it in teams, seem to reflect greater difficulty with using the tool. Study findings can contribute to improving ePortfolio implementation in the CPD context.

  4. Factors affecting injury severity of vehicle occupants following road traffic collisions.

    PubMed

    Abu-Zidan, Fikri M; Eid, Hani O

    2015-01-01

    We aimed to define factors affecting injury severity of vehicle occupants following road traffic collisions (RTC). 422 vehicle occupants (343 males, 81.3%) with RTC-related injuries were prospectively studied over 18 months. General linear model was used to test the effect of age, gender, alcohol and drug use, time of injury, mechanism of injury, size and speed of the vehicle, position in the vehicle, seatbelt usage, and air bag deployment on the Injury Severity Score (ISS) of the vehicle occupants. The mean (range) age of patients was 28.2 (1-78) years and the mean (range) ISS was 7.9 (1-50). Front impact was the most common mechanism of injury (32.9%) followed by rollover (25.6%) and side impact (22.3%). 18.2% used seatbelts. The general linear model was highly significant and showed that mechanism of injury (p<0.0001), speed of the vehicle (p=0.02), and age of the vehicle occupant (p=0.03) significantly affected the Injury Severity Score. The mechanism of the RTC, the vehicle speed, and age of the vehicle occupant are the most important factors affecting the severity of road traffic collision injuries. A detailed history of the mechanism of injury is important for alerting clinicians to severity of injury, the need for admission, and workup of the patients. Furthermore, strict speed limit enforcement is an injury prevention priority in our community. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Factors affecting frequency and orbit utilization by high power transmission satellite systems.

    NASA Technical Reports Server (NTRS)

    Kuhns, P. W.; Miller, E. F.; O'Malley, T. A.

    1972-01-01

    The factors affecting the sharing of the geostationary orbit by high power (primarily television) satellite systems having the same or adjacent coverage areas and by satellites occupying the same orbit segment are examined and examples using the results of computer computations are given. The factors considered include: required protection ratio, receiver antenna patterns, relative transmitter power, transmitter antenna patterns, satellite grouping, and coverage pattern overlap. The results presented indicate the limits of system characteristics and orbit deployment which can result from mixing systems.

  6. Factors affecting frequency and orbit utilization by high power transmission satellite systems

    NASA Technical Reports Server (NTRS)

    Kuhns, P. W.; Miller, E. F.; Malley, T. A.

    1972-01-01

    The factors affecting the sharing of the geostationary orbit by high power (primarily television) satellite systems having the same or adjacent coverage areas and by satellites occupying the same orbit segment are examined and examples using the results of computer computations are given. The factors considered include: required protection ratio, receiver antenna patterns, relative transmitter power, transmitter antenna patterns, satellite grouping, and coverage pattern overlap. The results presented indicated the limits of system characteristics and orbit deployment which can result from mixing systems.

  7. Analysis of Factors that Affect the Teacher Certification Exam Results in a University System in Puerto Rico

    ERIC Educational Resources Information Center

    Garofalo, Jorge H.

    2009-01-01

    The purpose of this study was to analyze the factors that affect a teacher preparation exam results within a University System in Puerto Rico. Using Bertalanffy's System Theory as theoretical framework, this mixed methods study examined factors in the university system that could have affected student's preparation for a teacher exam (PCMAS by its…

  8. Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project.

    PubMed

    Skoien, Wade; Page, Katie; Parsonage, William; Ashover, Sarah; Milburn, Tanya; Cullen, Louise

    2016-10-12

    The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. The overwhelmingly positive response suggests that it

  9. Implementation Science Supports Core Clinical Competencies: An Overview and Clinical Example.

    PubMed

    Kirchner, JoAnn E; Woodward, Eva N; Smith, Jeffrey L; Curran, Geoffrey M; Kilbourne, Amy M; Owen, Richard R; Bauer, Mark S

    2016-12-08

    Instead of asking clinicians to work faster or longer to improve quality of care, implementation science provides another option. Implementation science is an emerging interdisciplinary field dedicated to studying how evidence-based practice can be adopted into routine clinical care. This article summarizes principles and methods of implementation science, illustrates how they can be applied in a routine clinical setting, and highlights their importance to practicing clinicians as well as clinical trainees. A hypothetical clinical case scenario is presented that explains how implementation science improves clinical practice. The case scenario is also embedded within a real-world implementation study to improve metabolic monitoring for individuals prescribed antipsychotics. Context, recipient, and innovation (ie, the evidence-based practice) factors affected improvement of metabolic monitoring. To address these factors, an external facilitator and a local quality improvement team developed an implementation plan involving a multicomponent implementation strategy that included education, performance reports, and clinician follow-up. The clinic remained compliant with recommended metabolic monitoring at 1-year follow up. Implementation science improves clinical practice by addressing context, recipient, and innovation factors and uses this information to develop and utilize specific strategies that improve clinical practice. It also enriches clinical training, aligning with core competencies by the Accreditation Council for Graduate Medical Education and American Boards of Medical Specialties. By learning how to change clinical practice through implementation strategies, clinicians are more able to adapt in complex systems of practice. © Copyright 2016 Physicians Postgraduate Press, Inc.

  10. Resolution V fractional factorial design for screening of factors affecting weakly basic drugs liposomal systems.

    PubMed

    Nageeb El-Helaly, Sara; Habib, Basant A; Abd El-Rahman, Mohamed K

    2018-07-01

    This study aims to investigate factors affecting weakly basic drugs liposomal systems. Resolution V fractional factorial design (2 V 5-1 ) is used as an example of screening designs that would better be used as a wise step before proceeding with detailed factors effects or optimization studies. Five factors probable to affect liposomal systems of weakly basic drugs were investigated using Amisulpride as a model drug. Factors studied were; A: Preparation technique B: Phosphatidyl choline (PhC) amount (mg) C: Cholesterol: PhC molar ratio, D: Hydration volume (ml) and E: Sonication type. Levels investigated were; Ammonium sulphate-pH gradient technique or Transmembrane zinc chelation-pH gradient technique, 200 or 400 mg, 0 or 0.5, 10 or 20 ml and bath or probe sonication for A, B, C, D and E respectively. Responses measured were Particle size (PS) (nm), Zeta potential (ZP) (mV) and Entrapment efficiency percent (EE%). Ion selective electrode was used as a novel method for measuring unentrapped drug concentration and calculating entrapment efficiency without the need for liposomal separation. Factors mainly affecting the studied responses were Cholesterol: PhC ratio and hydration volume for PS, preparation technique for ZP and preparation technique and hydration volume for EE%. The applied 2 V 5-1 design enabled the use of only 16 trial combinations for screening the influence of five factors on weakly basic drugs liposomal systems. This clarifies the value of the use of screening experiments before extensive investigation of certain factors in detailed optimization studies. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Study of factors affecting the appearance of colors under microscopes

    NASA Astrophysics Data System (ADS)

    Zakizadeh, Roshanak; Martinez-Garcia, Juan; Raja, Kiran B.; Siakidis, Christos

    2013-11-01

    The variation of colors in microscopy systems can be quite critical for some users. To address this problem, a study is conducted to analyze how different factors such as size of the sample, intensity of the microscope's light source and the characteristics of the material like chroma and saturation can affect the color appearance through the eyepiece of the microscope. To study the changes in colors considering these factors, the spectral reflectance of 24 colors of GretagMacbeth Classic ColorChecker® and Mini ColorChecker® which are placed under a Nikon ECLIPSE MA200 microscope®2 using dark filed and bright field illuminations which result in different intensity levels, is measured using a spectroradiometer®3 which was placed in front of the eyepiece of the microscope. The results are compared with the original data from N. Ohta1. The evaluation is done by observing the shift in colors in the CIE 1931 Chromaticity Diagram and the CIELAB space, also by applying a wide set of color-difference formulas, namely: CIELAB, CMC, BFD, CIE94, CIEDE2000, DIN99d and DIN99b. Furthermore, to emphasize on the color regions in which the highest difference is observed, the authors have obtained the results from another microscope; Olympus SZX10®4, which in this case the measurement is done by mounting the spectroradiometer to the camera port of the microscope. The experiment leads to some interesting results, among which is the consistency in the highest difference observed considering different factors or how the change in saturation of the samples of the same hue can affect the results.

  12. Factors affecting the outcome of artificial insemination using cryopreserved spermatozoa in the giant panda (Ailuropoda melanoleuca).

    PubMed

    Huang, Yan; Li, Desheng; Zhou, Yingmin; Zhou, Qiang; Li, Rengui; Wang, Chengdong; Huang, Zhi; Hull, Vanessa; Zhang, Hemin

    2012-01-01

    Artificial insemination (AI) is an important component of captive breeding programs for endangered species, such as the giant panda. The panda has been the subject of increasingly successful captive breeding programs involving a compilation of assisted breeding techniques, including AI using cryopreserved spermatozoa. AI implementation is currently hampered by a lack of understanding of the factors that may cause failure. We investigated factors influencing the probability of success of AI for 14 giant panda females housed at the China Center for Research and Conservation of the Giant Panda (CCRCGP) inseminated in a total of 20 instances using cryopreserved spermatozoa from 11 males currently residing in 6 different captive breeding institutions. One of the pandas was the oldest giant panda female to ever successfully conceive from AI (20.5 years old). The success of AI was significantly affected by the timing of AI in relationship to both timing of peak urinary estrogen of the female and percent decline in urinary estrogen between the peak level and the first AI attempt. Our results suggest that the window for successful AI in giant pandas may be narrower than previously suspected, although individual differences in rates of decline in urinary estrogen may reflect some degree of variation in this crucial window across females. Our results are consistent with recent research on pandas and other species that demonstrates the efficacy of cryopreserved spermatozoa for AI and highlights the need for more in-depth analysis of factors related to female physiology that may influence its success. © 2011 Wiley Periodicals, Inc.

  13. A holistic approach to factors affecting depression in haemodialysis patients.

    PubMed

    Gerogianni, Georgia; Kouzoupis, Anastasios; Grapsa, Eirini

    2018-05-19

    Depression in dialysis populations is affected by co-morbid diseases, such as cardiovascular disease, diabetes, and immune dysfunction, and it also includes high suicide risk and frequent hospitalizations. Depressive disorders have a close association with malnutrition and chronic inflammation, as well as with cognitive impairment. Impaired cognitive function may be manifested as low adherence to dialysis treatment, leading to malnutrition. Additionally, chronic pain and low quality of sleep lead to high rates of depressive symptoms in haemodialysis patients, while an untreated depression can cause sleep disturbances and increased mortality risk. Depression can also lead to sexual dysfunction and non-adherence, while unemployment can cause depressive disorders, due to patients' feelings of being a financial burden on their family. The present review provides a holistic approach to the factors affecting depression in haemodialysis, offering significant knowledge to renal professionals.

  14. Factors Affecting Accent Acquisition: The Case of Russian Immigrants in Israel

    ERIC Educational Resources Information Center

    Abu-Rabia, Salim; Iliyan, Salman

    2011-01-01

    A debate centers on whether the native accent is acquired early in life or whether it can be acquired at any time. This study investigated factors that may affect native accent acquisition in a second language. Participants in this study were 50 Russians who immigrated to Israel, 17 males and 33 females. Their age on arrival was 5 to 25 years.…

  15. Factors Affecting the Identification of Hispanic English Language Learners in Special Education

    ERIC Educational Resources Information Center

    Becker, Gail I.

    2012-01-01

    This qualitative phenomenological study revealed factors affecting the overrepresentation of Hispanic English language learners (ELLs) in special education. An analysis of the lived experiences of school professionals indicate multiple causes that determine students to be disabled often in violation of state and federal guidelines. Child study…

  16. Factors affecting recovery from work-related, low back disorders in autoworkers.

    PubMed

    Oleske, Denise M; Neelakantan, Janani; Andersson, Gunnar B; Hinrichs, Bradley G; Lavender, Steven A; Morrissey, Mary J; Zold-Kilbourn, Phyllis; Taylor, Emily

    2004-08-01

    To simultaneously evaluate personal, medical, and job factors that could affect recovery from work-related, low back disorders, specifically focusing on an active working sample. Observational, longitudinal study. Two US automotive plants. Employees (N=352; 289 men, 63 women; mean age +/- standard deviation, 45.1+/-7.5 y) who were active hourly autoworkers, diagnosed with work-related, low back disorder by the plant's medical department. Not applicable. Oswestry Disability Questionnaire for back pain was used to evaluate recovery. Factors associated with better recovery were lower stress levels (P<.001) and exercise or physical activity outside work (P<.001); factors associated with higher disability levels over time were current cigarette smoking (P<.01) and bedrest (P<.001). Personal modifiable factors are major influences in the recovery from work-related, low back disorders, even in active working populations. Interventions aimed at increasing exercise and decreasing stress should also be considered as a part of rehabilitation in employed persons with low levels of disability.

  17. Factors affecting access to healthcare services by intermarried Filipino women in rural Tasmania: a qualitative study.

    PubMed

    Hannah, Chona T; Lê, Quynh

    2012-10-01

    Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.

  18. Multiple Weather Factors Affect Apparent Survival of European Passerine Birds

    PubMed Central

    Salewski, Volker; Hochachka, Wesley M.; Fiedler, Wolfgang

    2013-01-01

    Weather affects the demography of animals and thus climate change will cause local changes in demographic rates. In birds numerous studies have correlated demographic factors with weather but few of those examined variation in the impacts of weather in different seasons and, in the case of migrants, in different regions. Using capture-recapture models we correlated weather with apparent survival of seven passerine bird species with different migration strategies to assess the importance of selected facets of weather throughout the year on apparent survival. Contrary to our expectations weather experienced during the breeding season did not affect apparent survival of the target species. However, measures for winter severity were associated with apparent survival of a resident species, two short-distance/partial migrants and a long-distance migrant. Apparent survival of two short distance migrants as well as two long-distance migrants was further correlated with conditions experienced during the non-breeding season in Spain. Conditions in Africa had statistically significant but relatively minor effects on the apparent survival of the two long-distance migrants but also of a presumably short-distance migrant and a short-distance/partial migrant. In general several weather effects independently explained similar amounts of variation in apparent survival for the majority of species and single factors explained only relatively low amounts of temporal variation of apparent survival. Although the directions of the effects on apparent survival mostly met our expectations and there are clear predictions for effects of future climate we caution against simple extrapolations of present conditions to predict future population dynamics. Not only did weather explains limited amounts of variation in apparent survival, but future demographics will likely be affected by changing interspecific interactions, opposing effects of weather in different seasons, and the potential for

  19. Factors Affecting Patient Satisfaction with Community Health Service under the Gatekeeper System: A Cross-sectional Study in Nanjing, China.

    PubMed

    Li, Wen Zhen; Gan, Yong; Zhou, Yan Feng; Chen, Ya Wen; Li, Jing; Kkandawire, Naomiem; Hu, Sai; Qiao, Yan; Lu, Zu Xun

    2017-09-01

    The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service (CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor-patient relationships, information and support, organization of care, and accessibility (P < 0.001). One or more factors such as gender and self-perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  20. Factors Affecting the Inclusion Potency for Acicular Ferrite Nucleation in High-Strength Steel Welds

    NASA Astrophysics Data System (ADS)

    Kang, Yongjoon; Jeong, Seonghoon; Kang, Joo-Hee; Lee, Changhee

    2016-06-01

    Factors affecting the inclusion potency for acicular ferrite nucleation in high-strength weld metals were investigated and the contribution of each factor was qualitatively evaluated. Two kinds of weld metals with different hardenabilities were prepared, in both, MnTi2O4-rich spinel formed as the predominant inclusion phase. To evaluate the factors determining the inclusion potency, the inclusion characteristics of size, phase distribution in the multiphase inclusion, orientation relationship with ferrite, and Mn distribution near the inclusion were analyzed. Three factors affecting the ferrite nucleation potency of inclusions were evaluated: the Baker-Nutting (B-N) orientation relationship between ferrite and the inclusion; the formation of an Mn-depleted zone (MDZ) near the inclusion; and the strain energy around the inclusion. Among these, the first two factors were found to be the most important. In addition, it was concluded that the increased chemical driving force brought about by the formation of an MDZ contributed more to the formation of acicular ferrite in higher-strength weld metals, because the B-N orientation relationship between ferrite and the inclusion was less likely to form as the transformation temperature decreased.