A stakeholder co-design approach for developing a community pharmacy service to enhance screening and management of atrial fibrillation.

PubMed

Sabater-Hernández, Daniel; Tudball, Jacqueline; Ferguson, Caleb; Franco-Trigo, Lucía; Hossain, Lutfun N; Benrimoj, Shalom I

2018-02-27

Community pharmacies provide a suitable setting to promote self-screening programs aimed at enhancing the early detection of atrial fibrillation (AF). Developing and implementing novel community pharmacy services (CPSs) is a complex and acknowledged challenge, which requires comprehensive planning and the participation of relevant stakeholders. Co-design processes are participatory research approaches that can enhance the development, evaluation and implementation of health services. The aim of this study was to co-design a pharmacist-led CPS aimed at enhancing self-monitoring/screening of AF. A 3-step co-design process was conducted using qualitative methods: (1) interviews and focus group with potential service users (n = 8) to identify key needs and concerns; (2) focus group with a mixed group of stakeholders (n = 8) to generate a preliminary model of the service; and (3) focus group with community pharmacy owners and managers (n = 4) to explore the feasibility and appropriateness of the model. Data were analysed qualitatively to identify themes and intersections between themes. The JeMa2 model to conceptualize pharmacy-based health programs was used to build a theoretical model of the service. Stakeholders delineated: a clear target population (i.e., individuals ≥65 years old, with hypertension, with or without previous AF or stroke); the components of the service (i.e., patient education; self-monitoring at home; results evaluation, referral and follow-up); and a set of circumstances that may influence the implementation of the service (e.g., quality of the service, competency of the pharmacist, inter-professional relationships, etc.). A number of strategies were recommended to enable implementation (e.g.,. endorsement by leading cardiovascular organizations, appropriate communication methods and channels between the pharmacy and the general medical practice settings, etc.). A novel and preliminary model of a CPS aimed at enhancing the management of AF was generated from this participatory process. This model can be used to inform decision making processes aimed at adopting and piloting of the service. It is expected the co-designed service has been adapted to suit existing needs of patients and current care practices, which, in turn, may increase the feasibility and acceptance of the service when it is implemented into a real setting.

Implementation of Quality Management in Core Service Laboratories

PubMed Central

Creavalle, T.; Haque, K.; Raley, C.; Subleski, M.; Smith, M.W.; Hicks, B.

2010-01-01

CF-28 The Genetics and Genomics group of the Advanced Technology Program of SAIC-Frederick exists to bring innovative genomic expertise, tools and analysis to NCI and the scientific community. The Sequencing Facility (SF) provides next generation short read (Illumina) sequencing capacity to investigators using a streamlined production approach. The Laboratory of Molecular Technology (LMT) offers a wide range of genomics core services including microarray expression analysis, miRNA analysis, array comparative genome hybridization, long read (Roche) next generation sequencing, quantitative real time PCR, transgenic genotyping, Sanger sequencing, and clinical mutation detection services to investigators from across the NIH. As the technology supporting this genomic research becomes more complex, the need for basic quality processes within all aspects of the core service groups becomes critical. The Quality Management group works alongside members of these labs to establish or improve processes supporting operations control (equipment, reagent and materials management), process improvement (reengineering/optimization, automation, acceptance criteria for new technologies and tech transfer), and quality assurance and customer support (controlled documentation/SOPs, training, service deficiencies and continual improvement efforts). Implementation and expansion of quality programs within unregulated environments demonstrates SAIC-Frederick's dedication to providing the highest quality products and services to the NIH community.

The Impact of Large, Multi-Function/Multi-Site Competitions

DTIC Science & Technology

2003-08-01

this approach generates larger savings and improved service quality , and is less expensive to implement. Moreover, it is a way to meet the President s...of the study is to assess the degree to which large-scale competitions completed have resulted in increased savings and service quality and decreased

Next Generation Enterprise Network: Navy Implementing Revised Approach, but Improvement Needed in Mitigating Risks

DTIC Science & Technology

2012-09-01

Hewlett Packard Enterprise Services) that ended in September 2010.2 To bridge the time between the end of the NMCI contract and the full transition to...some leasehold improvements; and moveable infrastructure associated with local network operations. Award contract for transport services and

Developments in early intervention for psychosis in Hong Kong.

PubMed

Wong, G H Y; Hui, C L M; Wong, D Y; Tang, J Y M; Chang, W C; Chan, S K W; Lee, E H M; Xu, J Q; Lin, J J X; Lai, D C; Tam, W; Kok, J; Chung, D W S; Hung, S F; Chen, E Y H

2012-09-01

The year 2011 marked the 10-year milestone of early intervention for psychosis in Hong Kong. Since 2001, the landscape of early psychosis services has changed markedly in Hong Kong. Substantial progress has been made in the areas of early intervention service implementation, knowledge generation, and public awareness promotion. Favourable outcomes attributable to the early intervention service are supported by solid evidence from local clinical research studies; early intervention service users showed improved functioning, ameliorated symptoms, and decreased hospitalisation and suicide rates. Continued development of early intervention in Hong Kong over the decade includes the introduction and maturation of several key platforms, such as the Hospital Authority Early Assessment Service for Young People with Psychosis programme, the Psychosis Studies and Intervention Unit by the University of Hong Kong, the Hong Kong Early Psychosis Intervention Society, the Jockey Club Early Psychosis Project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. In this paper, we reviewed some of the major milestones in local service development with reference to features of the Hong Kong mental health system. We describe chronologically the implementation and consolidation of public early intervention services as well as recent progresses in public awareness work that are tied in with knowledge generation and transfer, and outline the prospects for early intervention in the next decade and those that follow.

A mobile network-based multimedia teleconference system for homecare services.

PubMed

Zhang, Zhaomin; He, Aiguo; Wei, Daming

2008-03-01

Because most research and development for homecare services have focused on providing connections between home and service centers, the goal of the present work is to develop techniques and create realtime communications to connect service centers and homecare workers in mobile environments. A key technical issue for this research is how to overcome the limitation of bandwidth in mobile media and networks. An effort has been made to balance performance of communication and basic demands in telehealth through optimized system design and technical implementation. Implementations using third generation (3G) Freedom Of Mobile multimedia Access (FOMA) and Personal Handyphone System (PHS) were developed and evaluated. We conclude that the system we developed based on 3G FOMA provides sufficient and satisfactory functions for use in homecare services.

Incorporating Servqual-QFD with Taguchi Design for optimizing service quality design

NASA Astrophysics Data System (ADS)

Arbi Hadiyat, M.

2018-03-01

Deploying good service design in service companies has been updated issue in improving customer satisfaction, especially based on the level of service quality measured by Parasuraman’s SERVQUAL. Many researchers have been proposing methods in designing the service, and some of them are based on engineering viewpoint, especially by implementing the QFD method or even using robust Taguchi method. The QFD method would found the qualitative solution by generating the “how’s”, while Taguchi method gives more quantitative calculation in optimizing best solution. However, incorporating both QFD and Taguchi has been done in this paper and yields better design process. The purposes of this research is to evaluate the incorporated methods by implemented it to a case study, then analyze the result and see the robustness of those methods to customer perception of service quality. Started by measuring service attributes using SERVQUAL and find the improvement with QFD, the deployment of QFD solution then generated by defining Taguchi factors levels and calculating the Signal-to-noise ratio in its orthogonal array, and optimized Taguchi response then found. A case study was given for designing service in local bank. Afterward, the service design obtained from previous analysis was then evaluated and shows that it was still meet the customer satisfaction. Incorporating QFD and Taguchi has performed well and can be adopted and developed for another research for evaluating the robustness of result.

Federal Aviation Administration weather program to improve aviation safety

NASA Technical Reports Server (NTRS)

Wedan, R. W.

1983-01-01

The implementation of the National Airspace System (NAS) will improve safety services to aviation. These services include collision avoidance, improved landing systems and better weather data acquisition and dissemination. The program to improve the quality of weather information includes the following: Radar Remote Weather Display System; Flight Service Automation System; Automatic Weather Observation System; Center Weather Processor, and Next Generation Weather Radar Development.

Comparison of waste composition in a continuing-care retirement community.

PubMed

Kim, T; Shanklin, C W; Su, A Y; Hackes, B L; Ferris, D

1997-04-01

To determine the composition of wastes generated in a continuing-care retirement community (CCRC) and to analyze the effects of source-reduction activities and meal delivery system change on the amount of waste generated in the facility. A waste stream analysis was conducted at the same CCRC during spring 1994 (period 1: baseline), spring 1995 (period 2: source reduction intervention), and fall 1995 (period 3: service delivery intervention). Weight, volume, and collapsed volume were determined for food and packaging wastes. Tray service and wait staff service are provided to 70 residents in a health care unit, and family-style service is an optional service available to 130 residents in the independent-living units. A mean of 229 meals are served per day. Intervention included the implementation of source-reduction activities and a change in a service-delivery system in periods 2 and 3, respectively. Descriptive statistics were used to determine the composition of waste. Analysis of variance and a multiple comparison method (least significant difference) were used to compare mean weight and volume of waste generated in period 1 with data collected during periods 2 and 3. Mean waste generated per meal by weight and volume ranged from 0.93 to 1.00 lb and 1.44 to 1.65 gal, respectively. Significantly less production waste by weight (0.18 lb/meal) and volume (0.12 gal/meal) was generated in period 2 than in period 1 (0.32 lb/meal and 0.16 gal/meal, respectively). Significantly less service waste by weight (0.31 lb/meal) and volume (0.05 gal/meal) was discarded in period 3 than in period 1 (0.37 lb/meal and 0.15 gal/meal, respectively). Significantly less total waste and plastic by weight was disposed of after the interventions. The study conclusions indicated that implementing source-reduction practices and changing the meal-delivery system affected the composition of waste generated. Knowledge of waste stream composition can help other foodservice professionals and consulting dietitians identify waste-reduction activities and recycling opportunities. The quantity and type of waste generated should be considered when operational decisions are made relative to market form of food, menu choices, service-delivery systems, and production forecast and controls.

STEM Images Revealing STEM Conceptions of Pre-Service Chemistry and Mathematics Teachers

ERIC Educational Resources Information Center

Akaygun, Sevil; Aslan-Tutak, Fatma

2016-01-01

Science, technology, engineering, and mathematics (STEM) education has been an integral part of many countries' educational policies. In last decade, various practices have been implemented to make STEM areas valuable for 21st century generation. These actions require reconsideration of both pre- and in-service teacher education because those who…

The New Hampshire retail competition pilot program and the role of green marketing

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

Holt, E.A.; Fang, J.M.

1997-11-01

Most states in the US are involved in electric industry restructuring, from considering the pros and cons in regulatory dockets to implementing legislative mandates for full restructuring and retail access for all consumers. Several states and utilities have initiated pilot programs in which multiple suppliers or service providers may compete for business and some utility customers can choose among competing suppliers. The State of New Hampshire has been experimenting with a pilot program, mandated by the State Legislature in 1995 and implemented by the New Hampshire Public Utilities Commission (NHPUC), before it implements full retail access. Green marketing, an attemptmore » to characterize the supplier or service provider as environmentally friendly without referring to the energy resource used to generate electricity, was used by several suppliers or service providers to attract customers. This appeal to environmental consumerism was moderately successful, but it raised a number of consumer protection and public policy issues. This issue brief examines the marketing methods used in New Hampshire and explores what green marketing might mean for the development of renewable energy generation. It also addresses the issues raised and their implications.« less

PUS Services Software Building Block Automatic Generation for Space Missions

NASA Astrophysics Data System (ADS)

Candia, S.; Sgaramella, F.; Mele, G.

2008-08-01

The Packet Utilization Standard (PUS) has been specified by the European Committee for Space Standardization (ECSS) and issued as ECSS-E-70-41A to define the application-level interface between Ground Segments and Space Segments. The ECSS-E- 70-41A complements the ECSS-E-50 and the Consultative Committee for Space Data Systems (CCSDS) recommendations for packet telemetry and telecommand. The ECSS-E-70-41A characterizes the identified PUS Services from a functional point of view and the ECSS-E-70-31 standard specifies the rules for their mission-specific tailoring. The current on-board software design for a space mission implies the production of several PUS terminals, each providing a specific tailoring of the PUS services. The associated on-board software building blocks are developed independently, leading to very different design choices and implementations even when the mission tailoring requires very similar services (from the Ground operative perspective). In this scenario, the automatic production of the PUS services building blocks for a mission would be a way to optimize the overall mission economy and improve the robusteness and reliability of the on-board software and of the Ground-Space interactions. This paper presents the Space Software Italia (SSI) activities for the development of an integrated environment to support: the PUS services tailoring activity for a specific mission. the mission-specific PUS services configuration. the generation the UML model of the software building block implementing the mission-specific PUS services and the related source code, support documentation (software requirements, software architecture, test plans/procedures, operational manuals), and the TM/TC database. The paper deals with: (a) the project objectives, (b) the tailoring, configuration, and generation process, (c) the description of the environments supporting the process phases, (d) the characterization of the meta-model used for the generation, (e) the characterization of the reference avionics architecture and of the reference on- board software high-level architecture.

Employing online quantum random number generators for generating truly random quantum states in Mathematica

NASA Astrophysics Data System (ADS)

Miszczak, Jarosław Adam

2013-01-01

The presented package for the Mathematica computing system allows the harnessing of quantum random number generators (QRNG) for investigating the statistical properties of quantum states. The described package implements a number of functions for generating random states. The new version of the package adds the ability to use the on-line quantum random number generator service and implements new functions for retrieving lists of random numbers. Thanks to the introduced improvements, the new version provides faster access to high-quality sources of random numbers and can be used in simulations requiring large amount of random data. New version program summaryProgram title: TRQS Catalogue identifier: AEKA_v2_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEKA_v2_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 18 134 No. of bytes in distributed program, including test data, etc.: 2 520 49 Distribution format: tar.gz Programming language: Mathematica, C. Computer: Any supporting Mathematica in version 7 or higher. Operating system: Any platform supporting Mathematica; tested with GNU/Linux (32 and 64 bit). RAM: Case-dependent Supplementary material: Fig. 1 mentioned below can be downloaded. Classification: 4.15. External routines: Quantis software library (http://www.idquantique.com/support/quantis-trng.html) Catalogue identifier of previous version: AEKA_v1_0 Journal reference of previous version: Comput. Phys. Comm. 183(2012)118 Does the new version supersede the previous version?: Yes Nature of problem: Generation of random density matrices and utilization of high-quality random numbers for the purpose of computer simulation. Solution method: Use of a physical quantum random number generator and an on-line service providing access to the source of true random numbers generated by quantum real number generator. Reasons for new version: Added support for the high-speed on-line quantum random number generator and improved methods for retrieving lists of random numbers. Summary of revisions: The presented version provides two signicant improvements. The first one is the ability to use the on-line Quantum Random Number Generation service developed by PicoQuant GmbH and the Nano-Optics groups at the Department of Physics of Humboldt University. The on-line service supported in the version 2.0 of the TRQS package provides faster access to true randomness sources constructed using the laws of quantum physics. The service is freely available at https://qrng.physik.hu-berlin.de/. The use of this service allows using the presented package with the need of a physical quantum random number generator. The second improvement introduced in this version is the ability to retrieve arrays of random data directly for the used source. This increases the speed of the random number generation, especially in the case of an on-line service, where it reduces the time necessary to establish the connection. Thanks to the speed improvement of the presented version, the package can now be used in simulations requiring larger amounts of random data. Moreover, the functions for generating random numbers provided by the current version of the package more closely follow the pattern of functions for generating pseudo- random numbers provided in Mathematica. Additional comments: Speed comparison: The implementation of the support for the QRNG on-line service provides a noticeable improvement in the speed of random number generation. For the samples of real numbers of size 101; 102,…,107 the times required to generate these samples using Quantis USB device and QRNG service are compared in Fig. 1. The presented results show that the use of the on-line service provides faster access to random numbers. One should note, however, that the speed gain can increase or decrease depending on the connection speed between the computer and the server providing random numbers. Running time: Depends on the used source of randomness and the amount of random data used in the experiment. References: [1] M. Wahl, M. Leifgen, M. Berlin, T. Röhlicke, H.-J. Rahn, O. Benson., An ultrafast quantum random number generator with provably bounded output bias based on photon arrival time measurements, Applied Physics Letters, Vol. 098, 171105 (2011). http://dx.doi.org/10.1063/1.3578456.

Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia).

PubMed

Beauchamp, Alison; Batterham, Roy W; Dodson, Sarity; Astbury, Brad; Elsworth, Gerald R; McPhee, Crystal; Jacobson, Jeanine; Buchbinder, Rachelle; Osborne, Richard H

2017-03-03

The need for healthcare strengthening to enhance equity is critical, requiring systematic approaches that focus on those experiencing lesser access and outcomes. This project developed and tested the Ophelia (OPtimising HEalth LIteracy and Access) approach for co-design of interventions to improve health literacy and equity of access. Eight principles guided this development: Outcomes focused; Equity driven, Needs diagnosis, Co-design, Driven by local wisdom, Sustainable, Responsive and Systematically applied. We report the application of the Ophelia process where proof-of-concept was defined as successful application of the principles. Nine sites were briefed on the aims of the project around health literacy, co-design and quality improvement. The sites were rural/metropolitan, small/large hospitals, community health centres or municipalities. Each site identified their own priorities for improvement; collected health literacy data using the Health Literacy Questionnaire (HLQ) within the identified priority groups; engaged staff in co-design workshops to generate ideas for improvement; developed program-logic models; and implemented their projects using Plan-Do-Study-Act (PDSA) cycles. Evaluation included assessment of impacts on organisations, practitioners and service users, and whether the principles were applied. Sites undertook co-design workshops involving discussion of service user needs informed by HLQ (n = 813) and interview data. Sites generated between 21 and 78 intervention ideas and then planned their selected interventions through program-logic models. Sites successfully implemented interventions and refined them progressively with PDSA cycles. Interventions generally involved one of four pathways: development of clinician skills and resources for health literacy, engagement of community volunteers to disseminate health promotion messages, direct impact on consumers' health literacy, and redesign of existing services. Evidence of application of the principles was found in all sites. The Ophelia approach guided identification of health literacy issues at each participating site and the development and implementation of locally appropriate solutions. The eight principles provided a framework that allowed flexible application of the Ophelia approach and generation of a diverse set of interventions. Changes were observed at organisational, staff, and community member levels. The Ophelia approach can be used to generate health service improvements that enhance health outcomes and address inequity of access to healthcare.

Estimating the Cost of Providing Foundational Public Health Services.

PubMed

Mamaril, Cezar Brian C; Mays, Glen P; Branham, Douglas Keith; Bekemeier, Betty; Marlowe, Justin; Timsina, Lava

2017-12-28

To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. © Health Research and Educational Trust.

Satellite communications for the next generation telecommunication services and networks

NASA Technical Reports Server (NTRS)

Chitre, D. M.

1991-01-01

Satellite communications can play an important role in provisioning the next-generation telecommunication services and networks, provided the protocols specifying these services and networks are satellite-compatible and the satellite subnetworks, consisting of earth stations interconnected by the processor and the switch on board the satellite, interwork effectively with the terrestrial networks. The specific parameters and procedures of frame relay and broadband integrated services digital network (B-ISDN) protocols which are impacted by a satellite delay. Congestion and resource management functions for frame relay and B-ISDN are discussed in detail, describing the division of these functions between earth stations and on board the satellite. Specific onboard and ground functions are identified as potential candidates for their implementation via neural network technology.

AdaFF: Adaptive Failure-Handling Framework for Composite Web Services

NASA Astrophysics Data System (ADS)

Kim, Yuna; Lee, Wan Yeon; Kim, Kyong Hoon; Kim, Jong

In this paper, we propose a novel Web service composition framework which dynamically accommodates various failure recovery requirements. In the proposed framework called Adaptive Failure-handling Framework (AdaFF), failure-handling submodules are prepared during the design of a composite service, and some of them are systematically selected and automatically combined with the composite Web service at service instantiation in accordance with the requirement of individual users. In contrast, existing frameworks cannot adapt the failure-handling behaviors to user's requirements. AdaFF rapidly delivers a composite service supporting the requirement-matched failure handling without manual development, and contributes to a flexible composite Web service design in that service architects never care about failure handling or variable requirements of users. For proof of concept, we implement a prototype system of the AdaFF, which automatically generates a composite service instance with Web Services Business Process Execution Language (WS-BPEL) according to the users' requirement specified in XML format and executes the generated instance on the ActiveBPEL engine.

Measuring Science Instructional Practice: A Survey Tool for the Age of NGSS

ERIC Educational Resources Information Center

Hayes, Kathryn N.; Lee, Christine S.; DiStefano, Rachelle; O'Connor, Dawn; Seitz, Jeffery C.

2016-01-01

Ambitious efforts are taking place to implement a new vision for science education in the United States, in both Next Generation Science Standards (NGSS)-adopted states and those states creating their own, often related, standards. In-service and pre-service teacher educators are involved in supporting teacher shifts in practice toward the new…

VHA mental health information system: applying health information technology to monitor and facilitate implementation of VHA Uniform Mental Health Services Handbook requirements.

PubMed

Trafton, Jodie A; Greenberg, Greg; Harris, Alex H S; Tavakoli, Sara; Kearney, Lisa; McCarthy, John; Blow, Fredric; Hoff, Rani; Schohn, Mary

2013-03-01

To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facilitation-based quality improvement programs led by the VHA Mental Health Operations. To support these programs, tailored site-specific reports were generated. Metric development required close collaboration between program evaluators, policy makers and clinical leadership, and consideration of policy language and intent. Electronic reports supporting different purposes required distinct formatting and presentation features, despite their having similar general goals and using the same metrics. Health information technology can facilitate mental health policy implementation but must be integrated into a process of consensus building and close collaboration with policy makers, evaluators, and practitioners.

Use of a remote clinical decision support service for a multicenter trial to implement prediction rules for children with minor blunt head trauma.

PubMed

Goldberg, Howard S; Paterno, Marilyn D; Grundmeier, Robert W; Rocha, Beatriz H; Hoffman, Jeffrey M; Tham, Eric; Swietlik, Marguerite; Schaeffer, Molly H; Pabbathi, Deepika; Deakyne, Sara J; Kuppermann, Nathan; Dayan, Peter S

2016-03-01

To evaluate the architecture, integration requirements, and execution characteristics of a remote clinical decision support (CDS) service used in a multicenter clinical trial. The trial tested the efficacy of implementing brain injury prediction rules for children with minor blunt head trauma. We integrated the Epic(®) electronic health record (EHR) with the Enterprise Clinical Rules Service (ECRS), a web-based CDS service, at two emergency departments. Patterns of CDS review included either a delayed, near-real-time review, where the physician viewed CDS recommendations generated by the nursing assessment, or a real-time review, where the physician viewed recommendations generated by their own documentation. A backstopping, vendor-based CDS triggered with zero delay when no recommendation was available in the EHR from the web-service. We assessed the execution characteristics of the integrated system and the source of the generated recommendations viewed by physicians. The ECRS mean execution time was 0.74 ±0.72 s. Overall execution time was substantially different at the two sites, with mean total transaction times of 19.67 and 3.99 s. Of 1930 analyzed transactions from the two sites, 60% (310/521) of all physician documentation-initiated recommendations and 99% (1390/1409) of all nurse documentation-initiated recommendations originated from the remote web service. The remote CDS system was the source of recommendations in more than half of the real-time cases and virtually all the near-real-time cases. Comparisons are limited by allowable variation in user workflow and resolution of the EHR clock. With maturation and adoption of standards for CDS services, remote CDS shows promise to decrease time-to-trial for multicenter evaluations of candidate decision support interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Global Framework for Climate Services (GFCS): status of implementation

NASA Astrophysics Data System (ADS)

Lucio, Filipe

2014-05-01

The GFCS is a global partnership of governments and UN and international agencies that produce and use climate information and services. WMO, which is leading the initiative in collaboration with UN ISDR, WHO, WFP, FAO, UNESCO, UNDP and other UN and international partners are pooling their expertise and resources in order to co-design and co-produce knowledge, information and services to support effective decision making in response to climate variability and change in four priority areas (agriculture and fod security, water, health and disaster risk reduction). To address the entire value chain for the effective production and application of climate services the GFCS main components or pillars are being implemented, namely: • User Interface Platform — to provide ways for climate service users and providers to interact to identify needs and capacities and improve the effectiveness of the Framework and its climate services; • Climate Services Information System — to produce and distribute climate data, products and information according to the needs of users and to agreed standards; • Observations and Monitoring - to generate the necessary data for climate services according to agreed standards; • Research, Modelling and Prediction — to harness science capabilities and results and develop appropriate tools to meet the needs of climate services; • Capacity Building — to support the systematic development of the institutions, infrastructure and human resources needed for effective climate services. Activities are being implemented in various countries in Africa, the Caribbean and South pacific Islands. This paper will provide details on the status of implementation of the GFCS worldwider.

Monitoring of the infrastructure and services used to handle and automatically produce Alignment and Calibration conditions at CMS

NASA Astrophysics Data System (ADS)

Sipos, Roland; Govi, Giacomo; Franzoni, Giovanni; Di Guida, Salvatore; Pfeiffer, Andreas

2017-10-01

The CMS experiment at CERN LHC has a dedicated infrastructure to handle the alignment and calibration data. This infrastructure is composed of several services, which take on various data management tasks required for the consumption of the non-event data (also called as condition data) in the experiment activities. The criticality of these tasks imposes tights requirements for the availability and the reliability of the services executing them. In this scope, a comprehensive monitoring and alarm generating system has been developed. The system has been implemented based on the Nagios open source industry standard for monitoring and alerting services, and monitors the database back-end, the hosting nodes and key heart-beat functionalities for all the services involved. This paper describes the design, implementation and operational experience with the monitoring system developed and deployed at CMS in 2016.

Technology Review of Multi-Agent Systems and Tools

DTIC Science & Technology

2005-06-01

over a network, including the Internet. A web services architecture is the logical evolution of object-oriented analysis and design coupled with...the logical evolution of components geared towards the architecture, design, implementation, and deployment of e-business solutions. As in object...querying. The Web Services architecture describes the principles behind the next generation of e- business architectures, presenting a logical evolution

Implementation of Policies and Strategies for Control of Noncommunicable Diseases in Malawi: Challenges and Opportunities.

PubMed

Lupafya, Phindile Chitsulo; Mwagomba, Beatrice L Matanje; Hosig, Kathy; Maseko, Lucy M; Chimbali, Henry

2016-04-01

Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control Program was established with subsequent development of a National Action Plan for prevention and management of NCDs launched in 2013. The current study was designed to identify gaps in implementation of NCD control program policies and action plan strategies by describing current efforts toward prevention and management of NCDs in Malawi with emphasis on challenges and opportunities. Semistructured questionnaires were used to collect quantitative and qualitative data from Malawi Ministry of Health personnel (senior officers, service providers, health education officers, and nutritionists) in 10 health districts and 3 central hospitals. Frequencies were generated for quantitative data. Qualitative data were used to generate themes and most common responses. Results showed that current services focus on facility-based NCD screening and clinical services rather than active screening, prevention, and community awareness and outreach, although respondents emphasized the importance of prevention, lifestyle education, and community outreach. Respondents indicated inadequate resources for NCD services including financial capital, human resources, equipment and supplies, and transportation. While Malawi has begun to address NCDs, policy and practice implications include (a) better integration of services within the existing infrastructure with emphasis on capacity building; (b) greater implementation of planned NCD activities; (c) a stronger, more comprehensive data management system; and (d) innovative funding solutions. © 2015 Society for Public Health Education.

Australia's personally controlled electronic health record and primary healthcare: generating a framework for implementation and evaluation.

PubMed

Almond, H; Cummings, E; Turner, P

2013-01-01

The Australian Government launched a personally controlled electronic health record (PCEHR) system in July 2012 committing $466.7m. Currently Australia lacks a clearly articulated implementation and evaluation framework and there remains limited detail on how this system's success will be determined. These problems are especially visible in primary healthcare. The UK and US, have been advocated as models, however they have started to report points of failure arising from their approaches. Evidence suggests that alternatives need to be considered, if mistakes are not to be replicated. Insights from e-health record implementation and evaluation approaches in Denmark and the Netherlands provide Australia with other approaches. The PCEHR requires different and radical thinking around the delivery of health services. Drawing on a range of English language articles identified between 1996 and 2012, the paper generates a conceptual framework for implementation and evaluation of the PCEHR. The generation of a grounded implementation and evaluation framework in primary healthcare will reduce provider scepticism and facilitate complex changes associated with PCEHR uptake.

REMORA: a pilot in the ocean of BioMoby web-services.

PubMed

Carrere, Sébastien; Gouzy, Jérôme

2006-04-01

Emerging web-services technology allows interoperability between multiple distributed architectures. Here, we present REMORA, a web server implemented according to the BioMoby web-service specifications, providing life science researchers with an easy-to-use workflow generator and launcher, a repository of predefined workflows and a survey system. Jerome.Gouzy@toulouse.inra.fr The REMORA web server is freely available at http://bioinfo.genopole-toulouse.prd.fr/remora, sources are available upon request from the authors.

Auto-Generated Semantic Processing Services

NASA Technical Reports Server (NTRS)

Davis, Rodney; Hupf, Greg

2009-01-01

Auto-Generated Semantic Processing (AGSP) Services is a suite of software tools for automated generation of other computer programs, denoted cross-platform semantic adapters, that support interoperability of computer-based communication systems that utilize a variety of both new and legacy communication software running in a variety of operating- system/computer-hardware combinations. AGSP has numerous potential uses in military, space-exploration, and other government applications as well as in commercial telecommunications. The cross-platform semantic adapters take advantage of common features of computer- based communication systems to enforce semantics, messaging protocols, and standards of processing of streams of binary data to ensure integrity of data and consistency of meaning among interoperating systems. The auto-generation aspect of AGSP Services reduces development time and effort by emphasizing specification and minimizing implementation: In effect, the design, building, and debugging of software for effecting conversions among complex communication protocols, custom device mappings, and unique data-manipulation algorithms is replaced with metadata specifications that map to an abstract platform-independent communications model. AGSP Services is modular and has been shown to be easily integrable into new and legacy NASA flight and ground communication systems.

Integration of next-generation sequencing in clinical diagnostic molecular pathology laboratories for analysis of solid tumours; an expert opinion on behalf of IQN Path ASBL.

PubMed

Deans, Zandra C; Costa, Jose Luis; Cree, Ian; Dequeker, Els; Edsjö, Anders; Henderson, Shirley; Hummel, Michael; Ligtenberg, Marjolijn Jl; Loddo, Marco; Machado, Jose Carlos; Marchetti, Antonio; Marquis, Katherine; Mason, Joanne; Normanno, Nicola; Rouleau, Etienne; Schuuring, Ed; Snelson, Keeda-Marie; Thunnissen, Erik; Tops, Bastiaan; Williams, Gareth; van Krieken, Han; Hall, Jacqueline A

2017-01-01

The clinical demand for mutation detection within multiple genes from a single tumour sample requires molecular diagnostic laboratories to develop rapid, high-throughput, highly sensitive, accurate and parallel testing within tight budget constraints. To meet this demand, many laboratories employ next-generation sequencing (NGS) based on small amplicons. Building on existing publications and general guidance for the clinical use of NGS and learnings from germline testing, the following guidelines establish consensus standards for somatic diagnostic testing, specifically for identifying and reporting mutations in solid tumours. These guidelines cover the testing strategy, implementation of testing within clinical service, sample requirements, data analysis and reporting of results. In conjunction with appropriate staff training and international standards for laboratory testing, these consensus standards for the use of NGS in molecular pathology of solid tumours will assist laboratories in implementing NGS in clinical services.

The Particle Physics Data Grid. Final Report

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

Livny, Miron

2002-08-16

The main objective of the Particle Physics Data Grid (PPDG) project has been to implement and evaluate distributed (Grid-enabled) data access and management technology for current and future particle and nuclear physics experiments. The specific goals of PPDG have been to design, implement, and deploy a Grid-based software infrastructure capable of supporting the data generation, processing and analysis needs common to the physics experiments represented by the participants, and to adapt experiment-specific software to operate in the Grid environment and to exploit this infrastructure. To accomplish these goals, the PPDG focused on the implementation and deployment of several critical services:more » reliable and efficient file replication service, high-speed data transfer services, multisite file caching and staging service, and reliable and recoverable job management services. The focus of the activity was the job management services and the interplay between these services and distributed data access in a Grid environment. Software was developed to study the interaction between HENP applications and distributed data storage fabric. One key conclusion was the need for a reliable and recoverable tool for managing large collections of interdependent jobs. An attached document provides an overview of the current status of the Directed Acyclic Graph Manager (DAGMan) with its main features and capabilities.« less

Philanthropy and Beyond: Creating Shared Value to Promote Well-Being for Individuals in Their Communities.

PubMed

Kottke, Thomas E; Pronk, Nico; Zinkel, Andrew R; Isham, George J

2017-01-01

Health care organizations can magnify the impact of their community service and other philanthropic activities by implementing programs that create shared value. By definition, shared value is created when an initiative generates benefit for the sponsoring organization while also generating societal and community benefit. Because the programs generate benefit for the sponsoring organizations, the magnitude of any particular initiative is limited only by the market for the benefit and not the resources that are available for philanthropy.In this article we use three initiatives in sectors other than health care to illustrate the concept of shared value. We also present examples of five types of shared value programs that are sponsored by health care organizations: telehealth, worksite health promotion, school-based health centers, green and healthy housing, and clean and green health services. On the basis of the innovativeness of health care organizations that have already implemented programs that create shared value, we conclude that the opportunities for all health care organizations to create positive impact for individuals and communities through similar programs is large, and the limits have yet to be defined.

Electric Water Heater Modeling and Control Strategies for Demand Response

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

Diao, Ruisheng; Lu, Shuai; Elizondo, Marcelo A.

2012-07-22

Abstract— Demand response (DR) has a great potential to provide balancing services at normal operating conditions and emergency support when a power system is subject to disturbances. Effective control strategies can significantly relieve the balancing burden of conventional generators and reduce investment on generation and transmission expansion. This paper is aimed at modeling electric water heaters (EWH) in households and tests their response to control strategies to implement DR. The open-loop response of EWH to a centralized signal is studied by adjusting temperature settings to provide regulation services; and two types of decentralized controllers are tested to provide frequency supportmore » following generator trips. EWH models are included in a simulation platform in DIgSILENT to perform electromechanical simulation, which contains 147 households in a distribution feeder. Simulation results show the dependence of EWH response on water heater usage . These results provide insight suggestions on the need of control strategies to achieve better performance for demand response implementation. Index Terms— Centralized control, decentralized control, demand response, electrical water heater, smart grid« less

Australian Community Pharmacists' Experience of Implementing a Chronic Kidney Disease Risk Assessment Service.

PubMed

Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L

2018-06-14

Community pharmacists are well positioned to deliver chronic kidney disease (CKD) screening services. However, little is known about the challenges faced by pharmacists during service implementation. This study aimed to explore community pharmacists' experiences and perceived barriers of implementing a CKD risk assessment service. Data collection was performed by using semistructured, open-ended interview questions. Pharmacists who had implemented a CKD screening service in Tasmania, Australia, were eligible to participate. A purposeful sampling strategy was used to select pharmacists, with variation in demographics and pharmacy location. A conventional content analysis approach was used to conduct the qualitative study. Transcripts were thematically analyzed by using the NVivo 11 software program. Initially, a list of free nodes was generated and data were coded exhaustively into relevant nodes. These nodes were then regrouped to form highly conceptualized themes. Five broad themes emerged from the analysis: contextual fit within community pharmacy; perceived scope of pharmacy practice; customer perception toward disease prevention; CKD - an underestimated disease; and remuneration for a beneficial service. Pharmacists found the CKD service efficient, user-friendly, and of substantial benefit to their customers. However, several pharmacists observed that their customers lacked interest in disease prevention, and had limited understanding of CKD. More importantly, pharmacists perceived the scope of pharmacy practice to depend substantially on interprofessional collaboration between pharmacists and general practitioners, and customer acknowledgment of pharmacists' role in disease prevention. Community pharmacists perceived the CKD service to be worth incorporating into pharmacy practice. To increase uptake, future CKD services should aim to improve customer awareness about CKD before providing risk assessment. Further research investigating strategies to enhance general practitioner involvement in pharmacist-initiated disease prevention services is also needed.

The second phase in creating the cardiac center for the next generation: beyond structure to process improvement.

PubMed

Woods, J

2001-01-01

The third generation cardiac institute will build on the successes of the past in structuring the service line, re-organizing to assimilate specialist interests, and re-positioning to expand cardiac services into cardiovascular services. To meet the challenges of an increasingly competitive marketplace and complex delivery system, the focus for this new model will shift away from improved structures, and toward improved processes. This shift will require a sound methodology for statistically measuring and sustaining process changes related to the optimization of cardiovascular care. In recent years, GE Medical Systems has successfully applied Six Sigma methodologies to enable cardiac centers to control key clinical and market development processes through its DMADV, DMAIC and Change Acceleration processes. Data indicates Six Sigma is having a positive impact within organizations across the United States, and when appropriately implemented, this approach can serve as a solid foundation for building the next generation cardiac institute.

Design and implementation of integrated solid wastes management pattern in industrial zones, case study of Shahroud, Iran.

PubMed

Saeid, Nazemi; Roudbari, Aliakbar; Yaghmaeian, Kamyar

2014-01-14

The aim of the study was to design and implementation of integrated solid wastes management pattern in Shahroud industrial zone, evaluates the results and determine possible performance problems. This cross - sectional study was carried out for 4 years in Shahroud industrial zone and the implementation process included:1- Qualitative and quantitative analysis of all solid waste generated in the city, 2- determine the current state of solid waste management in the zone and to identify programs conducted, 3- Design and implementation of integrated solid wastes management pattern including design and implementation of training programs, laws, penalties and incentives and explain and implement programs for all factories and 4- The monitoring of the implementation process and determine the results. Annually, 1,728 tons of solid wastes generated in the town including 1603 tons of industrial wastes and 125 tons of municipal wastes. By implementing this pattern, the two separated systems of collection and recycling of domestic and industrial wastes was launched in this zone. Also consistent with the goals, the amount of solid wastes generated and disposed in 2009 was 51.5 and 28.6 kg per 100 million Rials production, respectively. Results showed that implementation of pattern of separated collection, training programs, capacity building, providing technical services, completing chain of industries and strengthening the cooperation between industrial estate management and industrial units could greatly reduce the waste management problems.

Agriscience Teachers' Implementation of Digital Game-based Learning in an Introductory Animal Science Course

NASA Astrophysics Data System (ADS)

Webb, Angela W.; Bunch, J. C.; Wallace, Maria F. G.

2015-12-01

In today's technological age, visions for technology integration in the classroom continue to be explored and examined. Digital game-based learning is one way to purposefully integrate technology while maintaining a focus on learning objectives. This case study sought to understand agriscience teachers' experiences implementing digital game-based learning in an introductory animal science course. From interviews with agriscience teachers on their experiences with the game, three themes emerged: (1) the constraints of inadequate and inappropriate technologies, and time to game implementation; (2) the shift in teacher and student roles necessitated by implementing the game; and (3) the inherent competitive nature of learning through the game. Based on these findings, we recommend that pre-service and in-service professional development opportunities be developed for teachers to learn how to implement digital game-based learning effectively. Additionally, with the potential for simulations that address cross-cutting concepts in the next generation science standards, digital game-based learning should be explored in various science teaching and learning contexts.

Lean in service industries: A literature review

NASA Astrophysics Data System (ADS)

V, Vignesh; Suresh, M.; Aramvalarthan, S.

2016-09-01

Lean service is an amalgamation of tools and practices which, if applied appropriately, would definitely improve the existing quality of operations and ensure the generation of a large amount of favourable financial and economic outcomes and improve the behaviour of the workforce. As a result, it assumes of great significance in the fiercely competitive modern world. This article presents a comprehensive bibliographic study about the various lean service practices through a variety of approaches like service improvement, manufacturing, supply chain, market and retailing approaches, etc. Thus it gives a clear view on how the lean services are implemented in various sectors and the contribution of lean service towards improving the quality in the services provided while reducing the costs.

The Contribution for Improving GNSS Data and Derived Products for Solid Earth Sciences Promoted by EPOS-IP

NASA Astrophysics Data System (ADS)

Fernandes, R. M. S.; Bos, M. S.; Bruyninx, C.; Crocker, P.; Dousa, J.; Walpersdorf, A.; Socquet, A.; Avallone, A.; Ganas, A.; Ionescu, C.; Kenyeres, A.; Ofeigsson, B.; Ozener, H.; Vergnolle, M.; Lidberg, M.; Liwosz, T.; Soehne, W.; Bezdeka, P.; Cardoso, R.; Cotte, N.; Couto, R.; D'Agostino, N.; Deprez, A.; Fabian, A.; Gonçalves, H.; Féres, L.; Legrand, J.; Menut, J. L.; Nastase, E.; Ngo, K. M.; Sigurðarson, F.; Vaclavovic, P.

2017-12-01

The GNSS working group part of the EPOS-IP (European Plate Observing System - Implementation Phase) project oversees the implementation of services focused on GNSS data and derived products for the use of the geo-sciences community. The objective is to serve essentially the Solid Earth community, but other scientific and technical communities will also be able the benefit of the efforts being carried out to access the data (and derived products) of the European Geodetic Infrastructures. The geodetic component of EPOS is dealing essentially with implementing an e-infrastructure to store and disseminate continuous GNSS data (and derived solutions) from existing Research Infrastructures and new dedicated services. Present efforts are on developing an integrated software package, called GLASS, that will permit to disseminate quality controlled data (using special tools) in a seamless way from dozens of Geodetic Research Infrastructures in Europe. Conceptually, GLASS can be used in a single Research Infrastructure or in hundreds cooperative ones. We present and discuss the status of the implementation of these services, including also the generation of products - time-series, velocity fields and strain rate fields. In concrete, we will present the results of the current validation phase of these services and we will discuss in detail the technical and cooperative efforts being implemented. EPOS-IP is a project funded by the ESFRI European Union.

[Priorization of facilitators for the implementation of medication review with follow-up service in Spanish community pharmacies through exploratory factor analysis].

PubMed

Gil, Modesta Inmaculada; Benrimoj, Shalom Isaac; Martínez-Martínez, Fernando; Cardero, Manuel; Gastelurrutia, Miguel Ángel

2013-01-01

to prioritize previously identified in Spain facilitators for the implementation of new Pharmaceutical Services that allow designing strategies for the implementation of Medication Review with follow-up (MRFup) service. Exploratory factor analysis (EFA). A draft of a questionnaire was performed based on a previous literature review and following the RAND/UCLA methodology. An expert panel worked with it and generated a definitive questionnaire which, after piloting, was used with a representative sample of pharmacists, owners or staff members, who were working in community pharmacy, using computer-assisted telephone interviewing (CATI) methodology. To understand underlying constructs in the questionnaire an EFA was performed. Different approaches were tested such as principal components factor analysis and principal axis factoring method. The best interpretability was achieved using the Factorization of Principal axis method with Direct Oblimin rotation, which explained the 40.0% of total variance. This produced four factors defined as: «Incentives», «External campaigns», «Expert in MRFup» and «Professionalism of the pharmacist». It can be stated that for implementation and sustainability of MRFup Service it is necessary being paid; also it must be explained to health professional and society in general. Practice of MRFup service demands pharmacists receiving a more clinical education and assuming more responsibilities as health professionals. Copyright © 2012 Elsevier España, S.L. All rights reserved.

How to Invest in Getting Cost-effective Technologies into Practice? A Framework for Value of Implementation Analysis Applied to Novel Oral Anticoagulants.

PubMed

Faria, Rita; Walker, Simon; Whyte, Sophie; Dixon, Simon; Palmer, Stephen; Sculpher, Mark

2017-02-01

Cost-effective interventions are often implemented slowly and suboptimally in clinical practice. In such situations, a range of implementation activities may be considered to increase uptake. A framework is proposed to use cost-effectiveness analysis to inform decisions on how best to invest in implementation activities. This framework addresses 2 key issues: 1) how to account for changes in utilization in the future in the absence of implementation activities; and 2) how to prioritize implementation efforts between subgroups. A case study demonstrates the framework's application: novel oral anticoagulants (NOACs) for the prevention of stroke in the National Health Service in England and Wales. The results suggest that there is value in additional implementation activities to improve uptake of NOACs, particularly in targeting patients with average or poor warfarin control. At a cost-effectiveness threshold of £20,000 per quality-adjusted life-year (QALY) gained, additional investment in an educational activity that increases the utilization of NOACs by 5% in all patients currently taking warfarin generates an additional 254 QALYs, compared with 973 QALYs in the subgroup with average to poor warfarin control. However, greater value could be achieved with higher uptake of anticoagulation more generally: switching 5% of patients who are potentially eligible for anticoagulation but are currently receiving no treatment or are using aspirin would generate an additional 4990 QALYs. This work can help health services make decisions on investment at different points of the care pathway or across disease areas in a manner consistent with the value assessment of new interventions.

Climate Services Information System Activities in Support of The Global Framework for Climate Services Implementation

NASA Astrophysics Data System (ADS)

Timofeyeva-Livezey, M. M.; Horsfall, F. M. C.; Pulwarty, R. S.; Klein-Tank, A.; Kolli, R. K.; Hechler, P.; Dilley, M.; Ceron, J. P.; Goodess, C.

2017-12-01

The WMO Commission on Climatology (CCl) supports the implementation of the Global Framework for Climate Services (GFCS) with a particular focus on the Climate Services Information System (CSIS), which is the core operational component of GFCS at the global, regional, and national level. CSIS is designed for producing, packaging and operationally delivering authoritative climate information data and products through appropriate operational systems, practices, data exchange, technical standards, authentication, communication, and product delivery. Its functions include climate analysis and monitoring, assessment and attribution, prediction (monthly, seasonal, decadal), and projection (centennial scale) as well as tailoring the associated products tUEAo suit user requirements. A central, enabling piece of implementation of CSIS is a Climate Services Toolkit (CST). In its development phase, CST exists as a prototype (www.wmo.int/cst) as a compilation of tools for generating tailored data and products for decision-making, with a special focus on national requirements in developing countries. WMO provides a server to house the CST prototype as well as support operations and maintenance. WMO members provide technical expertise and other in-kind support, including leadership of the CSIS development team. Several recent WMO events have helped with the deployment of CST within the eight countries that have been recognized by GFCS as illustrative for developing their climate services at national levels. Currently these countries are developing climate services projects focusing service development and delivery for selected economic sectors, such as for health, agriculture, energy, water resources, and hydrometeorological disaster risk reduction. These countries are working together with their respective WMO Regional Climate Centers (RCCs), which provide technical assistance with implementation of climate services projects at the country level and facilitate development of regional climate products, starting with the CST. The paper will introduce the CST prototype to the wider meteorological, hydrological, and climatological communities and provide details of its implementation in the context of the global framework.

Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries

PubMed Central

BERNHARDT, ANTONIA K.; BERGER, GREGORY; LEE, JAMES A.; REUTER, KEVIN; DAVANZO, JOAN; MONTGOMERY, ANNE; DOBSON, ALLEN

2016-01-01

Policy Points: At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with “activities of daily living.” Available services fail to match frail elders’ needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs.The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long‐term care costs, and declining family caregiver availability portend gaps in badly needed services.The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. Context The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better‐coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. Methods The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. Findings The simulation projected third‐year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. Conclusions The MediCaring Communities financial simulation demonstrates that better care at lower cost for frail elderly Medicare beneficiaries is possible within current financing levels. Long‐term success of the initiative will require reinvestment of Medicare savings to bolster nonmedical supportive services in the community. Successful implementation will necessitate waiving certain regulations and developing new infrastructure in pilot communities. This financial simulation methodology will help leadership in other communities to project fiscal performance. Since the MediCaring Communities model also achieves the Centers for Medicare and Medicaid Services' vision for care for frail elders (better care, healthier people, smarter spending) and since these reforms can proceed with limited waivers from Medicare, willing communities should explore implementation and share best practices about how to achieve fundamental service delivery changes that can meet the challenges of a much older population in the 21st century. PMID:27378581

Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

PubMed

Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

2016-09-01

At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The MediCaring Communities financial simulation demonstrates that better care at lower cost for frail elderly Medicare beneficiaries is possible within current financing levels. Long-term success of the initiative will require reinvestment of Medicare savings to bolster nonmedical supportive services in the community. Successful implementation will necessitate waiving certain regulations and developing new infrastructure in pilot communities. This financial simulation methodology will help leadership in other communities to project fiscal performance. Since the MediCaring Communities model also achieves the Centers for Medicare and Medicaid Services' vision for care for frail elders (better care, healthier people, smarter spending) and since these reforms can proceed with limited waivers from Medicare, willing communities should explore implementation and share best practices about how to achieve fundamental service delivery changes that can meet the challenges of a much older population in the 21st century. © 2016 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

A DICOM-based 2nd generation Molecular Imaging Data Grid implementing the IHE XDS-i integration profile.

PubMed

Lee, Jasper; Zhang, Jianguo; Park, Ryan; Dagliyan, Grant; Liu, Brent; Huang, H K

2012-07-01

A Molecular Imaging Data Grid (MIDG) was developed to address current informatics challenges in archival, sharing, search, and distribution of preclinical imaging studies between animal imaging facilities and investigator sites. This manuscript presents a 2nd generation MIDG replacing the Globus Toolkit with a new system architecture that implements the IHE XDS-i integration profile. Implementation and evaluation were conducted using a 3-site interdisciplinary test-bed at the University of Southern California. The 2nd generation MIDG design architecture replaces the initial design's Globus Toolkit with dedicated web services and XML-based messaging for dedicated management and delivery of multi-modality DICOM imaging datasets. The Cross-enterprise Document Sharing for Imaging (XDS-i) integration profile from the field of enterprise radiology informatics was adopted into the MIDG design because streamlined image registration, management, and distribution dataflow are likewise needed in preclinical imaging informatics systems as in enterprise PACS application. Implementation of the MIDG is demonstrated at the University of Southern California Molecular Imaging Center (MIC) and two other sites with specified hardware, software, and network bandwidth. Evaluation of the MIDG involves data upload, download, and fault-tolerance testing scenarios using multi-modality animal imaging datasets collected at the USC Molecular Imaging Center. The upload, download, and fault-tolerance tests of the MIDG were performed multiple times using 12 collected animal study datasets. Upload and download times demonstrated reproducibility and improved real-world performance. Fault-tolerance tests showed that automated failover between Grid Node Servers has minimal impact on normal download times. Building upon the 1st generation concepts and experiences, the 2nd generation MIDG system improves accessibility of disparate animal-model molecular imaging datasets to users outside a molecular imaging facility's LAN using a new architecture, dataflow, and dedicated DICOM-based management web services. Productivity and efficiency of preclinical research for translational sciences investigators has been further streamlined for multi-center study data registration, management, and distribution.

The standard-based open workflow system in GeoBrain (Invited)

NASA Astrophysics Data System (ADS)

Di, L.; Yu, G.; Zhao, P.; Deng, M.

2013-12-01

GeoBrain is an Earth science Web-service system developed and operated by the Center for Spatial Information Science and Systems, George Mason University. In GeoBrain, a standard-based open workflow system has been implemented to accommodate the automated processing of geospatial data through a set of complex geo-processing functions for advanced production generation. The GeoBrain models the complex geoprocessing at two levels, the conceptual and concrete. At the conceptual level, the workflows exist in the form of data and service types defined by ontologies. The workflows at conceptual level are called geo-processing models and cataloged in GeoBrain as virtual product types. A conceptual workflow is instantiated into a concrete, executable workflow when a user requests a product that matches a virtual product type. Both conceptual and concrete workflows are encoded in Business Process Execution Language (BPEL). A BPEL workflow engine, called BPELPower, has been implemented to execute the workflow for the product generation. A provenance capturing service has been implemented to generate the ISO 19115-compliant complete product provenance metadata before and after the workflow execution. The generation of provenance metadata before the workflow execution allows users to examine the usability of the final product before the lengthy and expensive execution takes place. The three modes of workflow executions defined in the ISO 19119, transparent, translucent, and opaque, are available in GeoBrain. A geoprocessing modeling portal has been developed to allow domain experts to develop geoprocessing models at the type level with the support of both data and service/processing ontologies. The geoprocessing models capture the knowledge of the domain experts and are become the operational offering of the products after a proper peer review of models is conducted. An automated workflow composition has been experimented successfully based on ontologies and artificial intelligence technology. The GeoBrain workflow system has been used in multiple Earth science applications, including the monitoring of global agricultural drought, the assessment of flood damage, the derivation of national crop condition and progress information, and the detection of nuclear proliferation facilities and events.

Transformation of the California mental health system: stakeholder-driven planning as a transformational activity.

PubMed

Cashin, Cheryl; Scheffler, Richard; Felton, Mistique; Adams, Neal; Miller, Leonard

2008-10-01

This study describes strategies developed by California counties to transform their mental health systems under the 2004 Mental Health Services Act (MHSA). This voter initiative places a 1% tax on annual incomes over $1 million; tax monies are earmarked to transform county-operated mental health services into systems that are oriented more toward recovery. MHSA implementation itself can be considered "transformational" by balancing greater standardization of mental health service delivery in the state with a locally driven planning process. A qualitative content analysis of the three-year plans submitted by 12 counties to receive funds under MHSA was conducted to identify common themes, as well as innovative approaches. These 12 (out of 58) counties were chosen to represent both small and large counties, as well as geographic diversity, and they represent 62.3% of the state population. This analysis showed that the state guidelines and local planning process generated consistency across counties in establishing full-service partnerships with a "whatever it takes" approach to providing goal-directed services and supports to consumers and their families. There was, however, little convergence around the specific strategies to achieve this vision, reflecting both the local planning process and a relative lack of clear policy and guidance on evidence-based practices. There are many obstacles to the successful implementation of these ambitious plans. However, the state-guided, but stakeholder-driven, transformation in California appears to generate innovative approaches to recovery-oriented services, involve consumers and family members in service planning and delivery, and build community partnerships that create new opportunities for consumers to meet their recovery goals.

Implementation of the free maternity services policy and its implications for health system governance in Kenya

PubMed Central

Smith, Helen

2017-01-01

Introduction To move towards universal health coverage, the government of Kenya introduced free maternity services in all public health facilities in June 2013. User fees are, however, important sources of income for health facilities and their removal has implications for the way in which health facilities are governed. Objective To explore how implementation of Kenya’s financing policy has affected the way in which the rules governing health facilities are made, changed, monitored and enforced. Methods Qualitative research was carried out using semistructured interviews with 39 key stakeholders from six counties in Kenya: 10 national level policy makers, 10 county level policy makers and 19 implementers at health facilities. Participants were purposively selected using maximum variation sampling. Data analysis was informed by the institutional analysis framework, in which governance is defined by the rules that distribute roles among key players and shape their actions, decisions and interactions. Results Lack of clarity about the new policy (eg, it was unclear which services were free, leading to instances of service user exploitation), weak enforcement mechanisms (eg, delayed reimbursement to health facilities, which led to continued levying of service charges) and misaligned incentives (eg, the policy led to increased uptake of services thereby increasing the workload for health workers and health facilities losing control of their ability to generate and manage their own resources) led to weak policy implementation, further complicated by the concurrent devolution of the health system. Conclusion The findings show the consequences of discrepancies between formal institutions and informal arrangements. In introducing new policies, policy makers should ensure that corresponding institutional (re)arrangements, enforcement mechanisms and incentives are aligned with the objectives of the implementers. PMID:29177098

Design and implementation of integrated solid wastes management pattern in industrial zones, case study of Shahroud, Iran

PubMed Central

2014-01-01

Background The aim of the study was to design and implementation of integrated solid wastes management pattern in Shahroud industrial zone, evaluates the results and determine possible performance problems. This cross - sectional study was carried out for 4 years in Shahroud industrial zone and the implementation process included:1- Qualitative and quantitative analysis of all solid waste generated in the city, 2- determine the current state of solid waste management in the zone and to identify programs conducted, 3- Design and implementation of integrated solid wastes management pattern including design and implementation of training programs, laws, penalties and incentives and explain and implement programs for all factories and 4- The monitoring of the implementation process and determine the results. Results Annually, 1,728 tons of solid wastes generated in the town including 1603 tons of industrial wastes and 125 tons of municipal wastes. By implementing this pattern, the two separated systems of collection and recycling of domestic and industrial wastes was launched in this zone. Also consistent with the goals, the amount of solid wastes generated and disposed in 2009 was 51.5 and 28.6 kg per 100 million Rials production, respectively. Conclusion Results showed that implementation of pattern of separated collection, training programs, capacity building, providing technical services, completing chain of industries and strengthening the cooperation between industrial estate management and industrial units could greatly reduce the waste management problems. PMID:24423020

[Supply medicinal products improvement in outpatient care in a hospital pharmacy service].

PubMed

Santiago Pérez, A; Peña Pedrosa, J A; Alguacil Pau, A I; Pérez Morales, A; Molina Muñoz, P; Benítez Giménez, M T

Pharmaceutical care to outpatients is currently one of the main occupations of hospital pharmacy services (PEX). There are several questionnaires to measure the satisfaction of the PEX of a pharmacy service, and the results of these questionnaires can generate improvement actions that result in satisfaction. To verify if a satisfaction questionnaire for outpatients is valid for the generation of improvements in the care provided, and if after its implementation, the same questionnaire is able to detect changes in satisfaction. Prospective study of a single center carried out in a tertiary hospital in 2015 and 2016. A questionnaire previously validated with 16 Likert-type items was used. Demographic and classification data were collected. A descriptive analysis was performed and the internal consistency was calculated using the Cronbach's α value. A total of 258 questionnaires were collected in 2015 and 493 in 2016. There were no differences in the baseline characteristics of the patients and users of the service. The items with the lowest satisfaction scores in 2015 (comfort of the waiting room, dispensing privacy, drug pick-up time and medication pick-up time) guided the improvement actions to be implemented. In 2016 there was an improvement in the waiting time until collection in 12.3% (p = 0.002); in the comfort of the waiting room 4.9% (p = 0.304); business hours for medication collection, 10.7% (p = 0.013); and in the confidentiality of the dispensation 4% (p = 0.292). The remaining scores fluctuated minimally, with no statistical significance at all. A 5.1% improvement in overall satisfaction was found (p < 0.001). Satisfaction values obtained as a whole were high. The satisfaction questionnaire is a valid instrument for generating actions to improve the care received in an outpatient unit of a pharmacy service. This same questionnaire is a tool to monitor the changes implemented to improve the care received. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Competitive strategy for providers.

PubMed

Hackett, M C

1996-01-01

National Health Service (NHS) Trusts are struggling to determine a long-term strategic direction for their organizations in response to the competitive pressures generated by the NHS reforms. The development of long-term strategic direction and the methods to implement this are presenting real challenges to the Trusts which have inherited service configurations based on bureaucratic planning frameworks rather than service configurations suited to a more competitive environment. Examines the strategic choices available to these organizations; explores the importance of identifying positive strategic choices; and discusses the advantages and disadvantages in the context of the NHS internal market.

Study on generation and sharing of on-demand global seamless data—Taking MODIS NDVI as an example

NASA Astrophysics Data System (ADS)

Shen, Dayong; Deng, Meixia; Di, Liping; Han, Weiguo; Peng, Chunming; Yagci, Ali Levent; Yu, Genong; Chen, Zeqiang

2013-04-01

By applying advanced Geospatial Data Abstraction Library (GDAL) and BigTIFF technology in a Geographical Information System (GIS) with Service Oriented Architecture (SOA), this study has derived global datasets using tile-based input data and implemented Virtual Web Map Service (VWMS) and Virtual Web Coverage Service (VWCS) to provide software tools for visualization and acquisition of global data. Taking MODIS Normalized Difference Vegetation Index (NDVI) as an example, this study proves the feasibility, efficiency and features of the proposed approach.

A Fire Department Community Health Intervention to Prevent Carbon Monoxide Poisoning Following a Hurricane

PubMed Central

Levy, Matthew; Jenkins, J Lee; Seaman, Kevin

2014-01-01

Portable generators are commonly used during electrical service interruptions that occur following large storms such as hurricanes. Nearly all portable generators use carbon based fuels and produce deadly carbon monoxide gas. Despite universal warnings to operate these generators outside only, the improper placement of generators makes these devices the leading cause of engine related carbon monoxide deaths in the United States. The medical literature reports many cases of Carbon Monoxide (CO) toxicity associated with generator use following hurricanes and other weather events. This paper describes how Howard County, Maryland Fire and Rescue (HCFR) Services implemented a public education program that focused on prevention of Carbon Monoxide poisoning from portable generator use in the wake of events where electrical service interruptions occurred or had the potential to occur. A major challenge faced was communication with those members of the population who were almost completely dependent upon electronic and wireless technologies and were without redundancies. HCFR utilized several tactics to overcome this challenge including helicopter based surveillance and the use of geocoded information from the electrical service provider to identify outage areas. Once outage areas were identified, HCFR personnel conducted a door-to-door canvasing of effected communities, assessing for hazards and distributing information flyers about the dangers of generator use. This effort represents one of the first reported examples of a community-based endeavor by a fire department to provide proactive interventions designed to prevent carbon monoxide illness. PMID:24596660

Philanthropy and Beyond: Creating Shared Value to Promote Well-Being for Individuals in Their Communities

PubMed Central

Kottke, Thomas E; Pronk, Nico; Zinkel, Andrew R; Isham, George J

2017-01-01

Health care organizations can magnify the impact of their community service and other philanthropic activities by implementing programs that create shared value. By definition, shared value is created when an initiative generates benefit for the sponsoring organization while also generating societal and community benefit. Because the programs generate benefit for the sponsoring organizations, the magnitude of any particular initiative is limited only by the market for the benefit and not the resources that are available for philanthropy. In this article we use three initiatives in sectors other than health care to illustrate the concept of shared value. We also present examples of five types of shared value programs that are sponsored by health care organizations: telehealth, worksite health promotion, school-based health centers, green and healthy housing, and clean and green health services. On the basis of the innovativeness of health care organizations that have already implemented programs that create shared value, we conclude that the opportunities for all health care organizations to create positive impact for individuals and communities through similar programs is large, and the limits have yet to be defined. PMID:28488982

Development and implementation of a psychotherapy tracking database in primary care.

PubMed

Craner, Julia R; Sawchuk, Craig N; Mack, John D; LeRoy, Michelle A

2017-06-01

Although there is a rapid increase in the integration of behavioral health services in primary care, few studies have evaluated the effectiveness of these services in real-world clinical settings, in part due to the difficulty of translating traditional mental health research designs to this setting. Accordingly, innovative approaches are needed to fit the unique challenges of conducting research in primary care. The development and implementation of one such approach is described in this article. A continuously populating database for psychotherapy services was implemented across 5 primary care clinics in a large health system to assess several levels of patient care, including service utilization, symptomatic outcomes, and session-by-session use of psychotherapy principles by providers. Each phase of implementation revealed challenges, including clinician time, dissemination to clinics with different resources, and fidelity of data collection strategy across providers, as well as benefits, including the generation of useful data to inform clinical care, program development, and empirical research. The feasible and sustainable implementation of data collection for routine clinical practice in primary care has the potential to fuel the evidence base around integrated care. The current project describes the development of an innovative approach that, with further empirical study and refinement, could enable health care professionals and systems to understand their population and clinical process in a way that addresses essential gaps in the integrated care literature. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The e-health implementation toolkit: qualitative evaluation across four European countries

PubMed Central

2011-01-01

Background Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown. Methods We conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time. Results e-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers. Conclusion The use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems. PMID:22098945

The e-Health Implementation Toolkit: qualitative evaluation across four European countries.

PubMed

MacFarlane, Anne; Clerkin, Pauline; Murray, Elizabeth; Heaney, David J; Wakeling, Mary; Pesola, Ulla-Maija; Waterworth, Eva Lindh; Larsen, Frank; Makiniemi, Minna; Winblad, Ilkka

2011-11-19

Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown. We conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time. e-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers. The use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems.

Data Service Provider Cost Estimation Tool

NASA Technical Reports Server (NTRS)

Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel

2011-01-01

The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.

Implementing Children's Rights in Early Education

ERIC Educational Resources Information Center

Te One, Sarah

2011-01-01

Recent research (Te One, 2009) investigated perceptions of children's rights in a New Zealand early childhood care and education service (the Creche) for under-two-year-olds. Focus group interviews, interviews with teachers, observational field notes, photographs and a researcher's journal were used to generate data. Findings revealed that…

Modeling the Impact of School-based Universal Depression Screening on Additional Service Capacity Needs: A System Dynamics Approach

PubMed Central

Lyon, Aaron R.; Maras, Melissa A.; Pate, Christina M.; Igusa, Takeru; Stoep, Ann Vander

2016-01-01

Although it is widely known that the occurrence of depression increases over the course of adolescence, symptoms of mood disorders frequently go undetected. While schools are viable settings for conducting universal screening to systematically identify students in need of services for common health conditions, particularly those that adversely affect school performance, few school districts routinely screen their students for depression. Among the most commonly referenced barriers are concerns that the number of students identified may exceed schools’ service delivery capacities, but few studies have evaluated this concern systematically. System dynamics (SD) modeling may prove a useful approach for answering questions of this sort. The goal of the current paper is therefore to demonstrate how SD modeling can be applied to inform implementation decisions in communities. In our demonstration, we used SD modeling to estimate the additional service demand generated by universal depression screening in a typical high school. We then simulated the effects of implementing “compensatory approaches” designed to address anticipated increases in service need through (1) the allocation of additional staff time and (2) improvements in the effectiveness of mental health interventions. Results support the ability of screening to facilitate more rapid entry into services and suggest that improving the effectiveness of mental health services for students with depression via the implementation of an evidence-based treatment protocol may have a limited impact on overall recovery rates and service availability. In our example, the SD approach proved useful in informing systems’ decision-making about the adoption of a new school mental health service. PMID:25601192

Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis.

PubMed

Aarons, Gregory A; Wells, Rebecca S; Zagursky, Karen; Fettes, Danielle L; Palinkas, Lawrence A

2009-11-01

We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Implementation of EBP is a complex process. Cross-system-level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.

Production of the next-generation library virtual tour.

PubMed

Duncan, J M; Roth, L K

2001-10-01

While many libraries offer overviews of their services through their Websites, only a small number of health sciences libraries provide Web-based virtual tours. These tours typically feature photographs of major service areas along with textual descriptions. This article describes the process for planning, producing, and implementing a next-generation virtual tour in which a variety of media elements are integrated: photographic images, 360-degree "virtual reality" views, textual descriptions, and contextual floor plans. Hardware and software tools used in the project are detailed, along with a production timeline and budget, tips for streamlining the process, and techniques for improving production. This paper is intended as a starting guide for other libraries considering an investment in such a project.

Business Model Evaluation for an Advanced Multimedia Service Portfolio

NASA Astrophysics Data System (ADS)

Pisciella, Paolo; Zoric, Josip; Gaivoronski, Alexei A.

In this paper we analyze quantitatively a business model for the collaborative provision of an advanced mobile data service portfolio composed of three multimedia services: Video on Demand, Internet Protocol Television and User Generated Content. We provide a description of the provision system considering the relation occurring between tecnical aspects and business aspects for each agent providing the basic multimedia service. Such a techno-business analysis is then projected into a mathematical model dealing with the problem of the definition of incentives between the different agents involved in a collaborative service provision. Through the implementation of this model we aim at shaping the behaviour of each of the contributing agents modifying the level of profitability that the Service Portfolio yields to each of them.

E-government strategy of Surabaya city government through e-rt / rw to improve the quality of public service

NASA Astrophysics Data System (ADS)

Oktariyanda, T. A.; Rahaju, T.

2018-01-01

The use of information technology by Surabaya City Government has generated various innovations of public services such as “e-Sapa Warga”, e-Commerce, “e-RT/RW”, e-Budgeting, e-Project, e-Procurement, “e-Pendidikan”. Among the many innovations, e-RT/RW (Rukun Tetangga / Rukun Warga) is an innovation that is quite prominent because there are still many areas that have not implemented. This research can be classified as literature review and critical research. The aims of this research are to describe and analyze e-government strategy in Surabaya City through e-RT / RW to improve public service quality. The result of this research is e-government strategy in Surabaya City through e-RT / RW is already relevant and in accordance with Goldsmith’s theory of e-government. The positive impact of the implementation of e-RT / RW is the increasing quality of public services to bring benefits to all citizens Surabaya City.

Data-Driven Simulation-Enhanced Optimization of People-Based Print Production Service

NASA Astrophysics Data System (ADS)

Rai, Sudhendu

This paper describes a systematic six-step data-driven simulation-based methodology for optimizing people-based service systems on a large distributed scale that exhibit high variety and variability. The methodology is exemplified through its application within the printing services industry where it has been successfully deployed by Xerox Corporation across small, mid-sized and large print shops generating over 250 million in profits across the customer value chain. Each step of the methodology consisting of innovative concepts co-development and testing in partnership with customers, development of software and hardware tools to implement the innovative concepts, establishment of work-process and practices for customer-engagement and service implementation, creation of training and infrastructure for large scale deployment, integration of the innovative offering within the framework of existing corporate offerings and lastly the monitoring and deployment of the financial and operational metrics for estimating the return-on-investment and the continual renewal of the offering are described in detail.

Information Superiority generated through proper application of Geoinformatics

NASA Astrophysics Data System (ADS)

Teichmann, F.

2012-04-01

Information Superiority generated through proper application of Geoinformatics Information management and especially geoscience information delivery is a very delicate task. If it is carried out successfully, geoscientific data will provide the main foundation of Information Superiority. However, improper implementation of geodata generation, assimilation, distribution or storage will not only waste valuable resources like manpower or money, but could also give rise to crucial deficiency in knowledge and might lead to potentially extremely harmful disasters or wrong decisions. Comprehensive Approach, Effect Based Operations and Network Enabled Capabilities are the current buzz terms in the security regime. However, they also apply to various interdisciplinary tasks like catastrophe relief missions, civil task operations or even in day to day business operations where geo-science data is used. Based on experience in the application of geoscience data for defence applications the following procedure or tool box for generating geodata should lead to the desired information superiority: 1. Understand and analyse the mission, the task and the environment for which the geodata is needed 2. Carry out a Information Exchange Requirement between the user or customer and the geodata provider 3. Implementation of current interoperability standards and a coherent metadata structure 4. Execute innovative data generation, data provision, data assimilation and data storage 5. Apply a cost-effective and reasonable data life cycle 6. Implement IT security by focusing of the three pillar concepts Integrity, Availability and Confidentiality of the critical data 7. Draft and execute a service level agreement or a memorandum of understanding between the involved parties 8. Execute a Continuous Improvement Cycle These ideas from the IT world should be transferred into the geoscience community and applied in a wide set of scenarios. A standardized approach of how to generate, provide, handle, distribute and store geodata will can reduce costs, strengthen the ties between service costumer and geodata provider and improve the contribution geoscience can make for achieving information superiority for decision makers.

Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers.

PubMed

Balard, Frédéric; Gely-Nargeot, Marie-Christine; Corvol, Aline; Saint-Jean, Olivier; Somme, Dominique

2016-11-08

In 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006-2010). People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users' (old people and their informal caregivers) and case managers' first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation. The study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19), their informal caregivers (11) and the case managers (5) who participated in the program during the first 6 months. Thematic analysis of the data was carried out. The analysis revealed that each group of people generated its own representations of the case manager's role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager. The innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual's projected expectations of this social service. Analyzing the first representations of the case manager's role during the implementation phase of the CM service appears as a necessary step before considering the effects of the services. The implementation and the success of a case management model have to be evaluated regarding the previous healthcare context and the expectations of the people involved.

User-driven generation of standard data services

NASA Astrophysics Data System (ADS)

Díaz, Laura; Granell, Carlos; Gould, Michael; Huerta, Joaquín.

2010-05-01

Geospatial Information systems are experiencing the shift from monolithic to distributed environments (Bernard, 2003). Current research trends for discover and access of geospatial resources, in these distributed environments, are being addressed by deployment of interconnected Spatial Data Infrastructure (SDI) nodes at different scales to build a global spatial information infrastructure (Masser et al., 2008; Rajabifard et al., 2002). One of the challenges for implementing these global and multiscale SDIs is to agree with common standards in consideration with heterogeneity of various stakeholders [Masser 2005]. In Europe, the European Commission took the INSPIRE initiative to monitor the development of European SDIs. INSPIRE Directive addresses the need for web services to discover, view, transform, invoke, and download geospatial resources, which enable various stakeholders to share resources in an interoperable manner [INSPIRE 2007]. Such web services require technical specifications for the interoperability and harmonization of their SDIs [INSPIRE 2007]. Moreover, interoperability is ensured by a number of specification efforts, in the geo domain most prominently by ISO/TC 211 and the OpenGIS Consortium (OGC) (Bernard, 2003). Other research challenges regarding SDI are on one hand how to handle complexity by users in charge of maintaining SDIs as they grow, and on the other hand the fact the SDI maintenance and evolution should be guided (Bejar et al, 2009). So there is a motivation to improve the complex deployment mechanisms in SDI since there is a need of expertise and time to deploy resources and integrate them by means of standard services. In this context we present an architecture following the INSPIRE technical guidelines and therefore based on SDI principles. This architecture supports distributed applications and provides components to assist users in deploying and updating SDI resources. Therefore mechanisms and components for the automatic generation and publication of standard geospatial are proposed. These mechanisms deal with the fact of hiding the underlying technology and let stakeholders wrap resources as standard services to share these resources in a transparent manner. These components are integrated in our architecture within the Service Framework node (module). PIC Figure 1: Figure 1. Architecture components diagram Figure 1 shows the components of the architecture: The Application Node provides the entry point for users to run distributed applications. This software component has the user interface and the application logic. The Service Connector component provides the ability to connect to the services available in the middleware layer of SDI. This node acts as a socket to OGC Web Services. For instance we appreciate the WMS component implementing the OGC WMS specification as it is the standard recommended by the INSPIRE implementation rules as View Service Type.The Service Framework node contains several components. The Service Framework main functionality is to assist users in wrapping and sharing geospatial resources. It implements the proposed mechanisms to improve the availability and visibility of geospatial resources. The main components of this framework are the Data wrapper, the Process Wrapper and the Service Publisher. The Data Wrapper and Process Wrapper components guide users to wrap data and tools as standard services according with INSPIRE implementing rules (availability). The Service Publisher component aims at creating service metadata and publishing them in catalogues (visibility). Roughly speaking, all of these components are concerned with the idea of acting as a service generator and publisher, i.e., they get a resource (data or process) and return an INSPIRE service that will be published in catalogue services. References Béjar, R., Latre, M. Á., Nogueras-Iso, J., Muro-Medrano, P. R., Zarazaga-Soria, F. J. 2009. International Journal of Geographical Information Science, 23(3), 271-294. Bernard, L, U Einspanier, M Lutz & C Portele. Interoperability in GI Service Chains The Way Forward. In: M. Gould, R. Laurini & S. Coulondre (Eds.). 6th AGILE Conference on Geographic Information Science 2003, Lyon: 179-188. INSPIRE. Directive 2007/2/EC of the European Parliament and of the Council of 14 March 2007 establishing an Infrastructure for Spatial Information in the European Community. (2007) Masser, I. GIS Worlds: Creating Spatial Data Infrastructures. Redlands, California. ESRI Press. (2005) Masser, I., Rajabifard, A., Williamson, I. 2008. Spatially enabling governments through SDI implementation. International Journal of Geographical Information Science. Vol. 22, No. 1, (2008) 5-20 Rajabifard, A., Feeney, M-E. F., Williamson, I. P. 2002. Future directions for SDI development. International Journal of Applied Earth Observation and Geoinformation 4 (2002) 11-22

75 FR 10174 - Source-Specific Federal Implementation Plan for Navajo Generating Station; Navajo Nation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... Reclamation, the Los Angeles Department of Water and Power, the Arizona Public Service, the Nevada Power... over any normal 6 minute period, excluding condensed water vapour, and 40% opacity, averaged over 6 minutes, during absorber upset transition periods. The final opacity standard excludes uncombined water...

Effects of Horticulture Therapy on Engagement and Affect

ERIC Educational Resources Information Center

Gigliotti, Christina M.; Jarrott, Shannon E.

2005-01-01

Implementing generationally appropriate activities for persons with dementia is a challenging task. Horticulture therapy (HT) addresses this challenge through the use of plants to facilitate holistic outcomes. Utilizing the model of environmental press, the current study sought to analyse adult day service (ADS) participants' responses to HT as…

A Study of Strengthening Secondary Mathematics Teachers' Knowledge of Statistics and Probability via Professional Development

ERIC Educational Resources Information Center

DeVaul, Lina

2017-01-01

A professional development program (PSPD) was implemented to improve in-service secondary mathematics teachers' content knowledge, pedagogical knowledge, and self-efficacy in teaching secondary school statistics and probability. Participants generated a teaching resource website at the conclusion of the PSPD program. Participants' content…

A Generalized Framework for Modeling Next Generation 911 Implementations.

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

Kelic, Andjelka; Aamir, Munaf Syed; Kelic, Andjelka

This document summarizes the current state of Sandia 911 modeling capabilities and then addresses key aspects of Next Generation 911 (NG911) architectures for expansion of existing models. Analysis of three NG911 implementations was used to inform heuristics , associated key data requirements , and assumptions needed to capture NG911 architectures in the existing models . Modeling of NG911 necessitates careful consideration of its complexity and the diversity of implementations. Draft heuristics for constructing NG911 models are pres ented based on the analysis along with a summary of current challenges and ways to improve future NG911 modeling efforts . We foundmore » that NG911 relies on E nhanced 911 (E911) assets such as 911 selective routers to route calls originating from traditional tel ephony service which are a majority of 911 calls . We also found that the diversity and transitional nature of NG911 implementations necessitates significant and frequent data collection to ensure that adequate model s are available for crisis action support .« less

International Space Station Increment Operations Services

NASA Astrophysics Data System (ADS)

Michaelis, Horst; Sielaff, Christian

2002-01-01

The Industrial Operator (IO) has defined End-to-End services to perform efficiently all required operations tasks for the Manned Space Program (MSP) as agreed during the Ministerial Council in Edinburgh in November 2001. Those services are the result of a detailed task analysis based on the operations processes as derived from the Space Station Program Implementation Plans (SPIP) and defined in the Operations Processes Documents (OPD). These services are related to ISS Increment Operations and ATV Mission Operations. Each of these End-to-End services is typically characterised by the following properties: It has a clearly defined starting point, where all requirements on the end-product are fixed and associated performance metrics of the customer are well defined. It has a clearly defined ending point, when the product or service is delivered to the customer and accepted by him, according to the performance metrics defined at the start point. The implementation of the process might be restricted by external boundary conditions and constraints mutually agreed with the customer. As far as those are respected the IO has the free choice to select methods and means of implementation. The ISS Increment Operations Service (IOS) activities required for the MSP Exploitation program cover the complete increment specific cycle starting with the support to strategic planning and ending with the post increment evaluation. These activities are divided into sub-services including the following tasks: - ISS Planning Support covering the support to strategic and tactical planning up to the generation - Development &Payload Integration Support - ISS Increment Preparation - ISS Increment Execution These processes are tight together by the Increment Integration Management, which provides the planning and scheduling of all activities as well as the technical management of the overall process . The paper describes the entire End-to-End ISS Increment Operations service and the implementation to support the Columbus Flight 1E related increment and subsequent ISS increments. Special attention is paid to the implications caused by long term operations on hardware, software and operations personnel.

Strategic and Operational Considerations for the Implementation of Performance Based Logistics (PBL) Within the Japan Maritime Self Defense Force

DTIC Science & Technology

2010-06-01

logistics in support of weapon systems (D-2004-110). Washington, DC: Young , S. R. Keating , S., & Huff, K. (2005). Managing risk in the new supply chain...implementing PBL ( Keating & Huff, 2005; Reeve, 2001). Cohen (2007) found that cost-sharing support and maintenance services can generate "up to seven times as...to suppliers (Cohen, 2007; Keating & Huff, 2005); therefore, suppliers demand a risk premium (Cohen, & Nines, 2008). The degree of risk

Feasibility and implementation of a literature information management system for human papillomavirus in head and neck cancers with imaging.

PubMed

Wu, Dee H; Matthiesen, Chance L; Alleman, Anthony M; Fournier, Aaron L; Gunter, Tyler C

2014-01-01

This work examines the feasibility and implementation of information service-orientated architecture (ISOA) on an emergent literature domain of human papillomavirus, head and neck cancer, and imaging. From this work, we examine the impact of cancer informatics and generate a full set of summarizing clinical pearls. Additionally, we describe how such an ISOA creates potential benefits in informatics education, enhancing utility for creating enduring digital content in this clinical domain.

Identification of gaps for implementation science in the HIV prevention, care and treatment cascade; a qualitative study in 19 districts in Uganda.

PubMed

Bajunirwe, Francis; Tumwebaze, Flora; Abongomera, George; Akakimpa, Denis; Kityo, Cissy; Mugyenyi, Peter N

2016-04-14

Over the last 20 years, countries in sub Saharan Africa have made significant strides in the implementation of programs for HIV prevention, care and treatment. Despite, the significant progress made, many targets set by the United Nations have not been met. There remains a large gap between the ideal and what has been achieved. There are several operational issues that may be responsible for this gap, and these need to be addressed in order to achieve the targets. Therefore, the aim of this study was to identify gaps in the HIV prevention, care and treatment cascade, in a large district based HIV implementation program. We aimed to identify gaps that are amenable for evaluation using implementation science, in order to improve the delivery of HIV programs in rural Uganda. We conducted key informant (KI) interviews with 60 district health officers and managers of HIV/AIDS clinics and organizations and 32 focus group discussions with exit clients seeking care and treatment for HIV in the 19 districts. The data analysis process was guided using a framework approach. The recordings were transcribed verbatim. Transcripts were read back and forth and codes generated based on the framework. Nine emerging themes that comprise the gaps were identified and these were referral mechanisms indicating several loop holes, low levels of integration of HIV/TB services, low uptake of services for PMTCT services by pregnant women, low coverage of services for most at risk populations (MARPs), poor HIV coordination structures in the districts, poor continuity in the delivery of pediatric HIV/AIDS services, limited community support for orphans and vulnerable (OVC's), inadequate home based care services and HIV services and support for discordant couples. The themes indicate there are plenty of gaps that need to be covered and have been ignored by current programs. Our study has identified several gaps and suggested several interventions that should be tested before large scale implementation. The implementation of these programs should be adequately evaluated in order to provide field evidence of effectiveness and replicability in similar areas.

SSMNG Software Service Manager: A Scalable Building Blocks Architecture for PUS Services & FDIR Management

NASA Astrophysics Data System (ADS)

Lisio, Giovanni; Candia, Sante; Campolo, Giovanni; Pascucci, Dario

2011-08-01

Thales Alenia Space Italy has carried out the definition of a configurable (on mission basis) PUS ECSS-E_70- 41A see [3] Centralised Services Layer, characterised by:- a mission-independent set of 'classes' implementing the services logic.- a mission-dependent set of configuration data and selection flags.The software components belonging to this layer implement the PUS standard services ECSS-E_70-41A and a set of mission-specific services. The design of this layer has been performed by separating the services mechanisms (mission-independent execution logic) from the services configuration information (mission-dependent data). Once instantiated for a specific mission, the PUS Centralised Services Layer offers a large set of capabilities available to the CSCI's Applications Layer. This paper describes the building blocks PUS architectural solution developed by Thales Alenia Space Italy, emphasizing the mechanisms which allow easy configuration of the Scalable PUS library to fulfill the requirements of different missions. This paper also focus the Thales Alenia Space solution to automatically generate the mission-specific "PUS Services" flight software based on mission specific requirements. Building the PUS services mechanisms, which are configurable on mission basis is part of the PRIMA (Multipurpose Spacecraft Bus ) 'missionisation' process improvement. PRIMA Platform Avionics Software (ASW) is continuously evolving to improve modularity and standardization of interfaces and of SW components (see references in [1]).

Assessing biodiversity on the farm scale as basis for ecosystem service payments.

PubMed

von Haaren, Christina; Kempa, Daniela; Vogel, Katrin; Rüter, Stefan

2012-12-30

Ecosystem services payments must be based on a standardised transparent assessment of the goods and services provided. This is especially relevant in the context of EU agri-environmental programs, but also for organic-food companies that foster environmental services on their contractor farms. Addressing the farm scale is important because land users/owners are major recipients of payments and they could be more involved in data generation and conservation management. A standardised system for measuring on-farm biodiversity does not yet exist that concentrates on performance indicators and includes farmers in generating information. A method is required that produces ordinal or metric scaled assessment results as well as management measures. Another requirement is the ease of application, which includes the ease of gathering input data and understandability. In order to respond to this need, we developed a method which is designed for automated application in an open source farm assessment system named MANUELA. The method produces an ordinal scale assessment of biodiversity that includes biotopes, species, biotope connectivity and the influence of land use. In addition, specific measures for biotope types are proposed. The open source geographical information system OpenJump is used for the implementation of MANUELA. The results of the trial applications and robustness tests show that the assessment can be implemented, for the most part, using existing information as well as data available from farmers or advisors. The results are more sensitive for showing on-farm achievements and changes than existing biotope-type classifications. Such a differentiated classification is needed as a basis for ecosystem service payments and for designing effective measures. The robustness of the results with respect to biotope connectivity is comparable to that of complex models, but it should be further improved. Interviews with the test farmers substantiate that the assessment methods can be implemented on farms and they are understood by farmers. Copyright © 2012 Elsevier Ltd. All rights reserved.

From Standards to Standard Practice: A Critical Look at the Perceptions and Process of Integrating the Next Generation Science Standards in the Nation's Schools

NASA Astrophysics Data System (ADS)

Mercadante, Katie Lynn

The Next Generation Science Standards (NGSS) are the culmination of reform efforts spanning more than three decades and are the first major reform movement in science education since Sputnik. When implementing these new standards, teachers are faced with many barriers. NGSS requires critical thinking, cross-curricular learning, and key changes in teaching, learning, and assessment. Implementation nationwide has been slow, due to sweeping changes, and controversial content within the standards. Resistance to implementation occurs in nearly all levels for these reasons. The purpose of this descriptive study was to determine the perceptions of in-service teachers of the NGSS Framework, to identify barriers that inhibit implementation, and to identify commonalities among teachers who have successfully implemented the Framework, as well as assist others who may do the same in the future. Teachers from public, private, and charter schools from across the United States participated in the study. Based upon teacher response, a three-stage action plan and series of necessary recommendations were developed to assist teachers and administrators in K-12 schools to develop plans to implement the NGSS.

SAFIS Area Estimation Techniques

Treesearch

Gregory A. Reams

2000-01-01

The Southern Annual Forest inventory System (SAFIS) is in various stages of implementation in 8 of the 13 southern states served by the Southern Research Station of the USDA Forest Service. Compared to periodic inventories, SAFIS requires more rapid generation of land use and land cover maps. The current photo system for phase one area estimation has changed little...

User Acceptance of a Proposed Self-Evaluation and Continuous Assessment System

ERIC Educational Resources Information Center

Robles-Gómez, Antonio; Ros, Salvador; Hernández, Roberto; Tobarra, Llanos; Caminero, Agustin C.; Agudo, José M.

2015-01-01

The WWW nowadays enables faculty to develop new Internet-based applications that can be used to enhance classroom instruction. There is a clear evolution towards the implementation of new service-oriented learning/teaching systems, which can be considered as the latest generation of Internet-based platforms. This work first describes a…

SAFIS area estimation techniques

Treesearch

Gregory A. Reams

2000-01-01

The Southern Annual Forest Inventory System (SAFIS) is in various stages of implementation in 8 of the 13 southern states served by the Southern Research Station of the USDA Forest Service. Compared to periodic inventories, SAFIS requires more rapid generation of land use and land cover maps. The current photo system for phase one area estimation has changed little...

Implementing an interdisciplinary intergenerational program using the Cyber Seniors® reverse mentoring model within higher education.

PubMed

Leedahl, Skye N; Brasher, Melanie Sereny; Estus, Erica; Breck, Bethany M; Dennis, Cory B; Clark, Samantha C

2018-01-24

Intergenerational service-learning in higher education positively affects older adults and students, but little is known about the effectiveness of interdisciplinary, reverse mentoring programs that use technology as the medium of bringing generations together. This study describes an intergenerational service-learning program that utilizes reverse mentoring within higher education, the "Engaging Generations Program," at a midsized public university in New England where students help older adults learn about technology, and students gain communication and teaching skills. In this article, we outline how the program was implemented, present quantitative data on participation outcomes for students and older adults and qualitative data from older adults, and discuss best practices. Analysis of pre/post surveys found that students' attitudes toward aging improved (p < 0.01) and older adults interest in technology improved (p < 0.05) after program participation. Best practices identified included: multiple meetings with the same pair to deepen friendships, in-person training for student leaders, student responsibility for scheduling, tailoring sessions to each participant, student documentation of meetings, and active involvement by community partners.

Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

PubMed Central

Choi, Jinwook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-Sun; Kim, Young-Ah; Yang, Seung Hoon; Jo, Eun Mi; Hwang, Min-A; Kim, Wan Suk; Lee, Eun Hye; Choi, Su Hi

2010-01-01

Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system. PMID:21818449

Production of the next-generation library virtual tour

PubMed Central

Duncan, James M.; Roth, Linda K.

2001-01-01

While many libraries offer overviews of their services through their Websites, only a small number of health sciences libraries provide Web-based virtual tours. These tours typically feature photographs of major service areas along with textual descriptions. This article describes the process for planning, producing, and implementing a next-generation virtual tour in which a variety of media elements are integrated: photographic images, 360-degree “virtual reality” views, textual descriptions, and contextual floor plans. Hardware and software tools used in the project are detailed, along with a production timeline and budget, tips for streamlining the process, and techniques for improving production. This paper is intended as a starting guide for other libraries considering an investment in such a project. PMID:11837254

Worldwide telemedicine services based on distributed multimedia electronic patient records by using the second generation Web server hyperwave.

PubMed

Quade, G; Novotny, J; Burde, B; May, F; Beck, L E; Goldschmidt, A

1999-01-01

A distributed multimedia electronic patient record (EPR) is a central component of a medicine-telematics application that supports physicians working in rural areas of South America, and offers medical services to scientists in Antarctica. A Hyperwave server is used to maintain the patient record. As opposed to common web servers--and as a second generation web server--Hyperwave provides the capability of holding documents in a distributed web space without the problem of broken links. This enables physicians to browse through a patient's record by using a standard browser even if the patient's record is distributed over several servers. The patient record is basically implemented on the "Good European Health Record" (GEHR) architecture.

VLT interferometer upgrade for the 2nd generation of interferometric instruments

NASA Astrophysics Data System (ADS)

Gonté, Frederic; Woillez, Julien; Schuhler, Nicolas; Egner, Sebastian; Merand, Antoine; Abad, José Antonio; Abadie, Sergio; Abuter, Roberto; Acuña, Margarita; Allouche, Fatmé; Alonso, Jaime; Andolfalto, Luigi; Antonelli, Pierre; Avila, Gerardo; Barriga, Pablo José; Beltran, Juan; Berger, Jean-Philippe; Bolados, Carlos; Bonnet, Henri; Bourget, Pierre; Brast, Roland; Bristow, Paul; Caniguante, Luis; Castillo, Roberto; Conzelmann, Ralf; Cortes, Angela; Delplancke, Françoise; Del Valle, Diego; Derie, Frederic; Diaz, Alvaro; Donoso, Reinaldo; Dorn, Reinhold; Duhoux, Philippe; Dupuy, Christophe; Eisenhauer, Frank; Elao, Christian; Fuenteseca, Eloy; Fernandez, Ruben; Gaytan, Daniel; Glindemann, Andreas; Gonzales, Jaime; Guieu, Sylvain; Guisard, Stephane; Haguenauer, Pierre; Haimerl, Andreas; Heinz, Volker; Henriquez, Juan Pablo; van der Heyden, P.; Hubin, Norbert; Huerta, Rodrigo; Jochum, Lieselotte; Leiva, Alfredo; Lévêque, Samuel; Lizon, Jean-Louis; Luco, Fernando; Mardones, Pedro; Mellado, Angel; Osorio, Juan; Ott, Jürgen; Pallanca, Laurent; Pavez, Marcus; Pasquini, Luca; Percheron, Isabelle; Pirard, Jean-Francois; Than Phan, Duc; Pineda, Juan Carlos; Pino, Andres; Poupar, Sebastien; Ramírez, Andres; Reinero, Claudio; Riquelme, Miguel; Romero, Juan; Rivinius, Thomas; Rojas, Chester; Rozas, Felix; Salgado, Fernando; Scheithauer, Silvia; Schmid, Christian; Schöller, Markus; Siclari, Waldo; Stephan, Christian; Tamblay, Richard; Tapia, Mario; Tristram, Konrad; Valdes, Guillermo; de Wit, Willem-Jan; Wright, Andrew; Zins, Gerard

2016-08-01

ESO is undertaking a large upgrade of the infrastructure on Cerro Paranal in order to integrate the 2nd generation of interferometric instruments Gravity and MATISSE, and increase its performance. This upgrade started mid 2014 with the construction of a service station for the Auxiliary Telescopes and will end with the implementation of the adaptive optics system for the Auxiliary telescope (NAOMI) in 2018. This upgrade has an impact on the infrastructure of the VLTI, as well as its sub-systems and scientific instruments.

Prototype of Partial Cutting Tool of Geological Map Images Distributed by Geological Web Map Service

NASA Astrophysics Data System (ADS)

Nonogaki, S.; Nemoto, T.

2014-12-01

Geological maps and topographical maps play an important role in disaster assessment, resource management, and environmental preservation. These map information have been distributed in accordance with Web services standards such as Web Map Service (WMS) and Web Map Tile Service (WMTS) recently. In this study, a partial cutting tool of geological map images distributed by geological WMTS was implemented with Free and Open Source Software. The tool mainly consists of two functions: display function and cutting function. The former function was implemented using OpenLayers. The latter function was implemented using Geospatial Data Abstraction Library (GDAL). All other small functions were implemented by PHP and Python. As a result, this tool allows not only displaying WMTS layer on web browser but also generating a geological map image of intended area and zoom level. At this moment, available WTMS layers are limited to the ones distributed by WMTS for the Seamless Digital Geological Map of Japan. The geological map image can be saved as GeoTIFF format and WebGL format. GeoTIFF is one of the georeferenced raster formats that is available in many kinds of Geographical Information System. WebGL is useful for confirming a relationship between geology and geography in 3D. In conclusion, the partial cutting tool developed in this study would contribute to create better conditions for promoting utilization of geological information. Future work is to increase the number of available WMTS layers and the types of output file format.

An interprofessional exploration of nursing and social work roles when working jointly with families.

PubMed

Bennett, Elaine; Hauck, Yvonne; Radford, Georgina; Bindahneem, Sakina

2016-01-01

Ngala, an early parenting not-for-profit organisation in Western Australia, has provided services to families with young children since 1890. Child health nurses and mothercraft nurses were the primary workforce until the 1980s when a social worker was employed and a new era of interprofessional collaboration began. Evidence to date has focused on nursing workforce, interprofessional education, and interprofessional teams. Little is known about the roles of nursing and social work when working jointly with families. A new service commenced in 2012 for families with children with developmental delays. Social workers and child health nurses were employed for this service model. Our study aim was to explore the perceptions of how nurses and social workers work together with a family providing psychosocial support across a new service. The study was conducted alongside implementation of this new service. An exploratory case study approach was adopted to generate an in-depth understanding of the roles of nurses and social workers. In total, 22 semi-structured interviews and one focus group across the first year of implementing the new service were undertaken. Analysis of these data revealed four major themes. Findings presented in this article will inform further reflection and consideration into the future interprofessional workforce priorities and requirements for Early Parenting Services.

Web access and dissemination of Andalusian coastal erosion rates: viewers and standard/filtered map services.

NASA Astrophysics Data System (ADS)

Álvarez Francoso, Jose; Prieto Campos, Antonio; Ojeda Zujar, Jose; Guisado-Pintado, Emilia; Pérez Alcántara, Juan Pedro

2017-04-01

The accessibility to environmental information via web viewers using map services (OGC or proprietary services) has become more frequent since newly information sources (ortophotos, LIDAR, GPS) are of great detailed and thus generate a great volume of data which barely can be disseminated using either analogue (paper maps) or digital (pdf) formats. Moreover, governments and public institutions are concerned about the need of facilitates provision to research results and improve communication about natural hazards to citizens and stakeholders. This information ultimately, if adequately disseminated, it's crucial in decision making processes, risk management approaches and could help to increase social awareness related to environmental issues (particularly climate change impacts). To overcome this issue, two strategies for wide dissemination and communication of the results achieved in the calculation of beach erosion for the 640 km length of the Andalusian coast (South Spain) using web viewer technology are presented. Each of them are oriented to different end users and thus based on different methodologies. Erosion rates has been calculated at 50m intervals for different periods (1956-1977-2001-2011) as part of a National Research Project based on the spasialisation and web-access of coastal vulnerability indicators for Andalusian region. The 1st proposal generates WMS services (following OGC standards) that are made available by Geoserver, using a geoviewer client developed through Leaflet. This viewer is designed to be used by the general public (citizens, politics, etc) by combining a set of tools that give access to related documents (pdfs), visualisation tools (panoramio pictures, geo-localisation with GPS) are which are displayed within an user-friendly interface. Further, the use of WMS services (implemented on Geoserver) provides a detailed semiology (arrows and proportional symbols, using alongshore coastaline buffers to represent data) which not only enhances access to erosion rates but also enables multi-scale data representation. The 2nd proposal, as intended to be used by technicians and specialists on the field, includes a geoviewer with an innovative profile (including visualization of time-ranges, application of different uncertainty levels to the data, etc) to fulfil the needs of these users. For its development, a set of Javascript libraries combined with Openlayers (or Leaflet) are implemented to guarantee all the functionalities existing for the basic geoviewer. Further to this, the viewer has been improved by i) the generation of services by request through the application of a filter in ECQL language (Extended Common Query Language), using the vendor parameter CQL_FILTER from Geoserver. These dynamic filters allow the final user to predefine the visualised variable, its spatial and temporal domain, a range of specific values and other attributes, thus multiplying the generation of real-time cartography; ii) by using the layer's WFS service, the Javascript application exploit the alphanumeric data to generate related statistics in real time (e.g. mean rates, length of eroded coast, etc.) and interactive graphs (via HighCharts.js library) which accurately help in beach erosion rates interpretation (representing trends and bars diagrams, among others. As a result two approaches for communicating scientific results to different audiences based on web-based with complete dataset of geo-information, services and functionalities are implemented. The combination of standardised environmental data with tailor-made exploitation techniques (interactive maps, and real-time statistics) assures the correct access and interpretation of the information.

Software Defined Networking for Next Generation Converged Metro-Access Networks

NASA Astrophysics Data System (ADS)

Ruffini, M.; Slyne, F.; Bluemm, C.; Kitsuwan, N.; McGettrick, S.

2015-12-01

While the concept of Software Defined Networking (SDN) has seen a rapid deployment within the data center community, its adoption in telecommunications network has progressed slowly, although the concept has been swiftly adopted by all major telecoms vendors. This paper presents a control plane architecture for SDN-driven converged metro-access networks, developed through the DISCUS European FP7 project. The SDN-based controller architecture was developed in a testbed implementation targeting two main scenarios: fast feeder fiber protection over dual-homed Passive Optical Networks (PONs) and dynamic service provisioning over a multi-wavelength PON. Implementation details and results of the experiment carried out over the second scenario are reported in the paper, showing the potential of SDN in providing assured on-demand services to end-users.

Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis

PubMed Central

Wells, Rebecca S.; Zagursky, Karen; Fettes, Danielle L.; Palinkas, Lawrence A.

2009-01-01

Objectives. We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Methods. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Results. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Conclusions. Implementation of EBP is a complex process. Cross-system–level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns. PMID:19762654

EIDA Next Generation: ongoing and future developments

NASA Astrophysics Data System (ADS)

Strollo, Angelo; Quinteros, Javier; Sleeman, Reinoud; Trani, Luca; Clinton, John; Stammler, Klaus; Danecek, Peter; Pedersen, Helle; Ionescu, Constantin

2015-04-01

The European Integrated Data Archive (EIDA; http://www.orfeus-eu.org/eida/eida.html) is the distributed Data Centre system within ORFEUS, providing transparent access and services to high quality, seismic data across (currently) 9 large data archives in Europe. EIDA is growing, in terms of the number of participating data centres, the size of the archives, the variability of the data in the archives, the number of users, and the volume of downloads. The on-going success of EIDA is thus providing challenges that are the driving force behind the design of the next generation (NG) of EIDA, which is expected to be implemented within EPOS IP. EIDA ORFEUS must cope with further expansion of the system and more complex user requirements by developing new techniques and extended services. The EIDA NG is being designed to work on standard FDSN web services and two additional new web services: Routing Service and QC (quality controlled) service. This presentation highlights the challenges EIDA needs to address during the EPOS IP and focuses on these 2 new services. The Routing Service can be considered as the core of EIDA NG. It was designed to assist users and clients to locate data within a federated, decentralized data centre (e.g. EIDA). A detailed, FDSN-compliant specification of the service has been developed. Our implementation of this service will run at every EIDA node, but is also capable of running on a user's computer, allowing anyone to define virtual or integrate existing data centres. This (meta)service needs to be queried in order to locate the data. Some smart clients (in a beta status) have been also provided to offer the user an integrated view of the whole EIDA, hiding the complexity of its internal structure. The service is open and able to be queried by anyone without the need of credentials or authentication. The QC Service is developed to cope with user requirements to query for relevant data only. The web service provides detailed information on the contents of the waveform data in an archive and in particular the following features and quality parameters are provided: gaps, statistical values, availability, overlaps, quality flags and more. It is a tool to be used for quickly exploring the contents of the waveform files before downloading them, or by clients to fulfill user specific requirements. The API reflects almost identically the FDSN dataselect service with some additional features. The characteristics are computed on fixed daily intervals (day boundaries) and in case of gaps the service can additionally provide the above features for each continuous data segment in the day interval. The newly developed services and the mediator service being designed and implemented in the near future, will facilitate interoperability and sustainability of the EIDA system and ensure a smooth integration with other Thematic (TCS) and Integrated (ICS) Core Services within EPOS.

Qualitative evaluation: A critical and interpretative complementary approach to improve health programs and services

PubMed Central

Tayabas, Luz María Tejada; León, Teresita Castillo; ESPINO, JOEL MONARREZ

2014-01-01

This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders’ perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries. PMID:25152220

A methodology for generating a tailored implementation blueprint: an exemplar from a youth residential setting.

PubMed

Lewis, Cara C; Scott, Kelli; Marriott, Brigid R

2018-05-16

Tailored implementation approaches are touted as more likely to support the integration of evidence-based practices. However, to our knowledge, few methodologies for tailoring implementations exist. This manuscript will apply a model-driven, mixed methods approach to a needs assessment to identify the determinants of practice, and pilot a modified conjoint analysis method to generate an implementation blueprint using a case example of a cognitive behavioral therapy (CBT) implementation in a youth residential center. Our proposed methodology contains five steps to address two goals: (1) identify the determinants of practice and (2) select and match implementation strategies to address the identified determinants (focusing on barriers). Participants in the case example included mental health therapists and operations staff in two programs of Wolverine Human Services. For step 1, the needs assessment, they completed surveys (clinician N = 10; operations staff N = 58; other N = 7) and participated in focus groups (clinician N = 15; operations staff N = 38) guided by the domains of the Framework for Diffusion [1]. For step 2, the research team conducted mixed methods analyses following the QUAN + QUAL structure for the purpose of convergence and expansion in a connecting process, revealing 76 unique barriers. Step 3 consisted of a modified conjoint analysis. For step 3a, agency administrators prioritized the identified barriers according to feasibility and importance. For step 3b, strategies were selected from a published compilation and rated for feasibility and likelihood of impacting CBT fidelity. For step 4, sociometric surveys informed implementation team member selection and a meeting was held to identify officers and clarify goals and responsibilities. For step 5, blueprints for each of pre-implementation, implementation, and sustainment phases were generated. Forty-five unique strategies were prioritized across the 5 years and three phases representing all nine categories. Our novel methodology offers a relatively low burden collaborative approach to generating a plan for implementation that leverages advances in implementation science including measurement, models, strategy compilations, and methods from other fields.

Navigating the Information Ocean: Charting the Course. Abstracts from the Academic Library Association of Ohio Annual Conference (Columbus, Ohio, November 4, 1994).

ERIC Educational Resources Information Center

Academic Library Association of Ohio.

Abstracts of 14 papers presented at the conference are provided here. Titles are: "Electronic Information Terraforming: Designing and Implementing a Front-end System Using World-Wide Web Technology" (Abbie Basile; And Others); "Characteristics of Generation X and Implications for Reference and Instructional Services" (Catherine…

Nascom System Development Plan: System Description, Capabilities and Plans

NASA Technical Reports Server (NTRS)

1995-01-01

The NASA Communications (Nascom) System Development Plan (NSDP), reissued annually, describes the organization of Nascom, how it obtains communication services, its current systems, its relationship with other NASA centers and International Partner Agencies, some major spaceflight projects which generate significant operational communication support requirements, and major Nascom projects in various stages of development or implementation.

Universal coverage challenges require health system approaches; the case of India.

PubMed

Duran, Antonio; Kutzin, Joseph; Menabde, Nata

2014-02-01

This paper uses the case of India to demonstrate that Universal Health Coverage (UHC) is about not only health financing; personal and population services production issues, stewardship of the health system and generation of the necessary resources and inputs need to accompany the health financing proposals. In order to help policy makers address UHC in India and sort out implementation issues, the framework developed by the World Health Organization (WHO) in the World Health Report 2000 and its subsequent extensions are advocated. The framework includes final goals, generic intermediate objectives and four inter-dependent functions which interact as a system; it can be useful by diagnosing current shortcomings and facilitating the filling up of gaps between functions and goals. Different positions are being defended in India re the preconditions for UHC to succeed. This paper argues that more (public) money will be important, but not enough; it needs to be supplemented with broad interventions at various health system levels. The paper analyzes some of the most important issues in relation to the functions of service production, generation of inputs and the necessary stewardship. It also pays attention to reform implementation, as different from its design, and suggests critical aspects emanating from a review of recent health system reforms. Precisely because of the lack of comparative reference for India, emphasis is made on the need to accompany implementation with analysis, so that the "solutions" ("what to do?", "how to do it?") are found through policy analysis and research embedded into flexible implementation. Strengthening "evidence-to-policy" links and the intelligence dimension of stewardship/leadership as well as accountability during implementation are considered paramount. Countries facing similar challenges to those faced by India can also benefit from the above approaches. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Low Earth Orbit satellite/terrestrial mobile service compatibility

NASA Technical Reports Server (NTRS)

Sheriff, Ray E.; Gardiner, John G.

1993-01-01

Currently the geostationary type of satellite is the only one used to provide commercial mobile-satellite communication services. Low earth orbit (LEO) satellite systems are now being proposed as a future alternative. By the implementation of LEO satellite systems, predicted at between 5 and 8 years time, mobile space/terrestrial technology will have progressed to the third generation stage of development. This paper considers the system issues that will need to be addressed when developing a dual mode terminal, enabling access to both terrestrial and LEO satellite systems.

An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

PubMed

Abidi, S S

2001-06-01

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

Personalized Location-Based Recommendation Services for Tour Planning in Mobile Tourism Applications

NASA Astrophysics Data System (ADS)

Yu, Chien-Chih; Chang, Hsiao-Ping

Travel and tour planning is a process of searching, selecting, grouping and sequencing destination related products and services including attractions, accommodations, restaurants, and activities. Personalized recommendation services aim at suggesting products and services to meet users’ preferences and needs, while location-based services focus on providing information based on users’ current positions. Due to the fast growing of user needs in the mobile tourism domain, how to provide personalized location-based tour recommendation services becomes a critical research and practical issue. The objective of this paper is to propose a system architecture and design methods for facilitating the delivery of location-based recommendation services to support personalized tour planning. Based on tourists’ current location and time, as well as personal preferences and needs, various recommendations regarding sightseeing spots, hotels, restaurants, and packaged tour plans can be generated efficiently. An application prototype is also implemented to illustrate and test the system feasibility and effectiveness.

Overview of telepathology, virtual microscopy, and whole slide imaging: prospects for the future.

PubMed

Weinstein, Ronald S; Graham, Anna R; Richter, Lynne C; Barker, Gail P; Krupinski, Elizabeth A; Lopez, Ana Maria; Erps, Kristine A; Bhattacharyya, Achyut K; Yagi, Yukako; Gilbertson, John R

2009-08-01

Telepathology, the practice of pathology at a long distance, has advanced continuously since 1986. Today, fourth-generation telepathology systems, so-called virtual slide telepathology systems, are being used for education applications. Both conventional and innovative surgical pathology diagnostic services are being designed and implemented as well. The technology has been commercialized by more than 30 companies in Asia, the United States, and Europe. Early adopters of telepathology have been laboratories with special challenges in providing anatomic pathology services, ranging from the need to provide anatomic pathology services at great distances to the use of the technology to increase efficiency of services between hospitals less than a mile apart. As to what often happens in medicine, early adopters of new technologies are professionals who create model programs that are successful and then stimulate the creation of infrastructure (ie, reimbursement, telecommunications, information technologies, and so on) that forms the platforms for entry of later, mainstream, adopters. The trend at medical schools, in the United States, is to go entirely digital for their pathology courses, discarding their student light microscopes, and building virtual slide laboratories. This may create a generation of pathology trainees who prefer digital pathology imaging over the traditional hands-on light microscopy. The creation of standards for virtual slide telepathology is early in its development but accelerating. The field of telepathology has now reached a tipping point at which major corporations now investing in the technology will insist that standards be created for pathology digital imaging as a value added business proposition. A key to success in teleradiology, already a growth industry, has been the implementation of standards for digital radiology imaging. Telepathology is already the enabling technology for new, innovative laboratory services. Examples include STAT QA surgical pathology second opinions at a distance and a telehealth-enabled rapid breast care service. The innovative bundling of telemammography, telepathology, and teleoncology services may represent a new paradigm in breast care that helps address the serious issue of fragmentation of breast cancer care in the United States and elsewhere. Legal and regulatory issues in telepathology are being addressed and are regarded as a potential catalyst for the next wave of telepathology advances, applications, and implementations.

Implementation and validation of a conceptual benchmarking framework for patient blood management.

PubMed

Kastner, Peter; Breznik, Nada; Gombotz, Hans; Hofmann, Axel; Schreier, Günter

2015-01-01

Public health authorities and healthcare professionals are obliged to ensure high quality health service. Because of the high variability of the utilisation of blood and blood components, benchmarking is indicated in transfusion medicine. Implementation and validation of a benchmarking framework for Patient Blood Management (PBM) based on the report from the second Austrian Benchmark trial. Core modules for automatic report generation have been implemented with KNIME (Konstanz Information Miner) and validated by comparing the output with the results of the second Austrian benchmark trial. Delta analysis shows a deviation <0.1% for 95% (max. 1.4%). The framework provides a reliable tool for PBM benchmarking. The next step is technical integration with hospital information systems.

Using public policy to improve outcomes for asthmatic children in schools.

PubMed

Lynn, Jewlya; Oppenheimer, Sophie; Zimmer, Lorena

2014-12-01

School-based services to improve asthma management need to be accompanied by public policies that can help sustain services, scale effective interventions, create greater equity across schools, and improve outcomes for children. Several national organizations, including the Centers for Disease Control and Prevention, have recommended specific public policies the adoption of which in school settings can improve asthma outcomes for children. Although many states and school districts have adopted some of these policies, adoption is not universal, and implementation is not always successful, leaving inequities in children's access to asthma services and supports. These issues can be addressed by changing public policy. Policy change is a complex process, but it is one that will benefit from greater involvement by asthma experts, including the researchers who generate the knowledge base on what services, supports, and policies have the best outcomes for children. Asthma experts can participate in the policy process by helping to build awareness of the need for school-based asthma policy, estimating the costs associated with policy options and with inaction, advocating for the selection of specific policies, assisting in implementation (including providing feedback), conducting the research that can evaluate the effectiveness of implementation, and ultimately providing information back into the policy process to allow for improvements to the policies. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Performance, implementation and network management techniques for a European CDMA-based land-mobile satellite system

NASA Astrophysics Data System (ADS)

Arenaccio, S.; Vernucci, A.; Padovani, R.; Arcidiacono, A.

Results of a detailed comparative performance assessment between two candidate access solutions for the provision of land-mobile services, i.e., FDMA and CDMA, for the European Land-Mobile Satellite Services (LMSS) provision are presented. The design of the CDMA access system and the network architecture, system procedures, network control, operation in fading environments, and implementation aspects of the system are described. The CDMA system is shown to yield superior traffic capability, despite the absence of polarization reuse due to payload design, especially in the second-generation era (multiple spot-beams). In this case, the advantage was found to be largely dependent on the traffic distribution across spot beams. Power control techniques are proposed to cope with the geographical disadvantage suffered by mobile stations located at the beam borders to compensate for fadings.

Implementing integrated services for people with epilepsy in primary care in Ethiopia: a qualitative study.

PubMed

Catalao, Raquel; Eshetu, Tigist; Tsigebrhan, Ruth; Medhin, Girmay; Fekadu, Abebaw; Hanlon, Charlotte

2018-05-21

In order to tackle the considerable treatment gap for epilepsy in many low- and middle-income countries (LMICs), a task sharing model is recommended whereby care is integrated into primary health services. However, there are limited data on implementation and impact of such services in LMICs. Our study aimed to explore the perspectives of service users and caregivers on the accessibility, experience and perceived impact of epilepsy treatment received in a task-shared model in a rural district of Ethiopia. A qualitative study was carried out using interviews with purposively sampled service users (n = 13) and caregivers (n = 3) from a community-ascertained cohort of people with epilepsy receiving integrated services in primary care in rural Ethiopia. Interviews followed a topic guide with questions regarding acceptability, satisfaction, barriers to access care, pathways through care and impact of services. Framework analysis was employed to analyse the data. Proximity of the new service in local primary health centers decreased the cost of transportation for the majority of service users thus improving access to services. First-hand experience of services was in some cases associated with a willingness to promote the services and inform others of the existence of effective biomedical treatment for epilepsy. However, most service users and their caregivers continued to seek help from traditional healers alongside biomedical care. Most of the care received was focused on medication provision with limited information provided on how to manage their illness and its effects. Caregivers and service users spoke about the high emotional and financial burden of the disease and lack of ongoing practical and emotional support. The majority of participants reported clinical improvement on medication, which in over half of the participants was associated with ability to return to money generating activities. Task-sharing improved the accessibility of epilepsy care for services users and caregivers and was perceived as having a positive impact on symptoms and productivity. Nonetheless, promotion of self-management, holistic care and family engagement were highlighted as areas requiring further improvement. Future work on implementing chronic care models in LMIC contexts is warranted.

The TRIDEC Virtual Tsunami Atlas - customized value-added simulation data products for Tsunami Early Warning generated on compute clusters

NASA Astrophysics Data System (ADS)

Löwe, P.; Hammitzsch, M.; Babeyko, A.; Wächter, J.

2012-04-01

The development of new Tsunami Early Warning Systems (TEWS) requires the modelling of spatio-temporal spreading of tsunami waves both recorded from past events and hypothetical future cases. The model results are maintained in digital repositories for use in TEWS command and control units for situation assessment once a real tsunami occurs. Thus the simulation results must be absolutely trustworthy, in a sense that the quality of these datasets is assured. This is a prerequisite as solid decision making during a crisis event and the dissemination of dependable warning messages to communities under risk will be based on them. This requires data format validity, but even more the integrity and information value of the content, being a derived value-added product derived from raw tsunami model output. Quality checking of simulation result products can be done in multiple ways, yet the visual verification of both temporal and spatial spreading characteristics for each simulation remains important. The eye of the human observer still remains an unmatched tool for the detection of irregularities. This requires the availability of convenient, human-accessible mappings of each simulation. The improvement of tsunami models necessitates the changes in many variables, including simulation end-parameters. Whenever new improved iterations of the general models or underlying spatial data are evaluated, hundreds to thousands of tsunami model results must be generated for each model iteration, each one having distinct initial parameter settings. The use of a Compute Cluster Environment (CCE) of sufficient size allows the automated generation of all tsunami-results within model iterations in little time. This is a significant improvement to linear processing on dedicated desktop machines or servers. This allows for accelerated/improved visual quality checking iterations, which in turn can provide a positive feedback into the overall model improvement iteratively. An approach to set-up and utilize the CCE has been implemented by the project Collaborative, Complex, and Critical Decision Processes in Evolving Crises (TRIDEC) funded under the European Union's FP7. TRIDEC focuses on real-time intelligent information management in Earth management. The addressed challenges include the design and implementation of a robust and scalable service infrastructure supporting the integration and utilisation of existing resources with accelerated generation of large volumes of data. These include sensor systems, geo-information repositories, simulations and data fusion tools. Additionally, TRIDEC adopts enhancements of Service Oriented Architecture (SOA) principles in terms of Event Driven Architecture (EDA) design. As a next step the implemented CCE's services to generate derived and customized simulation products are foreseen to be provided via an EDA service for on-demand processing for specific threat-parameters and to accommodate for model improvements.

Wireless intelligent network: infrastructure before services?

NASA Astrophysics Data System (ADS)

Chu, Narisa N.

1996-01-01

The Wireless Intelligent Network (WIN) intends to take advantage of the Advanced Intelligent Network (AIN) concepts and products developed from wireline communications. However, progress of the AIN deployment has been slow due to the many barriers that exist in the traditional wireline carriers' deployment procedures and infrastructure. The success of AIN has not been truly demonstrated. The AIN objectives and directions are applicable to the wireless industry although the plans and implementations could be significantly different. This paper points out WIN characteristics in architecture, flexibility, deployment, and value to customers. In order to succeed, the technology driven AIN concept has to be reinforced by the market driven WIN services. An infrastructure suitable for the WIN will contain elements that are foreign to the wireline network. The deployment process is expected to seed with the revenue generated services. Standardization will be achieved by simplifying and incorporating the IS-41C, AIN, and Intelligent Network CS-1 recommendations. Integration of the existing and future systems impose the biggest challenge of all. Service creation has to be complemented with service deployment process which heavily impact the carriers' infrastructure. WIN deployment will likely start from an Intelligent Peripheral, a Service Control Point and migrate to a Service Node when sufficient triggers are implemented in the mobile switch for distributed call control. The struggle to move forward will not be based on technology, but rather on the impact to existing infrastructure.

Implementation of a Complex Intervention to Support Leadership Development in Nursing Homes: A Multimethod Participatory Study.

PubMed

Dewar, Belinda; Barrie, Karen; Sharp, Cathy; Meyer, Julienne

2017-04-01

Leadership is key to quality improvement in nursing homes. This article reports on the initial analysis of the transformational My Home Life Leadership Support program for nursing home managers being implemented in Scotland. It analyses learning from a multimethod participatory descriptive study. Contribution analysis theory informed the evaluation. Evidence-Based Practice, Relationship-Centered Care, Appreciative Inquiry, and Caring Conversations informed the intervention to develop transformational leadership. Data generation methods included baseline and postintervention questionnaires to describe culture change within the study population, together with more in-depth qualitative data generated from group discussions throughout the leadership support program. Qualitative data analysis was an iterative collaborative process with participants to generate themes about the impact of the program on themselves and their practice. Data showed positive changes in managers' perceptions of their self-awareness, leadership communication and relationship skills, and development of positive cultures. This model offers lessons for those interested in ways to approach the emotional, educational, and cultural dynamics of change in other human service contexts.

A Lesson Based on Student-Generated Ideas: A Practical Example Highlighting the Role of a Teacher

ERIC Educational Resources Information Center

Fuentes, Sarah Quebec

2011-01-01

The role of a teacher is different from that in traditional mathematics instruction when the implementation of a lesson is based on students' ideas. The author's experience teaching the same lesson (of the latter format) to two different classes of pre-service teachers in an elementary mathematics methods course is described. Since whole-class…

Including a Service Learning Educational Research Project in a Biology Course-I: Assessing Community Awareness of Childhood Lead Poisoning

ERIC Educational Resources Information Center

Abu-Shakra, Amal; Saliim, Eric

2012-01-01

A university course project was developed and implemented in a biology course, focusing on environmental problems, to assess community awareness of childhood lead poisoning. A set of 385 questionnaires was generated and distributed in an urban community in North Carolina, USA. The completed questionnaires were sorted first into yes and no sets…

Environmental Visualization and Horizontal Fusion

DTIC Science & Technology

2005-10-01

the section on EVIS Rules. Federated Search – Discovering Content Another method of discovering services and their content has been implemented...in HF through a next-generation knowledge discovery framework called Federated Search . A virtual information space, called Collateral Space was...environmental mission effects products, is presented later in the paper. Federated Search allows users to search through Collateral Space data that is

Applying Reflective Middleware Techniques to Optimize a QoS-enabled CORBA Component Model Implementation

NASA Technical Reports Server (NTRS)

Wang, Nanbor; Parameswaran, Kirthika; Kircher, Michael; Schmidt, Douglas

2003-01-01

Although existing CORBA specifications, such as Real-time CORBA and CORBA Messaging, address many end-to-end quality-of service (QoS) properties, they do not define strategies for configuring these properties into applications flexibly, transparently, and adaptively. Therefore, application developers must make these configuration decisions manually and explicitly, which is tedious, error-prone, and open sub-optimal. Although the recently adopted CORBA Component Model (CCM) does define a standard configuration framework for packaging and deploying software components, conventional CCM implementations focus on functionality rather than adaptive quality-of-service, which makes them unsuitable for next-generation applications with demanding QoS requirements. This paper presents three contributions to the study of middleware for QoS-enabled component-based applications. It outlines rejective middleware techniques designed to adaptively (1) select optimal communication mechanisms, (2) manage QoS properties of CORBA components in their contain- ers, and (3) (re)con$gure selected component executors dynamically. Based on our ongoing research on CORBA and the CCM, we believe the application of rejective techniques to component middleware will provide a dynamically adaptive and (re)configurable framework for COTS software that is well-suited for the QoS demands of next-generation applications.

Applying Reflective Middleware Techniques to Optimize a QoS-enabled CORBA Component Model Implementation

NASA Technical Reports Server (NTRS)

Wang, Nanbor; Kircher, Michael; Schmidt, Douglas C.

2000-01-01

Although existing CORBA specifications, such as Real-time CORBA and CORBA Messaging, address many end-to-end quality-of-service (QoS) properties, they do not define strategies for configuring these properties into applications flexibly, transparently, and adaptively. Therefore, application developers must make these configuration decisions manually and explicitly, which is tedious, error-prone, and often sub-optimal. Although the recently adopted CORBA Component Model (CCM) does define a standard configuration frame-work for packaging and deploying software components, conventional CCM implementations focus on functionality rather than adaptive quality-of service, which makes them unsuitable for next-generation applications with demanding QoS requirements. This paper presents three contributions to the study of middleware for QoS-enabled component-based applications. It outlines reflective middleware techniques designed to adaptively: (1) select optimal communication mechanisms, (2) man- age QoS properties of CORBA components in their containers, and (3) (re)configure selected component executors dynamically. Based on our ongoing research on CORBA and the CCM, we believe the application of reflective techniques to component middleware will provide a dynamically adaptive and (re)configurable framework for COTS software that is well-suited for the QoS demands of next-generation applications.

Smart grid as a service: a discussion on design issues.

PubMed

Chao, Hung-Lin; Tsai, Chen-Chou; Hsiung, Pao-Ann; Chou, I-Hsin

2014-01-01

Smart grid allows the integration of distributed renewable energy resources into the conventional electricity distribution power grid such that the goals of reduction in power cost and in environment pollution can be met through an intelligent and efficient matching between power generators and power loads. Currently, this rapidly developing infrastructure is not as "smart" as it should be because of the lack of a flexible, scalable, and adaptive structure. As a solution, this work proposes smart grid as a service (SGaaS), which not only allows a smart grid to be composed out of basic services, but also allows power users to choose between different services based on their own requirements. The two important issues of service-level agreements and composition of services are also addressed in this work. Finally, we give the details of how SGaaS can be implemented using a FIPA-compliant JADE multiagent system.

Smart Grid as a Service: A Discussion on Design Issues

PubMed Central

Tsai, Chen-Chou; Chou, I-Hsin

2014-01-01

Smart grid allows the integration of distributed renewable energy resources into the conventional electricity distribution power grid such that the goals of reduction in power cost and in environment pollution can be met through an intelligent and efficient matching between power generators and power loads. Currently, this rapidly developing infrastructure is not as “smart” as it should be because of the lack of a flexible, scalable, and adaptive structure. As a solution, this work proposes smart grid as a service (SGaaS), which not only allows a smart grid to be composed out of basic services, but also allows power users to choose between different services based on their own requirements. The two important issues of service-level agreements and composition of services are also addressed in this work. Finally, we give the details of how SGaaS can be implemented using a FIPA-compliant JADE multiagent system. PMID:25243214

Designing Crop Simulation Web Service with Service Oriented Architecture Principle

NASA Astrophysics Data System (ADS)

Chinnachodteeranun, R.; Hung, N. D.; Honda, K.

2015-12-01

Crop simulation models are efficient tools for simulating crop growth processes and yield. Running crop models requires data from various sources as well as time-consuming data processing, such as data quality checking and data formatting, before those data can be inputted to the model. It makes the use of crop modeling limited only to crop modelers. We aim to make running crop models convenient for various users so that the utilization of crop models will be expanded, which will directly improve agricultural applications. As the first step, we had developed a prototype that runs DSSAT on Web called as Tomorrow's Rice (v. 1). It predicts rice yields based on a planting date, rice's variety and soil characteristics using DSSAT crop model. A user only needs to select a planting location on the Web GUI then the system queried historical weather data from available sources and expected yield is returned. Currently, we are working on weather data connection via Sensor Observation Service (SOS) interface defined by Open Geospatial Consortium (OGC). Weather data can be automatically connected to a weather generator for generating weather scenarios for running the crop model. In order to expand these services further, we are designing a web service framework consisting of layers of web services to support compositions and executions for running crop simulations. This framework allows a third party application to call and cascade each service as it needs for data preparation and running DSSAT model using a dynamic web service mechanism. The framework has a module to manage data format conversion, which means users do not need to spend their time curating the data inputs. Dynamic linking of data sources and services are implemented using the Service Component Architecture (SCA). This agriculture web service platform demonstrates interoperability of weather data using SOS interface, convenient connections between weather data sources and weather generator, and connecting various services for running crop models for decision support.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid Power System

NASA Technical Reports Server (NTRS)

Bubenheim, David; Meiners, Dennis

2016-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA. Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40% and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well being in remote communities today and tomorrow.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

2017-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA.Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40 and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well-being in remote communities today and tomorrow.

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-off between co-design activities, the development of innovative services and the efforts allocated to widespread marketing and recruitment initiatives. © The Author(s) 2015.

Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study

PubMed Central

2011-01-01

Background Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. Methods A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Results Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. Conclusions A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly. PMID:22176739

Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study.

PubMed

Barnett, Julie; Vasileiou, Konstantina; Djemil, Fayika; Brooks, Laurence; Young, Terry

2011-12-16

Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly.

Integrating evidence into policy and sustainable disability services delivery in western New South Wales, Australia: the 'wobbly hub and double spokes' project.

PubMed

Veitch, Craig; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Dew, Angela; Bulkeley, Kim; Brentnall, Jennie; Griffiths, Scott

2012-03-21

Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia. The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability. Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation. Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences. Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects. Stage 4 uses mixed methods to monitor and evaluate the implementation and impact of new or adapted policies that arise from the preceding stages. The project will provide policy makers with research evidence to support consideration of the complex balance between: (i) the equitable allocation of scarce resources; (ii) the intent of current eligibility and prioritisation policies; (iii) workforce constraints (and strengths); and (iv) the most effective, evidence-based clinical practice.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2014-04-01

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

Estimating the Cost-Effectiveness of Implementation: Is Sufficient Evidence Available?

PubMed

Whyte, Sophie; Dixon, Simon; Faria, Rita; Walker, Simon; Palmer, Stephen; Sculpher, Mark; Radford, Stefanie

2016-01-01

Timely implementation of recommended interventions can provide health benefits to patients and cost savings to the health service provider. Effective approaches to increase the implementation of guidance are needed. Since investment in activities that improve implementation competes for funding against other health generating interventions, it should be assessed in term of its costs and benefits. In 2010, the National Institute for Health and Care Excellence released a clinical guideline recommending natriuretic peptide (NP) testing in patients with suspected heart failure. However, its implementation in practice was variable across the National Health Service in England. This study demonstrates the use of multi-period analysis together with diffusion curves to estimate the value of investing in implementation activities to increase uptake of NP testing. Diffusion curves were estimated based on historic data to produce predictions of future utilization. The value of an implementation activity (given its expected costs and effectiveness) was estimated. Both a static population and a multi-period analysis were undertaken. The value of implementation interventions encouraging the utilization of NP testing is shown to decrease over time as natural diffusion occurs. Sensitivity analyses indicated that the value of the implementation activity depends on its efficacy and on the population size. Value of implementation can help inform policy decisions of how to invest in implementation activities even in situations in which data are sparse. Multi-period analysis is essential to accurately quantify the time profile of the value of implementation given the natural diffusion of the intervention and the incidence of the disease. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The potential of using the Ecosystem Approach in the implementation of the EU Water Framework Directive.

PubMed

Vlachopoulou, M; Coughlin, D; Forrow, D; Kirk, S; Logan, P; Voulvoulis, N

2014-02-01

The Ecosystem Approach provides a framework for looking at whole ecosystems in decision making to ensure that society can maintain a healthy and resilient natural environment now and for future generations. Although not explicitly mentioned in the Water Framework Directive, the Ecosystem Approach appears to be a promising concept to help its implementation, on the basis that there is a connection between the aims and objectives of the Directive (including good ecological status) and the provision of ecosystem services. In this paper, methodological linkages between the Ecosystem Approach and the Water Framework Directive have been reviewed and a framework is proposed that links its implementation to the Ecosystem Approach taking into consideration all ecosystem services and water management objectives. Individual River Basin Management Plan objectives are qualitatively assessed as to how strong their link is with individual ecosystem services. The benefits of using this approach to provide a preliminary assessment of how it could support future implementation of the Directive have been identified and discussed. Findings also demonstrate its potential to encourage more systematic and systemic thinking as it can provide a consistent framework for identifying shared aims and evaluating alternative water management scenarios and options in decision making. Allowing for a broad consideration of the benefits, costs and tradeoffs that occur in each case, this approach can further improve the economic case for certain measures, and can also help restore the shift in focus from strict legislative compliance towards a more holistic implementation that can deliver the wider aims and intentions of the Directive. © 2013.

Earth Observation-Supported Service Platform for the Development and Provision of Thematic Information on the Built Environment - the Tep-Urban Project

NASA Astrophysics Data System (ADS)

Esch, T.; Asamer, H.; Boettcher, M.; Brito, F.; Hirner, A.; Marconcini, M.; Mathot, E.; Metz, A.; Permana, H.; Soukop, T.; Stanek, F.; Kuchar, S.; Zeidler, J.; Balhar, J.

2016-06-01

The Sentinel fleet will provide a so-far unique coverage with Earth observation data and therewith new opportunities for the implementation of methodologies to generate innovative geo-information products and services. It is here where the TEP Urban project is supposed to initiate a step change by providing an open and participatory platform based on modern ICT technologies and services that enables any interested user to easily exploit Earth observation data pools, in particular those of the Sentinel missions, and derive thematic information on the status and development of the built environment from these data. Key component of TEP Urban project is the implementation of a web-based platform employing distributed high-level computing infrastructures and providing key functionalities for i) high-performance access to satellite imagery and derived thematic data, ii) modular and generic state-of-the art pre-processing, analysis, and visualization techniques, iii) customized development and dissemination of algorithms, products and services, and iv) networking and communication. This contribution introduces the main facts about the TEP Urban project, including a description of the general objectives, the platform systems design and functionalities, and the preliminary portfolio products and services available at the TEP Urban platform.

New directions in Guatemala.

PubMed

1997-02-01

This news brief relates some new directions, since its inception in 1988, which the Family Welfare Association of Guatemala (APROFAM) will be undertaking during 1996-97. In December 1997, APROFAM restructured its program to include reproductive health services with family planning services. The program will target rural Mayan communities. The program will be working toward service sustainability, due to reduced external support. In October 1996 a new board was established that will focus on marketing, IEC, finance and administration, rural development, and clinical services. Meetings between the new board of directors of APROFAM and JOICFP focused on the use of integrated programs as a model for widespread programming among the rural Mayan population. The integrated program that was implemented by JOICFP was successful in reaching Mayan communities of Solola. This population was difficult to reach with conventional family planning approaches. The integrated program was successful in establishing trust with and participation of the rural Mayans. Activities such as parasite control, skills training, and income generation for women were useful in establishing trust and promoting self-reliance. Integrated programs will refocus on family planning and developing self-reliance. The UNFPA will be conducting an annual internal evaluation as a means of sharing information and deepening understanding of project implementation.

Field_ac: a research project on ocean modelling in coastal areas. The experience in the Catalan Sea.

NASA Astrophysics Data System (ADS)

Grifoll, Manel; Pallarès, Elena; Tolosana-Delgado, Raimon; Fernandez, Juan; Lopez, Jaime; Mosso, Cesar; Hermosilla, Fernando; Espino, Manuel; Sanchez-Arcilla, Agustín

2013-04-01

The EU founded Field_ac project has investigated during the last three years methods and strategies for improving operational services in coastal areas. The objective has been to generate added value for shelf and regional scale predictions from GMES Marine Core Services. In this sense the experience in the Catalan Sea site has allowed to combine high-resolution numerical modeling tools nested into regional GMES services, data from intensive field campaigns or local observational networks and remote sensing products. Multi-scale coupled models have been implemented to evaluate different temporal and spatial scales of the dominant physical processes related with waves, currents, continental/river discharges or sediment transport. In this sense the experience of the Field_ac project in the Catalan Sea has permit to "connect" GMES marine core service results to the coastal (local) anthropogenic forcing (e.g. causes of morphodynamic evolution and ecosystem degradation) and will support a knowledge-based assessment of decisions in the coastal zone. This will contribute to the implementation of EU directives (e.g., the Water Framework Directive for water quality at beaches near harbour entrances or the Risk or Flood Directives for waves and sea-level at beach/river-mouth scales).

Improving the quality of e-commerce web service: what is important for the request scheduling algorithm?

NASA Astrophysics Data System (ADS)

Suchacka, Grazyna

2005-02-01

The paper concerns a new research area that is Quality of Web Service (QoWS). The need for QoWS is motivated by a still growing number of Internet users, by a steady development and diversification of Web services, and especially by popularization of e-commerce applications. The goal of the paper is a critical analysis of the literature concerning scheduling algorithms for e-commerce Web servers. The paper characterizes factors affecting the load of the Web servers and discusses ways of improving their efficiency. Crucial QoWS requirements of the business Web server are identified: serving requests before their individual deadlines, supporting user session integrity, supporting different classes of users and minimizing a number of rejected requests. It is justified that meeting these requirements and implementing them in an admission control (AC) and scheduling algorithm for the business Web server is crucial to the functioning of e-commerce Web sites and revenue generated by them. The paper presents results of the literature analysis and discusses algorithms that implement these important QoWS requirements. The analysis showed that very few algorithms take into consideration the above mentioned factors and that there is a need for designing an algorithm implementing them.

Development and Implementation of a Pediatric Palliative Care Program in a Developing Country.

PubMed

Doherty, Megan; Thabet, Chloé

2018-01-01

Palliative care is recognized as an important component of care for children with cancer and other life-limiting conditions. In resource limited settings, palliative care is a key component of care for children with cancer and other life-limiting conditions. Globally, 98% of children who need palliative care live in low- or middle-income countries, where there are very few palliative care services available. There is limited evidence describing the practical considerations for the development and implementation of sustainable and cost-effective palliative care services in developing countries. Our aim is to describe the key considerations and initiatives that were successful in planning and implementing a hospital-based pediatric palliative care service specifically designed for a resource-limited setting. Bangabandu Sheikh Mujib Medical University (BSMMU) is a tertiary referral hospital in Bangladesh. Local palliative care services are very limited and focused on adult patients. In partnership with World Child Cancer, a project establishing a pediatric palliative care service was developed for children with cancer at BSMMU. We describe four key elements which were crucial for the success of this program: (1) raising awareness and sensitizing hospital administrators and clinical staff about pediatric palliative care; (2) providing education and training on pediatric palliative care for clinical staff; (3) forming a pediatric palliative care team; and (4) collecting data to characterize the need for pediatric palliative care. This model of a hospital-based pediatric palliative care service can be replicated in other resource-limited settings and can be expanded to include children with other life-limiting conditions. The development of pilot programs can generate interest among local physicians to become trained in pediatric palliative care and can be used to advocate for the palliative care needs of children.

Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol.

PubMed

Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep

2016-01-01

An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for accredited social health activists in India.

From hospital information system components to the medical record and clinical guidelines & protocols.

PubMed

Veloso, M; Estevão, N; Ferreira, P; Rodrigues, R; Costa, C T; Barahona, P

1997-01-01

This paper introduces an ongoing project towards the development of a new generation HIS, aiming at the integration of clinical and administrative information within a common framework. Its design incorporates explicit knowledge about domain objects and professional activities to be processed by the system together with related knowledge management services and act management services. The paper presents the conceptual model of the proposed HIS architecture, that supports a rich and fully integrated patient data model, enabling the implementation of a dynamic electronic patient record tightly coupled with computerised guideline knowledge bases.

Semi-automated software service integration in virtual organisations

NASA Astrophysics Data System (ADS)

Afsarmanesh, Hamideh; Sargolzaei, Mahdi; Shadi, Mahdieh

2015-08-01

To enhance their business opportunities, organisations involved in many service industries are increasingly active in pursuit of both online provision of their business services (BSs) and collaborating with others. Collaborative Networks (CNs) in service industry sector, however, face many challenges related to sharing and integration of their collection of provided BSs and their corresponding software services. Therefore, the topic of service interoperability for which this article introduces a framework is gaining momentum in research for supporting CNs. It contributes to generation of formal machine readable specification for business processes, aimed at providing their unambiguous definitions, as needed for developing their equivalent software services. The framework provides a model and implementation architecture for discovery and composition of shared services, to support the semi-automated development of integrated value-added services. In support of service discovery, a main contribution of this research is the formal representation of services' behaviour and applying desired service behaviour specified by users for automated matchmaking with other existing services. Furthermore, to support service integration, mechanisms are developed for automated selection of the most suitable service(s) according to a number of service quality aspects. Two scenario cases are presented, which exemplify several specific features related to service discovery and service integration aspects.

[Disease prevention in the elderly: misconceptions in current models].

PubMed

Veras, Renato Peixoto

2012-10-01

The Brazilian population is aging significantly within a context of gradual improvement in the country's social and economic indicators. Increased longevity leads to increased use of health services, pressuring the public and social welfare health services, generating higher costs, and jeopardizing the system's sustainability. The alternative to avoid overburdening the system is to invest in policies for disease prevention, stabilization of chronic diseases, and maintenance of functional capacity. The current article aims to analyze the difficulties in implementing preventive programs and the reasons for the failure of various programs in health promotion, prevention, and management of chronic diseases in the elderly. There can be no solution to the crisis in financing and restructuring the health sector without implementing a preventive logic. Scientific research has already correctly identified the risk factors for the elderly population, but this is not enough. We must use such knowledge to promote the necessary transition from a healthcare-centered model to a preventive one.

Use of ebRIM-based CSW with sensor observation services for registry and discovery of remote-sensing observations

NASA Astrophysics Data System (ADS)

Chen, Nengcheng; Di, Liping; Yu, Genong; Gong, Jianya; Wei, Yaxing

2009-02-01

Recent advances in Sensor Web geospatial data capture, such as high-resolution in satellite imagery and Web-ready data processing and modeling technologies, have led to the generation of large numbers of datasets from real-time or near real-time observations and measurements. Finding which sensor or data complies with criteria such as specific times, locations, and scales has become a bottleneck for Sensor Web-based applications, especially remote-sensing observations. In this paper, an architecture for use of the integration Sensor Observation Service (SOS) with the Open Geospatial Consortium (OGC) Catalogue Service-Web profile (CSW) is put forward. The architecture consists of a distributed geospatial sensor observation service, a geospatial catalogue service based on the ebXML Registry Information Model (ebRIM), SOS search and registry middleware, and a geospatial sensor portal. The SOS search and registry middleware finds the potential SOS, generating data granule information and inserting the records into CSW. The contents and sequence of the services, the available observations, and the metadata of the observations registry are described. A prototype system is designed and implemented using the service middleware technology and a standard interface and protocol. The feasibility and the response time of registry and retrieval of observations are evaluated using a realistic Earth Observing-1 (EO-1) SOS scenario. Extracting information from SOS requires the same execution time as record generation for CSW. The average data retrieval response time in SOS+CSW mode is 17.6% of that of the SOS-alone mode. The proposed architecture has the more advantages of SOS search and observation data retrieval than the existing sensor Web enabled systems.

AstroBus On-Board Software

NASA Astrophysics Data System (ADS)

Biscarros, D.; Cantenot, C.; Séronie-Vivien, J.; Schmidt, G.

AstroBus on-board software is a customisable software for ERC32 based avionics implementing standard ESA Packet Utilization Standard functions. Its architecture based on generic design templates and relying on a library providing standard PUS TC, TM and event services enhances its reusability on various programs. Finally, AstroBus on-board software development and validation environment is based on last generation tools providing an optimised customisation environment.

Increasing profitability through computerization.

PubMed

Sokol, D J

1988-01-01

The author explores the pragmatic or financial justification for computerizing a dental practice and discusses a computerized approach to precollection and collection for the dental office. The article also deals with the use of computerized correspondence to augment the recall policy of the office and to help generate new patient referrals and discusses the pros and cons of utilizing a dental computer service bureau in implementing these policies.

Cooperative advanced-generation breeding and testing of coastal Douglas-fir and western hemlock—strategy and implementation.

Treesearch

K. J.S. Jayawickrama; G.R. Johnson; T. Ye

2005-01-01

As in many temperate regions of the world, forest tree improvement got underway in the Pacific Northwest of the USA in the 1950s, with a number of companies and agencies starting independent tree improvement programs. Booth-Kelly Lumber Co., Crown Zellerbach Corp., the Industrial Forestry Association, Port Blakely Mill Co., Simpson Timber Co., Timber Service Co., the...

Transferring information to an out-of-hours primary care service for patients with palliative care needs: an action research study to improve the use of handover forms.

PubMed

Asprey, Anthea; Richards, Suzanne H; Wright, Christine; Seamark, Clare; Seamark, David; Moxon, Jane

2013-01-01

To work with service users and providers to optimise the design and implementation of handover forms to support the transfer of information between daytime and out-of-hours primary care services for patients with palliative care needs. There is a need for improved informational continuity between daytime and out-of-hours primary care services for patients with palliative care needs. Research suggests that while handover forms are vital to ensure continuity of care, they remain underused for such patients. Audit work in an out-of-hours primary care service in South West England identified that their current system of handover forms was underused. An action research study consisting of two phases was undertaken. In phase one, the views of general practitioners and nurses working in the out-of-hours and daytime primary care services (29 health professionals) in Devon (population c.1.4 million) and patients with palliative care needs and their carers (8 participants) were investigated using qualitative interviews and focus group methods. Participants' views on the content and use of handover forms, and of the systems supporting their generation were sought. In phase two, additional feedback from the health professional stakeholder groups was collected and collaborative work undertaken with the out-of-hours service to implement recommendations emerging from the qualitative research. Findings Respondents identified variable use of handover forms and inconsistent practice in terms of: who was responsible for generating and updating forms; when and where they were discussed in primary care; the criteria used to define which patient needed a form; and the information forms should contain. There was uncertainty about how handover forms were used by the out-of-hours service and concerns about incomplete access to forms for certain groups of staff. An action plan to improve the existing system was developed. This included distribution of educational materials (desktop guide, newsletter) to key stakeholders, and the modification of information systems to facilitate the updating of messages and the accessibility of electronic records for previously under-served staff.

A cluster-randomised controlled trial of values-based training to promote autonomously held recovery values in mental health workers.

PubMed

Williams, Virginia; Deane, Frank P; Oades, Lindsay G; Crowe, Trevor P; Ciarrochi, Joseph; Andresen, Retta

2016-02-02

The implementation and use of evidence-based practices is a key priority for recovery-oriented mental health service provision. Training and development programmes for employees continue to be a key method of knowledge and skill development, despite acknowledged difficulties with uptake and maintenance of behaviour change. Self-determination theory suggests that autonomy, or a sense that behaviour is self-generated, is a key motivator to sustained behaviour change, in this case practices in mental health services. This study examined the utility of values-focused staff intervention as a specific, reproducible method of autonomy support. Mental health workers (n = 146) were assigned via cluster randomisation to either a values clarification condition or an active problem-solving control condition. Results demonstrated that a structured values clarification exercise was useful in promoting integrated motivation for the changed practice and resulted in increased implementation planning. Structured values clarification intervention demonstrates utility as a reproducible means of autonomy support within the workplace. We discuss future directions for the study of autonomous motivation in the field of implementation science. ACTRN12613000353796.

Design, implementation, use, and preliminary evaluation of SEBASTIAN, a standards-based Web service for clinical decision support.

PubMed

Kawamoto, Kensaku; Lobach, David F

2005-01-01

Despite their demonstrated ability to improve care quality, clinical decision support systems are not widely used. In part, this limited use is due to the difficulty of sharing medical knowledge in a machine-executable format. To address this problem, we developed a decision support Web service known as SEBASTIAN. In SEBASTIAN, individual knowledge modules define the data requirements for assessing a patient, the conclusions that can be drawn using that data, and instructions on how to generate those conclusions. Using standards-based XML messages transmitted over HTTP, client decision support applications provide patient data to SEBASTIAN and receive patient-specific assessments and recommendations. SEBASTIAN has been used to implement four distinct decision support systems; an architectural overview is provided for one of these systems. Preliminary assessments indicate that SEBASTIAN fulfills all original design objectives, including the re-use of executable medical knowledge across diverse applications and care settings, the straightforward authoring of knowledge modules, and use of the framework to implement decision support applications with significant clinical utility.

Generic Sensor Data Fusion Services for Web-enabled Environmental Risk Management and Decision-Support Systems

NASA Astrophysics Data System (ADS)

Sabeur, Zoheir; Middleton, Stuart; Veres, Galina; Zlatev, Zlatko; Salvo, Nicola

2010-05-01

The advancement of smart sensor technology in the last few years has led to an increase in the deployment of affordable sensors for monitoring the environment around Europe. This is generating large amounts of sensor observation information and inevitably leading to problems about how to manage large volumes of data as well as making sense out the data for decision-making. In addition, the various European Directives (Water Framework Diectives, Bathing Water Directives, Habitat Directives, etc.. ) which regulate human activities in the environment and the INSPIRE Directive on spatial information management regulations have implicitely led the designated European Member States environment agencies and authorities to put in place new sensor monitoring infrastructure and share information about environmental regions under their statutory responsibilities. They will need to work cross border and collectively reach environmental quality standards. They will also need to regularly report to the EC on the quality of the environments of which they are responsible and make such information accessible to the members of the public. In recent years, early pioneering work on the design of service oriented architecture using sensor networks has been achieved. Information web-services infrastructure using existing data catalogues and web-GIS map services can now be enriched with the deployment of new sensor observation and data fusion and modelling services using OGC standards. The deployment of the new services which describe sensor observations and intelligent data-processing using data fusion techniques can now be implemented and provide added value information with spatial-temporal uncertainties to the next generation of decision support service systems. The new decision support service systems have become key to implement across Europe in order to comply with EU environmental regulations and INSPIRE. In this paper, data fusion services using OGC standards with sensor observation data streams are described in context of a geo-distributed service infrastructure specialising in multiple environmental risk management and decision-support. The sensor data fusion services are deployed and validated in two use cases. These are respectively concerned with: 1) Microbial risks forecast in bathing waters; and 2) Geohazards in urban zones during underground tunneling activities. This research was initiated in the SANY Integrated Project(www.sany-ip.org) and funded by the European Commission under the 6th Framework Programme.

EUMIS - an open portal framework for interoperable marine environmental services

NASA Astrophysics Data System (ADS)

Hamre, T.; Sandven, S.; Leadbetter, A.; Gouriou, V.; Dunne, D.; Grant, M.; Treguer, M.; Torget, Ø.

2012-04-01

NETMAR (Open service network for marine environmental data) is an FP7 project that aims to develop a pilot European Marine Information System (EUMIS) for searching, downloading and integrating satellite, in situ and model data from ocean and coastal areas. EUMIS will use a semantic framework coupled with ontologies for identifying and accessing distributed data, such as near-real time, forecast and historical data. Four pilots have been defined to clarify the needs for satellite, in situ and model based products and services in selected user communities. The pilots are: · Pilot 1: Arctic Sea Ice Monitoring and Forecasting · Pilot 2: Oil spill drift forecast and shoreline cleanup assessment services in France · Pilot 3: Ocean colour - Marine Ecosystem, Research and Monitoring · Pilot 4: International Coastal Atlas Network (ICAN) for coastal zone management NETMAR is developing a set of data delivery services for the targeted user communities by means of standard web-GIS and OPeNDAP protocols. Processing services and adaptive service chaining services will also be developed, to enable users to generate new products suited to their needs. Both data retrieved from online repositories as well as the products generated dynamically can be accessed and visualised in the EUMIS portal. For this purpose, a GIS Viewer, a Service Chaining Editor and a Ontology Browser/Discovery Client have been developed and integrated in EUMIS. The EUMIS portal is developed using a portal framework that is compliant with the JSR-168 (Java Portlet Specification 1.0) and JSR-286 (Java Portlet Specification, 2.0) standards. These standards defines the interface (contract) and lifecycle management for a portal system component, a portlet, which can be implemented in a number of programming languages, not only Java. The GIS Viewer is developed using a combination of Java, JavaScript and JSF (e.g. MapFaces). The Service chaining editor is implemented in JavaScript (using different libraries like jQuery and WireIt), and the Ontology Browser/Discovery Client by means of Adobe Flex. In addition to the portlets developed in the project, we have also used several of the pre-built portlets that come with the Liferay Community Edition portal framework, notably the wiki, forum and RSS feed portlets. The presentation will focus on the developed system components and show some examples of products and services from the defined pilots.

Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection.

PubMed

Rentz, Michael F; Ruffner, Andrew H; Ancona, Rachel M; Hart, Kimberly W; Kues, John R; Barczak, Christopher M; Lindsell, Christopher J; Fichtenbaum, Carl J; Lyons, Michael S

2017-11-23

Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT. The study aimed to evaluate pilot implementation of multi-component, multi-venue TNT in conjunction with HIV screening by a healthcare setting. Our urban, academic health center implemented a TNT program in collaboration with the local health department for five months during 2011. High-risk or HIV positive patients of the infectious diseases clinic and emergency department HIV screening program were recruited to access social and partner networks via compensated peer-referral, testing of companions present with them, and partner notification services. Contacts became the next-generation index cases in a snowball recruitment strategy. The pilot TNT program yielded 485 HIV tests for 482 individuals through eight generations of recruitment with five (1.0%; 95% CI = 0.4%, 2.3%) new diagnoses. Of these, 246 (51.0%; 95% CI = 46.6%, 55.5%) reported that they had not been tested for HIV within the last 12 months and 383 (79.5%; 95% CI = 75.7%, 82.9%) had not been tested by the existing ED screening program within the last five years. TNT complements population screening by more directly targeting high-risk individuals and by expanding the population receiving testing. Information from existing healthcare services could be used to seed TNT programs, or TNT could be implemented within healthcare settings. Research evaluating multi-component, multi-venue HIV detection is necessary to maximize complementary approaches while minimizing redundancy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Objective Speech Quality Assessment Based on Payload Discrimination of Lost Packets for Cellular Phones in NGN Environment

NASA Astrophysics Data System (ADS)

Uemura, Satoshi; Fukumoto, Norihiro; Yamada, Hideaki; Nakamura, Hajime

A feature of services provided in a Next Generation Network (NGN) is that the end-to-end quality is guaranteed. This is quite a challenging issue, given the considerable fluctuation in network conditions within a Fixed Mobile Convergence (FMC) network. Therefore, a novel approach, whereby a network node and a mobile terminal such as a cellular phone cooperate with each other to control service quality is essential. In order to achieve such cooperation, the mobile terminal needs to become more intelligent so it can estimate the service quality, including the user's perceptual quality, and notify the measurement result to the network node. Subsequently, the network node implements some kind of service control function, such as a resource and admission control function, based on the notification from the mobile terminal. In this paper, the role of the mobile terminal in such collaborative system is focused on. As a part of a QoS/QoE measurement system, we describe an objective speech quality assessment with payload discrimination of lost packets to measure the user's perceptual quality of VoIP. The proposed assessment is so simple that it can be implemented on a cellular phone. We therefore did this as part of the QoS/QoE measurement system. By using the implemented system, we can measure the user's perceptual quality of VoIP as well as the network QoS metrics, in terms of criteria such as packet loss rate, jitter and burstiness in real time.

Proposal of a Methodology for Implementing a Service-Oriented Architecture in Distributed Manufacturing Systems

NASA Astrophysics Data System (ADS)

Medina, I.; Garcia-Dominguez, A.; Aguayo, F.; Sevilla, L.; Marcos, M.

2009-11-01

As envisioned by Intelligent Manufacturing Systems (IMS), Next Generation Manufacturing Systems (NGMS) will satisfy the needs of an increasingly fast-paced and demanding market by dynamically integrating systems from inside and outside the manufacturing firm itself into a so-called extended enterprise. However, organizing these systems to ensure the maximum flexibility and interoperability with those from other organizations is difficult. Additionally, a defect in the system would have a great impact: it would affect not only its owner, but also its partners. For these reasons, we argue that a service-oriented architecture (SOA) would be a good candidate. It should be designed following a methodology where services play a central role, instead of being an implementation detail. In order for the architecture to be reliable enough as a whole, the methodology will need to help find errors before they arise in a production environment. In this paper we propose using SOA-specific testing techniques, compare some of the existing methodologies and outline several extensions upon one of them to integrate testing techniques.

Ethernet-Based Services for Next Generation Networks

NASA Astrophysics Data System (ADS)

Hernandez-Valencia, Enrique

Over the last few years, Ethernet technology and services have emerged as an indispensable component of the broadband networking and telecommunications infrastructure, both for network operators and service providers. As an example, Worldwide Enterprise customer demand for Ethernet services by itself is expected to hit the 30B US mark by year 2012. Use of Ethernet technology in the feeder networks that support residential applications, such as "triple play" voice, data, and video services, is equally on the rise. As the synergies between packet-aware transport and service oriented equipment continue to be exploited in the path toward transport convergence. Ethernet technology is expected to play a critical part in the evolution toward converged Optical/Packet Transport networks. Here we discuss the main business motivations, services, and technologies driving the specifications of so-called carrier Ethernet and highlight challenges associated with delivering the expectations for low implementation complexity, easy of use, provisioning and management of networks and network elements embracing this technology.

Interval-level measurement with visual analogue scales in Internet-based research: VAS Generator.

PubMed

Reips, Ulf-Dietrich; Funke, Frederik

2008-08-01

The present article describes VAS Generator (www.vasgenerator.net), a free Web service for creating a wide range of visual analogue scales that can be used as measurement devices in Web surveys and Web experimentation, as well as for local computerized assessment. A step-by-step example for creating and implementing a visual analogue scale with visual feedback is given. VAS Generator and the scales it generates work independently of platforms and use the underlying languages HTML and JavaScript. Results from a validation study with 355 participants are reported and show that the scales generated with VAS Generator approximate an interval-scale level. In light of previous research on visual analogue versus categorical (e.g., radio button) scales in Internet-based research, we conclude that categorical scales only reach ordinal-scale level, and thus visual analogue scales are to be preferred whenever possible.

NERC Policy 10: Measurement of two generation and load balancing IOS

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

Spicer, P.J.; Galow, G.G.

1999-11-01

Policy 10 will describe specific standards and metrics for most of the reliability functions described in the Interconnected Operations Services Working Group (IOS WG) report. The purpose of this paper is to discuss, in detail, the proposed metrics for two generation and load balancing IOSs: Regulation; Load Following. For purposes of this paper, metrics include both measurement and performance evaluation. The measurement methods discussed are included in the current draft of the proposed Policy 10. The performance evaluation method discussed is offered by the authors for consideration by the IOS ITF (Implementation Task Force) for inclusion into Policy 10.

Global Mobile Satellite Service Interference Analysis for the AeroMACS

NASA Technical Reports Server (NTRS)

Wilson, Jeffrey D.; Apaza, Rafael D.; Hall, Ward; Phillips, Brent

2013-01-01

The AeroMACS (Aeronautical Mobile Airport Communications System), which is based on the IEEE 802.16-2009 mobile wireless standard, is envisioned as the wireless network which will cover all areas of airport surfaces for next generation air transportation. It is expected to be implemented in the 5091-5150 MHz frequency band which is also occupied by mobile satellite service uplinks. Thus the AeroMACS must be designed to avoid interference with this incumbent service. Simulations using Visualyse software were performed utilizing a global database of 6207 airports. Variations in base station and subscriber antenna distribution and gain pattern were examined. Based on these simulations, recommendations for global airport base station and subscriber antenna power transmission limitations are provided.

Microstructure Modeling of 3rd Generation Disk Alloys

NASA Technical Reports Server (NTRS)

Jou, Herng-Jeng

2010-01-01

The objective of this program is to model, validate, and predict the precipitation microstructure evolution, using PrecipiCalc (QuesTek Innovations LLC) software, for 3rd generation Ni-based gas turbine disc superalloys during processing and service, with a set of logical and consistent experiments and characterizations. Furthermore, within this program, the originally research-oriented microstructure simulation tool will be further improved and implemented to be a useful and user-friendly engineering tool. In this report, the key accomplishment achieved during the second year (2008) of the program is summarized. The activities of this year include final selection of multicomponent thermodynamics and mobility databases, precipitate surface energy determination from nucleation experiment, multiscale comparison of predicted versus measured intragrain precipitation microstructure in quench samples showing good agreement, isothermal coarsening experiment and interaction of grain boundary and intergrain precipitates, primary microstructure of subsolvus treatment, and finally the software implementation plan for the third year of the project. In the following year, the calibrated models and simulation tools will be validated against an independently developed experimental data set, with actual disc heat treatment process conditions. Furthermore, software integration and implementation will be developed to provide material engineers valuable information in order to optimize the processing of the 3rd generation gas turbine disc alloys.

The International Network for Evaluating Outcomes of very low birth weight, very preterm neonates (iNeo): a protocol for collaborative comparisons of international health services for quality improvement in neonatal care

PubMed Central

2014-01-01

Background The International Network for Evaluating Outcomes in Neonates (iNeo) is a collaboration of population-based national neonatal networks including Australia and New Zealand, Canada, Israel, Japan, Spain, Sweden, Switzerland, and the UK. The aim of iNeo is to provide a platform for comparative evaluation of outcomes of very preterm and very low birth weight neonates at the national, site, and individual level to generate evidence for improvement of outcomes in these infants. Methods/design Individual-level data from each iNeo network will be used for comparative analysis of neonatal outcomes between networks. Variations in outcomes will be identified and disseminated to generate hypotheses regarding factors impacting outcome variation. Detailed information on physical and environmental factors, human and resource factors, and processes of care will be collected from network sites, and tested for association with neonatal outcomes. Subsequently, changes in identified practices that may influence the variations in outcomes will be implemented and evaluated using quality improvement methods. Discussion The evidence obtained using the iNeo platform will enable clinical teams from member networks to identify, implement, and evaluate practice and service provision changes aimed at improving the care and outcomes of very low birth weight and very preterm infants within their respective countries. The knowledge generated will be available worldwide with a likely global impact. PMID:24758585

Retrofitting Steam Turbines with Expired Service Life

NASA Astrophysics Data System (ADS)

Dubrovskii, V. G.; Zubov, A. P.; Koshelev, S. A.; Babiev, A. N.; Kremer, V. L.

2018-06-01

Many pieces of equipment installed at thermal power stations (TPS) have an expired service life or are close to expiry and are obsolete. In addition, the structure of heat consumption by end users has changed. Among the ways for solving the problem of aging equipment is the retrofitting of turbines that allows for service life recovery and improvement of their performance to the modern level. The service life is recovered through replacement of high-temperature assemblies and parts of a turbine, and the performance is improved by retrofitting and major overhaul of low-temperature assemblies. Implementation of modern engineering solutions and numerical methods in designing upgraded flow paths of steam turbines considerably improves the turbine effectiveness. New flow paths include sabre-like guide vanes, integrally-machined shrouds, and effective honeycomb or axial-radial seals. The flow paths are designed using optimization and hydraulic simulation methods as well as approaches for improving the performance on the turbine blading and internal steam flow paths. Retrofitting of turbines should be performed to meet the customers' needs. The feasibility of implementation of one or another alternative must be determined on a case-by-case basis depending on the turbine conditions, the availability of reserves for generating live steam and supplying circulation water, and the demands and capacities for generation and delivery of power and heat. The main principle of retrofitting is to retain the foundation and the auxiliary and heat-exchange equipment that is fit for further operation. With the example of PT-60-130 and T-100-130, the experience is presented of a comprehensive approach to retrofitting considering the customer's current needs and the actual equipment conditions. Due to the use of modern engineering solutions and procedures, retrofitting yields updating and upgrading of the turbine at a relatively low cost.

Nationwide validation of ensemble streamflow forecasts from the Hydrologic Ensemble Forecast Service (HEFS) of the U.S. National Weather Service

NASA Astrophysics Data System (ADS)

Lee, H. S.; Liu, Y.; Ward, J.; Brown, J.; Maestre, A.; Herr, H.; Fresch, M. A.; Wells, E.; Reed, S. M.; Jones, E.

2017-12-01

The National Weather Service's (NWS) Office of Water Prediction (OWP) recently launched a nationwide effort to verify streamflow forecasts from the Hydrologic Ensemble Forecast Service (HEFS) for a majority of forecast locations across the 13 River Forecast Centers (RFCs). Known as the HEFS Baseline Validation (BV), the project involves a joint effort between the OWP and the RFCs. It aims to provide a geographically consistent, statistically robust validation, and a benchmark to guide the operational implementation of the HEFS, inform practical applications, such as impact-based decision support services, and to provide an objective framework for evaluating strategic investments in the HEFS. For the BV, HEFS hindcasts are issued once per day on a 12Z cycle for the period of 1985-2015 with a forecast horizon of 30 days. For the first two weeks, the hindcasts are forced with precipitation and temperature ensemble forecasts from the Global Ensemble Forecast System of the National Centers for Environmental Prediction, and by resampled climatology for the remaining period. The HEFS-generated ensemble streamflow hindcasts are verified using the Ensemble Verification System. Skill is assessed relative to streamflow hindcasts generated from NWS' current operational system, namely climatology-based Ensemble Streamflow Prediction. In this presentation, we summarize the results and findings to date.

XMPP for cloud computing in bioinformatics supporting discovery and invocation of asynchronous web services

PubMed Central

Wagener, Johannes; Spjuth, Ola; Willighagen, Egon L; Wikberg, Jarl ES

2009-01-01

Background Life sciences make heavily use of the web for both data provision and analysis. However, the increasing amount of available data and the diversity of analysis tools call for machine accessible interfaces in order to be effective. HTTP-based Web service technologies, like the Simple Object Access Protocol (SOAP) and REpresentational State Transfer (REST) services, are today the most common technologies for this in bioinformatics. However, these methods have severe drawbacks, including lack of discoverability, and the inability for services to send status notifications. Several complementary workarounds have been proposed, but the results are ad-hoc solutions of varying quality that can be difficult to use. Results We present a novel approach based on the open standard Extensible Messaging and Presence Protocol (XMPP), consisting of an extension (IO Data) to comprise discovery, asynchronous invocation, and definition of data types in the service. That XMPP cloud services are capable of asynchronous communication implies that clients do not have to poll repetitively for status, but the service sends the results back to the client upon completion. Implementations for Bioclipse and Taverna are presented, as are various XMPP cloud services in bio- and cheminformatics. Conclusion XMPP with its extensions is a powerful protocol for cloud services that demonstrate several advantages over traditional HTTP-based Web services: 1) services are discoverable without the need of an external registry, 2) asynchronous invocation eliminates the need for ad-hoc solutions like polling, and 3) input and output types defined in the service allows for generation of clients on the fly without the need of an external semantics description. The many advantages over existing technologies make XMPP a highly interesting candidate for next generation online services in bioinformatics. PMID:19732427

XMPP for cloud computing in bioinformatics supporting discovery and invocation of asynchronous web services.

PubMed

Wagener, Johannes; Spjuth, Ola; Willighagen, Egon L; Wikberg, Jarl E S

2009-09-04

Life sciences make heavily use of the web for both data provision and analysis. However, the increasing amount of available data and the diversity of analysis tools call for machine accessible interfaces in order to be effective. HTTP-based Web service technologies, like the Simple Object Access Protocol (SOAP) and REpresentational State Transfer (REST) services, are today the most common technologies for this in bioinformatics. However, these methods have severe drawbacks, including lack of discoverability, and the inability for services to send status notifications. Several complementary workarounds have been proposed, but the results are ad-hoc solutions of varying quality that can be difficult to use. We present a novel approach based on the open standard Extensible Messaging and Presence Protocol (XMPP), consisting of an extension (IO Data) to comprise discovery, asynchronous invocation, and definition of data types in the service. That XMPP cloud services are capable of asynchronous communication implies that clients do not have to poll repetitively for status, but the service sends the results back to the client upon completion. Implementations for Bioclipse and Taverna are presented, as are various XMPP cloud services in bio- and cheminformatics. XMPP with its extensions is a powerful protocol for cloud services that demonstrate several advantages over traditional HTTP-based Web services: 1) services are discoverable without the need of an external registry, 2) asynchronous invocation eliminates the need for ad-hoc solutions like polling, and 3) input and output types defined in the service allows for generation of clients on the fly without the need of an external semantics description. The many advantages over existing technologies make XMPP a highly interesting candidate for next generation online services in bioinformatics.

Near Fault Observatories (NFO) services and integration plan for European Plate Observing System (EPOS) Implementation Phase

NASA Astrophysics Data System (ADS)

Chiaraluce, Lauro

2016-04-01

Coherently with the EPOS vision aimed at creating a pan-European infrastructure for Earth Sciences supporting research for a more sustainable society, we are working on the integration of NFOs and services implementation facilitating their data and products discovery and usage. NFOs are National Research Infrastructures (NRI) consisting of advanced networks of multi-parametric sensors continuously monitoring the chemical and physical processes related to the common underlying Earth instabilities governing active faults evolution and the genesis of earthquakes. These infrastructures will enable advancements in understanding of earthquakes generation processes and associated ground shaking due to their high-quality near-source multidisciplinary data. In EPOS-IP seven NFOs are going to be linked: 1) the Altotiberina and 2) Irpinia Observatories in Italy, 3) Corinth in Greece, 4) South-Iceland Seismic Zone, 5) Valais in Switzerland, 6) Marmara Sea (GEO Supersite) in Turkey and 7) Vrancea in Romania. EPOS-IP aims to implement integrated services from a technical, legal, governance and financial point of view. Accordingly, our first effort within this first core group of NFOs will be establishing legal governance for such a young community to ensure a long-term sustainability of the envisaged services including the full adoption of the EPOS data policy. The establishment of a Board including representatives of each NFO formally appointed by the Institutions supporting the NRI is a basic requirement to provide and validate a stable governance mechanism supporting the initiatives finalised to the services provision. Extremely dense networks and less common instruments deserve an extraordinary work on data quality control and description. We will work on linking all the NFOs in a single distributed network of observatories with instrumental and monitoring standards based on common protocols for observation, analysis, and data access and distributed channels. We will rely on the services provided by other Thematic Core Services for the standard data (e.g. seismic and geodetic) and on the direct access to the e-infrastructures of individual NFOs via the Integrated Core Services web services for access and distribution of non standard data (e.g. strain- and tilt-meters, geochemical and electro- magneto-telluric data). We will collaborate with the other groups possessing the same data on data harmonization in terms of both format and metadata description to optimise and facilitate the integration and interoperability processes. The services will include a Virtual Laboratory, novel visualization tools for data and products describing the anatomy of active faults and the physical processes governing earthquake generation. VL is an online engagement and knowledge sharing initiative for communicating to the other scientists, stockholders and the public the state of scientific knowledge concerning earthquake source and tectonic processes generating catastrophic events. The availability of real-time data provides the unique opportunity of observing all phases of the earthquake rupture. It is thus of crucial importance developing methodologies to follow in real-time the evolution of the event (e.g. Earthquake Early Warning systems). NFOs are ideal infrastructures for hosting testing centers where a variety of scientific algorithms for real-time monitoring can be independently evaluated. Besides the interest for fundamental science, such developments have a societal impact and can attract new stakeholders such as industry partners who are interested in adopting in such (e.g. EEW) technologies.

Home Crafts Days at Mountain Empire Community College Bridge Generation Gap in Mountain Youth's Search for Identity.

ERIC Educational Resources Information Center

Turnage, Martha; Moore, Roderick

Mountain Empire Community College has a commitment to preserve, learn, and teach the heritage of mountain folk. Community participation by those who can teach the heritage of the area is a part of the implementation of this commitment. Some of the older people in the MECC service area either take the course work in folklife or come to the classes…

Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples.

PubMed

Bailie, Ross; Si, Damin; Shannon, Cindy; Semmens, James; Rowley, Kevin; Scrimgeour, David J; Nagel, Tricia; Anderson, Ian; Connors, Christine; Weeramanthri, Tarun; Thompson, Sandra; McDermott, Robyn; Burke, Hugh; Moore, Elizabeth; Leon, Dallas; Weston, Richard; Grogan, Haylene; Stanley, Andrew; Gardner, Karen

2010-05-19

Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE) project has facilitated the implementation of modern Continuous Quality Improvement (CQI) approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1) explore the factors associated with variation in clinical performance; 2) examine specific strategies that have been effective in improving primary care clinical performance; and 3) work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria) over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. By linking researchers directly to users of research (service providers, managers and policy makers), the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary health care and fostering effective and efficient exchange and use of data and information among service providers and policy makers to achieve evidence-based resource allocation, service planning, system development, and improvements of service delivery and Indigenous health outcomes.

Maternal and neonatal implementation for equitable systems. A study design paper.

PubMed

Ekirapa-Kiracho, Elizabeth; Tetui, Moses; Bua, John; Muhumuza Kananura, Rornald; Waiswa, Peter; Makumbi, Fred; Atuyambe, Lynn; Ajeani, Judith; George, Asha; Mutebi, Aloysuis; Kakaire, Ayub; Namazzi, Gertrude; Paina, Ligia; Namusoke Kiwanuka, Suzanne

2017-08-01

Evidence on effective ways of improving maternal and neonatal health outcomes is widely available. The challenge that most low-income countries grapple with is implementation at scale and sustainability. The study aimed at improving access to quality maternal and neonatal health services in a sustainable manner by using a participatory action research approach.  The  study consisted of a quasi-experimental design, with a participatory action research approach to implementation in three rural districts (Pallisa, Kibuku and Kamuli) in Eastern Uganda. The intervention had two main components; namely, community empowerment for comprehensive birth preparedness, and health provider and management capacity-building. We collected data using both quantitative and qualitative methods using household and facility-level structured surveys, record reviews, key informant interviews and focus group discussions. We purposively selected the participants for the qualitative data collection, while for the surveys we interviewed all eligible participants in the sampled households and health facilities. Descriptive statistics were used to describe the data, while the difference in difference analysis was used to measure the effect of the intervention. Qualitative data were analysed using thematic analysis. This study was implemented to generate evidence on how to increase access to quality maternal and newborn health services in a sustainable manner using a multisectoral participatory  approach.

Translating knowledge into practice: An exploratory study of dementia-specific training for community-based service providers.

PubMed

O'Sullivan, Grace; Hocking, Clare; McPherson, Kathryn

2017-08-01

Objective To develop, deliver, and evaluate dementia-specific training designed to inform service delivery by enhancing the knowledge of community-based service providers. Methods This exploratory qualitative study used an interdisciplinary, interuniversity team approach to develop and deliver dementia-specific training. Participants included management, care staff, and clients from three organizations funded to provide services in the community. Data on the acceptability, applicability, and perceived outcomes of the training were gathered through focus group discussions and individual interviews. Transcripts were analyzed to generate open codes which were clustered into themes and sub-themes addressing the content, delivery, and value of the training. Findings Staff valued up-to-date knowledge and "real stories" grounded in practice. Clients welcomed the strengths-based approach. Contractual obligations impact on the application of knowledge in practice. Implications The capacity to implement new knowledge may be limited by the legislative policies which frame service provision, to the detriment of service users.

Sustainable sewerage servicing options for peri-urban areas with failing septic systems.

PubMed

Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F

2010-01-01

The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.

The Verification-based Analysis of Reliable Multicast Protocol

NASA Technical Reports Server (NTRS)

Wu, Yunqing

1996-01-01

Reliable Multicast Protocol (RMP) is a communication protocol that provides an atomic, totally ordered, reliable multicast service on top of unreliable IP Multicasting. In this paper, we develop formal models for R.W using existing automatic verification systems, and perform verification-based analysis on the formal RMP specifications. We also use the formal models of RW specifications to generate a test suite for conformance testing of the RMP implementation. Throughout the process of RMP development, we follow an iterative, interactive approach that emphasizes concurrent and parallel progress between the implementation and verification processes. Through this approach, we incorporate formal techniques into our development process, promote a common understanding for the protocol, increase the reliability of our software, and maintain high fidelity between the specifications of RMP and its implementation.

Generating Mosaics of Astronomical Images

NASA Technical Reports Server (NTRS)

Bergou, Attila; Berriman, Bruce; Good, John; Jacob, Joseph; Katz, Daniel; Laity, Anastasia; Prince, Thomas; Williams, Roy

2005-01-01

"Montage" is the name of a service of the National Virtual Observatory (NVO), and of software being developed to implement the service via the World Wide Web. Montage generates science-grade custom mosaics of astronomical images on demand from input files that comply with the Flexible Image Transport System (FITS) standard and contain image data registered on projections that comply with the World Coordinate System (WCS) standards. "Science-grade" in this context signifies that terrestrial and instrumental features are removed from images in a way that can be described quantitatively. "Custom" refers to user-specified parameters of projection, coordinates, size, rotation, and spatial sampling. The greatest value of Montage is expected to lie in its ability to analyze images at multiple wavelengths, delivering them on a common projection, coordinate system, and spatial sampling, and thereby enabling further analysis as though they were part of a single, multi-wavelength image. Montage will be deployed as a computation-intensive service through existing astronomy portals and other Web sites. It will be integrated into the emerging NVO architecture and will be executed on the TeraGrid. The Montage software will also be portable and publicly available.

Distributed utility technology cost, performance, and environmental characteristics

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

Wan, Y; Adelman, S

1995-06-01

Distributed Utility (DU) is an emerging concept in which modular generation and storage technologies sited near customer loads in distribution systems and specifically targeted demand-side management programs are used to supplement conventional central station generation plants to meet customer energy service needs. Research has shown that implementation of the DU concept could provide substantial benefits to utilities. This report summarizes the cost, performance, and environmental and siting characteristics of existing and emerging modular generation and storage technologies that are applicable under the DU concept. It is intended to be a practical reference guide for utility planners and engineers seeking informationmore » on DU technology options. This work was funded by the Office of Utility Technologies of the US Department of Energy.« less

Interoperability Using Lightweight Metadata Standards: Service & Data Casting, OpenSearch, OPM Provenance, and Shared SciFlo Workflows

NASA Astrophysics Data System (ADS)

Wilson, B. D.; Manipon, G.; Hua, H.; Fetzer, E.

2011-12-01

Under several NASA grants, we are generating multi-sensor merged atmospheric datasets to enable the detection of instrument biases and studies of climate trends over decades of data. For example, under a NASA MEASURES grant we are producing a water vapor climatology from the A-Train instruments, stratified by the Cloudsat cloud classification for each geophysical scene. The generation and proper use of such multi-sensor climate data records (CDR's) requires a high level of openness, transparency, and traceability. To make the datasets self-documenting and provide access to full metadata and traceability, we have implemented a set of capabilities and services using known, interoperable protocols. These protocols include OpenSearch, OPeNDAP, Open Provenance Model, service & data casting technologies using Atom feeds, and REST-callable analysis workflows implemented as SciFlo (XML) documents. We advocate that our approach can serve as a blueprint for how to openly "document and serve" complex, multi-sensor CDR's with full traceability. The capabilities and services provided include: - Discovery of the collections by keyword search, exposed using OpenSearch protocol; - Space/time query across the CDR's granules and all of the input datasets via OpenSearch; - User-level configuration of the production workflows so that scientists can select additional physical variables from the A-Train to add to the next iteration of the merged datasets; - Efficient data merging using on-the-fly OPeNDAP variable slicing & spatial subsetting of data out of input netCDF and HDF files (without moving the entire files); - Self-documenting CDR's published in a highly usable netCDF4 format with groups used to organize the variables, CF-style attributes for each variable, numeric array compression, & links to OPM provenance; - Recording of processing provenance and data lineage into a query-able provenance trail in Open Provenance Model (OPM) format, auto-captured by the workflow engine; - Open Publishing of all of the workflows used to generate products as machine-callable REST web services, using the capabilities of the SciFlo workflow engine; - Advertising of the metadata (e.g. physical variables provided, space/time bounding box, etc.) for our prepared datasets as "datacasts" using the Atom feed format; - Publishing of all datasets via our "DataDrop" service, which exploits the WebDAV protocol to enable scientists to access remote data directories as local files on their laptops; - Rich "web browse" of the CDR's with full metadata and the provenance trail one click away; - Advertising of all services as Google-discoverable "service casts" using the Atom format. The presentation will describe our use of the interoperable protocols and demonstrate the capabilities and service GUI's.

The next phase in professional services research: From implementation to sustainability.

PubMed

Crespo-Gonzalez, Carmen; Garcia-Cardenas, Victoria; Benrimoj, Shalom I

The provision of professional pharmacy services has been heralded as the professional and the economic future of pharmacy. There are different phases involved in a service creation including service design, impact evaluation, implementation and sustainability. The two first phases have been subject to extensive research. In the last years the principles of Implementation science have been applied in pharmacy to study the initial uptake and integration of evidence-based services into routine practice. However, little attention has been paid to the sustainability of those services, during which there is a continued use of the service previously implemented to achieve and sustain long-term outcomes. The objective of this commentary is to describe the differences and common characteristics between the implementation and the sustainability phase and to propose a definition for pharmacy. A literature search was performed. Four critical elements were identified: 1. The aim of the implementation phase is to incorporate new services into practice, the sustainability phase's aim is to make the services routine to achieve and sustain long-term benefits 2. At the implementation phase planned activities are used as a process to integrate the new service, at the sustainability phase there is a continuous improvement of the service 3. The implementation phase occurs during the period of time between the adoption of a service and its integration. Some authors suggest the sustainability phase is a concomitant phase with the implementation phase and others suggest it is independent 4. There is a lack of consensus regarding the duration of each phase. The following definition of sustainability for pharmacy services is proposed: "Sustainability is a phase in the process of a professional pharmacy service, in which the service previously integrated into practice during the implementation phase is routinized and institutionalized over time to achieve and sustain the expected service outcomes". An agreement on a definition will facilitate an understanding of when the profession has reached this ultimate goal. Copyright © 2017 Elsevier Inc. All rights reserved.

Paying for Early Interventions in Psychoses: A Three-Part Model.

PubMed

Frank, Richard G; Glied, Sherry A; McGuire, Thomas G

2015-07-01

Widespread dissemination of early interventions for psychosis, such as the intervention offered in the RAISE study (Recovery After an Initial Schizophrenia Episode), requires a funding mechanism that is both compatible with approaches already used by payers and generates incentives for providers that promote the desired behaviors. The authors propose a funding model with three components: a prospective per-case payment made conditional on patient engagement in treatment, a per-service component to cover the costs of clinical services, and an outcome-based component conditional on achieving measurable outcome milestones. The authors describe the components and how such a payment mechanism might be implemented.

Clinical operations generation next… The age of technology and outsourcing

PubMed Central

Temkar, Priya

2015-01-01

Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations. PMID:26623386

Bringing Managed Care Incentives to Medicare's Fee-for-Service Sector

PubMed Central

Tompkins, Christopher P.; Wallack, Stanley S.; Bhalotra, Sarita; Chilingerian, Jon A.; Glavin, Mitchell P.V.; Ritter, Grant A.; Hodgkin, Dominic

1996-01-01

The Health Care Financing Administration (HCFA) could work with eligible physician organizations to generate savings in total reimbursements for their Medicare patients. Medicare would continue to reimburse all providers according to standard payment policies and mechanisms, and beneficiaries would retain the freedom to choose providers. However, implementation of new financial incentives, based on meeting targets called Group-Specific Volume Performance Standards (GVPS), would encourage cost-effective service delivery patterns. HCFA could use new and existing data systems to monitor access, utilization patterns, cost outcomes and quality of care. In short, HCFA could manage providers, who, in turn, would manage their patients' care. PMID:10165712

Real-Time Charging Strategies for an Electric Vehicle Aggregator to Provide Ancillary Services

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

Wenzel, George; Negrete-Pincetic, Matias; Olivares, Daniel E.

Real-time charging strategies, in the context of vehicle to grid (V2G) technology, are needed to enable the use of electric vehicle (EV) fleets batteries to provide ancillary services (AS). Here, we develop tools to manage charging and discharging in a fleet to track an Automatic Generation Control (AGC) signal when aggregated. We also propose a real-time controller that considers bidirectional charging efficiency and extend it to study the effect of looking ahead when implementing Model Predictive Control (MPC). Simulations show that the controller improves tracking error as compared with benchmark scheduling algorithms, as well as regulation capacity and battery cycling.

Clinical operations generation next… The age of technology and outsourcing.

PubMed

Temkar, Priya

2015-01-01

Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations.

Real-Time Charging Strategies for an Electric Vehicle Aggregator to Provide Ancillary Services

DOE PAGES

Wenzel, George; Negrete-Pincetic, Matias; Olivares, Daniel E.; ...

2017-03-13

Real-time charging strategies, in the context of vehicle to grid (V2G) technology, are needed to enable the use of electric vehicle (EV) fleets batteries to provide ancillary services (AS). Here, we develop tools to manage charging and discharging in a fleet to track an Automatic Generation Control (AGC) signal when aggregated. We also propose a real-time controller that considers bidirectional charging efficiency and extend it to study the effect of looking ahead when implementing Model Predictive Control (MPC). Simulations show that the controller improves tracking error as compared with benchmark scheduling algorithms, as well as regulation capacity and battery cycling.

Implementation of a Relay Coordination System for the Mars Network

NASA Technical Reports Server (NTRS)

Allard, Daniel A.

2010-01-01

Mars network relay operations involve the coordination of lander and orbiter teams through long-term and short-term planning, tactical changes and post-pass analysis. Much of this coordination is managed through email traffic and point-to-point file data exchanges. It is often difficult to construct a complete and accurate picture of the relay situation at any given moment, as there is no centralized store of correlated relay data. The Mars Relay Operations Service (MaROS) is being implemented to address the problem of relay coordination for current and next-generation relay missions. The service is provided for the purpose of coordinating communications sessions between landed spacecraft assets and orbiting spacecraft assets at Mars. The service centralizes a set of functions previously distributed across multiple spacecraft operations teams, and as such greatly improves visibility into the end-to-end strategic coordination process. Most of the process revolves around the scheduling of communications sessions between the spacecraft during periods of time when a landed asset on Mars is geometrically visible by an orbiting spacecraft. These "relay" sessions are used to transfer data both to and from the landed asset via the orbiting asset on behalf of Earth-based spacecraft operators. This paper will discuss the relay coordination problem space, overview the architecture and design selected to meet system requirements, and describe the first phase of system implementation

Links among high-performance work environment, service quality, and customer satisfaction: an extension to the healthcare sector.

PubMed

Scotti, Dennis J; Harmon, Joel; Behson, Scott J

2007-01-01

Healthcare managers must deliver high-quality patient services that generate highly satisfied and loyal customers. In this article, we examine how a high-involvement approach to the work environment of healthcare employees may lead to exceptional service quality, satisfied patients, and ultimately to loyal customers. Specifically, we investigate the chain of events through which high-performance work systems (HPWS) and customer orientation influence employee and customer perceptions of service quality and patient satisfaction in a national sample of 113 Veterans Health Administration ambulatory care centers. We present a conceptual model for linking work environment to customer satisfaction and test this model using structural equations modeling. The results suggest that (1) HPWS is linked to employee perceptions of their ability to deliver high-quality customer service, both directly and through their perceptions of customer orientation; (2) employee perceptions of customer service are linked to customer perceptions of high-quality service; and (3) perceived service quality is linked with customer satisfaction. Theoretical and practical implications of our findings, including suggestions of how healthcare managers can implement changes to their work environments, are discussed.

Implementing a 6-day physiotherapy service in rehabilitation: exploring staff perceptions.

PubMed

Caruana, Erin L; Kuys, Suzanne S; Clarke, Jane; Brauer, Sandra G

2017-11-20

Objective Australian weekend rehabilitation therapy provision is increasing. Staff engagement optimises service delivery. The present mixed-methods process evaluation explored staff perceptions regarding implementation of a 6-day physiotherapy service in a private rehabilitation unit. Methods All multidisciplinary staff working in the rehabilitation unit were surveyed regarding barriers, facilitators and perceptions of the effect of a 6-day physiotherapy service on length of stay (LOS) and patient goal attainment at three time points: before and after implementation, as well as after modification of a 6-day physiotherapy service. Descriptive statistics and thematic analysis was used to analyse the data. Results Fifty-one staff (50%) responded. Before implementation, all staff identified barriers, the most common being staffing (62%) and patient selection (29%). After implementation, only 30% of staff identified barriers, which differed to those identified before implementation, and included staff rostering and experience (20%), timing of therapy (10%) and increasing the allocation of patients (5%). Over time, staff perceptions changed from being unsure to being positive about the effect of the 6-day service on LOS and patient goal attainment. Conclusion Staff perceived a large number of barriers before implementation of a 6-day rehabilitation service, but these did not eventuate following implementation. Staff perceived improved LOS and patient goal attainment after implementation of a 6-day rehabilitation service incorporating staff feedback. What is known about this topic? Rehabilitation weekend services improve patient quality of life and functional independence while reducing LOS. What does this study add? Staff feedback during implementation and modification of new services is important to address potential barriers and ensure staff satisfaction and support. What are the implications for practitioners? Staff engagement and open communication are important to successfully implement a new service in rehabilitation.

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

PubMed

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

2015-09-01

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

Modeling the effect of spatial policies on ecosystem services and human wellbeing

NASA Astrophysics Data System (ADS)

Geneletti, D.

2012-04-01

Land use conversions rank among the most significant drivers of change in ecosystem services worldwide, affecting human wellbeing and threatening the survival of other species. Hence, predicting the effects of land use decisions on ecosystem services has emerged as a crucial need in land management. Research addressing the link between land use changes and ecosystem services has grown significantly in the last few years, even though it has rarely addressed the tools that most countries use to regulate the development of land: spatial plans. Spatial plans aim at implementing an overall strategy through regulations ("spatial policies") concerning the physical organization of land. The paper presents a methodology aimed at empirically exploring how the implementation of different spatial policies can affect a set of ecosystem services in the future (water purification, soil conservation, habitat for species, carbon sequestration and timber production). Particularly, the study addressed the following three research questions: Q1: What are the effects of different spatial policies on the production of services through time? Q2: How changes in the production affect the actual benefits, hence human wellbeing? Q3: What are the tradeoffs between different ecosystem services and wellbeing constituents, and how are they affected by the spatial scale of analysis? The methodology is based on the generation of land use scenarios that simulate the implementation of different spatial policies through time. For each scenario, the production of key ecosystem services (e.g., water filtration, soil retention) is modeled and compared (Q1). The effects on the constituents of wellbeing (adequate livelihoods, health, etc) are then assessed by looking at spatially-resolved socioeconomic variables that estimate the appropriation of services by different groups of beneficiaries (Q2). Finally, the geographical and temporal patterns of tradeoffs are studied by disaggregating the results at different levels (from regional to sub-municipal) (Q3). The study area is represented by The Araucanía (southern Chile), a region rich in natural resources, but affected by widespread poverty. Conclusions on the potential contribution of the approach to support spatial planning processes are provided.

Measuring agreement between decision support reminders: the cloud vs. the local expert.

PubMed

Dixon, Brian Edward; Simonaitis, Linas; Perkins, Susan M; Wright, Adam; Middleton, Blackford

2014-04-10

A cloud-based clinical decision support system (CDSS) was implemented to remotely provide evidence-based guideline reminders in support of preventative health. Following implementation, we measured the agreement between preventive care reminders generated by an existing, local CDSS and the new, cloud-based CDSS operating on the same patient visit data. Electronic health record data for the same set of patients seen in primary care were sent to both the cloud-based web service and local CDSS. The clinical reminders returned by both services were captured for analysis. Cohen's Kappa coefficient was calculated to compare the two sets of reminders. Kappa statistics were further adjusted for prevalence and bias due to the potential effects of bias in the CDS logic and prevalence in the relative small sample of patients. The cloud-based CDSS generated 965 clinical reminders for 405 patient visits over 3 months. The local CDSS returned 889 reminders for the same patient visit data. When adjusted for prevalence and bias, observed agreement varied by reminder from 0.33 (95% CI 0.24 - 0.42) to 0.99 (95% CI 0.97 - 1.00) and demonstrated almost perfect agreement for 7 of the 11 reminders. Preventive care reminders delivered by two disparate CDS systems show substantial agreement. Subtle differences in rule logic and terminology mapping appear to account for much of the discordance. Cloud-based CDSS therefore show promise, opening the door for future development and implementation in support of health care providers with limited resources for knowledge management of complex logic and rules.

Extending and implementing the Persistent ID pillars

NASA Astrophysics Data System (ADS)

Car, Nicholas; Golodoniuc, Pavel; Klump, Jens

2017-04-01

The recent double decade anniversary of scholarly persistent identifier use has triggered journal special editions such as "20 Years of Persistent Identifiers". For such a publication, it is apt to consider the longevity of some persistent identifier (PID) mechanisms (Digital Object Identifiers) and the partial disappearance of others (Life Sciences IDs). We have previously postulated a set of "PID Pillars" [1] which are design principles aimed at ensuring PIDs can survive technology and social change and thus persist for the long term that we have drawn from our observations of PIDs at work over many years. The principles: describe how to ensure identifiers' system and organisation independence; codify the delivery of essential PID system functions; mandate a separation of PID functions from data delivery mechanisms; and require generation of policies detailing how change is handled. In this presentation, first we extend on our previous work of introducing the pillars by refining their descriptions, giving specific suggestions for each and presenting some work that addresses them. Second, we propose a baseline data model for persistent identifiers that, if used, would assist the separation of PID metadata and PID system functioning. This would allow PID system function specifics to change over time (e.g. resolver services or even resolution protocols) and yet preserve the PIDs themselves. Third, we detail our existing PID system — the PID Service [2] — that partially implements the pillars and describe both its successes and shortcomings. Finally, we describe our planned next-generation system that will aim to use the baseline data model and fully implement the pillars.

Measuring agreement between decision support reminders: the cloud vs. the local expert

PubMed Central

2014-01-01

Background A cloud-based clinical decision support system (CDSS) was implemented to remotely provide evidence-based guideline reminders in support of preventative health. Following implementation, we measured the agreement between preventive care reminders generated by an existing, local CDSS and the new, cloud-based CDSS operating on the same patient visit data. Methods Electronic health record data for the same set of patients seen in primary care were sent to both the cloud-based web service and local CDSS. The clinical reminders returned by both services were captured for analysis. Cohen’s Kappa coefficient was calculated to compare the two sets of reminders. Kappa statistics were further adjusted for prevalence and bias due to the potential effects of bias in the CDS logic and prevalence in the relative small sample of patients. Results The cloud-based CDSS generated 965 clinical reminders for 405 patient visits over 3 months. The local CDSS returned 889 reminders for the same patient visit data. When adjusted for prevalence and bias, observed agreement varied by reminder from 0.33 (95% CI 0.24 – 0.42) to 0.99 (95% CI 0.97 – 1.00) and demonstrated almost perfect agreement for 7 of the 11 reminders. Conclusions Preventive care reminders delivered by two disparate CDS systems show substantial agreement. Subtle differences in rule logic and terminology mapping appear to account for much of the discordance. Cloud-based CDSS therefore show promise, opening the door for future development and implementation in support of health care providers with limited resources for knowledge management of complex logic and rules. PMID:24720863

Multimedia Health Records: user-centered design approach for a multimedia uploading service.

PubMed

Plazzotta, Fernando; Mayan, John C; Storani, Fernando D; Ortiz, Juan M; Lopez, Gastón E; Gimenez, Gastón M; Luna, Daniel R

2015-01-01

Multimedia elements add value to text documents by transmitting information difficult to express in words. In healthcare, many professional and services keep this elements in their own repositories. This brings the problem of information fragmentation in different silos which hinder its access to other healthcare professionals. On the other hand patients have clinical data of their own in different formats generated in different healthcare organizations which is not accessible to professionals within our healthcare network. This paper describes the design, development and implementation processes of a service which allows media elements to be loaded in a patient clinical data repository (CDR) either through an electronic health record by professionals (EHR) or through a personal health record (PHR) by patients, in order to avoid fragmentation of the information.

Science Data Preservation: Implementation and Why It Is Important

NASA Technical Reports Server (NTRS)

Kempler, Steven J.; Moses, John F.; Gerasimov, Irina V.; Johnson, James E.; Vollmer, Bruce E.; Theobald, Michael L.; Ostrenga, Dana M.; Ahmad, Suraiya; Ramapriyan, Hampapuram K.; Khayat, Mohammad G.

2013-01-01

Remote Sensing data generation by NASA to study Earth s geophysical processes was initiated in 1960 with the launch of the first Television Infrared Observation Satellite Program (TIROS), to develop a meteorological satellite information system. What would be deemed as a primitive data set by today s standards, early Earth science missions were the foundation upon which today s remote sensing instruments have built their scientific success, and tomorrow s instruments will yield science not yet imagined. NASA Scientific Data Stewardship requirements have been documented to ensure the long term preservation and usability of remote sensing science data. In recent years, the Federation of Earth Science Information Partners and NASA s Earth Science Data System Working Groups have organized committees that specifically examine standards, processes, and ontologies that can best be employed for the preservation of remote sensing data, supporting documentation, and data provenance information. This presentation describes the activities, issues, and implementations, guided by the NASA Earth Science Data Preservation Content Specification (423-SPEC-001), for preserving instrument characteristics, and data processing and science information generated for 20 Earth science instruments, spanning 40 years of geophysical measurements, at the NASA s Goddard Earth Sciences Data and Information Services Center (GES DISC). In addition, unanticipated preservation/implementation questions and issues in the implementation process are presented.

SPARQL-enabled identifier conversion with Identifiers.org

PubMed Central

Wimalaratne, Sarala M.; Bolleman, Jerven; Juty, Nick; Katayama, Toshiaki; Dumontier, Michel; Redaschi, Nicole; Le Novère, Nicolas; Hermjakob, Henning; Laibe, Camille

2015-01-01

Motivation: On the semantic web, in life sciences in particular, data is often distributed via multiple resources. Each of these sources is likely to use their own International Resource Identifier for conceptually the same resource or database record. The lack of correspondence between identifiers introduces a barrier when executing federated SPARQL queries across life science data. Results: We introduce a novel SPARQL-based service to enable on-the-fly integration of life science data. This service uses the identifier patterns defined in the Identifiers.org Registry to generate a plurality of identifier variants, which can then be used to match source identifiers with target identifiers. We demonstrate the utility of this identifier integration approach by answering queries across major producers of life science Linked Data. Availability and implementation: The SPARQL-based identifier conversion service is available without restriction at http://identifiers.org/services/sparql. Contact: sarala@ebi.ac.uk PMID:25638809

Improvement in safety monitoring of biologic response modifiers after the implementation of clinical care guidelines by a specialty.

PubMed

Hanson, Rebekah L; Gannon, Michael J; Khamo, Nehrin; Sodhi, Monsheel; Orr, Alexander M; Stubbings, JoAnn

2013-01-01

Tumor necrosis factor (TNF)-alpha inhibitors and other biologic response modifiers (BRMs) are frequently used to treat a variety of inflammatory diseases. Use of these agents may increase risk of serious infections, malignancies, and other complications such as worsening symptoms of heart failure or demyelinating disease. Because of these risks, a baseline assessment and routine monitoring have been recommended, but standardized guidelines for monitoring have yet to be established. To measure the compliance with the recommended safety monitoring in the Clinical Care Guidelines for BRMs at the University of Illinois Hospitals and Health Sciences System (UI Health). The Clinical Care Guidelines for BRMs was developed by a committee of pharmacists, nurses, and physicians based on an assessment of published literature and medication labeling. The guidelines included recommendations for safety monitoring prior to BRM therapy, such as the tuberculosis (TB) test, Hepatitis B surface Antigen (HBsAg) test, liver function test (LFT), complete blood count (CBC), up-to-date vaccinations, risk assessment for cancer, pregnancy testing, monitoring for contraindications with concomitant medications, concomitant disease state risk assessment, and patient education. The guidelines were introduced to UI Health in February 2012 by a systemwide email and by in-services given by the health system's Specialty Pharmacy Service. In-services were given in the clinics known to generate large numbers of BRM orders (e.g., gastroenterology and rheumatology) and at the outpatient center for infused therapies. The purpose of the in-services was to introduce providers to the guidelines and encourage their compliance. To ensure that guideline requirements were met when BRMs were ordered, a process was established to identify BRM orders, assess the orders for compliance with 4 of the safety monitoring tests from the guidelines (TB, HBsAg, LFT, and CBC), and make interventions. When necessary, Specialty Pharmacy Services coordinated with the pharmacists and other providers in the clinic to order lab tests and ensure they were completed prior to the start of therapy. Feedback was provided during the study to proactively improve compliance with the guidelines. After completion of the study, a report containing outpatient prescription orders for BRMs (abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, and tocilizumab) from August 2011 through July 2012 was generated from the electronic medical record. Retrospective analyses of completion of safety monitoring were conducted for patients administered BRM treatment. Completion rates were compared before and after implementation of guidelines in February 2012. Completion was considered to have occurred when all 4 safety monitoring tests had been conducted -TB (unless known to be positive from a previous test), HBsAg, LFT, and CBC. Completion data from August 2011 through January 2012 were before the guidelines were implemented, and data from February 2012 through July 2012 were after the guidelines. Chi square analyses were performed on completion frequencies in the patients before and after the guidelines were implemented. Of the 320 unique patient BRM orders evaluated in this study, 195 (61%) were generated in the Rheumatology clinic, 99 (31%) in the Gastroenterology clinic, 21 (6.5%) in the Dermatology clinic, and 5 (1.5%) in the Transplant clinic. Before the guidelines were implemented, 54 ( 31%) of 173 patient orders complied with the safety monitoring by having all 4 clinical tests performed at the appropriate time points. After guideline implementation, 88 (60%) of 147 patient orders were compliant and had all 4 clinical tests conducted, which represents a statistically significant improvement in the rate of compliance (Pearson chi square = 26.43, degrees of freedom (df) = 1, P  less than  0.0001). This significant improvement in compliance rates after guideline implementation was observed in both the new patient group and the patients with continuing prescription orders/treatment changes. There was also an improvement in patients whose prescriptions were dispensed by UI Health and to a lesser degree those whose prescriptions were dispensed by an outside pharmacy. When the new patient group was analyzed separately (n = 92), 50 patients were treated before the guidelines were implemented, and 42 patients were treated after the guidelines were implemented. Compliance rates with safety monitoring in these 2 groups were 52% pre-implementation and 83% post-implementation, which represented a statistically significant improvement in compliance (Pearson chi square = 10.03, df=1, P = 0.0015). Similar results were observed in the second patient subgroup with continuing prescription orders/treatment change (n = 228). A total of 123 patients were treated before the guidelines were implemented, and 105 were treated after the guidelines were implemented. Compliance rates were 23% pre-implementation compared with 50% post-implementation, which represented a statistically significant improvement in compliance (Pearson chi square = 18.99, df = 1, P  less than  0.0001). Given the widespread and long-term use of BRMs, safety monitoring and management should be an important part of a comprehensive medication management program for their use. A coordinated effort may have a significant impact on compliance with safety monitoring guidelines.

The challenge of change in acute mental health services: measuring staff perceptions of barriers to change and their relationship to job status and satisfaction using a new measure (VOCALISE).

PubMed

Laker, Caroline; Callard, Felicity; Flach, Clare; Williams, Paul; Sayer, Jane; Wykes, Til

2014-02-20

Health services are subject to frequent changes, yet there has been insufficient research to address how staff working within these services perceive the climate for implementation. Staff perceptions, particularly of barriers to change, may affect successful implementation and the resultant quality of care. This study measures staff perceptions of barriers to change in acute mental healthcare. We identify whether occupational status and job satisfaction are related to these perceptions, as this might indicate a target for intervention that could aid successful implementation. As there were no available instruments capturing staff perceptions of barriers to change, we created a new measure (VOCALISE) to assess this construct. All nursing staff from acute in-patient settings in one large London mental health trust were eligible. Using a participatory method, a nurse researcher interviewed 32 staff to explore perceptions of barriers to change. This generated a measure through thematic analyses and staff feedback (N = 6). Psychometric testing was undertaken according to standard guidelines for measure development (N = 40, 42, 275). Random effects models were used to explore the associations between VOCALISE, occupational status, and job satisfaction (N = 125). VOCALISE was easy to understand and complete, and showed acceptable reliability and validity. The factor analysis revealed three underlying constructs: 'confidence,' 'de-motivation' and 'powerlessness.' Staff with negative perceptions of barriers to change held more junior positions, and had poorer job satisfaction. Qualitatively, nursing assistants expressed a greater sense of organisational unfairness in response to change. VOCALISE can be used to explore staff perceptions of implementation climate and to assess how staff attitudes shape the successful outcomes of planned changes. Negative perceptions were linked with poor job satisfaction and to those occupying more junior roles, indicating a negative climate for implementation in those groups. Staff from these groups may therefore need special attention prior to implementing changes in mental health settings.

Realistic evaluation of an emergency department-based mental health nurse practitioner outpatient service in Australia.

PubMed

Wand, Timothy; White, Kathryn; Patching, Joanna

2011-06-01

Evaluation of new models of care requires consideration of the complexity inherent within health care programs and their sensitivity to local contextual factors as well as broader community, social and political influences. Evaluation frameworks that are flexible and responsive while maintaining research rigor are therefore required. Realistic evaluation was adopted as the methodology for the implementation and evaluation of an emergency department-based mental health nurse practitioner outpatient service in Sydney, Australia. The aim of realistic evaluation is to generate, test and refine theories of how programs work within a given context. This paper represents the final methodological step from the completed evaluation. A summary of quantitative and qualitative findings from the mixed-methods evaluation is presented, which is transformed into a set of overarching statements or "middle range theories". Middle range theory statements seek to explain the success of a program and provide transferable lessons for practitioners wishing to implement similar programs elsewhere. For example, the research team consider that early consultation with key local stakeholders and emergency department ownership of the project was pivotal to the implementation process. © 2011 Blackwell Publishing Asia Pty Ltd.

Promoting country ownership and stewardship of health programs: The global fund experience.

PubMed

Atun, Rifat; Kazatchkine, Michel

2009-11-01

The Global Fund to Fight AIDS, Tuberculosis and Malaria was established in 2002 to provide large-scale financing to middle- and low-income countries to intensify the fight against the 3 diseases. Its model has enabled strengthening of local health leadership to improve governance of HIV programs in 5 ways. First, the Global Fund has encouraged development of local capacity to generate technically sound proposals reflecting country needs and priorities. Second, through dual-track financing-where countries are encouraged to nominate at least one government and one nongovernment principal recipient to lead program implementation-the Global Fund has enabled civil society and other nongovernmental organizations to play a critical role in the design, implementation, and oversight of HIV programs. Third, investments to strengthen community systems have enabled greater involvement of community leaders in effective mobilization of demand and scale-up for services to reach vulnerable groups. Fourth, capacity building outside the state sector has improved community participation in governance of public health. Finally, an emphasis on inclusiveness and diversity in planning, implementation, and oversight has broadly enhanced country coordination capacity. Strengthening local leadership capacity and governance are critical to building efficient and equitable health systems to deliver universal coverage of HIV services.

Enhancing the AliEn Web Service Authentication

NASA Astrophysics Data System (ADS)

Zhu, Jianlin; Saiz, Pablo; Carminati, Federico; Betev, Latchezar; Zhou, Daicui; Mendez Lorenzo, Patricia; Grigoras, Alina Gabriela; Grigoras, Costin; Furano, Fabrizio; Schreiner, Steffen; Vladimirovna Datskova, Olga; Sankar Banerjee, Subho; Zhang, Guoping

2011-12-01

Web Services are an XML based technology that allow applications to communicate with each other across disparate systems. Web Services are becoming the de facto standard that enable inter operability between heterogeneous processes and systems. AliEn2 is a grid environment based on web services. The AliEn2 services can be divided in three categories: Central services, deployed once per organization; Site services, deployed on each of the participating centers; Job Agents running on the worker nodes automatically. A security model to protect these services is essential for the whole system. Current implementations of web server, such as Apache, are not suitable to be used within the grid environment. Apache with the mod_ssl and OpenSSL only supports the X.509 certificates. But in the grid environment, the common credential is the proxy certificate for the purpose of providing restricted proxy and delegation. An Authentication framework was taken for AliEn2 web services to add the ability to accept X.509 certificates and proxy certificates from client-side to Apache Web Server. The authentication framework could also allow the generation of access control policies to limit access to the AliEn2 web services.

Case study of supply induced demand: the case of provision of imaging scans (computed tomography and magnetic resonance) at Unimed-Manaus.

PubMed

Andrade, Edson de Oliveira; Andrade, Elizabeth Nogueira de; Gallo, José Hiran

2011-01-01

To present the experience of a health plan operator (Unimed-Manaus) in Manaus, Amazonas, Brazil, with the accreditation of imaging services and the demand induced by the supply of new services (Roemer's Law). This is a retrospective work studying a time series covering the period from January 1998 to June 2004, in which the computed tomography and the magnetic resonance imaging services were implemented as part of the services offered by that health plan operator. Statistical analysis consisted of a descriptive and an inferential part, with the latter using a mean parametric test (Student T-test and ANOVA) and the Pearson correlation test. A 5% alpha and a 95% confidence interval were adopted. At Unimed-Manaus, the supply of new imaging services, by itself, was identified as capable of generating an increased service demand, thus characterizing the phenomenon described by Roemer. The results underscore the need to be aware of the fact that the supply of new health services could bring about their increased use without a real demand.

Web Service Model for Plasma Simulations with Automatic Post Processing and Generation of Visual Diagnostics*

NASA Astrophysics Data System (ADS)

Exby, J.; Busby, R.; Dimitrov, D. A.; Bruhwiler, D.; Cary, J. R.

2003-10-01

We present our design and initial implementation of a web service model for running particle-in-cell (PIC) codes remotely from a web browser interface. PIC codes have grown significantly in complexity and now often require parallel execution on multiprocessor computers, which in turn requires sophisticated post-processing and data analysis. A significant amount of time and effort is required for a physicist to develop all the necessary skills, at the expense of actually doing research. Moreover, parameter studies with a computationally intensive code justify the systematic management of results with an efficient way to communicate them among a group of remotely located collaborators. Our initial implementation uses the OOPIC Pro code [1], Linux, Apache, MySQL, Python, and PHP. The Interactive Data Language is used for visualization. [1] D.L. Bruhwiler et al., Phys. Rev. ST-AB 4, 101302 (2001). * This work is supported by DOE grant # DE-FG02-03ER83857 and by Tech-X Corp. ** Also University of Colorado.

[Prevention of cervical and breast cancer in health services and non-governmental organizations in the city of Buenos Aires].

PubMed

Ponce, Marisa

2013-08-01

The article analyzes actions for the prevention of cervical and breast cancer in public, private, and employment-based health services and in non-governmental organizations in the city of Buenos Aires. The article seeks to reflect on the reach and limitations of the approaches implemented in the three subsectors of the health care system and the community to prevent women from suffering or eventually dying as a consequence of these diseases, in the fragmented context of a health system with great heterogeneity in access and deep social inequalities in the use of preventive actions. The study utilizes a broad definition of prevention which integrates education, awareness-building and early detection of pre-carcinogenic and carcinogenic lesions, among other medical and non-medical components. The results were obtained using semi-structured interviews with subjects from public hospitals, employment-based health care services, private medical companies and non-governmental organizations with work in cancer prevention. These results show that contrary to a comprehensive approach, each institution limits its actions to only one aspect of prevention, implementing predominately isolated or disconnected actions inadequate to generate an autonomous and well-informed demand for treatment and health care among women.

Impact of Appointment-Based Medication Synchronization on Proportion of Days Covered for Chronic Medications.

PubMed

Dao, Nancy; Lee, Sun; Hata, Micah; Sarino, Lord

2018-05-22

Appointment-based medication synchronization (ABMS) programs have been associated with increased adherence and persistence to chronic medications. Adherence to statin therapy, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and non-insulin antidiabetic medications (NIDM) are used to determine a health plan's Centers for Medicare and Medicaid Services (CMS) Star Rating under a pay-for-performance model. The objective of this study was to evaluate the impact of implementing an ABMS program on overall pharmacy adherence measures for statins, ACEI/ARBs, and NIDM, as presented through the Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP©) platform. This retrospective, pre-post ABMS program study evaluated EQuIPP© generated adherence performance measures, represented as proportion of days covered (PDC), 6-months before and 6- and 12-months after the ABMS service for statin therapy, ACEIs/ARBs, and NIDM. All adherence measures showed statistically significant improvement in PDC percentage post ABMS implementation, except for NIDM percentage in 6-months post-ABMS service. This study shows that a comprehensive medication synchronization program can enhance adherence measures that are important to health plans to increase CMS Star Rating under a pay-for-performance model.

Ethical Considerations in Mandatory Disclosure of Data Acquired While Caring for Human Trafficking Survivors.

PubMed

Kerr, Patrick L; Dash, Rachel

2017-01-01

Accurate data on the prevalence and psychological effects of human trafficking as well as treatment outcomes for survivors are essential for measuring the impact of interventions and generating better understanding of this phenomenon. However, such data are difficult to obtain. A legal mandate for health care professionals to report trafficking opens opportunities for advancing our work in the field of human trafficking but also poses risks to survivors seeking services. In this article, we provide an analysis of some critical ethical considerations for the development and implementation of a mandatory reporting policy and offer recommendations for the ethical implementation of such a policy. © 2017 American Medical Association. All Rights Reserved.

The specification-based validation of reliable multicast protocol: Problem Report. M.S. Thesis

NASA Technical Reports Server (NTRS)

Wu, Yunqing

1995-01-01

Reliable Multicast Protocol (RMP) is a communication protocol that provides an atomic, totally ordered, reliable multicast service on top of unreliable IP multicasting. In this report, we develop formal models for RMP using existing automated verification systems, and perform validation on the formal RMP specifications. The validation analysis help identifies some minor specification and design problems. We also use the formal models of RMP to generate a test suite for conformance testing of the implementation. Throughout the process of RMP development, we follow an iterative, interactive approach that emphasizes concurrent and parallel progress of implementation and verification processes. Through this approach, we incorporate formal techniques into our development process, promote a common understanding for the protocol, increase the reliability of our software, and maintain high fidelity between the specifications of RMP and its implementation.

An Exploration of Pre-Service Teachers' Experiences in Outdoor `Places' and Intentions for Teaching in the Outdoors

NASA Astrophysics Data System (ADS)

Blatt, Erica; Patrick, Patricia

2014-09-01

This study explores pre-service teachers' past interactions with 'place' in outdoor settings and how these experiences contribute to their current perceptions of the importance of taking their own students into the outdoors. Specifically, the researchers were interested in investigating if current pre-service teachers are part of the 'nature-deficit disorder' generation described by Louv in his book, Last child in the woods: Saving our children from nature-deficit disorder (2005), as a generation of children growing up without direct experiences in nature. Study participants included 148 undergraduate pre-service elementary teachers enrolled in science teaching methods instructional courses at an urban college in the Northeastern United States and two suburban universities in the Southeastern United States. Participants wrote essay responses after reading Louv's Last Child in the Woods in which they were asked to relate the reading to their own past experiences and their ideas about elementary science education. Results indicate that a large majority of participants (97%) describe significant youth experiences in the outdoors, view nature as important in varying ways (89.9%), and express a desire to expose their own students to the outdoors (65.5%). Key findings are illustrated with direct quotations from the pre-service teachers' essay responses, as they write vividly of their interactions in outdoor places, referred to as 'place meanings'. Implications are presented for teacher educators working with pre-service teachers to build upon their outdoor experiences and prepare them for implementing nature-based instruction.

Reusing Information Management Services for Recommended Decadal Study Missions That Facilitate Aerosol and Cloud Studies

NASA Astrophysics Data System (ADS)

Alcott, G.; Kempler, S.; Lynnes, C.; Leptoukh, G.; Vollmer, B.; Berrick, S.

2008-12-01

NASA Earth Sciences Division (ESD), and its preceding Earth science organizations, has made great investments in the development and maintenance of data management systems, as well as information technologies, for the purpose of maximizing the use and usefulness of NASA generated Earth science data. Earth science information systems, evolving with the maturation and implementation of advancing technologies, reside at NASA data centers, known as Distributed Active Archive Centers (DAACs). With information management system infrastructure in place, and system data and user services already developed and operational, only very small delta costs are required to fully support data archival, processing, and data support services required by the recommended Decadal Study missions. This presentation describes the services and capabilities of the Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) (one of NASAs DAACs) and their potential reuse for these future missions. After 14 years working with instrument teams and the broader science community, GES DISC personnel expertise in atmospheric, water cycle, and atmospheric modeling data and information services, as well as Earth science missions, information system engineering, operations, and user services have developed a series of modular, reusable data management components currently is use in several projects. The knowledge and experience gained at the GES DISC lend themselves to providing science driven information systems in the areas of aerosols, clouds, and atmospheric chemicals to be measured by recommended Decadal Survey missions. Available reusable capabilities include data archive and distribution (Simple, Scalable, Script-based, Science [S4] Product Archive aka S4PA), data processing (S4 Processor for Measurements aka S4PM), data search (Mirador), data browse, visualization, and analysis (Giovanni), and data mining services. In addition, recent enhancements, such as Open Geospatial Consortium (OGC), Inc. interoperability implementations and data fusion prototypes, will be described. As a result of the information management systems developed by NASAs GES DISC, not only are large cost savings realized through system reuse, but maintenance costs are also minimized due to the simplicity of their implementations.

The GOES-R Product Generation Architecture - Post CDR Update

NASA Astrophysics Data System (ADS)

Dittberner, G.; Kalluri, S.; Weiner, A.

2012-12-01

The GOES-R system will substantially improve the accuracy of information available to users by providing data from significantly enhanced instruments, which will generate an increased number and diversity of products with higher resolution, and much shorter relook times. Considerably greater compute and memory resources are necessary to achieve the necessary latency and availability for these products. Over time, new and updated algorithms are expected to be added and old ones removed as science advances and new products are developed. The GOES-R GS architecture is being planned to maintain functionality so that when such changes are implemented, operational product generation will continue without interruption. The primary parts of the PG infrastructure are the Service Based Architecture (SBA) and the Data Fabric (DF). SBA is the middleware that encapsulates and manages science algorithms that generate products. It is divided into three parts, the Executive, which manages and configures the algorithm as a service, the Dispatcher, which provides data to the algorithm, and the Strategy, which determines when the algorithm can execute with the available data. SBA is a distributed architecture, with services connected to each other over a compute grid and is highly scalable. This plug-and-play architecture allows algorithms to be added, removed, or updated without affecting any other services or software currently running and producing data. Algorithms require product data from other algorithms, so a scalable and reliable messaging is necessary. The SBA uses the DF to provide this data communication layer between algorithms. The DF provides an abstract interface over a distributed and persistent multi-layered storage system (e.g., memory based caching above disk-based storage) and an event management system that allows event-driven algorithm services to know when instrument data are available and where they reside. Together, the SBA and the DF provide a flexible, high performance architecture that can meet the needs of product processing now and as they grow in the future.

The GOES-R Product Generation Architecture

NASA Astrophysics Data System (ADS)

Dittberner, G. J.; Kalluri, S.; Hansen, D.; Weiner, A.; Tarpley, A.; Marley, S.

2011-12-01

The GOES-R system will substantially improve users' ability to succeed in their work by providing data with significantly enhanced instruments, higher resolution, much shorter relook times, and an increased number and diversity of products. The Product Generation architecture is designed to provide the computer and memory resources necessary to achieve the necessary latency and availability for these products. Over time, new and updated algorithms are expected to be added and old ones removed as science advances and new products are developed. The GOES-R GS architecture is being planned to maintain functionality so that when such changes are implemented, operational product generation will continue without interruption. The primary parts of the PG infrastructure are the Service Based Architecture (SBA) and the Data Fabric (DF). SBA is the middleware that encapsulates and manages science algorithms that generate products. It is divided into three parts, the Executive, which manages and configures the algorithm as a service, the Dispatcher, which provides data to the algorithm, and the Strategy, which determines when the algorithm can execute with the available data. SBA is a distributed architecture, with services connected to each other over a compute grid and is highly scalable. This plug-and-play architecture allows algorithms to be added, removed, or updated without affecting any other services or software currently running and producing data. Algorithms require product data from other algorithms, so a scalable and reliable messaging is necessary. The SBA uses the DF to provide this data communication layer between algorithms. The DF provides an abstract interface over a distributed and persistent multi-layered storage system (e.g., memory based caching above disk-based storage) and an event management system that allows event-driven algorithm services to know when instrument data are available and where they reside. Together, the SBA and the DF provide a flexible, high performance architecture that can meet the needs of product processing now and as they grow in the future.

GOES-R GS Product Generation Infrastructure Operations

NASA Astrophysics Data System (ADS)

Blanton, M.; Gundy, J.

2012-12-01

GOES-R GS Product Generation Infrastructure Operations: The GOES-R Ground System (GS) will produce a much larger set of products with higher data density than previous GOES systems. This requires considerably greater compute and memory resources to achieve the necessary latency and availability for these products. Over time, new algorithms could be added and existing ones removed or updated, but the GOES-R GS cannot go down during this time. To meet these GOES-R GS processing needs, the Harris Corporation will implement a Product Generation (PG) infrastructure that is scalable, extensible, extendable, modular and reliable. The primary parts of the PG infrastructure are the Service Based Architecture (SBA), which includes the Distributed Data Fabric (DDF). The SBA is the middleware that encapsulates and manages science algorithms that generate products. The SBA is divided into three parts, the Executive, which manages and configures the algorithm as a service, the Dispatcher, which provides data to the algorithm, and the Strategy, which determines when the algorithm can execute with the available data. The SBA is a distributed architecture, with services connected to each other over a compute grid and is highly scalable. This plug-and-play architecture allows algorithms to be added, removed, or updated without affecting any other services or software currently running and producing data. Algorithms require product data from other algorithms, so a scalable and reliable messaging is necessary. The SBA uses the DDF to provide this data communication layer between algorithms. The DDF provides an abstract interface over a distributed and persistent multi-layered storage system (memory based caching above disk-based storage) and an event system that allows algorithm services to know when data is available and to get the data that they need to begin processing when they need it. Together, the SBA and the DDF provide a flexible, high performance architecture that can meet the needs of product processing now and as they grow in the future.

Consider long-term care as service alternative.

PubMed

Loria, L S

1987-04-01

The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

The Ecology of Sustainable Implementation: Reflection on a 10-Year Case History Illustration.

PubMed

Rimehaug, Tormod

2014-01-01

The primary aim of this paper is to illustrate the strategic and ecological nature of implementation. The ultimate aim of implementation is not dissemination but sustainability beyond the implementation effort. A case study is utilized to illustrate these broad and long-term perspectives of sustainable implementation based on qualitative analyses of a 10-year implementation effort. The purveyors aimed to develop selective community prevention services for children in families burdened by parental psychiatric or addictive problems. Services were gradually disseminated to 23 sites serving 40 municipalities by 2013. Up to 2013, only one site terminated services after initial implementation. Although many sites suspended services for shorter periods, services are still offered at 22 sites. This case analysis is based on project reports, user evaluations, practitioner interviews, and service statistics. The paper focuses on the analyses and strategies utilized to cope with quality decay and setbacks as well as progress and success in disseminating and sustaining the services and their quality. Low-cost multilevel strategies to implement services at the community level were organized by a prevention unit in child psychiatry, supervised by a university department (purveyors). The purveyors were also involved in national and international collaboration and development. Multilevel strategies included manualized intervention, in-practice training methods, organizational responsibility, media strategies, service evaluation, staff motivation maintenance, quality assurance, and proposals for new law regulations. These case history aspects will be discussed in relation to the implementation literature, focusing on possible applicability across settings.

Successful Implementation of Clinical Information Technology: Seven Key Lessons from CPOE.

PubMed

Gellert, G A; Hill, V; Bruner, K; Maciaz, G; Saucedo, L; Catzoela, L; Ramirez, R; Jacobs, W J; Nguyen, P; Patel, L; Webster, S L

2015-01-01

To identify and describe the most critical strategic and operational contributors to the successful implementation of clinical information technologies, as deployed within a moderate sized system of U.S. community hospitals. CHRISTUS Health is a multi-state system comprised of more than 350 services and 60 hospitals with over 9 000 physicians. The Santa Rosa region of CHRISTUS Health, located in greater San Antonio, Texas is comprised of three adult community hospital facilities and one Children's hospital each with bed capacities of 142-180. Computerized Patient Order Entry (CPOE) was first implemented in 2012 within a complex market environment. The Santa Rosa region has 2 417 credentialed physicians and 263 mid-level allied health professionals. This report focuses on the seven most valuable strategies deployed by the Health Informatics team in a large four hospital CHRISTUS region to achieve strong CPOE adoption and critical success lessons learned. The findings are placed within the context of the literature describing best practices in health information technology implementation. While the elements described involved discrete de novo process generation to support implementation and operations, collectively they represent the creation of a new customer-centric service culture in our Health Informatics team, which has served as a foundation for ensuring strong clinical information technology adoption beyond CPOE. The seven success factors described are not limited in their value to and impact on CPOE adoption, but generalize to - and can advance success in - varied other clinical information technology implementations across diverse hospitals. A number of these factors are supported by reports in the literature of other institutions' successful implementations of CPOE and other clinical information technologies, and while not prescriptive to other settings, may be adapted to yield value elsewhere.

A Semantic Grid Oriented to E-Tourism

NASA Astrophysics Data System (ADS)

Zhang, Xiao Ming

With increasing complexity of tourism business models and tasks, there is a clear need of the next generation e-Tourism infrastructure to support flexible automation, integration, computation, storage, and collaboration. Currently several enabling technologies such as semantic Web, Web service, agent and grid computing have been applied in the different e-Tourism applications, however there is no a unified framework to be able to integrate all of them. So this paper presents a promising e-Tourism framework based on emerging semantic grid, in which a number of key design issues are discussed including architecture, ontologies structure, semantic reconciliation, service and resource discovery, role based authorization and intelligent agent. The paper finally provides the implementation of the framework.

GEO Label Web Services for Dynamic and Effective Communication of Geospatial Metadata Quality

NASA Astrophysics Data System (ADS)

Lush, Victoria; Nüst, Daniel; Bastin, Lucy; Masó, Joan; Lumsden, Jo

2014-05-01

We present demonstrations of the GEO label Web services and their integration into a prototype extension of the GEOSS portal (http://scgeoviqua.sapienzaconsulting.com/web/guest/geo_home), the GMU portal (http://gis.csiss.gmu.edu/GADMFS/) and a GeoNetwork catalog application (http://uncertdata.aston.ac.uk:8080/geonetwork/srv/eng/main.home). The GEO label is designed to communicate, and facilitate interrogation of, geospatial quality information with a view to supporting efficient and effective dataset selection on the basis of quality, trustworthiness and fitness for use. The GEO label which we propose was developed and evaluated according to a user-centred design (UCD) approach in order to maximise the likelihood of user acceptance once deployed. The resulting label is dynamically generated from producer metadata in ISO or FDGC format, and incorporates user feedback on dataset usage, ratings and discovered issues, in order to supply a highly informative summary of metadata completeness and quality. The label was easily incorporated into a community portal as part of the GEO Architecture Implementation Programme (AIP-6) and has been successfully integrated into a prototype extension of the GEOSS portal, as well as the popular metadata catalog and editor, GeoNetwork. The design of the GEO label was based on 4 user studies conducted to: (1) elicit initial user requirements; (2) investigate initial user views on the concept of a GEO label and its potential role; (3) evaluate prototype label visualizations; and (4) evaluate and validate physical GEO label prototypes. The results of these studies indicated that users and producers support the concept of a label with drill-down interrogation facility, combining eight geospatial data informational aspects, namely: producer profile, producer comments, lineage information, standards compliance, quality information, user feedback, expert reviews, and citations information. These are delivered as eight facets of a wheel-like label, which are coloured according to metadata availability and are clickable to allow a user to engage with the original metadata and explore specific aspects in more detail. To support this graphical representation and allow for wider deployment architectures we have implemented two Web services, a PHP and a Java implementation, that generate GEO label representations by combining producer metadata (from standard catalogues or other published locations) with structured user feedback. Both services accept encoded URLs of publicly available metadata documents or metadata XML files as HTTP POST and GET requests and apply XPath and XSLT mappings to transform producer and feedback XML documents into clickable SVG GEO label representations. The label and services are underpinned by two XML-based quality models. The first is a producer model that extends ISO 19115 and 19157 to allow fuller citation of reference data, presentation of pixel- and dataset- level statistical quality information, and encoding of 'traceability' information on the lineage of an actual quality assessment. The second is a user quality model (realised as a feedback server and client) which allows reporting and query of ratings, usage reports, citations, comments and other domain knowledge. Both services are Open Source and are available on GitHub at https://github.com/lushv/geolabel-service and https://github.com/52North/GEO-label-java. The functionality of these services can be tested using our GEO label generation demos, available online at http://www.geolabel.net/demo.html and http://geoviqua.dev.52north.org/glbservice/index.jsf.

Design and implementation of flexible TWDM-PON with PtP WDM overlay based on WSS for next-generation optical access networks

NASA Astrophysics Data System (ADS)

Wu, Bin; Yin, Hongxi; Qin, Jie; Liu, Chang; Liu, Anliang; Shao, Qi; Xu, Xiaoguang

2016-09-01

Aiming at the increasing demand of the diversification services and flexible bandwidth allocation of the future access networks, a flexible passive optical network (PON) scheme combining time and wavelength division multiplexing (TWDM) with point-to-point wavelength division multiplexing (PtP WDM) overlay is proposed for the next-generation optical access networks in this paper. A novel software-defined optical distribution network (ODN) structure is designed based on wavelength selective switches (WSS), which can implement wavelength and bandwidth dynamical allocations and suits for the bursty traffic. The experimental results reveal that the TWDM-PON can provide 40 Gb/s downstream and 10 Gb/s upstream data transmission, while the PtP WDM-PON can support 10 GHz point-to-point dedicated bandwidth as the overlay complement system. The wavelengths of the TWDM-PON and PtP WDM-PON are allocated dynamically based on WSS, which verifies the feasibility of the proposed structure.

Increased dependence of humans on ecosystem services and biodiversity.

PubMed

Guo, Zhongwei; Zhang, Lin; Li, Yiming

2010-10-01

Humans have altered ecosystems more rapidly and extensively than ever, largely to meet rapidly growing demands for resources along with economic development. These demands have been considered important drivers of ecosystem degradation and biodiversity loss. Are humans becoming less dependent on ecosystem services and biodiversity following economic development? Here, we used roundwood production, hydroelectricity generation and tourism investment in 92 biodiversity hotspot and 60 non-hotspot countries as cases to seek the answer. In 1980-2005, annual growth rates of roundwood production, hydroelectricity generation and tourism investment were higher in hotspot countries (5.2, 9.1 and 7.5%) than in non-hotspot countries (3.4, 5.9 and 5.6%), when GDP grew more rapidly in hotspot countries than non-hotspot countries. Annual growth rates of per capita hydropower and per capita tourism investment were higher in hotspot countries (5.3% and 6.1%) than in non-hotspot countries (3.5% and 4.3%); however, the annual growth rate of per capita roundwood production in hotspot countries (1%) was lower than in non-hotspot countries (1.4%). The dependence of humans on cultural services has increased more rapidly than on regulating services, while the dependence on provisioning services has reduced. This pattern is projected to continue during 2005-2020. Our preliminary results show that economic growth has actually made humans more dependent upon ecosystem services and biodiversity. As a consequence, the policies and implementations of both economic development and ecosystems/biodiversity conservation should be formulated and carried out in the context of the increased dependence of humans on ecosystem services along with economic development.

Evaluating the impacts of real-time pricing on the usage of wind generation

DOE PAGES

Sioshansi, Ramteen; Short, Walter

2009-02-13

One of the impediments to large-scale use of wind generation within power systems is its nondispatchability and variable and uncertain real-time availability. Operating constraints on conventional generators such as minimum generation points, forbidden zones, and ramping limits as well as system constraints such as power flow limits and ancillary service requirements may force a system operator to curtail wind generation in order to ensure feasibility. Furthermore, the pattern of wind availability and electricity demand may not allow wind generation to be fully utilized in all hours. One solution to these issues, which could reduce these inflexibilities, is the use ofmore » real-time pricing (RTP) tariffs which can both smooth-out the diurnal load pattern in order to reduce the impact of binding unit operating and system constraints on wind utilization, and allow demand to increase in response to the availability of costless wind generation. As a result, we use and analyze a detailed unit commitment model of the Texas power system with different estimates of demand elasticities to demonstrate the potential increases in wind generation from implementing RTP.« less

Awareness campaign.

PubMed

2007-01-01

LifeBridge Health developed and implemented an awareness campaign to generate buzz about the breast cancer services at the Alvin & Lois Lapidus Cancer Institute of LifeBridge Health and the Herman & Walter Samuelson Breast Cancer Care Center at Northwest Hospital Center. With the help of talented local breast cancer survivors, celebrities, fashion designers, and artists, LifeBridge Health created a campaign, including an interactive Web site, public relations outreach, and a unique event in October 2006 that featured a collection of hand-made decorated bras.

An assessment of the safe delivery incentive program at a tertiary level hospital in Nepal.

PubMed

Baral, G

2012-05-01

Maternity incentive program of Nepal known as Safe Delivery Incentive Program (SDIP) was introduced nationwide in 2005 with the intention of increasing utilization of professional care at childbirth. The program provided both childbirth service as well as 'cash' to women giving birth in a health facility in addition to incentives to health provider for each delivery attended, either at home or the facility. Due to a lack of uniformity in its implementation and administrative delays, the program was reformed and even extended to many not-for-profit health institutions in early 2007, and implemented as a 'Safer Mother Program' popularly known as "Aama-Suraksha-Karyakram" since January 2009. This is a system research with observational and analytical components. Plausibility design is selected to evaluate the performance-based funding (PBF) as a system level intervention of maternity care using two instruments: Pay-For-Performance and Conditional-Cash-Transfer. It uses interrupted time-series to control for the natural trend. Research tools used are interviews, the focus group discussions and literature review. Numerical data are presented in simple graphs. While online random number generator was used partly, the purposive sampling was used for qualitative data. There is a gross discrepancy in non-targeted service delivery at the tertiary level health facility. Overflooding of maternity cases has hampered gynecological admission and surgical management delaying subspecialty care and junior physicians' training. With the same number and quality of physical facility and human resource, the additional program has put more strains to service providers and administrators. There should be adequate planning and preparation at all levels of health facilities; implementing a new program should not adversely affect another existing service delivery system. For the optional implementation, hospital organogram should be revised; and physical facilities and the low-risk birthing-centers with referral linkages should be expanded.

Global health diplomacy investments in Afghanistan: adaptations and outcomes of global fund malaria programs.

PubMed

Kevany, Sebastian; Sahak, Omar; Workneh, Nibretie Gobezie; Saeedzai, Sayed Ataullah

2014-01-01

Global health programmes require extensive adaptation for implementation in conflict and post-conflict settings. Without such adaptations, both implementation success and diplomatic, international relations and other indirect outcomes may be threatened. Conversely, diplomatic successes may be made through flexible and responsive programmes. We examine adaptations and associated outcomes for malaria treatment and prevention programmes in Afghanistan. In conjunction with the completion of monitoring and evaluation activities for the Global Fund to Fight AIDS, Tuberculosis and Malaria, we reviewed adaptations to the structure, design, selection, content and delivery of malaria-related interventions in Afghanistan. Interviews were conducted with programme implementers, service delivery providers, government representatives and local stakeholders, and site visits to service delivery points were completed. Programmes for malaria treatment and prevention require a range of adaptations for successful implementation in Afghanistan. These include (1) amendment of educational materials for rural populations, (2) religious awareness in gender groupings for health educational interventions, (3) recruitment of local staff, educated in languages and customs, for both quality assurance and service delivery, (4) alignment with diplomatic principles and, thereby, avoidance of confusion with broader strategic and military initiatives and (5) amendments to programme 'branding' procedures. The absence of provision for these adaptations made service delivery excessively challenging and increased the risk of tension between narrow programmatic and broader diplomatic goals. Conversely, adapted global health programmes displayed a unique capacity to access potentially extremist populations and groups in remote regions otherwise isolated from international activities. A range of diplomatic considerations when delivering global health programmes in conflict and post-conflict settings are required in order to ensure that health gains are not offset by broader international relations losses through challenges to local cultural, religious and social norms, as well as in order to ensure the security of programme staff. Conversely, when global health programmes are delivered with international relations considerations in mind, they have the potential to generate unquantified diplomatic outcomes.

Corporate dashboard for payphone service

NASA Astrophysics Data System (ADS)

Siraj, Fadzilah; Shadan, Hezlin

2015-12-01

Making assured that managements are kept abreast of what is happening in the company is not an easy task. The quantity of data generated by the business process is astonishing large and non-centralized. The challenge facing business organizations is how to extract, load, transform data, and then deliver useful information to key decision makers. The major challenge for the payphone industries is in making a good decision, particularly to increase quality of service, customer satisfaction while achieving high revenue. With current practice, the process is very time consuming and therefore, a systematic and informative corporate dashboard needs to be provided especially for managerial level in supporting their decision making process. This paper proposed a dashboard application design that provides a single-screen display of relevant information such as the phone performance and coin collection reports, as well as generated revenue to enable faster and more effective decision making. The development of the dashboard is divided into requirement, design and implementation phases. The implementation using real data has demonstrated the potential use of the dashboard. The evaluation results indicate that the dashboard can be used as a tool that can support payphone operation works and decision process by providing the analytical analysis of the KPI report and the performance status. In addition, the results can be used as a guideline for the dashboard developer to understand the process and focuses on the key elements and the principle in designing the effective dashboard.

The implementation of interconception care in two community health settings: lessons learned.

PubMed

Handler, Arden; Rankin, Kristin M; Peacock, Nadine; Townsell, Stephanie; McGlynn, Andrea; Issel, L Michele

2013-01-01

This study reports on an evaluation of the implementation of a pilot interconceptional care program (ICCP) in Chicago and the experiences of the participants in their first postpartum year. A longitudinal, multi-method approach was used to gather data to measure success in achieving project benchmarks and to gain insights into women's experiences after an adverse pregnancy outcome. The ICCP interventions were provided in two different health care settings. Low-income African-American women with a prior adverse pregnancy outcome were recruited to participate. Data on services delivered are available for 220 women; linked interview data are also available for 99 of these women. The ICCP focused on the integration of social services, family planning, and medical care provided through a team approach. An interview questionnaire asked detailed information about interconceptional health status, attitudes, and behaviors. A services database documented all services delivered to each participant. Key informant interviews were conducted with the ICCP project staff. Simple frequencies were generated. Chi-square and t-tests were used to compare participants and benchmarks at the two different sites. The planned delivery of interventions based on women's unique interconceptional health needs was often replaced by efforts to address women's socioeconomic needs. Although medical care remained important, participants viewed themselves as healthy and did not view medical care as a priority. Women's perceptions of contraceptive effectiveness were not always in sync with clinical knowledge. Interconceptional care is a complex process of matching interventions and services to meet women's unique needs, including their socioeconomic needs.

Services for Emodnet-Chemistry Data Products

NASA Astrophysics Data System (ADS)

Santinelli, Giorgio; Hendriksen, Gerrit; Barth, Alexander

2016-04-01

In the framework of Emodnet Chemistry lot, data products from regional leaders were made available in order to transform information into a database. This has been done by using functions and scripts, reading so-called enriched ODV files and inserting data directly into a cloud relational geodatabase. The main table is the one of observations which contains the main data and meta-data associated with the enriched ODV files. A particular implementation in data loading is used in order to improve on-the-fly computational speed. Data from Baltic Sea, North Sea, Mediterrean, Black Sea and part of the Atlantic region has been entered into the geodatabase, and consequently being instantly available from the OceanBrowser Emodnet portal. Furthermore, Deltares has developed an application that provides additional visualisation services for the aggregated and validated data collections. The visualisations are produced by making use of part of the OpenEarthTool stack (http://www.openearth.eu), by the integration of Web Feature Services and by the implementation of Web Processing Services. The goal is the generation of server-side plots of timeseries, profiles, timeprofiles and maps of selected parameters from data sets of selected stations. Regional data collections are retrieved using Emodnet Chemistry cloud relational geo-database. The spatial resolution in time and the intensity of data availability for selected parameters is shown using Web Service requests via the OceanBrowser Emodnet Web portal. OceanBrowser also shows station reference codes, which are used to establish a link for additional metadata, further data shopping and download.

Food Service Perspectives on National School Lunch Program Implementation.

PubMed

Tabak, Rachel G; Moreland-Russell, Sarah

2015-09-01

Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.

Simulation Data Management - Requirements and Design Specification

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

Clay, Robert L.; Friedman-Hill, Ernest J.; Gibson, Marcus J.

Simulation Data Management (SDM), the ability to securely organize, archive, and share analysis models and the artifacts used to create them, is a fundamental requirement for modern engineering analysis based on computational simulation. We have worked separately to provide secure, network SDM services to engineers and scientists at our respective laboratories for over a decade. We propose to leverage our experience and lessons learned to help develop and deploy a next-generation SDM service as part of a multi-laboratory team. This service will be portable across multiple sites and platforms, and will be accessible via a range of command-line tools andmore » well-documented APIs. In this document, we’ll review our high-level and low-level requirements for such a system, review one existing system, and briefly discuss our proposed implementation.« less

Sustainable access to data, products, services and software from the European seismological Research Infrastructures: the EPOS TCS Seismology

NASA Astrophysics Data System (ADS)

Haslinger, Florian; Dupont, Aurelien; Michelini, Alberto; Rietbrock, Andreas; Sleeman, Reinoud; Wiemer, Stefan; Basili, Roberto; Bossu, Rémy; Cakti, Eser; Cotton, Fabrice; Crawford, Wayne; Diaz, Jordi; Garth, Tom; Locati, Mario; Luzi, Lucia; Pinho, Rui; Pitilakis, Kyriazis; Strollo, Angelo

2016-04-01

Easy, efficient and comprehensive access to data, data products, scientific services and scientific software is a key ingredient in enabling research at the frontiers of science. Organizing this access across the European Research Infrastructures in the field of seismology, so that it best serves user needs, takes advantage of state-of-the-art ICT solutions, provides cross-domain interoperability, and is organizationally and financially sustainable in the long term, is the core challenge of the implementation phase of the Thematic Core Service (TCS) Seismology within the EPOS-IP project. Building upon the existing European-level infrastructures ORFEUS for seismological waveforms, EMSC for seismological products, and EFEHR for seismological hazard and risk information, and implementing a pilot Computational Earth Science service starting from the results of the VERCE project, the work within the EPOS-IP project focuses on improving and extending the existing services, aligning them with global developments, to at the end produce a well coordinated framework that is technically, organizationally, and financially integrated with the EPOS architecture. This framework needs to respect the roles and responsibilities of the underlying national research infrastructures that are the data owners and main providers of data and products, and allow for active input and feedback from the (scientific) user community. At the same time, it needs to remain flexible enough to cope with unavoidable challenges in the availability of resources and dynamics of contributors. The technical work during the next years is organized in four areas: - constructing the next generation software architecture for the European Integrated (waveform) Data Archive EIDA, developing advanced metadata and station information services, fully integrate strong motion waveforms and derived parametric engineering-domain data, and advancing the integration of mobile (temporary) networks and OBS deployments in EIDA; - further development and expansion of services to access seismological products of scientific interest as provided by the community by implementing a common collection and development (IT) platform, improvements in the earthquake information services e.g. by introducing more robust quality indicators and diversifying collection and dissemination mechanisms, as well as improving historical earthquake data services; - development of a comprehensive suite of earthquake hazard products, tools, and services harmonized on the European level and available through a common access platform, encompassing information on seismic sources, seismogenic faults, ground-motion prediction equations, geotechnical information, and strong-motion recordings in buildings, together with an interface to earthquake risk; - a portal implementation of computational seismology tools and services, specifically for seismic waveform propagation in complex 3D media following the results of the VERCE project, and initiating the inclusion of further suitable codes on that portal in discussion with the community, forming the basis of EPOS computational earth science infrastructure. This will be accompanied by development and implementation of integrated and interoperable metadata structures, adequate and referencable persistent identifiers, and appropriate user access and authorization mechanisms. Here we present further detail on the work plan with the attempt to foster interaction with the target user community on the spectrum of services as well as on feedback mechanisms and governance.

Providing QoS guarantee in 3G wireless networks

NASA Astrophysics Data System (ADS)

Chuah, MooiChoo; Huang, Min; Kumar, Suresh

2001-07-01

The third generation networks and services present opportunities to offer multimedia applications and services that meet end-to-end quality of service requirements. In this article, we present UMTS QoS architecture and its requirements. This includes the definition of QoS parameters, traffic classes, the end-to-end data delivery model, and the mapping of end-to-end services to the services provided by the network elements of the UMTS. End-to-end QoS of a user flow is achieved by the combination of the QoS control over UMTS Domain and the IP core Network. In the Third Generation Wireless network, UMTS bearer service manager is responsible to manage radio and transport resources to QoS-enabled applications. The UMTS bearer service consists of the Radio Access Bearer Service between Mobile Terminal and SGSN and Core Network bearer service between SGSN and GGSN. The Radio Access Bearer Service is further realized by the Radio Bearer Service (mostly air interface) and Iu bearer service. For the 3G air interface, one can provide differentiated QoS via intelligent burst allocation scheme, adaptive spreading factor control and weighted fair queueing scheduling algorithms. Next, we discuss the requirements for the transport technologies in the radio access network to provide differentiated QoS to multiple classes of traffic. We discuss both ATM based and IP based transport solutions. Last but not least, we discuss how QoS mechanism is provided in the core network to ensure e2e quality of service requirements. We discuss how mobile terminals that use RSVP as QoS signaling mechanisms can be are supported in the 3G network which may implement only IETF diffserv mechanism. . We discuss how one can map UMTS QoS classes with IETF diffserv code points. We also discuss 2G/3G handover scenarios and how the 2G/3G QoS parameters can be mapped.

29 CFR 779.371 - Some automobile, truck, and farm implement establishments may qualify for exemption under section...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Some automobile, truck, and farm implement establishments... OR SERVICES Exemptions for Certain Retail or Service Establishments Automobile, Truck, Farm Implement, Trailer, and Aircraft Sales and Services § 779.371 Some automobile, truck, and farm implement...

Improving Retention in Care Among Pregnant Women and Mothers Living With HIV: Lessons From INSPIRE and Implications for Future WHO Guidance and Monitoring

PubMed Central

Essajee, Shaffiq M.; Bellare, Nita; Doherty, Meg; Hirnschall, Gottfried O.

2017-01-01

Abstract: Identifying women living with HIV, initiating them on lifelong antiretroviral treatment (ART), and retaining them in care are among the important challenges facing this generation of health care managers and public health researchers. Implementation research attempts to solve a wide range of implementation problems by trying to understand and work within real-world conditions to find solutions that have a measureable impact on the outcomes of interest. Implementation research is distinct from clinical research in many ways yet demands similar standards of conceptual thinking and discipline to generate robust evidence that can be, to some extent, generalized to inform policy and service delivery. In 2011, the World Health Organization (WHO), with funding from Global Affairs Canada, began support to 6 implementation research projects in Malawi, Nigeria, and Zimbabwe. All focused on evaluating approaches for improving rates of retention in care among pregnant women and mothers living with HIV and ensuring their continuation of ART. This reflected the priority given by ministries of health, program implementers, and researchers in each country to the importance of women living with HIV returning to health facilities for routine care, adherence to ART, and improved health outcomes. Five of the studies were cluster randomized controlled trials, and 1 adopted a matched cohort design. Here, we summarize some of the main findings and key lessons learned. We also consider some of the broader implications, remaining knowledge gaps, and how implementation research is integral to, and essential for, global guideline development and to inform HIV/AIDS strategies. PMID:28498179

Improving Retention in Care Among Pregnant Women and Mothers Living With HIV: Lessons From INSPIRE and Implications for Future WHO Guidance and Monitoring.

PubMed

Rollins, Nigel C; Essajee, Shaffiq M; Bellare, Nita; Doherty, Meg; Hirnschall, Gottfried O

2017-06-01

Identifying women living with HIV, initiating them on lifelong antiretroviral treatment (ART), and retaining them in care are among the important challenges facing this generation of health care managers and public health researchers. Implementation research attempts to solve a wide range of implementation problems by trying to understand and work within real-world conditions to find solutions that have a measureable impact on the outcomes of interest. Implementation research is distinct from clinical research in many ways yet demands similar standards of conceptual thinking and discipline to generate robust evidence that can be, to some extent, generalized to inform policy and service delivery. In 2011, the World Health Organization (WHO), with funding from Global Affairs Canada, began support to 6 implementation research projects in Malawi, Nigeria, and Zimbabwe. All focused on evaluating approaches for improving rates of retention in care among pregnant women and mothers living with HIV and ensuring their continuation of ART. This reflected the priority given by ministries of health, program implementers, and researchers in each country to the importance of women living with HIV returning to health facilities for routine care, adherence to ART, and improved health outcomes. Five of the studies were cluster randomized controlled trials, and 1 adopted a matched cohort design. Here, we summarize some of the main findings and key lessons learned. We also consider some of the broader implications, remaining knowledge gaps, and how implementation research is integral to, and essential for, global guideline development and to inform HIV/AIDS strategies.

Implementing new routines in adult mental health care to identify and support children of mentally ill parents.

PubMed

Lauritzen, Camilla; Reedtz, Charlotte; Van Doesum, Karin T M; Martinussen, Monica

2014-02-07

Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. The design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker's knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. The results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice. The main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant.

Implementing new routines in adult mental health care to identify and support children of mentally ill parents

PubMed Central

2014-01-01

Background Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. Methods The design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker’s knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. Results The results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice. Conclusion The main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant. PMID:24507566

Implementation strategies for collaborative primary care-mental health models.

PubMed

Franx, Gerdien; Dixon, Lisa; Wensing, Michel; Pincus, Harold

2013-09-01

Extensive research exists that collaborative primary care-mental health models can improve care and outcomes for patients. These programs are currently being implemented throughout the United States and beyond. The purpose of this study is to review the literature and to generate an overview of strategies currently used to implement such models in daily practice. Six overlapping strategies to implement collaborative primary care-mental health models were described in 18 selected studies. We identified interactive educational strategies, quality improvement change processes, technological support tools, stakeholder engagement in the design and execution of implementation plans, organizational changes in terms of expanding the task of nurses and financial strategies such as additional collaboration fees and pay for performance incentives. Considering the overwhelming evidence about the effectiveness of primary care-mental health models, there is a lack of good studies focusing on their implementation strategies. In practice, these strategies are multifaceted and locally defined, as a result of intensive and required stakeholder engagement. Although many barriers still exist, the implementation of collaborative models could have a chance to succeed in the United States, where new service delivery and payment models, such as the Patient-Centered Medical Home, the Health Home and the Accountable Care Organization, are being promoted.

Relationships among providing maternal, child, and adolescent health services; implementing various financial strategy responses; and performance of local health departments.

PubMed

Issel, L Michele; Olorunsaiye, Comfort; Snebold, Laura; Handler, Arden

2015-04-01

We explored the relationships between local health department (LHD) structure, capacity, and macro-context variables and performance of essential public health services (EPHS). In 2012, we assessed a stratified, random sample of 195 LHDs that provided data via an online survey regarding performance of EPHS, the services provided or contracted out, the financial strategies used in response to budgetary pressures, and the extent of collaborations. We performed weighted analyses that included analysis of variance, pairwise correlations by jurisdiction population size, and linear regressions. On average, LHDs provided approximately 13 (36%) of 35 possible services either directly or by contract. Rather than cut services or externally consolidating, LHDs took steps to generate more revenue and maximize capacity. Higher LHD performance of EPHS was significantly associated with delivering more services, initiating more financial strategies, and engaging in collaboration, after adjusting for the effects of the Affordable Care Act and jurisdiction size. During changing economic and health care environments, we found that strong structural capacity enhanced local health department EPHS performance for maternal, child, and adolescent health.

Personal communications services: Improving theater deployable communications for the 21st century

NASA Astrophysics Data System (ADS)

Cournoyer, Ronald C., Jr.

1994-06-01

Personal Communications Services (PCS) may be the key ingredient for vastly improved military communications capabilities at the turn of the century. The Federal Communications Commission (FCC) defines PCS as a family of mobile or portable radio communications services which could provide services to individuals and businesses and be integrated with a variety of competing networks ... the primary focus of PCS will be to meet communications requirements of people on the move. Today's generation of Theater Deployable Communications, which provides joint tactical communications to deployed forces, is the Tri-Service Tactical Communications (TRI-TAC) system. A description of TRITAC's family of equipment, network topology, typical employment, and critical limitations is presented in this thesis. Five commercial Mobile Satellite Services (MSS) are described as viable candidates for augmenting existing communications systems. Cellular design principles such as frequency reuse, cell splitting, channel access methods, and propagation factors are also addressed. Finally, a framework for comparison of the candidate MSS systems is proposed as a baseline for further studies into the most beneficial implementation of PCS into theater deployable communications systems for the future.

Report of the Interagency Optical Network Testbeds Workshop 2 September 12-14, 2006 NASA Ames Research Center

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

Joe Mambretti Richard desJardins

2006-05-01

A new generation of optical networking services and technologies is rapidly changing the world of communications. National and international networks are implementing optical services to supplement traditional packet routed services. On September 12-14, 2005, the Optical Network Testbeds Workshop 2 (ONT2), an invitation-only forum hosted by the NASA Research and Engineering Network (NREN) and co-sponsored by the Department of Energy (DOE), was held at NASA Ames Research Center in Mountain View, California. The aim of ONT2 was to help the Federal Large Scale Networking Coordination Group (LSN) and its Joint Engineering Team (JET) to coordinate testbed and network roadmaps describingmore » agency and partner organization views and activities for moving toward next generation communication services based on leading edge optical networks in the 3-5 year time frame. ONT2 was conceived and organized as a sequel to the first Optical Network Testbeds Workshop (ONT1, August 2004, www.nren.nasa.gov/workshop7). ONT1 resulted in a series of recommendations to LSN. ONT2 was designed to move beyond recommendations to agree on a series of “actionable objectives” that would proactively help federal and partner optical network testbeds and advanced research and education (R&E) networks to begin incorporating technologies and services representing the next generation of advanced optical networks in the next 1-3 years. Participants in ONT2 included representatives from innovative prototype networks (Panel A), basic optical network research testbeds (Panel B), and production R&D networks (Panels C and D), including “JETnets,” selected regional optical networks (RONs), international R&D networks, commercial network technology and service providers (Panel F), and senior engineering and R&D managers from LSN agencies and partner organizations. The overall goal of ONT2 was to identify and coordinate short and medium term activities and milestones for researching, developing, identifying, evaluating, and implementing the services, technologies, and interoperability mechanisms required. The roadmaps were formulated and presented not so much to reconcile the roadmaps with each other but rather to provide a means to compare the major ongoing and planned optical networking activities in the R&E community, organized by categories of activities and communities of interest. In addition, a 5-15 year network research perspective was provided by Panel E, which presented a report on two recent National Science Foundation workshops that examined long term research goals and directions, and industry perspectives on forthcoming optical networking technologies and services were presented in Panel F by representatives from optical technologies and network services industries. The report, “Mapping a Future for Optical Networking and Communications” is available on the NSF website (www.nsf.gov), and the industry perspectives will be available on the ONT2 website.« less

Automating Visualization Service Generation with the WATT Compiler

NASA Astrophysics Data System (ADS)

Bollig, E. F.; Lyness, M. D.; Erlebacher, G.; Yuen, D. A.

2007-12-01

As tasks and workflows become increasingly complex, software developers are devoting increasing attention to automation tools. Among many examples, the Automator tool from Apple collects components of a workflow into a single script, with very little effort on the part of the user. Tasks are most often described as a series of instructions. The granularity of the tasks dictates the tools to use. Compilers translate fine-grained instructions to assembler code, while scripting languages (ruby, perl) are used to describe a series of tasks at a higher level. Compilers can also be viewed as transformational tools: a cross-compiler can translate executable code written on one computer to assembler code understood on another, while transformational tools can translate from one high-level language to another. We are interested in creating visualization web services automatically, starting from stand-alone VTK (Visualization Toolkit) code written in Tcl. To this end, using the OCaml programming language, we have developed a compiler that translates Tcl into C++, including all the stubs, classes and methods to interface with gSOAP, a C++ implementation of the Soap 1.1/1.2 protocols. This compiler, referred to as the Web Automation and Translation Toolkit (WATT), is the first step towards automated creation of specialized visualization web services without input from the user. The WATT compiler seeks to automate all aspects of web service generation, including the transport layer, the division of labor and the details related to interface generation. The WATT compiler is part of ongoing efforts within the NSF funded VLab consortium [1] to facilitate and automate time-consuming tasks for the science related to understanding planetary materials. Through examples of services produced by WATT for the VLab portal, we will illustrate features, limitations and the improvements necessary to achieve the ultimate goal of complete and transparent automation in the generation of web services. In particular, we will detail the generation of a charge density visualization service applicable to output from the quantum calculations of the VLab computation workflows, plus another service for mantle convection visualization. We also discuss WATT-LIVE [2], a web-based interface that allows users to interact with WATT. With WATT-LIVE users submit Tcl code, retrieve its C++ translation with various files and scripts necessary to locally install the tailor-made web service, or launch the service for a limited session on our test server. This work is supported by NSF through the ITR grant NSF-0426867. [1] Virtual Laboratory for Earth and Planetary Materials, http://vlab.msi.umn.edu, September 2007. [2] WATT-LIVE website, http://vlab2.scs.fsu.edu/watt-live, September 2007.

Steam generator tubing NDE performance

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

Henry, G.; Welty, C.S. Jr.

1997-02-01

Steam generator (SG) non-destructive examination (NDE) is a fundamental element in the broader SG in-service inspection (ISI) process, a cornerstone in the management of PWR steam generators. Based on objective performance measures (tube leak forced outages and SG-related capacity factor loss), ISI performance has shown a continually improving trend over the years. Performance of the NDE element is a function of the fundamental capability of the technique, and the ability of the analysis portion of the process in field implementation of the technique. The technology continues to improve in several areas, e.g. system sensitivity, data collection rates, probe/coil design, andmore » data analysis software. With these improvements comes the attendant requirement for qualification of the technique on the damage form(s) to which it will be applied, and for training and qualification of the data analysis element of the ISI process on the field implementation of the technique. The introduction of data transfer via fiber optic line allows for remote data acquisition and analysis, thus improving the efficiency of analysis for a limited pool of data analysts. This paper provides an overview of the current status of SG NDE, and identifies several important issues to be addressed.« less

Implementation of Age-Specific Services for Transition-Age Youths in California.

PubMed

Ojeda, Victoria D; Hiller, Sarah P; Hurst, Samantha; Jones, Nev; McMenamin, Sara; Burgdorf, James; Gilmer, Todd P

2016-09-01

This study examined the implementation of age-specific services for transition-age youths in California under the Mental Health Services Act (MHSA). This study employed a sequential, exploratory mixed-methods design. Qualitative interviews with 39 mental health service area administrators in California were analyzed to develop an understanding of how the MHSA has facilitated the development of youth-specific programs or services. A quantitative survey of 180 youth-focused programs was also used to describe the range of services that were implemented, the use of evidence-based and promising practices, and the role of youths in the design, planning, delivery, and evaluation of services. Administrators described the MHSA as providing a programmatic focus and financial support for youth-specific services, outlining a stakeholder process to create buy-in and develop a vision for services, and emphasizing the role of youths in service delivery and planning. Youth-specific programs implemented a diverse array of services, including general medical care; employment and education support; housing placement and support; and family, mentoring, and social support. Programs described implementing evidence-based and promising practices and involving youths in service planning, implementation, or quality improvement activities. The MHSA has had a substantial impact on the landscape of youth-specific services in California by expanding both the number of programs and the diversity in types of services and by promoting the engagement of youths in the planning and delivery of services. Additional efforts are necessary to determine the extent to which youth-specific services yield greater improvements in youths' outcomes compared with services designed for adults.

Providing Limited Local Electric Service During a Major Grid Outage: A First Assessment Based on Customer Willingness to Pay.

PubMed

Baik, Sunhee; Morgan, M Granger; Davis, Alexander L

2018-02-01

While they are rare, widespread blackouts of the bulk power system can result in large costs to individuals and society. If local distribution circuits remain intact, it is possible to use new technologies including smart meters, intelligent switches that can change the topology of distribution circuits, and distributed generation owned by customers and the power company, to provide limited local electric power service. Many utilities are already making investments that would make this possible. We use customers' measured willingness to pay to explore when the incremental investments needed to implement these capabilities would be justified. Under many circumstances, upgrades in advanced distribution systems could be justified for a customer charge of less than a dollar a month (plus the cost of electricity used during outages), and would be less expensive and safer than the proliferation of small portable backup generators. We also discuss issues of social equity, extreme events, and various sources of underlying uncertainty. © 2017 Society for Risk Analysis.

The Catalonia World Health Organization demonstration project for palliative care implementation: quantitative and qualitative results at 20 years.

PubMed

Gómez-Batiste, Xavier; Caja, Carmen; Espinosa, Jose; Bullich, Ingrid; Martínez-Muñoz, Marisa; Porta-Sales, Josep; Trelis, Jordi; Esperalba, Joaquim; Stjernsward, Jan

2012-04-01

Catalonia (Spain) has a total population of 7.3 million citizens for whom the National Health Service (NHS) provides health care that is free at the point of access. The prevalence of terminally ill patients is between 30,100 and 39,600. Twenty years ago, the World Health Organization (WHO), in collaboration with the Catalan Department of Health and the Catalan Institute of Oncology, began a demonstration project (WHO Demonstration Project) in palliative care (PC) with the aim of implementing specialist PC services, generating experience in this field, identifying areas for improvement, and introducing educative procedures (clinical and nonclinical). Over the past 20 years, 237 PC clinical services (72 home care support teams, 49 hospital support teams, 60 units with 742 dedicated beds, 50 outpatient clinics, and six psychosocial support teams) have been implemented. In the five years since the previous evaluation, 57 new clinical services (15 new hospital support teams, 36 outpatient clinics, and six psychosocial support teams among others) and four nonclinical services (education, research, WHO Collaborating Center, and planning) have been implemented. During the year 2010, a total of 46,200 processes were undertaken for the care of 23,100 patients, of whom 12,100 (52%) had cancer and 11,000 (48%) had other chronic advanced diseases. The overall yearly costs are around €52,568,000, with an overall savings of €69,300,000 (€2275 per patient, net savings to the NHS of €16,732,000). In the last five years, three qualitative evaluations and a benchmarking process have been performed to identify weak points and inequities in care provision among districts. Systematic assessments indicate high cost-effectiveness of care as well as high levels of satisfaction by patients and their relatives, thus reinforcing the principle that access to PC under the auspices of the NHS at the end of life is a basic human right. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

National Database for Autism Research (NDAR): Big Data Opportunities for Health Services Research and Health Technology Assessment.

PubMed

Payakachat, Nalin; Tilford, J Mick; Ungar, Wendy J

2016-02-01

The National Database for Autism Research (NDAR) is a US National Institutes of Health (NIH)-funded research data repository created by integrating heterogeneous datasets through data sharing agreements between autism researchers and the NIH. To date, NDAR is considered the largest neuroscience and genomic data repository for autism research. In addition to biomedical data, NDAR contains a large collection of clinical and behavioral assessments and health outcomes from novel interventions. Importantly, NDAR has a global unique patient identifier that can be linked to aggregated individual-level data for hypothesis generation and testing, and for replicating research findings. As such, NDAR promotes collaboration and maximizes public investment in the original data collection. As screening and diagnostic technologies as well as interventions for children with autism are expensive, health services research (HSR) and health technology assessment (HTA) are needed to generate more evidence to facilitate implementation when warranted. This article describes NDAR and explains its value to health services researchers and decision scientists interested in autism and other mental health conditions. We provide a description of the scope and structure of NDAR and illustrate how data are likely to grow over time and become available for HSR and HTA.

Optimizability of OGC Standards Implementations - a Case Study

NASA Astrophysics Data System (ADS)

Misev, D.; Baumann, P.

2012-04-01

Why do we shop at Amazon? Because they have a unique offering that is nowhere else available? Certainly not. Rather, Amazon offers (i) simple, yet effective search; (ii) very simple payment; (iii) extremely rapid delivery. This is how scientific services will be distinguished in future: not for their data holding (there will be manifold choice), but for their service quality. We are facing the transition from data stewardship to service stewardship. One of the OGC standards which particularly enables flexible retrieval is the Web Coverage Processing Service (WCPS). It defines a high-level query language on large, multi-dimensional raster data, such as 1D timeseries, 2D EO imagery, 3D x/y/t image time series and x/y/z geophysical data, 4D x/y/z/t climate and ocean data. We have implemented WCPS based on an Array Database Management System, rasdaman, which is available in open source. In this demonstration, we study WCPS queries on 2D, 3D, and 4D data sets. Particular emphasis is placed on the computational load queries generate in such on-demand processing and filtering. We look at different techniques and their impact on performance, such as adaptive storage partitioning, query rewriting, and just-in-time compilation. Results show that there is significant potential for effective server-side optimization once a query language is sufficiently high-level and declarative.

Lightweight SIP/SDP compression scheme (LSSCS)

NASA Astrophysics Data System (ADS)

Wu, Jian J.; Demetrescu, Cristian

2001-10-01

In UMTS new IP based services with tight delay constraints will be deployed over the W-CDMA air interface such as IP multimedia and interactive services. To integrate the wireline and wireless IP services, 3GPP standard forum adopted the Session Initiation Protocol (SIP) as the call control protocol for the UMTS Release 5, which will implement next generation, all IP networks for real-time QoS services. In the current form the SIP protocol is not suitable for wireless transmission due to its large message size which will need either a big radio pipe for transmission or it will take far much longer to transmit than the current GSM Call Control (CC) message sequence. In this paper we present a novel compression algorithm called Lightweight SIP/SDP Compression Scheme (LSSCS), which acts at the SIP application layer and therefore removes the information redundancy before it is sent to the network and transport layer. A binary octet-aligned header is added to the compressed SIP/SDP message before sending it to the network layer. The receiver uses this binary header as well as the pre-cached information to regenerate the original SIP/SDP message. The key features of the LSSCS compression scheme are presented in this paper along with implementation examples. It is shown that this compression algorithm makes SIP transmission efficient over the radio interface without losing the SIP generality and flexibility.

Testing evidence routine practice: Using an implementation framework to embed a clinically proven asthma service in Australian community pharmacy.

PubMed

Fuller, Joanne M; Saini, Bandana; Bosnic-Anticevich, Sinthia; Garcia Cardenas, Victoria; Benrimoj, Shalom I; Armour, Carol

Community pharmacists are well placed and evidence clearly demonstrates that they can be suitably trained to deliver professional services that improve the management of asthma patients in clinical, economic and humanistic terms. However the gap between this evidence and practice reality remains wide. In this study we measure the implementation process as well as the service benefits of an asthma service model. Using an effectiveness-implementation hybrid design, a defined implementation process (progression from Exploration through Preparation and Testing to Operation stages) supporting an asthma service (promoting asthma control and inhaler technique) was tested in 17 community pharmacies across metropolitan Sydney. Seven pharmacies reached the Operation stage of implementation. Eight pharmacies reached the Testing stage of implementation and two pharmacies did not progress beyond the Preparation stage of implementation. A total of 128 patients were enrolled in the asthma service with 110 patients remaining enrolled at the close of the study. Asthma control showed a positive trend throughout the service with the overall proportion of patients with 'poor' asthma control at baseline decreasing from 72% to 57% at study close. There was a statistically significant increase in the proportion of patients with correct inhaler technique from 12% at Baseline (Visit 1) to 33% at Visit 2 and 57% at study close. Implementation of the asthma service varied across pharmacies. Different strategies specific to practice sites at different stages of the implementation model may result in greater uptake of professional services. The asthma service led to improved patient outcomes overall with a positive trend in asthma control and significant change in inhaler technique. Copyright © 2017 Elsevier Inc. All rights reserved.

Distributed Generation: Challenges and Opportunities, 7. edition

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

NONE

2007-10-15

The report is a comprehensive study of the Distributed Generation (DG) industry. The report takes a wide-ranging look at the current and future state of DG and both individually and collectively addresses the technologies of Microturbines, Reciprocating Engines, Stirling Engines, Fuel Cells, Photovoltaics, Concentrating Solar, Wind, and Microgrids. Topics covered include: the key technologies being used or planned for DG; the uses of DG from utility, energy service provider, and customer viewpoints; the economics of DG; the benefits of DG from multiple perspectives; the barriers that exist to implementing DG; the government programs supporting the DG industry; and, an analysismore » of DG interconnection and net metering rules.« less

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

PubMed Central

Osaro, Erhabor; Chima, Njemanze

2014-01-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness. PMID:25182941

Parents' and professionals' perceptions of family-centered care for children with autism spectrum disorder across service sectors.

PubMed

Hodgetts, Sandra; Nicholas, David; Zwaigenbaum, Lonnie; McConnell, David

2013-11-01

Family-centered care (FCC) has been linked with improved parent and child outcomes, yet its implementation can be challenging due to family, professional, organizational and systemic factors and policies. This study aims to increase knowledge and understanding of how families with children with autism spectrum disorder (ASD) experience FCC in Alberta, Canada. 152 parents with a child with ASD completed the Measure of Processes of Care, separately for each utilized service sector, and 146 professionals working with persons with ASD completed the Measure of Processes of Care - Service Providers. Additionally, in-depth interviews were conducted with a sub-sample of 19 parents, purposefully sampled for diversity in child and family characteristics. Data were collected in 2011. Descriptive and inferential statistics were used to analyze quantitative data. Interview transcripts were analyzed using grounded theory constant comparison methods, yielding a data generated theoretical model depicting families' experiences with FCC over time and across service sectors. There were no statistically significant differences in FCC scores across service sectors, but statistically significant differences in FCC scores between parents' and professionals' were found. Qualitative data revealed positive experiences and perceptions of receiving FCC from professionals "on the ground" across sectors, but negative experiences and perceptions of FCC at the systems level (i.e., administration, funders). These broad experiences emerged as a core theme "System of Exclusion", which integrated the key themes: (1) "The Fight", (2) "Roles and Restrictions of Care", and (3) "Therapeutic Rapport". Professionals and service providers can use findings to ensure that services reflect current conceptualizations of FCC, and decision and policy makers can use findings to recognize systemic barriers to implementing FCC and inform policy change. Copyright © 2013 Elsevier Ltd. All rights reserved.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England.

PubMed

Osaro, Erhabor; Chima, Njemanze

2014-06-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

A longitudinal study of the implementation experiences of the Australian National Disability Insurance Scheme: investigating transformative policy change.

PubMed

Carey, Gemma; Dickinson, Helen

2017-08-17

Internationally there has been a growth in the use of publicly funded service markets as a mechanism to deliver health and social services. This has accompanied the emergence of 'self-directed care' in a number of different policy areas including disability and aged care - often referred to as 'personalisation' (Giaimo and Manow, Comp. Pol Stud 32:967-1000, 1999; Needham, Public Money Manage 30:136-8, 2010; [Hood], [The Idea of Joined-up Government: A Historical Perspective], [2005]; Klijn and Koppenjan, Public Manage 2:437-54, 2000, Greener, Policy Polit 36:93-108, 2008). These reforms are underpinned by an idea that individuals should be placed in control of their own service needs, given funding directly by government and encouraged to exercise choice and control through purchasing their own services. A major challenge for governments in charge of these reforms is determining the best way to structure and govern emerging service markets markets. Given the growing international embrace of market-based reform mechanisms to provide essential services to citizens, finding ways to ensure they promote, and not diminish, people's health and wellbeing is vital. The Australian National Disability Insurance Scheme (NDIS) is Australia's first national approach to the use of personalised budgets. The program of research outlined in this paper brings together streams from a range of different studies in order to investigate the implementation of the NDIS longitudinally across different administrative levels of government, service providers and scheme participants. This programme of research will make a contribution to our understanding of the Australian scheme and how individualised funding operates within this context, but will also generate much needed evidence that will have relevance to other jurisdictions and help fill a gap in the evidence base.

The SBAS Sentinel-1 Surveillance service for automatic and systematic generation of Earth surface displacement within the GEP platform.

NASA Astrophysics Data System (ADS)

Casu, Francesco; De Luca, Claudio; Lanari, Riccardo; Manunta, Michele; Zinno, Ivana

2017-04-01

The Geohazards Exploitation Platform (GEP) is an ESA activity of the Earth Observation (EO) ground segment to demonstrate the benefit of new technologies for large scale processing of EO data. GEP aims at providing both on-demand processing services for scientific users of the geohazards community and an integration platform for new EO data analysis processors dedicated to scientists and other expert users. In the Remote Sensing scenario, a crucial role is played by the recently launched Sentinel-1 (S1) constellation that, with its global acquisition policy, has literally flooded the scientific community with a huge amount of data acquired over large part of the Earth on a regular basis (down to 6-days with both Sentinel-1A and 1B passes). Moreover, the S1 data, as part of the European Copernicus program, are openly and freely accessible, thus fostering their use for the development of tools for Earth surface monitoring. In particular, due to their specific SAR Interferometry (InSAR) design, Sentinel-1 satellites can be exploited to build up operational services for the generation of advanced interferometric products that can be very useful within risk management and natural hazard monitoring scenarios. Accordingly, in this work we present the activities carried out for the development, integration, and deployment of the SBAS Sentinel-1 Surveillance service of CNR-IREA within the GEP platform. This service is based on a parallel implementation of the SBAS approach, referred to as P-SBAS, able to effectively run in large distributed computing infrastructures (grid and cloud) and to allow for an efficient computation of large SAR data sequences with advanced DInSAR approaches. In particular, the Surveillance service developed on GEP platform consists on the systematic and automatic processing of Sentinel-1 data on selected Areas of Interest (AoI) to generate updated surface displacement time series via the SBAS-InSAR algorithm. We built up a system that is automatically triggered by every new S1 acquisition over the AoI, once it is available on the S1 catalogue. Then, tacking benefit from the SBAS results generated by previous runs of the service, the system processes the new acquisitions only, thus saving storage space and computing time and finally generating an updated SBAS time series. The same P-SBAS processor underlying the Surveillance service is also available through the GEP as a standard on-demand DInSAR service, thus allowing the scientific community to generate S1 SBAS time series on areas not covered by the Surveillance service itself. It is worth noting that the SBAS Sentinel-1 Surveillance service on GEP represents the core of the EPOSAR service, which will deliver S1 displacement time series of Earth surface on a regular basis for the European Plate Observing System (EPOS) Research Infrastructure community. In particular, the main goal of EPOSAR is to contribute with advanced technique and methods, which have already well demonstrated their effectiveness and relevance, in investigating the physical processes controlling earthquakes, volcanic eruptions and unrest episodes as well as those driving tectonics and Earth surface dynamics.

Flexible reserve markets for wind integration

NASA Astrophysics Data System (ADS)

Fernandez, Alisha R.

The increased interconnection of variable generation has motivated the use of improved forecasting to more accurately predict future production with the purpose to lower total system costs for balancing when the expected output exceeds or falls short of the actual output. Forecasts are imperfect, and the forecast errors associated with utility-scale generation from variable generators need new balancing capabilities that cannot be handled by existing ancillary services. Our work focuses on strategies for integrating large amounts of wind generation under the flex reserve market, a market that would called upon for short-term energy services during an under or oversupply of wind generation to maintain electric grid reliability. The flex reserve market would be utilized for time intervals that fall in-between the current ancillary services markets that would be longer than second-to-second energy services for maintaining system frequency and shorter than reserve capacity services that are called upon for several minutes up to an hour during an unexpected contingency on the grid. In our work, the wind operator would access the flex reserve market as an energy service to correct for unanticipated forecast errors, akin to paying the generators participating in the market to increase generation during a shortfall or paying the other generators to decrease generation during an excess of wind generation. Such a market does not currently exist in the Mid-Atlantic United States. The Pennsylvania-New Jersey-Maryland Interconnection (PJM) is the Mid-Atlantic electric grid case study that was used to examine if a flex reserve market can be utilized for integrating large capacities of wind generation in a lowcost manner for those providing, purchasing and dispatching these short-term balancing services. The following work consists of three studies. The first examines the ability of a hydroelectric facility to provide short-term forecast error balancing services via a flex reserve market, identifying the operational constraints that inhibit a multi-purpose dam facility to meet the desired flexible energy demand. The second study transitions from the hydroelectric facility as the decision maker providing flex reserve services to the wind plant as the decision maker purchasing these services. In this second study, methods for allocating the costs of flex reserve services under different wind policy scenarios are explored that aggregate farms into different groupings to identify the least-cost strategy for balancing the costs of hourly day-ahead forecast errors. The least-cost strategy may be different for an individual wind plant and for the system operator, noting that the least-cost strategy is highly sensitive to cost allocation and aggregation schemes. The latter may also cause cross-subsidies in the cost for balancing wind forecast errors among the different wind farms. The third study builds from the second, with the objective to quantify the amount of flex reserves needed for balancing future forecast errors using a probabilistic approach (quantile regression) to estimating future forecast errors. The results further examine the usefulness of separate flexible markets PJM could use for balancing oversupply and undersupply events, similar to the regulation up and down markets used in Europe. These three studies provide the following results and insights to large-scale wind integration using actual PJM wind farm data that describe the markets and generators within PJM. • Chapter 2 provides an in-depth analysis of the valuable, yet highly-constrained, energy services multi-purpose hydroelectric facilities can provide, though the opportunity cost for providing these services can result in large deviations from the reservoir policies with minimal revenue gain in comparison to dedicating the whole of dam capacity to providing day-ahead, baseload generation. • Chapter 3 quantifies the system-wide efficiency gains and the distributive effects of PJM's decision to act as a single balancing authority, which means that it procures ancillary services across its entire footprint simultaneously. This can be contrasted to Midwest Independent System Operator (MISO), which has several balancing authorities operating under its footprint. • Chapter 4 uses probabilistic methods to estimate the uncertainty in the forecast errors and the quantity of energy needed to balance these forecast errors at a certain percentile. Current practice is to use a point forecast that describes the conditional expectation of the dependent variable at each time step. The approach here uses quantile regression to describe the relationship between independent variable and the conditional quantiles (equivalently the percentiles) of the dependent variable. An estimate of the conditional density is performed, which contains information about the covariate relationship of the sign of the forecast errors (negative for too much wind generation and positive for too little wind generation) and the wind power forecast. This additional knowledge may be implemented in the decision process to more accurately schedule day-ahead wind generation bids and provide an example for using separate markets for balancing an oversupply and undersupply of generation. Such methods are currently used for coordinating large footprints of wind generation in Europe.

The Semantic Automated Discovery and Integration (SADI) Web service Design-Pattern, API and Reference Implementation

PubMed Central

2011-01-01

Background The complexity and inter-related nature of biological data poses a difficult challenge for data and tool integration. There has been a proliferation of interoperability standards and projects over the past decade, none of which has been widely adopted by the bioinformatics community. Recent attempts have focused on the use of semantics to assist integration, and Semantic Web technologies are being welcomed by this community. Description SADI - Semantic Automated Discovery and Integration - is a lightweight set of fully standards-compliant Semantic Web service design patterns that simplify the publication of services of the type commonly found in bioinformatics and other scientific domains. Using Semantic Web technologies at every level of the Web services "stack", SADI services consume and produce instances of OWL Classes following a small number of very straightforward best-practices. In addition, we provide codebases that support these best-practices, and plug-in tools to popular developer and client software that dramatically simplify deployment of services by providers, and the discovery and utilization of those services by their consumers. Conclusions SADI Services are fully compliant with, and utilize only foundational Web standards; are simple to create and maintain for service providers; and can be discovered and utilized in a very intuitive way by biologist end-users. In addition, the SADI design patterns significantly improve the ability of software to automatically discover appropriate services based on user-needs, and automatically chain these into complex analytical workflows. We show that, when resources are exposed through SADI, data compliant with a given ontological model can be automatically gathered, or generated, from these distributed, non-coordinating resources - a behaviour we have not observed in any other Semantic system. Finally, we show that, using SADI, data dynamically generated from Web services can be explored in a manner very similar to data housed in static triple-stores, thus facilitating the intersection of Web services and Semantic Web technologies. PMID:22024447

The Semantic Automated Discovery and Integration (SADI) Web service Design-Pattern, API and Reference Implementation.

PubMed

Wilkinson, Mark D; Vandervalk, Benjamin; McCarthy, Luke

2011-10-24

The complexity and inter-related nature of biological data poses a difficult challenge for data and tool integration. There has been a proliferation of interoperability standards and projects over the past decade, none of which has been widely adopted by the bioinformatics community. Recent attempts have focused on the use of semantics to assist integration, and Semantic Web technologies are being welcomed by this community. SADI - Semantic Automated Discovery and Integration - is a lightweight set of fully standards-compliant Semantic Web service design patterns that simplify the publication of services of the type commonly found in bioinformatics and other scientific domains. Using Semantic Web technologies at every level of the Web services "stack", SADI services consume and produce instances of OWL Classes following a small number of very straightforward best-practices. In addition, we provide codebases that support these best-practices, and plug-in tools to popular developer and client software that dramatically simplify deployment of services by providers, and the discovery and utilization of those services by their consumers. SADI Services are fully compliant with, and utilize only foundational Web standards; are simple to create and maintain for service providers; and can be discovered and utilized in a very intuitive way by biologist end-users. In addition, the SADI design patterns significantly improve the ability of software to automatically discover appropriate services based on user-needs, and automatically chain these into complex analytical workflows. We show that, when resources are exposed through SADI, data compliant with a given ontological model can be automatically gathered, or generated, from these distributed, non-coordinating resources - a behaviour we have not observed in any other Semantic system. Finally, we show that, using SADI, data dynamically generated from Web services can be explored in a manner very similar to data housed in static triple-stores, thus facilitating the intersection of Web services and Semantic Web technologies.

Food Service Perspectives on National School Lunch Program Implementation

PubMed Central

Tabak, Rachel G.; Moreland-Russell, Sarah

2015-01-01

Objectives Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Methods Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Results Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Conclusions Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation. PMID:26417607

Who benefits from free institutional delivery? evidence from a cross sectional survey of North Central and Southwestern Nigeria.

PubMed

Ajayi, Anthony I; Akpan, Wilson

2017-09-02

The reasons for low utilisation of maternal health services in settings where the user-fee removal policy has been implemented continue to generate scholarly debates. Evidence of whether user-fee removal benefits the poor women in underserved settings is scanty and inconsistent. This article examines use of maternal health care services in the context of free maternal healthcare and profiles the beneficiaries of user-fee removal. The study adopted a descriptive design. A three-stage cluster sampling method was used to select a representative sample of 1227 women who gave birth between 2011 and 2015. Questionnaires were administered using a face-to-face interview approach and data generated were analysed using descriptive and inferential statistics. The analysis shows that the use of maternal healthcare services has improved considerably in North Central and Southwestern Nigeria. While socioeconomic and geographical inequality in the use of maternal healthcare services appear to be disappearing in Southwestern Nigeria, it appears to be widening in North Central Nigeria. The findings indicate that 33.6% of women reported to have benefitted from the free child-delivery programme; however, substantial variation exists across the two regions. The proportion of beneficiaries of user-fee removal policy was highest in urban areas (35.9%), among women belonging to the middle income category (38.3%), among women who gave birth in primary health centres (63.1%) and among women who resided in communities where there was availability of health facilities (37.2%). The study concludes that low coverage of the free maternal health programme, especially among women of low socioeconomic status residing in underserved settings is among the reasons for persistent poor maternal health outcomes in the context of free maternal healthcare. A model towards improving maternal health in underserved settings, especially in North Central Nigeria, would entail provisioning of health facilities as well as focusing on implementing equitable maternal health policies.

Developing and implementing a service charter for an integrated regional stroke service: an exploratory case study

PubMed Central

2014-01-01

Background Based on practices in commercial organizations and public services, healthcare organizations are using service charters to inform patients about the quality of service they can expect and to increase patient-centeredness. In the Netherlands, an integrated regional stroke service involving five organizations has developed and implemented a single service charter. The purpose of this study is to determine the organizational enablers for the effective development and implementation of this service charter. Methods We have conducted an exploratory qualitative study using Grounded Theory to determine the organizational enablers of charter development and implementation. Individual semi-structured interviews were held with all members of the steering committee and the taskforce responsible for the service charter. In these twelve interviews, participants were retrospectively asked for their opinions of the enablers. Interview transcripts have been analysed using Glaser’s approach of substantive coding consisting of open and selective coding in order to develop a framework of these enablers. A tabula rasa approach was used without any preconceived frameworks used in the coding process. Results We have determined seven categories of enablers formed of a total of 27 properties. The categories address a broad spectrum of enablers dealing with the basic foundations for cooperation, the way to manage the project’s organization and the way to implement the service charter. In addition to the enablers within each individual organization, enablers that reflect the whole chain seem to be important for the effective development and implementation of this service charter. Strategic alignment of goals within the chain, trust between organizations, willingness to cooperate and the extent of process integration are all important properties. Conclusions This first exploratory study into the enablers of the effective development and implementation was based on a single case study in the Netherlands. This is the only integrated care chain using a single service charter that we could find. Nevertheless, the results of our explorative study provide an initial framework for the development and implementation of service charters in integrated care settings. This research contributes to the literature on service charters, on patient-centeredness in integrated care and on the implementation of innovations. PMID:24678839

Data analytics approach to create waste generation profiles for waste management and collection.

PubMed

Niska, Harri; Serkkola, Ari

2018-04-30

Extensive monitoring data on waste generation is increasingly collected in order to implement cost-efficient and sustainable waste management operations. In addition, geospatial data from different registries of the society are opening for free usage. Novel data analytics approaches can be built on the top of the data to produce more detailed, and in-time waste generation information for the basis of waste management and collection. In this paper, a data-based approach based on the self-organizing map (SOM) and the k-means algorithm is developed for creating a set of waste generation type profiles. The approach is demonstrated using the extensive container-level waste weighting data collected in the metropolitan area of Helsinki, Finland. The results obtained highlight the potential of advanced data analytic approaches in producing more detailed waste generation information e.g. for the basis of tailored feedback services for waste producers and the planning and optimization of waste collection and recycling. Copyright © 2018 Elsevier Ltd. All rights reserved.

EPOS-Seismology: building the Thematic Core Service for Seismology during the EPOS Implementation Phase

NASA Astrophysics Data System (ADS)

Haslinger, Florian; EPOS Seismology Consortium, the

2015-04-01

After the successful completion of the EPOS Preparatory Phase, the community of European Research Infrastructures in Seismology is now moving ahead with the build-up of the Thematic Core Service (TCS) for Seismology in EPOS, EPOS-Seismology. Seismology is a domain where European-level infrastructures have been developed since decades, often supported by large-scale EU projects. Today these infrastructures provide services to access earthquake waveforms (ORFEUS), parameters (EMSC) and hazard data and products (EFEHR). The existing organizations constitute the backbone of infrastructures that also in future will continue to manage and host the services of the TCS EPOS-Seismology. While the governance and internal structure of these organizations will remain active, and continue to provide direct interaction with the community, EPOS-Seismology will provide the integration of these within EPOS. The main challenge in the build-up of the TCS EPOS-Seismology is to improve and extend these existing services, producing a single framework which is technically, organizationally and financially integrated with the EPOS architecture, and to further engage various kinds of end users (e.g. scientists, engineers, public managers, citizen scientists). On the technical side the focus lies on four major tasks: - the construction of the next generation software architecture for the European Integrated (waveform) Data Archive EIDA, developing advanced metadata and station information services, fully integrate strong motion waveforms and derived parametric engineering-domain data, and advancing the integration of mobile (temporary) networks and OBS deployments in EIDA; - the further development and expansion of services to access seismological products of scientific interest as provided by the community by implementing a common collection and development (IT) platform, improvements in the earthquake information services e.g. by introducing more robust quality indicators and diversifying collection and dissemination mechanisms, as well as improving historical earthquake data services; - the development of a comprehensive suite of earthquake hazard products, tools, and services harmonized on the European level and available through a common access platform, encompassing information on seismic sources, seismogenic faults, ground-motion prediction equations, geotechnical information, and strong-motion recordings in buildings, together with an interface to earthquake risk; - a portal implementation of computational seismology tools and services, specifically for seismic waveform propagation in complex 3D media following the results of the VERCE project, and initiating the inclusion of further suitable codes on that portal in discussion with the community, forming the basis of EPOS computational earth science infrastructure. Important features common to all tasks are the development of EPOS-wide integrated and interoperable metadata structures, the introduction and utilization of adequate and referencable persistent identifiers for data and products, and the implementation of appropriate user access and authorization mechanisms. Here we present further details on the technical work plan for Seismology during the EPOS Implementation Phase and its integration into the overall EPOS build-up, together with the current view and state of the discussion on the development of adequate governance structures, and discuss how we envision the interaction with and involvement of the wider community outside the consortium in these activities.

Brief report: Service implementation and maternal distress surrounding evaluation recommendations for young children diagnosed with autism

PubMed Central

Warren, Zachary; Vehorn, Alison; Dohrmann, Elizabeth; Newsom, Cassandra; Taylor, Julie Lounds

2014-01-01

There is limited evidence surrounding the ability of families of children with autism spectrum disorders to access and implement recommended interventions following diagnosis. The distress a family may encounter with regard to inability to access recommended services is also poorly understood. In this study, we present preliminary data regarding implementation of clinical recommendations following autism spectrum disorder diagnosis as well as associations of implementation with maternal functioning. In total, 75 mothers of young children diagnosed with autism spectrum disorder through a university-based preschool autism clinic returned surveys regarding access to recommended services as well as maternal mental health and distress. Results indicate that while families were able to implement numerous recommendations, specific categories of intervention were less likely to be received. Challenges implementing recommended services were not related to increased maternal distress. These results suggest that despite potential barriers toward accessing some specific recommended services following diagnosis of autism spectrum disorder, many families may be quite successful in implementing many other core recommended services and that failure to access such services may not necessarily negatively impact maternal mental health and distress. PMID:23045221

Implementation of personalized medicine services in community pharmacies: perceptions of independent community pharmacists.

PubMed

Alexander, Katelyn M; Divine, Holly S; Hanna, Cathy R; Gokun, Yevgeniya; Freeman, Patricia R

2014-01-01

To evaluate the perceptions of independent community pharmacists within a regional independent community pharmacy cooperative on implementing personalized medicine services at their pharmacies and to gauge the pharmacists' self-reported knowledge of pharmacogenomic principles. Descriptive, exploratory, nonexperimental study. American Pharmacy Services Corporation (APSC), 2011-12. Pharmacists (n = 101) affiliated with the independent pharmacies of APSC. Single-mode survey. Independent community pharmacists' interest in implementing personalized medicine services, perceived readiness to provide such services, and perceived barriers to implementation. 101 completed surveys were returned for data analysis. The majority of pharmacists surveyed (75%) expressed interest in offering personalized medicine services. When asked to describe their knowledge of pharmacogenomics and readiness to implement such services, more than 50% said they were not knowledgeable on the subject and would not currently be comfortable making drug therapy recommendations to physicians or confident counseling patients based on results of genetic screenings without further training and education. Respondents identified cost of providing the service, reimbursement issues, current knowledge of pharmacogenomics, and time to devote to the program as the greatest barriers to implementing personalized medicine services. The majority of independent community pharmacists are interested in incorporating personalized medicine services into their practices, but they require further education before this is possible. Future initiatives should focus on the development of comprehensive education programs to further train pharmacists for provision of these services.

High-Performance Tiled WMS and KML Web Server

NASA Technical Reports Server (NTRS)

Plesea, Lucian

2007-01-01

This software is an Apache 2.0 module implementing a high-performance map server to support interactive map viewers and virtual planet client software. It can be used in applications that require access to very-high-resolution geolocated images, such as GIS, virtual planet applications, and flight simulators. It serves Web Map Service (WMS) requests that comply with a given request grid from an existing tile dataset. It also generates the KML super-overlay configuration files required to access the WMS image tiles.

Wheat productivity estimates using LANDSAT data

NASA Technical Reports Server (NTRS)

Nalepka, R. F.; Colwell, J. E. (Principal Investigator); Rice, D. P.; Bresnahan, P. A.

1977-01-01

The author has identified the following significant results. Large area LANDSAT yield estimates were generated. These results were compared with estimates computed using a meteorological yield model (CCEA). Both of these estimates were compared with Kansas Crop and Livestock Reporting Service (KCLRS) estimates of yield, in an attempt to assess the relative and absolute accuracy of the LANDSAT and CCEA estimates. Results were inconclusive. A large area direct wheat prediction procedure was implemented. Initial results have produced a wheat production estimate comparable with the KCLRS estimate.

Implementation and Analysis of a Threat Model for IPv6 Host Autoconfiguration

DTIC Science & Technology

2006-09-01

Collision Generator”, two Denial of Service attacks. The software was developed in NetBeans IDE 5.0, and the comments were converted to Javadoc with the...appropriate NetBeans function. A. ICMPV6 SUPPORT FOR JPCAP As the attack uses ICMPv6 messages, a means must be provided to generate these messages...ICMP packet. * * Developed in NetBeans IDE 5.0 * Makes use of Jpcap 0.5.1 library * (http://netresearch.ics.uci.edu/kfujii/jpcap/doc

Safety Assurance in NextGen

NASA Technical Reports Server (NTRS)

HarrisonFleming, Cody; Spencer, Melissa; Leveson, Nancy; Wilkinson, Chris

2012-01-01

The generation of minimum operational, safety, performance, and interoperability requirements is an important aspect of safely integrating new NextGen components into the Communication Navigation Surveillance and Air Traffic Management (CNS/ATM) system. These requirements are used as part of the implementation and approval processes. In addition, they provide guidance to determine the levels of design assurance and performance that are needed for each element of the new NextGen procedures, including aircraft, operator, and Air Navigation and Service Provider. Using the enhanced Airborne Traffic Situational Awareness for InTrail Procedure (ATSA-ITP) as an example, this report describes some limitations of the current process used for generating safety requirements and levels of required design assurance. An alternative process is described, as well as the argument for why the alternative can generate more comprehensive requirements and greater safety assurance than the current approach.

Situational Analysis for Complex Systems: Methodological Development in Public Health Research.

PubMed

Martin, Wanda; Pauly, Bernie; MacDonald, Marjorie

2016-01-01

Public health systems have suffered infrastructure losses worldwide. Strengthening public health systems requires not only good policies and programs, but also development of new research methodologies to support public health systems renewal. Our research team considers public health systems to be complex adaptive systems and as such new methods are necessary to generate knowledge about the process of implementing public health programs and services. Within our program of research, we have employed situational analysis as a method for studying complex adaptive systems in four distinct research studies on public health program implementation. The purpose of this paper is to demonstrate the use of situational analysis as a method for studying complex systems and highlight the need for further methodological development.

NASA Alternate Access to Station Service Concept

NASA Technical Reports Server (NTRS)

Bailey, Michelle D.; Crumbly, Chris

2001-01-01

The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research - and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply with existing technologies, not only will a new category of autonomous vehicles deliver cargo, but a commercial business base will be incubated that will improve the likelihood of commercial convergence with the next generation of RLVs. Traditional paradigms in government management and acquisition philosophy are being challenged in order to bring about the objective of the AAS project. The phased procurement approach is proving to be the most questionable aspect to date. This work addresses the fresh approach AAS is adopting in management and procurement through a study of the AAS history, current solutions, key technologies, procurement complications, and an incremental forward plan leading to the purchase of a service to deliver goods to ISS. Included in this work is a discussion of the Commercial Space Act of 1998 and how it affects government purchase of space launch and space vehicle services. Industry should find these topics pertinent to their current state of business.

NASA Alternate Access to Station Service Concept

NASA Astrophysics Data System (ADS)

Bailey, M. D.; Crumbly, C.

2002-01-01

The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply with existing technologies, not only will a new category of autonomous vehicles deliver cargo, but a commercial business base will be incubated that will improve the likelihood of commercial convergence with the next generation of RLVs. Traditional paradigms in government management and acquisition philosophy are being challenged in order to bring about the objective of the AAS project. The phased procurement approach is proving to be the most questionable aspect to date. This work addresses the fresh approach AAS is adopting in management and procurement through a study of the AAS history, current solutions, key technologies, procurement complications, and an incremental forward plan leading to the purchase of a service to deliver goods to ISS. Included in this work is a discussion of the Commercial Space Act of 1998 and how it affects government purchase of space launch and space vehicle services. Industry should find these topics pertinent to their current state of business.

Development of a diabetes care management curriculum in a family practice residency program.

PubMed

Nuovo, Jim; Balsbaugh, Thomas; Barton, Sue; Davidson, Ellen; Fox-Garcia, Jane; Gandolfo, Angela; Levich, Bridget; Seibles, Joann

2004-01-01

Improving the quality of care for patients with chronic illness has become a high priority. Implementing training programs in disease management (DM) so the next generation of physicians can manage chronic illness more effectively is challenging. Residency training programs have no specific mandate to implement DM training. Additional barriers at the training facility include: 1) lack of a population-based perspective for service delivery; 2) weak support for self-management of illness; 3) incomplete implementation due to physician resistance or inertia; and 4) few incentives to change practices and behaviors. In order to overcome these barriers, training programs must take the initiative to implement DM training that addresses each of these issues. We report the implementation of a chronic illness management curriculum based on the Improving Chronic Illness Care (ICIC) Model. Features of this process included both patient care and learner objectives. These were: development of a multidisciplinary diabetes DM team; development of a patient registry; development of diabetes teaching clinics in the family practice center (nutrition, general management classes, and one-on-one teaching); development of a group visit model; and training the residents in the elements of the ICIC Model, ie, the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Barriers to implementing these curricular changes were: the development of a patient registry; buy-in from faculty, residents, clinic leadership, staff, and patients for the chronic care model; the ability to bill for services and maintain clinical productivity; and support from the health system key stakeholders for sustainability. Unique features of each training site will dictate differences in emphasis and structure; however, the core principles of the ICIC Model in enhancing self-management may be generalized to all sites.

[Evaluation of budget design and execution, an instrument of performance-based budgeting: some experiences applied to health].

PubMed

Peñaloza-Vassallo, K; Gutiérrez-Aguado, A; Prado-Fernández, M

2017-01-01

Since 2008, the evaluation of budget design and execution (EDEP for its acronym in Spanish) - one of the evaluations tools developed by the Peruvian Ministry of Economy and Finance (MEF) as part of the implementation of Performance Budgeting- seek to provide reliable information about design coherence and progress in the implementation of public interventions, in order to improve their management and make informed budget decisions. The EDEP methodology includes preparing an evaluation report and defining a matrix of commitments to improve performance. Commitments are defined based on the recommendation of the EDEP. The EDEP seeks to correct exiting problems in public programs and optimize their results. MEF tracks the fulfillment of these commitments and links together the analysis of public budget requests and the progress of these commitments. Now, almost 10 years after its implementation, 57 EDEP have been carried out in different sectors and 07 of them are related to health interventions such as: the comprehensive health system, vaccination service, normal births, acute respiratory infections and acute diarrheal diseases, among others. Beyond the discrepancies in the application of this tool, the EDEP and its matrix of commitments have allowed the use of the results of the evaluations and have become a mechanism to generate useful information to improve the public services.

Implementation of Sensor Twitter Feed Web Service Server and Client

DTIC Science & Technology

2016-12-01

ARL-TN-0807 ● DEC 2016 US Army Research Laboratory Implementation of Sensor Twitter Feed Web Service Server and Client by...Implementation of Sensor Twitter Feed Web Service Server and Client by Bhagyashree V Kulkarni University of Maryland Michael H Lee Computational...

Recovery as a model of care? Insights from an Australian case study.

PubMed

Hungerford, Catherine

2014-03-01

The terms "model of health care," "service model." and "nursing model of practice" are often used interchangeably in practice, policy, and research, despite differences in definitions. This article considers these terms in the context of consumer-centred recovery and its implementation into a publicly-funded health service organization in Australia. Findings of a case study analysis are used to inform the discussion, which considers the diverse models of health care employed by health professionals; together with the implications for organizations worldwide that are responsible for operationalizing recovery approaches to health care. As part of the discussion, it is suggested that the advent of recovery-oriented services, rather than recovery models of health care, presents challenges for the evaluation of the outcomes of these services. At the same time, this situation provides opportunities for mental health nurses to lead the way, by developing rigorous models of practice that support consumers who have acute, chronic, or severe mental illness on their recovery journey; and generate positive, measureable outcomes.

A web service system supporting three-dimensional post-processing of medical images based on WADO protocol.

PubMed

He, Longjun; Xu, Lang; Ming, Xing; Liu, Qian

2015-02-01

Three-dimensional post-processing operations on the volume data generated by a series of CT or MR images had important significance on image reading and diagnosis. As a part of the DIOCM standard, WADO service defined how to access DICOM objects on the Web, but it didn't involve three-dimensional post-processing operations on the series images. This paper analyzed the technical features of three-dimensional post-processing operations on the volume data, and then designed and implemented a web service system for three-dimensional post-processing operations of medical images based on the WADO protocol. In order to improve the scalability of the proposed system, the business tasks and calculation operations were separated into two modules. As results, it was proved that the proposed system could support three-dimensional post-processing service of medical images for multiple clients at the same moment, which met the demand of accessing three-dimensional post-processing operations on the volume data on the web.

Health service accreditation: report of a pilot programme for community hospitals.

PubMed Central

Shaw, C. D.; Collins, C. D.

1995-01-01

Voluntary accreditation in the United Kingdom is being used by health care providers to improve and market their services and by commissioners to define and monitor service contracts. In a three year pilot scheme in the south west of England, 43 out of 57 eligible community hospitals volunteered to be surveyed; 37 of them were ultimately accredited for up to two years by the hospital accreditation programme. The main causes for non-accreditation related to safety, clinical records, and medical organisation. Follow up visits in 10 hospitals showed that, overall, 69% of recommendations were implemented. An independent survey of participating hospitals showed the perceived benefits to include team building, review of operational policies, improvement of data systems, and the generation of local prestige. Purchasers are increasingly influenced by accreditation status but are mostly unwilling to finance the process directly. None the less, the concept may become an important factor moderating the quality of service in the new NHS. PMID:7711585

Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis.

PubMed

Moullin, Joanna C; Sabater-Hernández, Daniel; Benrimoj, Shalom I

2016-08-25

Multiple studies have explored the implementation process and influences, however it appears there is no study investigating these influences across the stages of implementation. Community pharmacy is attempting to implement professional services (pharmaceutical care and other health services). The use of implementation theory may assist the achievement of widespread provision, support and integration. The objective was to investigate professional service implementation in community pharmacy to contextualise and advance the concepts of a generic implementation framework previously published. Purposeful sampling was used to investigate implementation across a range of levels of implementation in community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a framework methodology. Data was charted using implementation stages as overarching themes and each stage was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation. Six stages emerged, labelled as development or discovery, exploration, preparation, testing, operation and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences (pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified. The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely. Evaluations were lacking. The process of implementation and five overarching influences of professional services implementation in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences, factors influencing implementation varied across the implementation stages. It is proposed at each stage, for each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.

Data-centric multiobjective QoS-aware routing protocol for body sensor networks.

PubMed

Razzaque, Md Abdur; Hong, Choong Seon; Lee, Sungwon

2011-01-01

In this paper, we address Quality-of-Service (QoS)-aware routing issue for Body Sensor Networks (BSNs) in delay and reliability domains. We propose a data-centric multiobjective QoS-Aware routing protocol, called DMQoS, which facilitates the system to achieve customized QoS services for each traffic category differentiated according to the generated data types. It uses modular design architecture wherein different units operate in coordination to provide multiple QoS services. Their operation exploits geographic locations and QoS performance of the neighbor nodes and implements a localized hop-by-hop routing. Moreover, the protocol ensures (almost) a homogeneous energy dissipation rate for all routing nodes in the network through a multiobjective Lexicographic Optimization-based geographic forwarding. We have performed extensive simulations of the proposed protocol, and the results show that DMQoS has significant performance improvements over several state-of-the-art approaches.

Cloud GIS Based Watershed Management

NASA Astrophysics Data System (ADS)

Bediroğlu, G.; Colak, H. E.

2017-11-01

In this study, we generated a Cloud GIS based watershed management system with using Cloud Computing architecture. Cloud GIS is used as SAAS (Software as a Service) and DAAS (Data as a Service). We applied GIS analysis on cloud in terms of testing SAAS and deployed GIS datasets on cloud in terms of DAAS. We used Hybrid cloud computing model in manner of using ready web based mapping services hosted on cloud (World Topology, Satellite Imageries). We uploaded to system after creating geodatabases including Hydrology (Rivers, Lakes), Soil Maps, Climate Maps, Rain Maps, Geology and Land Use. Watershed of study area has been determined on cloud using ready-hosted topology maps. After uploading all the datasets to systems, we have applied various GIS analysis and queries. Results shown that Cloud GIS technology brings velocity and efficiency for watershed management studies. Besides this, system can be easily implemented for similar land analysis and management studies.

Electricity market liberalization under the power of customer value evaluation and service model

NASA Astrophysics Data System (ADS)

Bai, Hong Kun; Wang, Jiang Bo; Song, Da Wei

2018-06-01

After the power reform No. 9 was released in March 2015, the state officially released the Opinions on the Implementation of the Reform on the Power Sales Side. From this document, we can see that the openness of sales of social capital to the electricity business, the sales side of the market competition through multiple ways to train the main competitors, the result is more users have the right to choose, sales service quality and user energy levels will significantly improve. With the gradual promotion of the electricity sales market, the national electricity sales companies have been established one after another. In addition to power grid outside the power generation companies, energy-saving service companies and distributed power companies may become the main selling power, while industrial parks, commercial complex, large residential area, industrial and commercial users, large industrial users in the new electricity demand appearing The new changes, some power customers have also self-built distributed power supply, installation of energy storage devices or equipment to participate in the transformation of the electricity market. The main body of the electricity sales market has gradually evolved from the traditional electricity generation main body to the multi-unit main body and emerged new value points. Therefore, the electricity sales companies need to establish a power customer value evaluation method and service mode to adapt to the new electricity reform, Provide supportive decision support.

Priorities for implementing nutritional science into practice to optimize military performance.

PubMed

Elfenbaum, Pamela; Crawford, Cindy; Enslein, Viviane; Berry, Kevin

2017-06-01

The Metabolically Optimized Brain study explores nutritional science believed to be ready to place into practice to help improve US service member mission-readiness and performance. To this end, an implementation expert panel considered how the US Department of Defense Subsistence Food Service Program, which is operated by each branch of the military in dining facilities within the continental United States, could apply the best nutritional science in a cost-effective manner. The work of this panel was facilitated through a series of thematic conversations guided by evidence generated through systematic reviews, which were performed to identify systems and process gaps and propose possible solutions. The expert panel used a Delphi method of multiple voting, and ultimately proposed 11 systems changes, of which 6 were ranked as highest priority. The proposed highest priority changes were then discussed by the participants with additional stakeholders. The process described here highlights how experts from different sectors operating in a complex system of subsystems can come together to cross talk, identify gaps, and propose mutually beneficial system and process changes to improve the alignment of nutritional science and institutional food-service practice. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Water chemistry of the secondary circuit at a nuclear power station with a VVER power reactor

NASA Astrophysics Data System (ADS)

Tyapkov, V. F.; Erpyleva, S. F.

2017-05-01

Results of implementation of the secondary circuit organic amine water chemistry at Russian nuclear power plant (NPP) with VVER-1000 reactors are presented. The requirements for improving the reliability, safety, and efficiency of NPPs and for prolonging the service life of main equipment items necessitate the implementation of new technologies, such as new water chemistries. Data are analyzed on the chemical control of power unit coolant for quality after the changeover to operation with the feed of higher amines, such as morpholine and ethanolamine. Power units having equipment containing copper alloy components were converted from the all-volatile water chemistry to the ethanolamine or morpholine water chemistry with no increase in pH of the steam generator feedwater. This enables the iron content in the steam generator feedwater to be decreased from 6-12 to 2.0-2.5 μg/dm3. It is demonstrated that pH of high-temperature water is among the basic factors controlling erosion and corrosion wear of the piping and the ingress of corrosion products into NPP steam generators. For NPP power units having equipment whose construction material does not include copper alloys, the water chemistries with elevated pH of the secondary coolant are adopted. Stable dosing of correction chemicals at these power units maintains pH25 of 9.5 to 9.7 in the steam generator feedwater with a maximum iron content of 2 μg/dm3 in the steam generator feedwater.

Explaining outcomes in major system change: a qualitative study of implementing centralised acute stroke services in two large metropolitan regions in England.

PubMed

Fulop, Naomi J; Ramsay, Angus I G; Perry, Catherine; Boaden, Ruth J; McKevitt, Christopher; Rudd, Anthony G; Turner, Simon J; Tyrrell, Pippa J; Wolfe, Charles D A; Morris, Stephen

2016-06-03

Implementing major system change in healthcare is not well understood. This gap may be addressed by analysing change in terms of interrelated components identified in the implementation literature, including decision to change, intervention selection, implementation approaches, implementation outcomes, and intervention outcomes. We conducted a qualitative study of two cases of major system change: the centralisation of acute stroke services in Manchester and London, which were associated with significantly different implementation outcomes (fidelity to referral pathway) and intervention outcomes (provision of evidence-based care, patient mortality). We interviewed stakeholders at national, pan-regional, and service-levels (n = 125) and analysed 653 documents. Using a framework developed for this study from the implementation science literature, we examined factors influencing implementation approaches; how these approaches interacted with the models selected to influence implementation outcomes; and their relationship to intervention outcomes. London and Manchester's differing implementation outcomes were influenced by the different service models selected and implementation approaches used. Fidelity to the referral pathway was higher in London, where a 'simpler', more inclusive model was used, implemented with a 'big bang' launch and 'hands-on' facilitation by stroke clinical networks. In contrast, a phased approach of a more complex pathway was used in Manchester, and the network acted more as a platform to share learning. Service development occurred more uniformly in London, where service specifications were linked to financial incentives, and achieving standards was a condition of service launch, in contrast to Manchester. 'Hands-on' network facilitation, in the form of dedicated project management support, contributed to achievement of these standards in London; such facilitation processes were less evident in Manchester. Using acute stroke service centralisation in London and Manchester as an example, interaction between model selected and implementation approaches significantly influenced fidelity to the model. The contrasting implementation outcomes may have affected differences in provision of evidence-based care and patient mortality. The framework used in this analysis may support planning and evaluating major system changes, but would benefit from application in different healthcare contexts.

The MacGyver effect: alive and well in health services research?

PubMed Central

2011-01-01

Background In a manner similar to the television action hero MacGyver, health services researchers need to respond to the pressure of unpredictable demands and constrained time frames. The results are often both innovative and functional, with the creation of outputs that could not have been anticipated in the initial planning and design of the research. Discussion In the conduct of health services research many challenges to robust research processes are generated as a result of the interface between academic research, health policy and implementation agendas. Within a complex and rapidly evolving environment the task of the health services researcher is, therefore, to juggle sometimes contradictory pressures to produce valid results. Summary This paper identifies the MacGyver-type dilemmas which arise in health services research, wherein innovation may be called for, to maintain the intended scientific method and rigour. These 'MacGyver drivers' are framed as opposing issues from the perspective of both academic and public policy communities. The ideas expressed in this paper are illustrated by four examples from research projects positioned at the interface between public policy strategy and academia. PMID:21929826

Merging Real-Time and Retrospective Data Services, NOAA's Solar X-Ray Imager

NASA Astrophysics Data System (ADS)

Wilkinson, D. C.

2004-12-01

The ground systems team for NOAA's first Solar X-ray Imager (SXI) proposed a merger of real-time and retrospective data services with two goals in mind. First, it was anticipated that this would be a more economical approach than legacy systems that divided these services between two separate organizations within NOAA. Also, unifying these services would naturally provide a simpler, and more consistent public interface for all SXI data users. The implementation of this innovative approach has been successful on both accounts. NOAA's Space Environment Center (SEC) receives the telemetry stream from SXI and generates the raw and processed imagery that they use in their Space Weather alert and forecast services. These data are instantaneously transferred to NOAA's National Geophysical Data Center through a combination of data push and pull protocols. The result is an interface that provides access to all SXI data, including images that are less than two minutes old. The success of this system has prompted its use in the ground systems design for the SXI and Space Environment Monitor (SEM) data collected from GOES-N, schedule for launch in December 2004.

The dependency on central government funding of decentralised health systems: experiences of the challenges and coping strategies in the Kongwa District, Tanzania.

PubMed

Frumence, Gasto; Nyamhanga, Tumaini; Mwangu, Mughwira; Hurtig, Anna-Karin

2014-01-25

Decentralised health systems in Tanzania depend largely on funding from the central government to run health services. Experience has shown that central funding in a decentralised system is not an appropriate approach to ensure the effective and efficient performance of local authorities due to several limitations. One of the limitations is that funds from the central government are not disbursed on a timely basis, which in turn, leads to the serious problem of shortage of financial resources for Council Health Management Teams (CHMT). This paper examines how dependency on central government funding in Tanzania affects health activities in Kongwa district council and the strategies used by the CHMT cope with the situation. The study adopted a qualitative approach and data were collected using semi-structured interviews and focus group discussions. One district in the central region of Tanzania was strategically selected. Ten key informants involved in the management of health service delivery at the district level were interviewed and one focus group discussion was held, which consisted of members of the council health management team. The data generated were analysed for themes and patterns. The results showed that late disbursement of funds interrupts the implementation of health activities in the district health system. This situation delays the implementation of some activities, while a few activities may not be implemented at all. However, based on their prior knowledge of the anticipated delays in financial disbursements, the council health management team has adopted three main strategies to cope with this situation. These include obtaining supplies and other services on credit, borrowing money from other projects in the council, and using money generated from cost sharing. Local government authorities (LGAs) face delays in the disbursement of funds from the central government. This has necessitated introduction of informal coping strategies to deal with the situation. National-level policy and decision makers should minimise the bureaucracy involved in allocating funds to the district health systems to reduce delays.

The dependency on central government funding of decentralised health systems: experiences of the challenges and coping strategies in the Kongwa District, Tanzania

PubMed Central

2014-01-01

Background Decentralised health systems in Tanzania depend largely on funding from the central government to run health services. Experience has shown that central funding in a decentralised system is not an appropriate approach to ensure the effective and efficient performance of local authorities due to several limitations. One of the limitations is that funds from the central government are not disbursed on a timely basis, which in turn, leads to the serious problem of shortage of financial resources for Council Health Management Teams (CHMT). This paper examines how dependency on central government funding in Tanzania affects health activities in Kongwa district council and the strategies used by the CHMT cope with the situation. Methods The study adopted a qualitative approach and data were collected using semi-structured interviews and focus group discussions. One district in the central region of Tanzania was strategically selected. Ten key informants involved in the management of health service delivery at the district level were interviewed and one focus group discussion was held, which consisted of members of the council health management team. The data generated were analysed for themes and patterns. Results The results showed that late disbursement of funds interrupts the implementation of health activities in the district health system. This situation delays the implementation of some activities, while a few activities may not be implemented at all. However, based on their prior knowledge of the anticipated delays in financial disbursements, the council health management team has adopted three main strategies to cope with this situation. These include obtaining supplies and other services on credit, borrowing money from other projects in the council, and using money generated from cost sharing. Conclusion Local government authorities (LGAs) face delays in the disbursement of funds from the central government. This has necessitated introduction of informal coping strategies to deal with the situation. National-level policy and decision makers should minimise the bureaucracy involved in allocating funds to the district health systems to reduce delays. PMID:24460781

Climate services for society: origins, institutional arrangements, and design elements for an evaluation framework

PubMed Central

Vaughan, Catherine; Dessai, Suraje

2014-01-01

Climate services involve the generation, provision, and contextualization of information and knowledge derived from climate research for decision making at all levels of society. These services are mainly targeted at informing adaptation to climate variability and change, widely recognized as an important challenge for sustainable development. This paper reviews the development of climate services, beginning with a historical overview, a short summary of improvements in climate information, and a description of the recent surge of interest in climate service development including, for example, the Global Framework for Climate Services, implemented by the World Meteorological Organization in October 2012. It also reviews institutional arrangements of selected emerging climate services across local, national, regional, and international scales. By synthesizing existing literature, the paper proposes four design elements of a climate services evaluation framework. These design elements include: problem identification and the decision-making context; the characteristics, tailoring, and dissemination of the climate information; the governance and structure of the service, including the process by which it is developed; and the socioeconomic value of the service. The design elements are intended to serve as a guide to organize future work regarding the evaluation of when and whether climate services are more or less successful. The paper concludes by identifying future research questions regarding the institutional arrangements that support climate services and nascent efforts to evaluate them. PMID:25798197

Climate services for society: origins, institutional arrangements, and design elements for an evaluation framework.

PubMed

Vaughan, Catherine; Dessai, Suraje

2014-09-01

Climate services involve the generation, provision, and contextualization of information and knowledge derived from climate research for decision making at all levels of society. These services are mainly targeted at informing adaptation to climate variability and change, widely recognized as an important challenge for sustainable development. This paper reviews the development of climate services, beginning with a historical overview, a short summary of improvements in climate information, and a description of the recent surge of interest in climate service development including, for example, the Global Framework for Climate Services, implemented by the World Meteorological Organization in October 2012. It also reviews institutional arrangements of selected emerging climate services across local, national, regional, and international scales. By synthesizing existing literature, the paper proposes four design elements of a climate services evaluation framework. These design elements include: problem identification and the decision-making context; the characteristics, tailoring, and dissemination of the climate information; the governance and structure of the service, including the process by which it is developed; and the socioeconomic value of the service. The design elements are intended to serve as a guide to organize future work regarding the evaluation of when and whether climate services are more or less successful. The paper concludes by identifying future research questions regarding the institutional arrangements that support climate services and nascent efforts to evaluate them.

Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International

PubMed Central

Thurston, Sarah; Chakraborty, Nirali M; Hayes, Brendan; Mackay, Anna; Moon, Pierre

2015-01-01

In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014—up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI’s 17 and PSI’s 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations’ operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the potential to contribute to universal health coverage. PMID:26085017

[Implementation and evaluation of case management in Catalonia: the ISP-SMD program].

PubMed

Balsera Gómez, J; Rodríguez Medina, C; Caba Calvet, R; Vega Prada, R; Ruiz Ureña, H; Berruezo Ortiz, L; Clusa Gironella, D; Rodríguez Montes, M J; Haro Abad, J M

2002-01-01

The pilot study of the Individualized Service Program for people with Severe Mental Disorders (ISP-SMD) consists of the implementation of case management services in Catalonia. The ISP-SMD has been implemented in two health care sectors and will be expanded to the rest of Catalonia in the next years. The program serves people with persistent mental disorders who have serious social or family problems and/or who have inadequate mental health service use (high use of inpatient services, no use of community services). The ISP-SMD is a community intervention program that focuses its activities on direct care and coordination between services. Thirty patients have been included in the evaluation. The results of the pilot study have shown that, compared to the year before entering the program, the patients show better clinical status, they decrease their unmet need level, they have more appropriate use of health services and have lower treatment costs. Satisfaction of the patients, family members and professionals with the program is very high. It is possible to adapt and implement case management services in Catalonia. When implemented, they improve patient quality of life.

Applying TOGAF for e-government implementation based on service oriented architecture methodology towards good government governance

NASA Astrophysics Data System (ADS)

Hodijah, A.; Sundari, S.; Nugraha, A. C.

2018-05-01

As a Local Government Agencies who perform public services, General Government Office already has utilized Reporting Information System of Local Government Implementation (E-LPPD). However, E-LPPD has upgrade limitation for the integration processes that cannot accommodate General Government Offices’ needs in order to achieve Good Government Governance (GGG), while success stories of the ultimate goal of e-government implementation requires good governance practices. Currently, citizen demand public services as private sector do, which needs service innovation by utilizing the legacy system as a service based e-government implementation, while Service Oriented Architecture (SOA) to redefine a business processes as a set of IT enabled services and Enterprise Architecture from the Open Group Architecture Framework (TOGAF) as a comprehensive approach in redefining business processes as service innovation towards GGG. This paper takes a case study on Performance Evaluation of Local Government Implementation (EKPPD) system on General Government Office. The results show that TOGAF will guide the development of integrated business processes of EKPPD system that fits good governance practices to attain GGG with SOA methodology as technical approach.

The Effects of Medicaid Policy Changes on Adults' Service Use Patterns in Kentucky and Idaho

PubMed Central

Marton, James; Kenney, Genevieve M.; Pelletier, Jennifer E.; Talbert, Jeffery; Klein, Ariel

2013-01-01

Background In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Methods Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. Results While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. Conclusions We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions. PMID:24800159

The effects of Medicaid policy changes on adults' service use patterns in Kentucky and Idaho.

PubMed

Marton, James; Kenney, Genevieve M; Pelletier, Jennifer E; Talbert, Jeffery; Klein, Ariel

2012-01-01

In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions.

Management of patients with diabetes through information technology: tools for monitoring and control of the patients' metabolic behavior.

PubMed

Bellazzi, Riccardo; Arcelloni, Marco; Ferrari, Pietro; Decata, Pasquale; Hernando, M Elena; García, Angel; Gazzaruso, Carmine; Gómez, Enrique J; Larizza, Cristiana; Fratino, Pietro; Stefanelli, Mario

2004-10-01

The junction of telemedicine home monitoring with multifaceted disease management programs seems nowadays a promising direction to combine the need for an intensive approach to deal with diabetes and the pressure to contain the costs of the interventions. Several projects in the European Union and the United States are implementing information technology-based services for diabetes management using a comprehensive approach. Within these systems, the role of tools for data analysis and automatic reminder generation seems crucial to deal with the information overload that may result from large home monitoring programs. The objective of this study was to describe the automatic reminder generation system and the summary indicators used in a clinical center within the telemedicine project M2DM, funded by the European Commission, and to show their usage during a 7-month on-field testing period. M2DM is a multi-access service for management of patients with diabetes. The basic functionality of the technical service includes a Web-based electronic medical record and messaging system, a computer telephony integration service, a smart-modem located at home, and a set of specialized software modules for automated data analysis. The information flow is regulated by a software scheduler, called the Organizer, that, on the basis of the knowledge on the health care organization, is able to automatically send e-mails and alerts notifications as well as to commit activities to software agents, such as data analysis. Thanks to this system, it was possible to define an automatic reminder system, which relies on a data analysis tool and on a number of technologies for communication. Within the M2DM system, we have also defined and implemented a number of indexes able to summarize the patients' day-by-day metabolic control. In particular, we have defined the global risk index (GRI) of developing microangiopathic complications. The system for generating automatic alarms and reminders coupled with the indexes for evaluating the patients' metabolic control has been used for 7 months at the Fondazione Salvatore Maugeri (FSM) in Pavia, Italy. Twenty-two patients (43 +/- 16 years old, 12 men and 10 women) have been involved; six dropped out from the study. The average number of monthly automatic messages was 29.44 +/- 9.83, i.e., about 1.8 messages per patient per month. The number of monthly alarm reminders generated by the system was 16.44 +/- 4.39, so that the number of alarms per patient was about 1. The number of messages sent by patients and physicians during the project was about 13 per month. The GRI analysis shows, during the last trimester, a slight improvement of the performance of the FSM clinic, with a decrease in the percentage of badly controlled values from 33% to 27%. Finally, we found the presence of a linear increasing correlation between the mean GRI values and the number of alarms generated by the system. A telemedicine system may incorporate features that make it a suitable technological backbone for implementing a disease management program. The availability of data analysis tools, automated messaging system, and summary indicators of the effectiveness of the health care program may help in defining efficient clinical interventions.

Low earth orbit satellite/terrestrial mobile service compatibility

NASA Technical Reports Server (NTRS)

Sheriff, R. E.; Gardiner, J. G.

1993-01-01

Digital cellular mobile 'second generation' systems are now gradually being introduced into service; one such example is GSM, which will provide a digital voice and data service throughout Europe. Total coverage is not expected to be achieved until the mid '90's, which has resulted in several proposals for the integration of GSM with a geostationary satellite service. Unfortunately, because terrestrial and space systems have been designed to optimize their performance for their particular environment, integration between a satellite and terrestrial system is unlikely to develop further than the satellite providing a back-up service. This lack of system compatibility is now being addressed by system designers of third generation systems. The next generation of mobile systems, referred to as FPLMTS (future public land mobile telecommunication systems) by CCIR and UMTS (universal mobile telecommunication system) in European research programs, are intended to provide inexpensive, hand-held terminals that can operate in either satellite, cellular, or cordless environments. This poses several challenges for system designers, not least in terms of the choice of multiple access technique and power requirements. Satellite mobile services have been dominated by the geostationary orbital type. Recently, however, a number of low earth orbit configurations have been proposed, for example Iridium. These systems are likely to be fully operational by the turn of the century, in time for the implementation of FPLMTS. The developments in LEO mobile satellite service technology were recognized at WARC-92 with the allocation of specific frequency bands for 'big' LEO's, as well as a frequency allocation for FPLMTS which included a specific satellite allocation. When considering integrating a space service into the terrestrial network, LEO's certainly appear to have their attractions: they can provide global coverage, the round trip delay is of the order of tens of milliseconds, and good visibility to the satellite is usually possible. This has resulted in their detailed investigation in the European COST 227 program and in the work program of the European Telecommunications Standards Institute (ETSI). This paper will consider the system implications of integrating a LEO mobile service with a terrestrial service. Results will be presented from simulation software to show how a particular orbital configuration affects the performance of the system in terms of area coverage and visibility to a terminal for various locations and minimum elevation angle. Possible network topologies are then proposed for an integrated satellite/terrestrial network.

[Training of institutional research networks as a strategy of improvement].

PubMed

Galván-Plata, María Eugenia; Almeida-Gutiérrez, Eduardo; Salamanca-Gómez, Fabio Abdel

2017-01-01

The Instituto Mexicano del Seguro Social (IMSS) through the Coordinación de Investigación en Salud (Health Research Council) has promoted a strong link between the generation of scientific knowledge and the clinical care through the program Redes Institucionales de Investigación (Institutional Research Network Program), whose main aim is to promote and generate collaborative research between clinical, basic, epidemiologic, educational, economic and health services researchers, seeking direct benefits for patients, as well as to generate a positive impact on institutional processes. All of these research lines have focused on high-priority health issues in Mexico. The IMSS internal structure, as well as the sufficient health services coverage, allows the integration of researchers at the three levels of health care into these networks. A few years after their creation, these networks have already generated significant results, and these are currently applied in the institutional regulations in diseases that represent a high burden to health care. Two examples are the National Health Care Program for Patients with Acute Myocardial Infarction "Código Infarto", and the Early Detection Program on Chronic Kidney Disease; another result is the generation of multiple scientific publications, and the promotion of training of human resources in research from the same members of our Research Networks. There is no doubt that the Coordinación de Investigación en Salud advances steadily implementing the translational research, which will keep being fruitful to the benefit of our patients, and of our own institution.

Advancing Cervical Cancer Prevention in India: Implementation Science Priorities

PubMed Central

Madsen, Emily; Porterfield, Deborah; Varghese, Beena

2013-01-01

Cervical cancer is the leading cause of cancer mortality in India, accounting for 17% of all cancer deaths among women aged 30 to 69 years. At current incidence rates, the annual burden of new cases in India is projected to increase to 225,000 by 2025, but there are few large-scale, organized cervical cancer prevention programs in the country. We conducted a review of the cervical cancer prevention research literature and programmatic experiences in India to summarize the current state of knowledge and practices and recommend research priorities to address the gap in services. We found that research and programs in India have demonstrated the feasibility and acceptability of cervical cancer prevention efforts and that screening strategies requiring minimal additional human resources and laboratory infrastructure can reduce morbidity and mortality. However, additional evidence generated through implementation science research is needed to ensure that cervical cancer prevention efforts have the desired impact and are cost-effective. Specifically, implementation science research is needed to understand individual- and community-level barriers to screening and diagnostic and treatment services; to improve health care worker performance; to strengthen links among screening, diagnosis, and treatment; and to determine optimal program design, outcomes, and costs. With a quarter of the global burden of cervical cancer in India, there is no better time than now to translate research findings to practice. Implementation science can help ensure that investments in cervical cancer prevention and control result in the greatest impact. PMID:24217555

IMPlementation of A Relatives' Toolkit (IMPART study): an iterative case study to identify key factors impacting on the implementation of a web-based supported self-management intervention for relatives of people with psychosis or bipolar experiences in a National Health Service: a study protocol.

PubMed

Lobban, Fiona; Appleton, Victoria; Appelbe, Duncan; Barraclough, Johanna; Bowland, Julie; Fisher, Naomi R; Foster, Sheena; Johnson, Sonia; Lewis, Elizabeth; Mateus, Céu; Mezes, Barbara; Murray, Elizabeth; O'Hanlon, Puffin; Pinfold, Vanessa; Rycroft-Malone, Jo; Siddle, Ron; Smith, Jo; Sutton, Chris J; Walker, Andrew; Jones, Steven H

2017-12-28

Web-based interventions to support people to manage long-term health conditions are available and effective but rarely used in clinical services. The aim of this study is to identify critical factors impacting on the implementation of an online supported self-management intervention for relatives of people with recent onset psychosis or bipolar disorder into routine clinical care and to use this information to inform an implementation plan to facilitate widespread use and inform wider implementation of digital health interventions. A multiple case study design within six early intervention in psychosis (EIP) services in England, will be used to test and refine theory-driven hypotheses about factors impacting on implementation of the Relatives' Education And Coping Toolkit (REACT). Qualitative data including behavioural observation, document analysis, and in-depth interviews collected in the first two EIP services (wave 1) and analysed using framework analysis, combined with quantitative data describing levels of use by staff and relatives and impact on relatives' distress and wellbeing, will be used to identify factors impacting on implementation. Consultation via stakeholder workshops with staff and relatives and co-facilitated by relatives in the research team will inform development of an implementation plan to address these factors, which will be evaluated and refined in the four subsequent EIP services in waves 2 and 3. Transferability of the implementation plan to non-participating services will be explored. Observation of implementation in a real world clinical setting, across carefully sampled services, in real time provides a unique opportunity to understand factors impacting on implementation likely to be generalizable to other web-based interventions, as well as informing further development of implementation theories. However, there are inherent challenges in investigating implementation without influencing the process under observation. We outline our strategies to ensure our design is transparent, flexible, and responsive to the timescales and activities happening within each service whilst also meeting the aims of the project. ISCTRN 16267685 (09/03/2016).

Bridging the gap between Hydrologic and Atmospheric communities through a standard based framework

NASA Astrophysics Data System (ADS)

Boldrini, E.; Salas, F.; Maidment, D. R.; Mazzetti, P.; Santoro, M.; Nativi, S.; Domenico, B.

2012-04-01

Data interoperability in the study of Earth sciences is essential to performing interdisciplinary multi-scale multi-dimensional analyses (e.g. hydrologic impacts of global warming, regional urbanization, global population growth etc.). This research aims to bridge the existing gap between hydrologic and atmospheric communities both at semantic and technological levels. Within the context of hydrology, scientists are usually concerned with data organized as time series: a time series can be seen as a variable measured at a particular point in space over a period of time (e.g. the stream flow values as periodically measured by a buoy sensor in a river); atmospheric scientists instead usually organize their data as coverages: a coverage can be seen as a multidimensional data array (e.g. satellite images acquired through time). These differences make non-trivial the set up of a common framework to perform data discovery and access. A set of web services specifications and implementations is already in place in both the scientific communities to allow data discovery and access in the different domains. The CUAHSI-Hydrologic Information System (HIS) service stack lists different services types and implementations: - a metacatalog (implemented as a CSW) used to discover metadata services by distributing the query to a set of catalogs - time series catalogs (implemented as CSW) used to discover datasets published by the feature services - feature services (implemented as WFS) containing features with data access link - sensor observation services (implemented as SOS) enabling access to the stream of acquisitions Within the Unidata framework, there lies a similar service stack for atmospheric data: - the broker service (implemented as a CSW) distributes a user query to a set of heterogeneous services (i.e. catalogs services, but also inventory and access services) - the catalog service (implemented as a CSW) is able to harvest the available metadata offered by THREDDS services, and executes complex queries against the available metadata. - inventory service (implemented as a THREDDS) being able to hierarchically organize and publish a local collection of multi-dimensional arrays (e.g. NetCDF, GRIB files), as well as publish auxiliary standard services to realize the actual data access and visualization (e.g. WCS, OPeNDAP, WMS). The approach followed in this research is to build on top of the existing standards and implementations, by setting up a standard-aware interoperable framework, able to deal with the existing heterogeneity in an organic way. As a methodology, interoperability tests against real services were performed; existing problems were thus highlighted and possibly solved. The use of flexible tools, able to deal in a smart way with heterogeneity has proven to be successful, in particular experiments were carried on with both GI-cat broker and ESRI GeoPortal frameworks. GI-cat discovery broker was proven successful at implementing the CSW interface, as well as federating heterogeneous resources, such as THREDDS and WCS services published by Unidata, HydroServer, WFS and SOS services published by CUAHSI. Experiments with ESRI GeoPortal were also successful: the GeoPortal was used to deploy a web interface able to distribute searches amongst catalog implementations from both the hydrologic and the atmospheric communities, including HydroServers and GI-cat, combining results from both the domains in a seamless way.

The Canadian National EMS Research Agenda: Impact and Feasibility of Implementation of Previously Generated Recommendations.

PubMed

Jensen, J L; Blanchard, I E; Bigham, B L; Carter, Aje; Brown, R; Socha, D; Brown, L H; Travers, A H; Craig, A M; Morrison, L J

2015-09-01

A recent mixed-methods study on the state of emergency medical services (EMS) research in Canada led to the generation of nineteen actionable recommendations. As part of the dissemination plan, a survey was distributed to EMS stakeholders to determine the anticipated impact and feasibility of implementing these recommendations in Canadian systems. An online survey explored both the implementation impact and feasibility for each recommendation using a five-point scale. The sample consisted of participants from the Canadian National EMS Research Agenda study (published in 2013) and additional EMS research stakeholders identified through snowball sampling. Responses were analysed descriptively using median and plotted on a matrix. Participants reported any planned or ongoing initiatives related to the recommendations, and required or anticipated resources. Free text responses were analysed with simple content analysis, collated by recommendation. The survey was sent to 131 people, 94 (71.8%) of whom responded: 30 EMS managers/regulators (31.9%), 22 researchers (23.4%), 15 physicians (16.0%), 13 educators (13.8%), and 5 EMS providers (5.3%). Two recommendations (11%) had a median impact score of 4 (of 5) and feasibility score of 4 (of 5). Eight recommendations (42%) had an impact score of 5, with a feasibility score of 3. Nine recommendations (47%) had an impact score of 4 and a feasibility score of 3. For most recommendations, participants scored the anticipated impact higher than the feasibility to implement. Ongoing or planned initiatives exist pertaining to all recommendations except one. All of the recommendations will require additional resources to implement.

Rapid research and implementation priority setting for wound care uncertainties.

PubMed

Gray, Trish A; Dumville, Jo C; Christie, Janice; Cullum, Nicky A

2017-01-01

People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services. We solicited practitioner and manager uncertainties in wound care and held a priority setting workshop to facilitate a collaborative approach to prioritising wound care-related uncertainties. We recruited healthcare professionals who regularly cared for patients with complex wounds, were wound care specialists or managed wound care services. Participants submitted up to five wound care uncertainties in consultation with their colleagues, via an on-line survey and attended a priority setting workshop. Submitted uncertainties were collated, sorted and categorised according professional group. On the day of the workshop, participants were divided into four groups depending on their profession. Uncertainties submitted by their professional group were viewed, discussed and amended, prior to the first of three individual voting rounds. Participants cast up to ten votes for the uncertainties they judged as being high priority. Continuing in the professional groups, the top 10 uncertainties from each group were displayed, and the process was repeated. Groups were then brought together for a plenary session in which the final priorities were individually scored on a scale of 0-10 by participants. Priorities were ranked and results presented. Nominal group technique was used for generating the final uncertainties, voting and discussions. Thirty-three participants attended the workshop comprising; 10 specialist nurses, 10 district nurses, seven podiatrists and six managers. Participants had been qualified for a mean of 20.7 years with a mean of 16.8 years of wound care experience. One hundred and thirty-nine uncertainties were submitted electronically and a further 20 were identified on the day of the workshop following lively, interactive group discussions. Twenty-five uncertainties from the total of 159 generated made it to the final prioritised list. These included six of the 20 new uncertainties. The uncertainties varied in focus, but could be broadly categorised into three themes: service delivery and organisation, patient centred care and treatment options. Specialist nurses were more likely to vote for service delivery and organisation topics, podiatrists for patient centred topics, district nurses for treatment options and operational leads for a broad range. This collaborative priority setting project is the first to engage front-line clinicians in prioritising research and implementation topics in wound care. We have shown that it is feasible to conduct topic prioritisation in a short time frame. This project has demonstrated that with careful planning and rigor, important questions that are raised in the course of clinicians' daily decision making can be translated into meaningful research and implementation initiatives that could make a difference to service delivery and patient care.

Rapid research and implementation priority setting for wound care uncertainties

PubMed Central

Dumville, Jo C.; Christie, Janice; Cullum, Nicky A.

2017-01-01

Introduction People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services. We solicited practitioner and manager uncertainties in wound care and held a priority setting workshop to facilitate a collaborative approach to prioritising wound care-related uncertainties. Methods We recruited healthcare professionals who regularly cared for patients with complex wounds, were wound care specialists or managed wound care services. Participants submitted up to five wound care uncertainties in consultation with their colleagues, via an on-line survey and attended a priority setting workshop. Submitted uncertainties were collated, sorted and categorised according professional group. On the day of the workshop, participants were divided into four groups depending on their profession. Uncertainties submitted by their professional group were viewed, discussed and amended, prior to the first of three individual voting rounds. Participants cast up to ten votes for the uncertainties they judged as being high priority. Continuing in the professional groups, the top 10 uncertainties from each group were displayed, and the process was repeated. Groups were then brought together for a plenary session in which the final priorities were individually scored on a scale of 0–10 by participants. Priorities were ranked and results presented. Nominal group technique was used for generating the final uncertainties, voting and discussions. Results Thirty-three participants attended the workshop comprising; 10 specialist nurses, 10 district nurses, seven podiatrists and six managers. Participants had been qualified for a mean of 20.7 years with a mean of 16.8 years of wound care experience. One hundred and thirty-nine uncertainties were submitted electronically and a further 20 were identified on the day of the workshop following lively, interactive group discussions. Twenty-five uncertainties from the total of 159 generated made it to the final prioritised list. These included six of the 20 new uncertainties. The uncertainties varied in focus, but could be broadly categorised into three themes: service delivery and organisation, patient centred care and treatment options. Specialist nurses were more likely to vote for service delivery and organisation topics, podiatrists for patient centred topics, district nurses for treatment options and operational leads for a broad range. Conclusions This collaborative priority setting project is the first to engage front-line clinicians in prioritising research and implementation topics in wound care. We have shown that it is feasible to conduct topic prioritisation in a short time frame. This project has demonstrated that with careful planning and rigor, important questions that are raised in the course of clinicians’ daily decision making can be translated into meaningful research and implementation initiatives that could make a difference to service delivery and patient care. PMID:29206884

STEM-related, Student-led Service Learning / Community Engagement Projects: Examples and Benefits

NASA Astrophysics Data System (ADS)

Swap, R. J.; Wayland, K.

2015-12-01

Field-based, STEM-related service learning / community engagement projects present an opportunity for undergraduate students to demonstrate proficiencies related to the process of inquiry. These proficiencies include: appreciation of the larger project context, articulation of an informed question/hypothesis, project proposal development, interdisciplinary collaboration, project management (including planning, implementation reconfiguration and synthesis) and lastly the generation and handing off of acquired knowledge. Calls for these types of proficiencies have been expressed by governmental, non-governmental as well as the private sector. Accordingly, institutions of higher learning have viewed such activities as opportunities for enriching the learning experience for undergraduate students and for making such students more marketable, especially those from STEM-related fields. This institutional interest has provided an opportunity to support and expand field-based learning. Here we present examples of student-led/faculty-mentored international service learning and community engagement projects along the arc of preparation, implementation and post-field process. Representative examples that draw upon environmental science and engineering knowledge have been selected from more than 20 international undergraduate student projects over past decade and include: slow-sand water filtration, rainwater harvesting, methane biodigesters, water reticulation schemes and development and implementation of rocket stoves for communal cooking. We discuss these efforts in terms of the development of the aforementioned proficiencies, the utility of such proficiencies to the larger enterprise of STEM and the potential for transformative student learning outcomes. We share these experiences and lessons learned with the hope that others may intelligently borrow from our approach in a manner appropriate for their particular context.

User's perspectives of barriers and facilitators to implementing quality colonoscopy services in Canada: a study protocol.

PubMed

Jobin, Gilles; Gagnon, Marie Pierre; Candas, Bernard; Dubé, Catherine; Ben Abdeljelil, Anis; Grenier, Sonya

2010-11-02

Colorectal cancer (CRC) represents a serious and growing health problem in Canada. Colonoscopy is used for screening and diagnosis of symptomatic or high CRC risk individuals. Although a number of countries are now implementing quality colonoscopy services, knowledge synthesis of barriers and facilitators perceived by healthcare professionals and patients during implementation has not been carried out. In addition, the perspectives of various stakeholders towards the implementation of quality colonoscopy services and the need of an efficient organisation of such services have been reported in the literature but have not been synthesised yet. The present study aims to produce a comprehensive synthesis of actual knowledge on the barriers and facilitators perceived by all stakeholders to the implementation of quality colonoscopy services in Canada. First, we will conduct a comprehensive review of the scientific literature and other published documentation on the barriers and facilitators to implementing quality colonoscopy services. Standardised literature searches and data extraction methods will be used. The quality of the studies and their relevance to informing decisions on colonoscopy services implementation will be assessed. For each group of users identified, barriers and facilitators will be categorised and compiled using narrative synthesis and meta-analytical techniques. The principle factors identified for each group of users will then be validated for its applicability to various Canadian contexts using the Delphi study method. Following this study, a set of strategies will be identified to inform decision makers involved in the implementation of quality colonoscopy services across Canadian jurisdictions. This study will be the first to systematically summarise the barriers and facilitators to implementation of quality colonoscopy services perceived by different groups and to consider the local contexts in order to ensure the applicability of this knowledge to the particular realities of various Canadian jurisdictions. Linkages with strategic partners and decision makers in the realisation of this project will favour the utilisation of its results to support strategies for implementing quality colonoscopy services and CRC screening programs in the Canadian health system.

Open access and preservation of data on the coupled geosphere-biosphere system: the case of the H2020 Project ECOPOTENTIAL

NASA Astrophysics Data System (ADS)

Provenzale, Antonello; Nativi, Stefano

2016-04-01

The H2020 ECOPOTENTIAL Project addresses the entire chain of ecosystem-related services, by focusing on the interaction between the biotic and abiotic components of ecosystems (geosphere-biosphere interactions), developing ecosystem data services with special emphasis on Copernicus services, implementing model output services to distribute the results of the modelling activities, and estimating current and future ecosystem services and benefits combining ecosystem functions (supply) with beneficiaries needs (demand). In ECOPOTENTIAL all data, model results and acquired knowledge will be made available on common and open platforms, coherent with the Global Earth Observation System of Systems (GEOSS) data sharing principles and fully interoperable with the GEOSS Common Infrastructure (GCI). ECOPOTENTIAL will be conducted in the context of the implementation of the Copernicus EO Component and in synergy with the ESA Climate Change Initiative. The project activities will contribute to Copernicus and non-Copernicus contexts for ecosystems, and will create an Ecosystem Data Service for Copernicus (ECOPERNICUS), a new open-access, smart and user-friendly geospatial data/products retrieval portal and web coverage service using a dedicated online server. ECOPOTENTIAL will make data, scientific results, models and information accessible and available through a cloud-based open platform implementing virtual laboratories. The platform will be a major contribution to the GEOSS Common Infrastructure, reinforcing the GEOSS Data-CORE. By the end of the project, new prototype products and ecosystem services, based on improved access (notably via GEOSS) and long-term storage of ecosystem EO data and information in existing PAs, will be realized. In this contribution, we discuss the approach followed in the project for Open Data access and use. ECOPOTENTIAL introduced a set of architecture and interoperability principles to facilitate data (and the associated software) discovery, access, (re-)use, and preservation. According to these principles, ECOPOTENTIAL worked out a Data Management Plan that describes how the different data types (generated and/or collected by the project) are going to be managed in the project; in particular: (1) What standards will be used for these data discoverability, accessibility and (re-)use; (2) How these data will be exploited and/or shared/made accessible for verification and reuse; if data cannot be made available, the reasons will be fully explained; and (3) How these data will be curated and preserved, even after the project duration.

Exorcising the Ghost in the Machine: Synthetic Spectral Data Cubes for Assessing Big Data Algorithms

NASA Astrophysics Data System (ADS)

Araya, M.; Solar, M.; Mardones, D.; Hochfärber, T.

2015-09-01

The size and quantity of the data that is being generated by large astronomical projects like ALMA, requires a paradigm change in astronomical data analysis. Complex data, such as highly sensitive spectroscopic data in the form of large data cubes, are not only difficult to manage, transfer and visualize, but they make traditional data analysis techniques unfeasible. Consequently, the attention has been placed on machine learning and artificial intelligence techniques, to develop approximate and adaptive methods for astronomical data analysis within a reasonable computational time. Unfortunately, these techniques are usually sub optimal, stochastic and strongly dependent of the parameters, which could easily turn into “a ghost in the machine” for astronomers and practitioners. Therefore, a proper assessment of these methods is not only desirable but mandatory for trusting them in large-scale usage. The problem is that positively verifiable results are scarce in astronomy, and moreover, science using bleeding-edge instrumentation naturally lacks of reference values. We propose an Astronomical SYnthetic Data Observations (ASYDO), a virtual service that generates synthetic spectroscopic data in the form of data cubes. The objective of the tool is not to produce accurate astrophysical simulations, but to generate a large number of labelled synthetic data, to assess advanced computing algorithms for astronomy and to develop novel Big Data algorithms. The synthetic data is generated using a set of spectral lines, template functions for spatial and spectral distributions, and simple models that produce reasonable synthetic observations. Emission lines are obtained automatically using IVOA's SLAP protocol (or from a relational database) and their spectral profiles correspond to distributions in the exponential family. The spatial distributions correspond to simple functions (e.g., 2D Gaussian), or to scalable template objects. The intensity, broadening and radial velocity of each line is given by very simple and naive physical models, yet ASYDO's generic implementation supports new user-made models, which potentially allows adding more realistic simulations. The resulting data cube is saved as a FITS file, also including all the tables and images used for generating the cube. We expect to implement ASYDO as a virtual observatory service in the near future.

Overview of the Affordable Care Act's impact on military and veteran mental health services: nine implications for significant improvements in care.

PubMed

Russell, Mark C; Figley, Charles R

2014-01-01

On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Implications of the ACA on mental health care for 9.7 million military active-duty, reserve, and family members and 22.2 million veterans, as well as 1.3 uninsured veterans, is reviewed in light of a major crisis. The authors trace historical roots of the ACA to the World War II generation and efforts to transform the mental health care system by implementing hard-won war trauma lessons. The authors posit 9 principles reflected in the ACA that represent unfulfilled generational war trauma lessons and potential transformation of the military and national mental health care systems.

PARRoT- a homology-based strategy to quantify and compare RNA-sequencing from non-model organisms.

PubMed

Gan, Ruei-Chi; Chen, Ting-Wen; Wu, Timothy H; Huang, Po-Jung; Lee, Chi-Ching; Yeh, Yuan-Ming; Chiu, Cheng-Hsun; Huang, Hsien-Da; Tang, Petrus

2016-12-22

Next-generation sequencing promises the de novo genomic and transcriptomic analysis of samples of interests. However, there are only a few organisms having reference genomic sequences and even fewer having well-defined or curated annotations. For transcriptome studies focusing on organisms lacking proper reference genomes, the common strategy is de novo assembly followed by functional annotation. However, things become even more complicated when multiple transcriptomes are compared. Here, we propose a new analysis strategy and quantification methods for quantifying expression level which not only generate a virtual reference from sequencing data, but also provide comparisons between transcriptomes. First, all reads from the transcriptome datasets are pooled together for de novo assembly. The assembled contigs are searched against NCBI NR databases to find potential homolog sequences. Based on the searched result, a set of virtual transcripts are generated and served as a reference transcriptome. By using the same reference, normalized quantification values including RC (read counts), eRPKM (estimated RPKM) and eTPM (estimated TPM) can be obtained that are comparable across transcriptome datasets. In order to demonstrate the feasibility of our strategy, we implement it in the web service PARRoT. PARRoT stands for Pipeline for Analyzing RNA Reads of Transcriptomes. It analyzes gene expression profiles for two transcriptome sequencing datasets. For better understanding of the biological meaning from the comparison among transcriptomes, PARRoT further provides linkage between these virtual transcripts and their potential function through showing best hits in SwissProt, NR database, assigning GO terms. Our demo datasets showed that PARRoT can analyze two paired-end transcriptomic datasets of approximately 100 million reads within just three hours. In this study, we proposed and implemented a strategy to analyze transcriptomes from non-reference organisms which offers the opportunity to quantify and compare transcriptome profiles through a homolog based virtual transcriptome reference. By using the homolog based reference, our strategy effectively avoids the problems that may cause from inconsistencies among transcriptomes. This strategy will shed lights on the field of comparative genomics for non-model organism. We have implemented PARRoT as a web service which is freely available at http://parrot.cgu.edu.tw .

eHealth Use Among First-Generation Immigrants From Pakistan in the Oslo Area, Norway, With Focus on Diabetes: Survey Protocol

PubMed Central

Kjøllesdal, Marte Karoline Råberg; Mirkovic, Jelena; Andreassen, Hege Kristin

2016-01-01

Background A variety of eHealth services are available and commonly used by the general public. eHealth has the potential to engage and empower people with managing their health. The prerequisite is, however, that eHealth services are adapted to the sociocultural heterogeneity of the user base and are available in a language and with contents that fit the users’ preference, skills, and abilities. Pakistani immigrants in the Oslo area, Norway, have a much higher risk of Type-2 diabetes (T2D) than their Norwegian counterparts do. In spite of having access to information and communication technology (ICT) and the Internet, ICT skills in this population are reported to be relatively low. Further, there is insufficient information about their use of and attitudes toward eHealth services, necessitating investigation of this group in particular. Objective This study targets first-generation immigrants from Pakistan living in the Oslo area and examines their use of and attitudes toward eHealth services, specifically: information searches, communication using ICT, and use of ICT for self-management or decision making, all concerning T2D. Methods Due to a high prevalence of low literacy among the target population, we employed questionnaire-based individual interviews. The questionnaire was developed by implementing potentially relevant theoretical constructs (technology acceptance model (TAM) and health belief model (HBM)) as measures. To explore issues around language, culture, and general ICT skills, we also implemented questions that we assume were particularly relevant in the context studied but do not appear in any theoretical frameworks. The questionnaire was revised to reflect results of a pilot study involving 10 participants. We employed culturally sensitive sampling methods to reach informants who could otherwise fail to be included in the survey. Results This paper presents a survey protocol. The data collection is ongoing. The aim is to collect 200 responses in total by March 2016. Conclusions For eHealth to become an influential social innovation, equal access to eHealth services regardless of users’ language, culture, and ICT skills is a prerequisite. Results from this study will be of importance for understanding how people who may not maximally benefit from eHealth services today could be targeted in the future. PMID:27113854

Web service activities at the IRIS DMC to support federated and multidisciplinary access

NASA Astrophysics Data System (ADS)

Trabant, Chad; Ahern, Timothy K.

2013-04-01

At the IRIS Data Management Center (DMC) we have developed a suite of web service interfaces to access our large archive of, primarily seismological, time series data and related metadata. The goals of these web services include providing: a) next-generation and easily used access interfaces for our current users, b) access to data holdings in a form usable for non-seismologists, c) programmatic access to facilitate integration into data processing workflows and d) a foundation for participation in federated data discovery and access systems. To support our current users, our services provide access to the raw time series data and metadata or conversions of the raw data to commonly used formats. Our services also support simple, on-the-fly signal processing options that are common first steps in many workflows. Additionally, high-level data products derived from raw data are available via service interfaces. To support data access by researchers unfamiliar with seismic data we offer conversion of the data to broadly usable formats (e.g. ASCII text) and data processing to convert the data to Earth units. By their very nature, web services are programmatic interfaces. Combined with ubiquitous support for web technologies in programming & scripting languages and support in many computing environments, web services are very well suited for integrating data access into data processing workflows. As programmatic interfaces that can return data in both discipline-specific and broadly usable formats, our services are also well suited for participation in federated and brokered systems either specific to seismology or multidisciplinary. Working within the International Federation of Digital Seismograph Networks, the DMC collaborated on the specification of standardized web service interfaces for use at any seismological data center. These data access interfaces, when supported by multiple data centers, will form a foundation on which to build discovery and access mechanisms for data sets spanning multiple centers. To promote the adoption of these standardized services the DMC has developed portable implementations of the software needed to host these interfaces, minimizing the work required at each data center. Within the COOPEUS project framework, the DMC is working with EU partners to install web services implementations at multiple data centers in Europe.

Development and evaluation of SOA-based AAL services in real-life environments: a case study and lessons learned.

PubMed

Stav, Erlend; Walderhaug, Ståle; Mikalsen, Marius; Hanke, Sten; Benc, Ivan

2013-11-01

The proper use of ICT services can support seniors in living independently longer. While such services are starting to emerge, current proprietary solutions are often expensive, covering only isolated parts of seniors' needs, and lack support for sharing information between services and between users. For developers, the challenge is that it is complex and time consuming to develop high quality, interoperable services, and new techniques are needed to simplify the development and reduce the development costs. This paper provides the complete view of the experiences gained in the MPOWER project with respect to using model-driven development (MDD) techniques for Service Oriented Architecture (SOA) system development in the Ambient Assisted Living (AAL) domain. To address this challenge, the approach of the European research project MPOWER (2006-2009) was to investigate and record the user needs, define a set of reusable software services based on these needs, and then implement pilot systems using these services. Further, a model-driven toolchain covering key development phases was developed to support software developers through this process. Evaluations were conducted both on the technical artefacts (methodology and tools), and on end user experience from using the pilot systems in trial sites. The outcome of the work on the user needs is a knowledge base recorded as a Unified Modeling Language (UML) model. This comprehensive model describes actors, use cases, and features derived from these. The model further includes the design of a set of software services, including full trace information back to the features and use cases motivating their design. Based on the model, the services were implemented for use in Service Oriented Architecture (SOA) systems, and are publicly available as open source software. The services were successfully used in the realization of two pilot applications. There is therefore a direct and traceable link from the user needs of the elderly, through the service design knowledge base, to the service and pilot implementations. The evaluation of the SOA approach on the developers in the project revealed that SOA is useful with respect to job performance and quality. Furthermore, they think SOA is easy to use and support development of AAL applications. An important finding is that the developers clearly report that they intend to use SOA in the future, but not for all type of projects. With respect to using model-driven development in web services design and implementation, the developers reported that it was useful. However, it is important that the code generated from the models is correct if the full potential of MDD should be achieved. The pilots and their evaluation in the trial sites showed that the services of the platform are sufficient to create suitable systems for end users in the domain. A SOA platform with a set of reusable domain services is a suitable foundation for more rapid development and tailoring of assisted living systems covering reoccurring needs among elderly users. It is feasible to realize a tool-chain for model-driven development of SOA applications in the AAL domain, and such a tool-chain can be accepted and found useful by software developers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Service Learning for At-Risk Student Populations: The Contextual Dynamism of Implementation

ERIC Educational Resources Information Center

Akin, Jacob T.; Vesely, Randall S.

2016-01-01

The central purpose of this article is to explore research, issues, and perspectives on the implementation of service learning programs to improve student achievement in at-risk student populations. The implementation of service learning programs takes place within multiple contexts and across several terrains. The complexities of implementing…

Collaborating with community-based services to promote evidence-based practice: Process description of a national initiative to improve services for youth with mental health and substance use problems.

PubMed

Henderson, Joanna L; Chaim, Gloria; Brownlie, E B

2017-08-01

Many youth with significant mental health (MH) and/or substance use (SU) difficulties do not receive specialized services. Collaboration between service providers, researchers, and other stakeholders is essential to improve youth service system capacity to provide evidence-based services to meet the complex array of needs of youth. Facilitators and barriers of implementing evidence-based practice have been identified, but few studies provide examples of the processes of collaboration and implementation for youth MH services. This study explicates the design features and implementation processes of a project to improve screening activities in youth services. These processes supported the building of 16 collaborative networks of service providers from diverse youth-serving sectors (e.g., MH, youth justice, child welfare) in urban, rural, suburban, and remote Canadian communities. These cross-sectoral networks implemented an evidence-based practice (screening youth aged 12-24 years for MH and SU problems using the Global Assessment of Individual Needs-Short Screener [GAIN-SS]) across their services. Materials and resources were provided by a centralized research team. Core project components were standardized and adherence to these components was monitored. Over 800 service providers participated in cross-sectoral networks, capacity-building events, joint data analysis, or interpretation and recommendation sessions. Across the 89 participating agencies, service providers for 84% of participating youth implemented the evidence-based practice accurately in accordance with project protocols, with 98% of positive screens reviewed and addressed according to organizational protocols. Service provider feedback is reported. Facilitators, barriers, and implications of promoting implementation of evidence-based practices across sites and sectors are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

PubMed

Coetzee, L M; Cassim, N; Glencross, D K

2015-12-16

The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

Aiming for Service Excellence: Implementing a Plan for Customer Service Quality at a Blended Service Desk

ERIC Educational Resources Information Center

Oud, Joanne; Genzinger, Peter

2016-01-01

This article discusses a public service review and redesign that resulted in a blended service desk combining reference and circulation functions, staffed by nonlibrarians. The redesign implements a number of organizational structures that encourage service excellence, as found in the business literature and in examples of nonlibrary organizations…

Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

PubMed Central

Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian

2012-01-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

Developing and implementing health and sustainability guidelines for institutional food service.

PubMed

Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

2012-05-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

Policy implementation in practice: the case of national service frameworks in general practice.

PubMed

Checkland, Kath; Harrison, Stephen

2004-10-01

National Service Frameworks are an integral part of the government's drive to 'modernise' the NHS, intended to standardise both clinical care and the design of the services used to deliver that clinical care. This article uses evidence from qualitative case studies in three general practices to illustrate the difficulties associated with the implementation of such top-down guidelines and models of service. In these studies it was found that, while there had been little explicit activity directed at implementation overall, the National Service Framework for coronary heart disease had in general fared better than that for older people. Gunn's notion of 'perfect implementation' is used to make sense of the findings.

The Crucible simulation: Behavioral simulation improves clinical leadership skills and understanding of complex health policy change.

PubMed

Cohen, Daniel; Vlaev, Ivo; McMahon, Laurie; Harvey, Sarah; Mitchell, Andy; Borovoi, Leah; Darzi, Ara

2017-05-11

The Health and Social Care Act 2012 represents the most complex National Health Service reforms in history. High-quality clinical leadership is important for successful implementation of health service reform. However, little is known about the effectiveness of current leadership training. This study describes the use of a behavioral simulation to improve the knowledge and leadership of a cohort of medical doctors expected to take leadership roles in the National Health Service. A day-long behavioral simulation (The Crucible) was developed and run based on a fictitious but realistic health economy. Participants completed pre- and postsimulation questionnaires generating qualitative and quantitative data. Leadership skills, knowledge, and behavior change processes described by the "theory of planned behavior" were self-assessed pre- and postsimulation. Sixty-nine medical doctors attended. Participants deemed the simulation immersive and relevant. Significant improvements were shown in perceived knowledge, capability, attitudes, subjective norms, intentions, and leadership competency following the program. Nearly one third of participants reported that they had implemented knowledge and skills from the simulation into practice within 4 weeks. This study systematically demonstrates the effectiveness of behavioral simulation for clinical management training and understanding of health policy reform. Potential future uses and strategies for analysis are discussed. High-quality care requires understanding of health systems and strong leadership. Policymakers should consider the use of behavioral simulation to improve understanding of health service reform and development of leadership skills in clinicians, who readily adopt skills from simulation into everyday practice.

Economic grand rounds: financing first-episode psychosis services in the United States.

PubMed

Goldman, Howard H; Karakus, Mustafa; Frey, William; Beronio, Kirsten

2013-06-01

Adequate financing is essential to implementing services for individuals experiencing a first episode of a psychotic illness. Recovery After an Initial Schizophrenia Episode (RAISE), a project sponsored by the National Institute of Mental Health, is providing a practical test of the implementation and effectiveness of first-episode services in real-world settings. This column describes approaches to financing early intervention services that are being used at five of 18 U.S. sites participating in a clinical trial of a team-based, multielement RAISE intervention. The authors also describe new options for financing that will become available as the Affordable Care Act (ACA) is implemented more fully. The ACA will rationalize coverage of first-episode services, but the all-important Medicaid provisions will also require individual state action to implement services optimally.

New data model with better functionality for VLab

NASA Astrophysics Data System (ADS)

da Silveira, P. R.; Wentzcovitch, R. M.; Karki, B. B.

2009-12-01

The VLab infrastructure and architecture was further developed to allow for several new features. First, workflows for first principles calculations of thermodynamics properties and static elasticity programmed in Java as Web Services can now be executed by multiple users. Second, jobs generated by these workflows can now be executed in batch in multiple servers. A simple internal schedule was implemented to handle hundreds of execution packages generated by multiple users and avoid the overload on servers. Third, a new data model was implemented to guarantee integrity of a project (workflow execution) in case of failure. The latter can happen in an execution package or in a workflow phase. By recording all executed steps of a project, its execution can be resumed after dynamic alteration of parameters through the VLab Portal. Fourth, batch jobs can also be monitored through the portal. Now, better and faster interaction with servers is achieved using Ajax technology. Finally, plots are now created on the Vlab server using Gnuplot 4.2.2. Research supported by NSF grants ATM 0428774 (VLab). Vlab is hosted by the Minnesota Supercomputing Institute.

User Evaluation of the NASA Technical Report Server Recommendation Service

NASA Technical Reports Server (NTRS)

Nelson, Michael L.; Bollen, Johan; Calhoun, JoAnne R.; Mackey, Calvin E.

2004-01-01

We present the user evaluation of two recommendation server methodologies implemented for the NASA Technical Report Server (NTRS). One methodology for generating recommendations uses log analysis to identify co-retrieval events on full-text documents. For comparison, we used the Vector Space Model (VSM) as the second methodology. We calculated cosine similarities and used the top 10 most similar documents (based on metadata) as recommendations . We then ran an experiment with NASA Langley Research Center (LaRC) staff members to gather their feedback on which method produced the most quality recommendations. We found that in most cases VSM outperformed log analysis of co-retrievals. However, analyzing the data revealed the evaluations may have been structurally biased in favor of the VSM generated recommendations. We explore some possible methods for combining log analysis and VSM generated recommendations and suggest areas of future work.

User Evaluation of the NASA Technical Report Server Recommendation Service

NASA Technical Reports Server (NTRS)

Nelson, Michael L.; Bollen, Johan; Calhoun, JoAnne R.; Mackey, Calvin E.

2004-01-01

We present the user evaluation of two recommendation server methodologies implemented for the NASA Technical Report Server (NTRS). One methodology for generating recommendations uses log analysis to identify co-retrieval events on full-text documents. For comparison, we used the Vector Space Model (VSM) as the second methodology. We calculated cosine similarities and used the top 10 most similar documents (based on metadata) as 'recommendations'. We then ran an experiment with NASA Langley Research Center (LaRC) staff members to gather their feedback on which method produced the most 'quality' recommendations. We found that in most cases VSM outperformed log analysis of co-retrievals. However, analyzing the data revealed the evaluations may have been structurally biased in favor of the VSM generated recommendations. We explore some possible methods for combining log analysis and VSM generated recommendations and suggest areas of future work.

Hybrid Storage Market Assessment: A JISEA White Paper

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

Ericson, Sean J.; Rose, Eric; Jayaswal, Harshit

This white paper evaluates which markets are best suited for battery storage and storage hybrids and reviews regulations and incentives that support or impede the implementation of standalone storage and battery hybrids. The costs of battery storage technologies have dropped in recent years, resulting in a seven-fold increase in installed capacity over the last decade (1). These technologies offer an attractive rate of return in some locations; however, cost and regulatory barriers still limit the market for storage. Hybridizing a battery (combining the battery with a generator) can in some instances reduce total system costs and increase value compared tomore » separate installations. The fast ramping and dispatchability of a battery can complement the generator to provide services that neither battery nor generator could provide alone. Battery hybrids also benefit from some policy incentives and may be better able to meet market and regulatory requirements.« less

42 CFR 441.575 - Development and Implementation Council.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and implementing a State plan amendment to provide Community First Choice services and supports. ... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice...

Wellness in the healing ministry.

PubMed

Burke, B K

1993-09-01

Wellness has gained a foothold in most healthcare delivery systems because of its focus: Keeping people well is the ultimate goal of a healthcare system. Three generations of wellness models have evolved over the past 16 years. First-generation wellness efforts focus on reducing health risks. Hospitals have developed programs and services to improve customers' and employees' health status. And corporations are lowering health risks by offering employees worksite fitness centers, cholesterol and other screenings, and smoking-cessation programs. Second-generation wellness efforts link wellness to benefits. Hospitals and corporations have implemented health incentive programs, structured to reward people for maintaining low ranges in their controllable health risk factors. Third-generation wellness efforts show that connectedness can improve health. Such efforts emphasize the importance of spiritual and emotional well-being as an inextricable part of physical health and healing. Today prayer and support groups, guided imagery, and prayerful meditation are becoming more mainstream. Such wellness approaches encourage persons to think and care for themselves more holistically.

High-Performance CCSDS Encapsulation Service Implementation in FPGA

NASA Technical Reports Server (NTRS)

Clare, Loren P.; Torgerson, Jordan L.; Pang, Jackson

2010-01-01

The Consultative Committee for Space Data Systems (CCSDS) Encapsulation Service is a convergence layer between lower-layer space data link framing protocols, such as CCSDS Advanced Orbiting System (AOS), and higher-layer networking protocols, such as CFDP (CCSDS File Delivery Protocol) and Internet Protocol Extension (IPE). CCSDS Encapsulation Service is considered part of the data link layer. The CCSDS AOS implementation is described in the preceding article. Recent advancement in RF modem technology has allowed multi-megabit transmission over space links. With this increase in data rate, the CCSDS Encapsulation Service needs to be optimized to both reduce energy consumption and operate at a high rate. CCSDS Encapsulation Service has been implemented as an intellectual property core so that the aforementioned problems are solved by way of operating the CCSDS Encapsulation Service inside an FPGA. The CCSDS En capsula tion Service in FPGA implementation consists of both packetizing and de-packetizing features

A Workflow-based Intelligent Network Data Movement Advisor with End-to-end Performance Optimization

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

Zhu, Michelle M.; Wu, Chase Q.

2013-11-07

Next-generation eScience applications often generate large amounts of simulation, experimental, or observational data that must be shared and managed by collaborative organizations. Advanced networking technologies and services have been rapidly developed and deployed to facilitate such massive data transfer. However, these technologies and services have not been fully utilized mainly because their use typically requires significant domain knowledge and in many cases application users are even not aware of their existence. By leveraging the functionalities of an existing Network-Aware Data Movement Advisor (NADMA) utility, we propose a new Workflow-based Intelligent Network Data Movement Advisor (WINDMA) with end-to-end performance optimization formore » this DOE funded project. This WINDMA system integrates three major components: resource discovery, data movement, and status monitoring, and supports the sharing of common data movement workflows through account and database management. This system provides a web interface and interacts with existing data/space management and discovery services such as Storage Resource Management, transport methods such as GridFTP and GlobusOnline, and network resource provisioning brokers such as ION and OSCARS. We demonstrate the efficacy of the proposed transport-support workflow system in several use cases based on its implementation and deployment in DOE wide-area networks.« less

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

PubMed

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

2018-02-07

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

Implementation Evaluation in a Private Nonprofit Setting: A Mixed-Methods Approach

ERIC Educational Resources Information Center

Walker, Jacquelyn Ann

2013-01-01

Demand for quality service provision in the human services industry requires that private nonprofit organizations have the administrative and management capacities to ensure successful implementation and sustain staff development programs. Unfamiliarity with implementation challenges, and limited awareness of implementation strategies, can trigger…

The Impact of Perceived Need and Relational Factors on Mental Health Service Use Among Generations of Asian Americans.

PubMed

Lee, Minsun; Takeuchi, David; Gellis, Zvi; Kendall, Philip; Zhu, Lin; Zhao, Shanyang; Ma, Grace X

2017-08-01

The present study examined generational differences in the patterns and predictors of formal and informal mental health service utilization among a nationally representative sample of 1850 Asian Americans from the National Latino and Asian American Study. We focused on the effects of perceived need and relational factors on service utilization among 1st-, 1.5-, and 2nd-generation Asian Americans. Results of hierarchical logistic regression showed significant intergenerational differences. Specifically, 1.5-generation Asian Americans exhibited distinctive pattern of service use, with perceived need being associated with a higher likelihood of using formal mental health services, but only for those with high level of social support. First- and second-generation Asian Americans, on the other hand, perceived need was independently associated with formal service use, and a significant predictor of informal service use for first generation. Greater family conflict was also associated with greater use of formal and informal services for both first- and second generations. However, family cohesion was associated with only informal service use among first -generation Asian Americans. Implications for mental health service policy were discussed.

Method to implement the CCD timing generator based on FPGA

NASA Astrophysics Data System (ADS)

Li, Binhua; Song, Qian; He, Chun; Jin, Jianhui; He, Lin

2010-07-01

With the advance of the PFPA technology, the design methodology of digital systems is changing. In recent years we develop a method to implement the CCD timing generator based on FPGA and VHDL. This paper presents the principles and implementation skills of the method. Taking a developed camera as an example, we introduce the structure, input and output clocks/signals of a timing generator implemented in the camera. The generator is composed of a top module and a bottom module. The bottom one is made up of 4 sub-modules which correspond to 4 different operation modes. The modules are implemented by 5 VHDL programs. Frame charts of the architecture of these programs are shown in the paper. We also describe implementation steps of the timing generator in Quartus II, and the interconnections between the generator and a Nios soft core processor which is the controller of this generator. Some test results are presented in the end.

29 CFR 779.371 - Some automobile, truck, and farm implement establishments may qualify for exemption under section...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Some automobile, truck, and farm implement establishments... OR SERVICES Exemptions for Certain Retail or Service Establishments Automobile, Truck and Farm Implement Sales and Services, and Trailer, Boat and Aircraft Sales § 779.371 Some automobile, truck, and...

29 CFR 779.371 - Some automobile, truck, and farm implement establishments may qualify for exemption under section...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Some automobile, truck, and farm implement establishments... OR SERVICES Exemptions for Certain Retail or Service Establishments Automobile, Truck and Farm Implement Sales and Services, and Trailer, Boat and Aircraft Sales § 779.371 Some automobile, truck, and...

29 CFR 779.371 - Some automobile, truck, and farm implement establishments may qualify for exemption under section...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Some automobile, truck, and farm implement establishments... OR SERVICES Exemptions for Certain Retail or Service Establishments Automobile, Truck and Farm Implement Sales and Services, and Trailer, Boat and Aircraft Sales § 779.371 Some automobile, truck, and...

29 CFR 779.371 - Some automobile, truck, and farm implement establishments may qualify for exemption under section...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Some automobile, truck, and farm implement establishments... OR SERVICES Exemptions for Certain Retail or Service Establishments Automobile, Truck and Farm Implement Sales and Services, and Trailer, Boat and Aircraft Sales § 779.371 Some automobile, truck, and...

The First Six Years of Building and Implementing a Return-to-Work Service for Patients with Acquired Brain Injury. The Rapid-Return-to-Work-Cohort-Study.

PubMed

Haveraaen, L; Brouwers, E P M; Sveen, U; Skarpaas, L S; Sagvaag, H; Aas, R W

2017-12-01

Background and objective Despite large activity worldwide in building and implementing new return-to-work (RTW) services, few studies have focused on how such implementation processes develop. The aim of this study was to examine the development in patient and service characteristics the first six years of implementing a RTW service for persons with acquired brain injury (ABI). Methods The study was designed as a cohort study (n=189). Data were collected by questionnaires, filled out by the service providers. The material was divided into, and analyzed with, two implementation phases. Non-parametrical statistical methods and hierarchical regression analyses were applied on the material. Results The number of patients increased significantly, and the patient group became more homogeneous. Both the duration of the service, and the number of consultations and group session days were significantly reduced. Conclusion The patient group became more homogenous, but also significantly larger during the first six years of building the RTW service. At the same time, the duration of the service decreased. This study therefore questions if there is a lack of consensus on the intensity of work rehabilitation for this group.

Sobriety Treatment and Recovery Teams: Implementation Fidelity and Related Outcomes.

PubMed

Huebner, Ruth A; Posze, Lynn; Willauer, Tina M; Hall, Martin T

2015-01-01

Although integrated programs between child welfare and substance abuse treatment are recommended for families with co-occurring child maltreatment and substance use disorders, implementing integrated service delivery strategies with fidelity is a challenging process. This study of the first five years of the Sobriety Treatment and Recovery Team (START) program examines implementation fidelity using a model proposed by Carroll et al. (2007). The study describes the process of strengthening moderators of implementation fidelity, trends in adherence to START service delivery standards, and trends in parent and child outcomes. Qualitative and quantitative measures were used to prospectively study three START sites serving 341 families with 550 parents and 717 children. To achieve implementation fidelity to service delivery standards required a pre-service year and two full years of operation, persistent leadership, and facilitative actions that challenged the existing paradigm. Over four years of service delivery, the time from the child protective services report to completion of five drug treatment sessions was reduced by an average of 75 days. This trend was associated with an increase in parent retention, parental sobriety, and parent retention of child custody. Conclusions/Importance: Understanding the implementation processes necessary to establish complex integrated programs may support realistic allocation of resources. Although implementation fidelity is a moderator of program outcome, complex inter-agency interventions may benefit from innovative measures of fidelity that promote improvement without extensive cost and data collection burden. The implementation framework applied in this study was useful in examining implementation processes, fidelity, and related outcomes.

Health diplomacy the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: Evaluating findings from Project Accept (HPTN 043)

PubMed Central

2012-01-01

Background Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of ‘global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. Methods We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Results Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of ‘youth-friendly’ services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand: and adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). Conclusions Adaptation selection, development and approval during multi-site global health research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a global health diplomacy perspective. PMID:22716131

Establishment, Implementation, and Consolidation of Clinical Pharmacy Services in Community Pharmacies: Perceptions of a Group of Pharmacists.

PubMed

Dosea, Aline S; Brito, Giselle C; Santos, Lincoln M C; Marques, Tatiane C; Balisa-Rocha, Blície; Pimentel, Deborah; Bueno, Denise; Lyra, Divaldo P

2017-02-01

When pharmacists incorporate clinical practice into their routine, barriers and facilitators influence the implementation of patient care services. Three focus groups were conducted with 11 pharmacists who were working for the Farmácia Popular do Brasil program on the establishment, implementation, and consolidation of clinical pharmacy services. The perception of the pharmacists in Brazil about the program was that it facilitated access to health care and medication. The distance between neighboring cities made it difficult for patients to return for services. Lack of staff training created a lack of communication skills and knowledge. The pharmacists wanted to have increased technical support, skill development opportunities, and monitoring of researchers who assessed progress of the service. Pharmacists overcame many of their insecurities and felt more proactive and committed to quality service. Positive experiences in service implementations have shown that it is possible to develop a model of clinical services in community pharmacies.

Financial management using a computerized system for evaluating health care invoices.

PubMed

Magnezi, Racheli; Ashkenazi, Isaac

2005-02-01

The Medical Corps of the Israel Defense Forces (IDF) provides health care services for hundreds of thousands of soldiers in IDF clinics and by purchasing services from civilian institutes. Monthly invoices from civilian institutes are so numerous that most are paid with insufficient scrutiny and valuable information regarding soldiers' health care is lost. Our objective was to develop a computerized system for reviewing invoices and gathering data. Based on Oracle software (Oracle, Redwood Shores, California), the system stores the terms of agreements with medical institutes, enters billing data, calculates invoice totals, manages information, and generates reports. It automatically checks for duplicate invoices and confirms payment. The system allows users to view data for decision-making, creates insurance claim files, identifies incorrect charges, assists in quality assurance, and maintains personal patient records. With the system in operation since 2001, savings significantly increased, to approximately 5% of the IDF health care budget. On the basis of information gathered by the system, changes in medical procedures were implemented that are expected to generate even greater savings.

eTOXlab, an open source modeling framework for implementing predictive models in production environments.

PubMed

Carrió, Pau; López, Oriol; Sanz, Ferran; Pastor, Manuel

2015-01-01

Computational models based in Quantitative-Structure Activity Relationship (QSAR) methodologies are widely used tools for predicting the biological properties of new compounds. In many instances, such models are used as a routine in the industry (e.g. food, cosmetic or pharmaceutical industry) for the early assessment of the biological properties of new compounds. However, most of the tools currently available for developing QSAR models are not well suited for supporting the whole QSAR model life cycle in production environments. We have developed eTOXlab; an open source modeling framework designed to be used at the core of a self-contained virtual machine that can be easily deployed in production environments, providing predictions as web services. eTOXlab consists on a collection of object-oriented Python modules with methods mapping common tasks of standard modeling workflows. This framework allows building and validating QSAR models as well as predicting the properties of new compounds using either a command line interface or a graphic user interface (GUI). Simple models can be easily generated by setting a few parameters, while more complex models can be implemented by overriding pieces of the original source code. eTOXlab benefits from the object-oriented capabilities of Python for providing high flexibility: any model implemented using eTOXlab inherits the features implemented in the parent model, like common tools and services or the automatic exposure of the models as prediction web services. The particular eTOXlab architecture as a self-contained, portable prediction engine allows building models with confidential information within corporate facilities, which can be safely exported and used for prediction without disclosing the structures of the training series. The software presented here provides full support to the specific needs of users that want to develop, use and maintain predictive models in corporate environments. The technologies used by eTOXlab (web services, VM, object-oriented programming) provide an elegant solution to common practical issues; the system can be installed easily in heterogeneous environments and integrates well with other software. Moreover, the system provides a simple and safe solution for building models with confidential structures that can be shared without disclosing sensitive information.

Funding Mechanisms for Ecosystem Services Projects

NASA Astrophysics Data System (ADS)

Russell, V.

2014-12-01

Ecosystem services projects ideally should be funded through commoditized markets. Where those markets do not exist financing directly from interested private sector parties can be a direct link between business interested in fulfilling sustainability goals and project implementers. Challenges exist, however in 1) linking those interests; 2) carefully quantifying the services produced, their true costs to implement and meeting protocol standards; 3) measuring the success of projects, especially over lengthy periods of time; and 4) balancing issues related to multiple spatial scales for projects and funding to make a difference. Examples from National Forest Foundation's experience implementing carbon and water projects with multiple private sector funders and the USDA Forest Service will highlight experiences and lessons learned in funding and implementing ecosystem service projects.

Implementation of cloud computing in higher education

NASA Astrophysics Data System (ADS)

Asniar; Budiawan, R.

2016-04-01

Cloud computing research is a new trend in distributed computing, where people have developed service and SOA (Service Oriented Architecture) based application. This technology is very useful to be implemented, especially for higher education. This research is studied the need and feasibility for the suitability of cloud computing in higher education then propose the model of cloud computing service in higher education in Indonesia that can be implemented in order to support academic activities. Literature study is used as the research methodology to get a proposed model of cloud computing in higher education. Finally, SaaS and IaaS are cloud computing service that proposed to be implemented in higher education in Indonesia and cloud hybrid is the service model that can be recommended.

Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

PubMed

Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

2017-03-10

This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

Writing for publication: institutional support provides an enabling environment.

PubMed

Kramer, Beverley; Libhaber, Elena

2016-04-18

Due to the excessive service delivery loads in public hospitals supported by academic institutions in developing environments, researchers at these institutions have little time to develop scientific writing skills or to write up their research. It is imperative to expand the writing skills of researchers and train the next generation of health sciences academics in order to disseminate research findings. This study reports on the implementation of approaches for writing and publication and the extent of support to staff suffering from the overload of service delivery and of heavy teaching duties. Workshops in scientific writing and writing retreats were initiated and were offered to all staff. Feedback from participants of the writing skills workshops indicated that the workshops provided an injection of confidence and proficiency. Protected writing time resulted in 132 papers submitted to journals and 95 in preparation from 230 participants of the writing retreats over a two year period. Staff commended the off-site, collegial environment, which also supported future collaboration with new-found colleagues. This enabling environment facilitates not only the development of writing skills per se, but also the dissemination of the generated scientific knowledge. In addition, the training in writing skills of this generation will be of value in the training of future cohorts in countries with similar health care deliverables.

Patients’ Data Management System Protected by Identity-Based Authentication and Key Exchange

PubMed Central

Rivero-García, Alexandra; Santos-González, Iván; Hernández-Goya, Candelaria; Caballero-Gil, Pino; Yung, Moti

2017-01-01

A secure and distributed framework for the management of patients’ information in emergency and hospitalization services is proposed here in order to seek improvements in efficiency and security in this important area. In particular, confidentiality protection, mutual authentication, and automatic identification of patients are provided. The proposed system is based on two types of devices: Near Field Communication (NFC) wristbands assigned to patients, and mobile devices assigned to medical staff. Two other main elements of the system are an intermediate server to manage the involved data, and a second server with a private key generator to define the information required to protect communications. An identity-based authentication and key exchange scheme is essential to provide confidential communication and mutual authentication between the medical staff and the private key generator through an intermediate server. The identification of patients is carried out through a keyed-hash message authentication code. Thanks to the combination of the aforementioned tools, a secure alternative mobile health (mHealth) scheme for managing patients’ data is defined for emergency and hospitalization services. Different parts of the proposed system have been implemented, including mobile application, intermediate server, private key generator and communication channels. Apart from that, several simulations have been performed, and, compared with the current system, significant improvements in efficiency have been observed. PMID:28362328

RFIC's challenges for third-generation wireless systems

NASA Astrophysics Data System (ADS)

Boric-Lubecke, Olga; Lin, Jenshan; Gould, Penny; Kermalli, Munawar

2001-11-01

Third generation (3G) cellular wireless systems are envisioned to offer low cost, high-capacity mobile communications with data rates of up to 2 Mbit/s, with global roaming and advanced data services. Besides adding mobility to the internet, 3G systems will provide location-based services, as well as personalized information and entertainment. Low cost, high dynamic-range radios, both for base stations (BS) and for mobile stations (MS) are required to enable worldwide deployment of such networks. A receiver's reference sensitivity, intermodulation characteristics, and blocking characteristics, set by a wireless standard, define performance requirements of individual components of a receiver front end. Since base station handles multiple signals from various distances simultaneously, its radio specifications are significantly more demanding than those for mobile devices. While high level of integration has already been achieved for second generation hand-sets using low-cost silicon technologies, the cost and size reduction of base stations still remains a challenge and necessity. While silicon RFIC technology is steadily improving, it is still difficult to achieve noise figure (NF), linearity, and phase noise requirements with presently available devices. This paper will discuss base station specification for 2G (GSM) and 3G (UMTS) systems, as well as the feasibility of implementing base station radios in low-cost silicon processes.

Patients' Data Management System Protected by Identity-Based Authentication and Key Exchange.

PubMed

Rivero-García, Alexandra; Santos-González, Iván; Hernández-Goya, Candelaria; Caballero-Gil, Pino; Yung, Moti

2017-03-31

A secure and distributed framework for the management of patients' information in emergency and hospitalization services is proposed here in order to seek improvements in efficiency and security in this important area. In particular, confidentiality protection, mutual authentication, and automatic identification of patients are provided. The proposed system is based on two types of devices: Near Field Communication (NFC) wristbands assigned to patients, and mobile devices assigned to medical staff. Two other main elements of the system are an intermediate server to manage the involved data, and a second server with a private key generator to define the information required to protect communications. An identity-based authentication and key exchange scheme is essential to provide confidential communication and mutual authentication between the medical staff and the private key generator through an intermediate server. The identification of patients is carried out through a keyed-hash message authentication code. Thanks to the combination of the aforementioned tools, a secure alternative mobile health (mHealth) scheme for managing patients' data is defined for emergency and hospitalization services. Different parts of the proposed system have been implemented, including mobile application, intermediate server, private key generator and communication channels. Apart from that, several simulations have been performed, and, compared with the current system, significant improvements in efficiency have been observed.

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.

In-situ medical simulation for pre-implementation testing of clinical service in a regional hospital in Hong Kong.

PubMed

Chen, P P; Tsui, N Tk; Fung, A Sw; Chiu, A Hf; Wong, W Cw; Leong, H T; Lee, P Sf; Lau, J Yw

2017-08-01

The implementation of a new clinical service is associated with anxiety and challenges that may prevent smooth and safe execution of the service. Unexpected issues may not be apparent until the actual clinical service commences. We present a novel approach to test the new clinical setting before actual implementation of our endovascular aortic repair service. In-situ simulation at the new clinical location would enable identification of potential process and system issues prior to implementation of the service. After preliminary planning, a simulation test utilising a case scenario with actual simulation of the entire care process was carried out to identify any logistic, equipment, settings or clinical workflow issues, and to trial a contingency plan for a surgical complication. All patient care including anaesthetic, surgical, and nursing procedures and processes were simulated and tested. Overall, 17 vital process and system issues were identified during the simulation as potential clinical concerns. They included difficult patient positioning, draping pattern, unsatisfactory equipment setup, inadequate critical surgical instruments, blood products logistics, and inadequate nursing support during crisis. In-situ simulation provides an innovative method to identify critical deficiencies and unexpected issues before implementation of a new clinical service. Life-threatening and serious practical issues can be identified and corrected before formal service commences. This article describes our experience with the use of simulation in pre-implementation testing of a clinical process or service. We found the method useful and would recommend it to others.

The implementation of the Care Programme Approach for service users with a learning disability. Building Bridges to the same Old Horizons?

PubMed

Kelly, M

2017-08-01

WHAT IS KNOWN ON THE SUBJECT?: People with mental health problems and learning disabilities often do not receive the care they require. The Care Programme Approach (CPA) is meant to help with this. However, there have been many problems in the past with the introduction of the CPA into mental health services. There is no literature which explores what factors help or hinder the introduction of the CPA for service users with a mental health and learning disability, especially from the perspective of those responsible for overseeing this process. WHAT DOES THIS ARTICLE ADD TO EXISTING KNOWLEDGE?: The implementation of the CPA for this service user group is fragmented, and services are not working together in partnership. The CPA is being effectively implemented for people who are deemed to present with a risk to themselves or others. If a service user does not present with a high risk, they are not provided care through the CPA. Service users were not involved in the development or introduction of the policy in practice. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Services need to work better at engaging service users when they are developing and introducing new policies. Rather than applying the CPA for all service users, across all services, it should only be considered for those deemed to present with a high risk. It is effectively implemented for these people. For those not deemed to present with a high risk, services should consider using alternative service user led care planning frameworks. Introduction The Care Programme Approach was introduced in England to ensure services met the needs of people with mental health problems and a concurrent learning disability (dual diagnosis). The CPA implementation was patchy and services failed to work in partnership. Aim This study aimed to explore the factors shaping the recent implementation of the CPA for service users with a dual diagnosis. Method A single case study approach was undertaken. Data were collected through interview (n = 26), documentary analysis (n = 64), steering group observation (n = 3) and the Partnership Assessment Tool (n = 26). Data were analysed using the Framework Approach. Results The CPA was only effectively implemented for people who were deemed to present with a high level of risk. Discussion The problems associated with implementation in the 1990s continue more recently for those with a dual diagnosis. The CPA has become more aligned with risk management protocols than supporting individual service user's recovery. Implications for practice Service users should be involved in the implementation of policies which have an impact on their recovery. The CPA should only be applied for those who present with high-risk issues, whilst alternative user-led initiatives should be considered for other service users. © 2017 John Wiley & Sons Ltd.

Investigating Pre-service Science Teachers' Developing Professional Knowledge Through the Lens of Differentiated Instruction

NASA Astrophysics Data System (ADS)

Goodnough, Karen

2010-03-01

In this study, the author implemented a problem-based learning (PBL) experience that allowed students in an advanced science methodology course to explore differentiated instruction. Through working systematically in small, collaborative groups, students explored the nature of differentiated instruction. The objective of the study was to examine pre-service teachers’ developing conceptions of differentiated instruction (DI) as a way to teach for diversity. The author adopted action research as a strategy to explore students’ perceptions of DI in the context of science teaching and learning. Several data collection methods and sources were adopted in the study, including student-generated products, student interviews, classroom observation, and journal writing. Outcomes report on students’ perceptions of both the potential and challenges associated with adopting a DI approach to science teaching and learning.

[Glass ceiling and slippery stairs? Gender inequalities and strategies for change in the Spanish Society of Public Health and Health Services Administration].

PubMed

Colomer Revuelta, C; Peiró Pérez, R

2002-01-01

In scientific societies, as in other social fields, women's participation in decision making is lower than that of men. We describe the situation in SESPAS (Spanish Society of Public Health and Health Services Administration) where, despite representing a 40% of its members, very few women have been in positions in which decisions are taken or in those of professional recognition. The process of change implemented during recent years and some of the effects of the actions taken are presented. Making the existing inequalities known has generated debate and interest in the intervention. A gender and public health working group was set up. In the last two years more women have been promoted to more senior positions in SESPAS.

Comparative study: TQ and Lean Production ownership models in health services

PubMed Central

Eiro, Natalia Yuri; Torres-Junior, Alvair Silveira

2015-01-01

Objective: compare the application of Total Quality (TQ) models used in processes of a health service, cases of lean healthcare and literature from another institution that has also applied this model. Method: this is a qualitative research that was conducted through a descriptive case study. Results: through critical analysis of the institutions studied it was possible to make a comparison between the traditional quality approach checked in one case and the theoretical and practice lean production approach used in another case and the specifications are described below. Conclusion: the research identified that the lean model was better suited for people that work systemically and generate the flow. It also pointed towards some potential challenges in the introduction and implementation of lean methods in health. PMID:26487134

Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

PubMed

Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

2016-09-06

Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed.

Engineering calculations for communications satellite systems planning

NASA Technical Reports Server (NTRS)

Martin, C. H.; Gonsalvez, D. J.; Levis, C. A.; Wang, C. W.

1983-01-01

Progress is reported on a computer code to improve the efficiency of spectrum and orbit utilization for the Broadcasting Satellite Service in the 12 GHz band for Region 2. It implements a constrained gradient search procedure using an exponential objective function based on aggregate signal to noise ratio and an extended line search in the gradient direction. The procedure is tested against a manually generated initial scenario and appears to work satisfactorily. In this test it was assumed that alternate channels use orthogonal polarizations at any one satellite location.

New control center for EPM in Medellin, Columbia

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

Gomez, H.C.; Zadeh, K.N.; Meyer, R.C.

1989-07-01

The municipal electric utility of Empresas Publicas de Medellin (EPM) in Medellin, Colombia, has completed the installation and testing of their new control center. These facilities, which include all the functions expected from a modern control center, were implemented through carefully monitored and executed project stages, which are described in this article. EPM generates and transmits 1400 MW of exclusively hydroelectric energy to their service territory of the city of Medellin and nine neighboring cities and 77 smaller cities. The EPM system load ranges from 400 MW to 1200 MW.

Finding of No Significant Impact: Repair and Renovate Airborne Warning and Control System Maintenance Group Complex, Building 230 Tinker Air Force Base Oklahoma City, Oklahoma

DTIC Science & Technology

2012-02-01

BASE OKLAHOMA CITY, OKLAHOMA An Environmental Assessment (EA) has been prepared to assess the potential effects on the human and natural...hangars, and associated administrative and shop areas to allow the 552d ACW to inspect, service, and maintain E-3 AWACS aircraft safely and effectively ...maintain Tinker AFB’s mission effectiveness and optimize the 552d ACW’s sortie generation rates. Implementing the Proposed Action would provide a

The Design and Development of a Management Information System for the Monterey Navy Flying Club.

DTIC Science & Technology

1986-03-27

Management Information System for the Monterey Navy Flying Club. It supplies the tools necessary to enable the club manager to maintain all club records and generate required administrative and financial reports. The Monterey Navy Flying Club has one of the largest memberships of the Navy sponsored flying clubs. As a result of this large membership and the amount of manual paperwork required to properly maintain club records, the Manager’s ability to provide necessary services and reports in severely hampered. The implementation of an efficient

Operational recovery of turbine No. 3 at Potomac Edison`s Dam No. 4 hydrogenerating facility

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

Pelczar, R.S.

1995-12-31

The Potomac Edison Dam No. 4 hydroelectric generating station is a historic, turn of the century facility located on the Potomac River near Shepherdstown, West Virginia. The station, originally constructed in 1909, employed twin horizontal Francis hydroturbine generating systems. The systems are unique in that the turbines and generators are offset 37 feet, interconnected by rope and sheaves. In May 1989 a third vertical open flume turbine generating system was added to make use of available site capacity. Both the turbine and speed increaser were the largest products developed by their respective manufacturers for a hydro turbine-generator application. This papermore » will review the subsequent operational experience which led to the original speed increaser failure on unit No. 3 and replacement of the drive system including special design considerations to the replacement speed increaser and its support structure. Specific design challenges included: (1) Designing and implementing a reliable configuration. (2) Reducing operational sound levels. (3) Minimizing harmful structure-borne vibrations which were affecting the internal rotating elements. (4) Incorporating a system brake for emergency and service purposes.« less

The Center for In-Service Education. Final Evaluation Report. Volume I. Part 1.

ERIC Educational Resources Information Center

Tennessee State Dept. of Education, Nashville.

The primary objectives of the Center for In-Service Education in implementing a model for in-service education were to a) implement and demonstrate the comprehensive in-service model developed during the planning phase, b) provide coordinated planning of in-service education for all participating school systems, c) directly assist regional…

Common Misconceptions About Service-Oriented Architecture

DTIC Science & Technology

2007-11-01

addition, the architect(s) must make decisions on how services are implemented. Service implementations may involve developing new software , wrapping a...legacy software system, incor- porating services provided by third par- ties, or a combination of these options. Information about the quality attrib...temperature. However, there 28 CROSSTALK The Journal of Defense Software Engineering November 2007 Common Misconceptions About Service -Oriented

Implementing Service Learning into a Graduate Social Work Course: A Step-by-Step Guide

ERIC Educational Resources Information Center

Campbell, Evelyn Marie

2012-01-01

Service learning is a powerful pedagogical tool linking community service to academic learning. Several steps are necessary to implement service learning effectively into the curriculum. This study uses a case example as an exploratory study to pilot-test data on how service learning impacts student outcomes. The paper will (1) provide an overview…

Development and implementation of the compensation plan for pharmacy services in Alberta, Canada.

PubMed

Breault, Rene R; Whissell, Jeff G; Hughes, Christine A; Schindel, Theresa J

To describe experiences with development and implementation of a compensation plan for pharmacy services delivered by pharmacists in community pharmacies. Community pharmacy practice in Alberta, Canada. Pharmacists in Alberta have one of the most progressive scopes of practice in North America. They have authority to prescribe drugs independently, administer drugs by injection, access electronic health records, and order laboratory tests. A publicly funded compensation plan for pharmacy services was implemented in 2012. Principles that guided development of the compensation plan aimed to 1) ensure payment for pharmacy services, 2) support pharmacists in using their full scope of practice, 3) enable the development of long-term relationships with patients, 4) facilitate expansion of services delivered by pharmacists, and 5) provide access to pharmacy services for all eligible Albertans. Services covered by the compensation plan include care planning, prescribing, and administering drugs by injection. The guiding principles were used to evaluate experiences with the compensation plan. Claims for pharmacy services covered by the compensation plan increased from 30,000 per month in July 2012 to 170,000 per month in March 2016. From September 2015 to August 2016, 1226 pharmacies submitted claims for services provided by 3901 pharmacists. The number of pharmacists with authorization to prescribe and administer injections continued to increase following implementation of the plan. Alberta's experiences with the development and implementation of the compensation plan will be of interest to jurisdictions considering implementation of remunerated pharmacy services. The potential impact of the plan on health and economic outcomes, in addition to the value of the services as perceived by the public, patients, pharmacists, and other health care providers, should also be explored. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

[Inpatient pain consultation service at a university hospital: a retrospective analysis of patient characteristics and the rate of the implementation of recommendations].

PubMed

Lassen, C L; Sommer, M; Meyer, N; Klier, T W; Graf, B M; Pawlik, M T; Wiese, C H R

2012-08-01

The aim of this study was to conduct an audit of a university inpatient pain consultation service and to examine the quality and the implementation of the recommended therapeutic measures. Factors that influenced the implementation should be identified. All inpatients treated by the consultation service in the years 2009 and 2010 were analyzed retrospectively. Demographic patient characteristics as well as quality parameters of the consultation service and pharmacological and non-pharmacological recommendations and their implementation were analyzed. In total 1,048 requests for the consultation service were processed of which 39.7% of the requests were for patients with acute pain, 33.8% with chronic and 19.9% with tumor-associated pain. Measures recommended most were medication, physiotherapy and psychological treatment. Recommended medications were actually prescribed in more than 80%, physiotherapy recommended in about 75% and psychological treatment recommended in 47% of the cases. Only a few influencing factors for the implementation of the recommended measures could be identified. Many different pain states are seen in an inpatient pain consultation service. The recommendations given are implemented in most cases especially concerning the medication.

Implementation of the Strengths Model at an area mental health service.

PubMed

Chopra, Prem; Hamilton, Bridget; Castle, David; Smith, Jenny; Mileshkin, Cris; Deans, Michael; Wynne, Brad; Prigg, Glenn; Toomey, Nigel; Wilson, Michael

2009-06-01

The objectives of this paper are to provide an overview of recovery-focused models of care and discuss the implementation of the Strengths Model at St. Vincent's Mental Health Melbourne (SVMH), Victoria, Australia. The implementation of the Strengths Model at SVMH is discussed with particular emphasis on the process of implementation, service implications, practical challenges and dilemmas that have arisen, and proposed evaluation. Recovery-focused care is feasible and can enhance current practice of mental health services.

20 CFR 1010.220 - How are recipients required to implement priority of service?

Code of Federal Regulations, 2010 CFR

2010-04-01

... COVERED PERSONS Understanding Priority of Service § 1010.220 How are recipients required to implement...) memoranda of understanding or other service provision agreements, issued or executed by qualified job...

Semantic Web Infrastructure Supporting NextFrAMES Modeling Platform

NASA Astrophysics Data System (ADS)

Lakhankar, T.; Fekete, B. M.; Vörösmarty, C. J.

2008-12-01

Emerging modeling frameworks offer new ways to modelers to develop model applications by offering a wide range of software components to handle common modeling tasks such as managing space and time, distributing computational tasks in parallel processing environment, performing input/output and providing diagnostic facilities. NextFrAMES, the next generation updates to the Framework for Aquatic Modeling of the Earth System originally developed at University of New Hampshire and currently hosted at The City College of New York takes a step further by hiding most of these services from modeler behind a platform agnostic modeling platform that allows scientists to focus on the implementation of scientific concepts in the form of a new modeling markup language and through a minimalist application programming interface that provide means to implement model processes. At the core of the NextFrAMES modeling platform there is a run-time engine that interprets the modeling markup language loads the module plugins establishes the model I/O and executes the model defined by the modeling XML and the accompanying plugins. The current implementation of the run-time engine is designed for single processor or symmetric multi processing (SMP) systems but future implementation of the run-time engine optimized for different hardware architectures are anticipated. The modeling XML and the accompanying plugins define the model structure and the computational processes in a highly abstract manner, which is not only suitable for the run-time engine, but has the potential to integrate into semantic web infrastructure, where intelligent parsers can extract information about the model configurations such as input/output requirements applicable space and time scales and underlying modeling processes. The NextFrAMES run-time engine itself is also designed to tap into web enabled data services directly, therefore it can be incorporated into complex workflow to implement End-to-End application from observation to the delivery of highly aggregated information. Our presentation will discuss the web services ranging from OpenDAP and WaterOneFlow data services to metadata provided through catalog services that could serve NextFrAMES modeling applications. We will also discuss the support infrastructure needed to streamline the integration of NextFrAMES into an End-to-End application to deliver highly processed information to end users. The End-to-End application will be demonstrated through examples from the State-of-the Global Water System effort that builds on data services provided through WMO's Global Terrestrial Network for Hydrology to deliver water resources related information to policy makers for better water management. Key components of this E2E system are promoted as Community of Practice examples for the Global Observing System of Systems therefore the State-of-the Global Water System can be viewed as test case for the interoperability of the incorporated web service components.

An open science cloud for scientific research

NASA Astrophysics Data System (ADS)

Jones, Bob

2016-04-01

The Helix Nebula initiative was presented at EGU 2013 (http://meetingorganizer.copernicus.org/EGU2013/EGU2013-1510-2.pdf) and has continued to expand with more research organisations, providers and services. The hybrid cloud model deployed by Helix Nebula has grown to become a viable approach for provisioning ICT services for research communities from both public and commercial service providers (http://dx.doi.org/10.5281/zenodo.16001). The relevance of this approach for all those communities facing societal challenges in explained in a recent EIROforum publication (http://dx.doi.org/10.5281/zenodo.34264). This presentation will describe how this model brings together a range of stakeholders to implement a common platform for data intensive services that builds upon existing public funded e-infrastructures and commercial cloud services to promote open science. It explores the essential characteristics of a European Open Science Cloud if it is to address the big data needs of the latest generation of Research Infrastructures. The high-level architecture and key services as well as the role of standards is described. A governance and financial model together with the roles of the stakeholders, including commercial service providers and downstream business sectors, that will ensure a European Open Science Cloud can innovate, grow and be sustained beyond the current project cycles is described.

[General Agreement on Trade in Services and its implications for public health].

PubMed

Umaña-Peña, Román; Alvarez-Dardet, Carlos

2005-01-01

Due to the economic importance of the service sector and its trade potential, in 1995 the World Trade Organization (WTO) launched the General Agreement on Trade in Services with the objective of liberalizing trade in services worldwide and of establishing rules and disciplines to regulate it. Until now, the Agreement has produced few case laws on its rules and some of them are in the process of being developed, which makes the Agreement ambiguous and hampers accurate forecasting of its implications. Nevertheless, some analysts consider that certain characteristics and rules represent a threat to the funding mechanisms of public services and to the sovereignty of governments to generate their own rules. Moreover, the Agreement would lead to irreversible formalization of commitments, without the possibility of returning to previous conditions in the case of failure of the market and/or private participation. In addition, the Agreement acts against exclusive monopolies and providers and to a certain extent this will affect subsidies to local providers. The ability of the European Communities Court of Justice to enforce the implementation of competitive measures in public services has produced uncertainty because of the implications for health services. The Spanish Agreement with the WTO contains many questions that remain open, representing an opportunity for the participation of the health sector in the next negotiation rounds.

Quality Assurance Framework for Mini-Grids

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

Baring-Gould, Ian; Burman, Kari; Singh, Mohit

Providing clean and affordable energy services to the more than 1 billion people globally who lack access to electricity is a critical driver for poverty reduction, economic development, improved health, and social outcomes. More than 84% of populations without electricity are located in rural areas where traditional grid extension may not be cost-effective; therefore, distributed energy solutions such as mini-grids are critical. To address some of the root challenges of providing safe, quality, and financially viable mini-grid power systems to remote customers, the U.S. Department of Energy (DOE) teamed with the National Renewable Energy Laboratory (NREL) to develop a Qualitymore » Assurance Framework (QAF) for isolated mini-grids. The QAF for mini-grids aims to address some root challenges of providing safe, quality, and affordable power to remote customers via financially viable mini-grids through two key components: (1) Levels of service: Defines a standard set of tiers of end-user service and links them to technical parameters of power quality, power availability, and power reliability. These levels of service span the entire energy ladder, from basic energy service to high-quality, high-reliability, and high-availability service (often considered 'grid parity'); (2) Accountability and performance reporting framework: Provides a clear process of validating power delivery by providing trusted information to customers, funders, and/or regulators. The performance reporting protocol can also serve as a robust monitoring and evaluation tool for mini-grid operators and funding organizations. The QAF will provide a flexible alternative to rigid top-down standards for mini-grids in energy access contexts, outlining tiers of end-user service and linking them to relevant technical parameters. In addition, data generated through implementation of the QAF will provide the foundation for comparisons across projects, assessment of impacts, and greater confidence that will drive investment and scale-up in this sector. The QAF implementation process also defines a set of implementation guidelines that help the deployment of mini-grids on a regional or national scale, helping to insure successful rapid deployment of these relatively new remote energy options. Note that the QAF is technology agnostic, addressing both alternating current (AC) and direct current (DC) mini-grids, and is also applicable to renewable, fossil-fuel, and hybrid systems.« less

A Tale of Two Observing Systems: Interoperability in the World of Microsoft Windows

NASA Astrophysics Data System (ADS)

Babin, B. L.; Hu, L.

2008-12-01

Louisiana Universities Marine Consortium's (LUMCON) and Dauphin Island Sea Lab's (DISL) Environmental Monitoring System provide a unified coastal ocean observing system. These two systems are mirrored to maintain autonomy while offering an integrated data sharing environment. Both systems collect data via Campbell Scientific Data loggers, store the data in Microsoft SQL servers, and disseminate the data in real- time on the World Wide Web via Microsoft Internet Information Servers and Active Server Pages (ASP). The utilization of Microsoft Windows technologies presented many challenges to these observing systems as open source tools for interoperability grow. The current open source tools often require the installation of additional software. In order to make data available through common standards formats, "home grown" software has been developed. One example of this is the development of software to generate xml files for transmission to the National Data Buoy Center (NDBC). OOSTethys partners develop, test and implement easy-to-use, open-source, OGC-compliant software., and have created a working prototype of networked, semantically interoperable, real-time data systems. Partnering with OOSTethys, we are developing a cookbook to implement OGC web services. The implementation will be written in ASP, will run in a Microsoft operating system environment, and will serve data via Sensor Observation Services (SOS). This cookbook will give observing systems running Microsoft Windows the tools to easily participate in the Open Geospatial Consortium (OGC) Oceans Interoperability Experiment (OCEANS IE).

Implementation of Service-Learning in Business Education: Issues and Challenges

ERIC Educational Resources Information Center

Poon, Patrick; Chan, Tsang Sing; Zhou, Lianxi

2011-01-01

This paper examines the issues and challenges in the implementation of service-learning in undergraduate business education. It also provides an assessment of the students' learning efficacy and outcomes over time through the service-learning participation. Service-learning is a pedagogical approach that integrates academic learning and community…

Sustainability in Health care by Allocating Resources Effectively (SHARE) 7: supporting staff in evidence-based decision-making, implementation and evaluation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Dyer, Tim; Brooke, Vanessa; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Gust, Anthony; Farjou, Dina

2017-06-21

This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. From the literature and responses of local stakeholders it was clear that provision of expertise and education, training and support of health service staff would be required to achieve these aims. Four support services were proposed. This paper is a detailed case report of the development, implementation and evaluation of a Data Service, Capacity Building Service and Project Support Service. An Evidence Service is reported separately. Literature reviews, surveys, interviews, consultation and workshops were used to capture and process the relevant information. Existing theoretical frameworks were adapted for evaluation and explication of processes and outcomes. Surveys and interviews identified current practice in use of evidence in decision-making, implementation and evaluation; staff needs for evidence-based practice; nature, type and availability of local health service data; and preferred formats for education and training. The Capacity Building and Project Support Services were successful in achieving short term objectives; but long term outcomes were not evaluated due to reduced funding. The Data Service was not implemented at all. Factors influencing the processes and outcomes are discussed. Health service staff need access to education, training, expertise and support to enable evidence-based decision-making and to implement and evaluate the changes arising from those decisions. Three support services were proposed based on research evidence and local findings. Local factors, some unanticipated and some unavoidable, were the main barriers to successful implementation. All three proposed support services hold promise as facilitators of EBP in the local healthcare setting. The findings from this study will inform further exploration.

Implementation of a system to provide mobile satellite services in North America

NASA Technical Reports Server (NTRS)

Johanson, Gary A.; Davies, N. George; Tisdale, William R. H.

1993-01-01

This paper describes the implementation of the ground network to support Mobile Satellite Services (MSS). The system is designed to take advantage of a powerful new satellite series and provides significant improvements in capacity and throughput over systems in service today. The system is described in terms of the services provided and the system architecture being implemented to deliver those services. The system operation is described including examples of a circuit switched and packet switched call placement. The physical architecture is presented showing the major hardware components and software functionality placement within the hardware.

REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings (RESTORE): study protocol.

PubMed

MacFarlane, Anne; O'Donnell, Catherine; Mair, Frances; O'Reilly-de Brún, Mary; de Brún, Tomas; Spiegel, Wolfgang; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; Lionis, Christos; Burns, Nicola; Gravenhorst, Katja; Princz, Christine; Teunissen, Erik; van den Driessen Mareeuw, Francine; Saridaki, Aristoula; Papadakaki, Maria; Vlahadi, Maria; Dowrick, Christopher

2012-11-20

The implementation of guidelines and training initiatives to support communication in cross-cultural primary care consultations is ad hoc across a range of international settings with negative consequences particularly for migrants. This situation reflects a well-documented translational gap between evidence and practice and is part of the wider problem of implementing guidelines and the broader range of professional educational and quality interventions in routine practice. In this paper, we describe our use of a contemporary social theory, Normalization Process Theory and participatory research methodology--Participatory Learning and Action--to investigate and support implementation of such guidelines and training initiatives in routine practice. This is a qualitative case study, using multiple primary care sites across Europe. Purposive and maximum variation sampling approaches will be used to identify and recruit stakeholders-migrant service users, general practitioners, primary care nurses, practice managers and administrative staff, interpreters, cultural mediators, service planners, and policy makers. We are conducting a mapping exercise to identify relevant guidelines and training initiatives. We will then initiate a PLA-brokered dialogue with stakeholders around Normalization Process Theory's four constructs--coherence, cognitive participation, collective action, and reflexive monitoring. Through this, we will enable stakeholders in each setting to select a single guideline or training initiative for implementation in their local setting. We will prospectively investigate and support the implementation journeys for the five selected interventions. Data will be generated using a Participatory Learning and Action approach to interviews and focus groups. Data analysis will follow the principles of thematic analysis, will occur in iterative cycles throughout the project and will involve participatory co-analysis with key stakeholders to enhance the authenticity and veracity of findings. This research employs a unique combination of Normalization Process Theory and Participatory Learning and Action, which will provide a novel approach to the analysis of implementation journeys. The findings will advance knowledge in the field of implementation science because we are using and testing theoretical and methodological approaches so that we can critically appraise their scope to mediate barriers and improve the implementation processes.

The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study.

PubMed

van der Krieke, Lian; Bird, Victoria; Leamy, Mary; Bacon, Faye; Dunn, Rebecca; Pesola, Francesca; Janosik, Monika; Le Boutillier, Clair; Williams, Julie; Slade, Mike

2015-05-23

Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions. SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated. There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ (2)(3) = 133.77, p < 0.001) and recovery interventions (χ (2)(3) = 104.67, p < 0.001) and (b) did not differ in number of enablers from recovery interventions (χ (2)(3) = 0.74, p = 0.863) but had fewer enablers than psychosocial interventions (χ (2)(3) = 28.92, p < 0.001). Potential adverse events associated with the intervention tend to be a block for pharmacological interventions, whereas complexity of the intervention was the most consistent block for recovery and psychosocial interventions. Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers.

Investigation of Service Quality of Measurement Reference Points for the Internet Services on Mobile Networks

NASA Astrophysics Data System (ADS)

Lipenbergs, E.; Bobrovs, Vj.; Ivanovs, G.

2016-10-01

To ensure that end-users and consumers have access to comprehensive, comparable and user-friendly information regarding the Internet access service quality, it is necessary to implement and regularly renew a set of legislative regulatory acts and to provide monitoring of the quality of Internet access services regarding the current European Regulatory Framework. The actual situation regarding the quality of service monitoring solutions in different European countries depends on national regulatory initiatives and public awareness. The service monitoring solutions are implemented using different measurement methodologies and tools. The paper investigates the practical implementations for developing a harmonising approach to quality monitoring in order to obtain objective information on the quality of Internet access services on mobile networks.

OA8 Caring for the family caregiver: working with volunteers to implement and improve a service to enable family caregivers to maintain their own wellbeing.

PubMed

Cohen, S Robin; Keats, Susan; Cherba, Maria; Allen, Dawn; MacKinnon, Christopher J; Bitzas, Vasiliki; Kogan, Naomi; Penner, Jamie L; Calislar, Monica Parmar; Feindel, Anna; Lapointe, Bernard; Baxter, Sharon; O'Brien, Suzanne; Stajduhar, Kelli

2015-04-01

Family caregivers suffer physically, mentally, and spiritually. Community volunteers play an important role in supporting patients at the end of life or former caregivers in bereavement. However, there are no research reports of volunteer services focused on maintaining the wellbeing of end-of-life caregivers. To have volunteers, a hired volunteer coordinator, health care providers, and researchers implement and formatively evaluate a volunteer service to enable family caregivers to maintain their well being while providing care and subsequent bereavement. This presentation will focus on the volunteers' roles with the project as both agents of change to the service and as support for the caregivers. A qualitative formative evaluation informed by Guba and Lincoln's Fourth Generation Evaluation (1989) participatory design was conducted. Data was collected through individual interviews, focus groups, participant observation during volunteer support meetings, and through volunteers' written reflections. Amongst the volunteers, volunteer coordinator, and principal investigator, there was mutual respect for and interest in learning about everyone's roles and experiences in the project. The experience was rewarding because they felt they helped the family caregiver and enjoyed developing and improving the service and working in a supportive team. Volunteers' challenges included being nervous for their first meeting with a caregiver, and frustration with some rules put in place to protect them (e.g. not helping the caregiver with direct care for the patient). Volunteers can be an effective part of the research team, while providing valuable support and encouragement for family caregivers to maintain their own wellbeing. © 2015, 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.

Water Data Infrastructure for Next-Generation e-Water-Services in Flanders

NASA Astrophysics Data System (ADS)

Smets, Steven; Pannemans, Bart; Minnema, Bennie; Weerts, Albrech H.; de Rooij, Erik; Natschke, Michael; Stiers, Walter; Wolfs, Vincenct; Willems, Patrick; Vansteenkiste, Thomas; Cauwenberghs, Kris

2017-04-01

Efficient sharing of water data and services (e.g. models, tools) is a challenging task. Several EU projects (e.g. DRIHM) already investigated some of the bottlenecks. In a new project, we investigated several issues to establish a Water Data Infrastructure for e-WaterServices in Flanders. Important features of such a WDI deals are - Institutional arrangements - agreement around technology and standards - agreement about dissemination of water related data and tools The goal of the WDI is to get to one (distributed) environment with models, data and tools for professionals, scientists and citizens to analyse data and run (the latest state of the art) models without (direct) interaction with the providers and developers of these data, models and tools. In the project, a WDI architecture was developed and proposed based on the developed WDI principles. The WDI principles and architecture were tested and demonstrated with 3 proof of concept (where execution of a lumped and distributed hydrological model and hydraulic models, running and visualisation were distributed over the infrastructure of the different projecpartners). We will present the WDI principles and architecture and its implementation for 3 use cases (operational, policy and on the fly modelling of accidents, e.g. spill). Results of the proof of concepts will be shown. It was found that institutional arrangements are the biggest hurdle for implementation of such a WDI.

The Urban Exploitation Platform - An instrument for the global provision of indicators related to sustainable cities and communities

NASA Astrophysics Data System (ADS)

Esch, Thomas; Asamer, Hubert; Hirner, Andreas; Marconcini, Mattia; Metz, Annekatrin; Uereyen, Soner; Zeidler, Julian; Boettcher, Martin; Permana, Hans; Boissier, Enguerran; Mathot, Emmanuel; Soukop, Tomas; Balhar, Jakub; Svaton, Vaclav; Kuchar, Stepan

2017-04-01

The Sentinel fleet will provide a so-far unique coverage with Earth Observation (EO) data and therewith new opportunities for the implementation of methodologies to generate innovative geo-information products and services supporting the SDG targets. It is here where the TEP Urban project is supposed to initiate a step change by providing an open and participatory platform that allows any interested user to easily exploit large-volume EO data pools, in particular those of the European Sentinel and the US Landsat missions, and derive thematic geo-information, metrics and indicators related to the status and development of the built environment. Key component of TEP Urban initiative is the implementation of a web-based platform (https://urban-tep.eo.esa.int) employing distributed high-level computing infrastructures and providing key functionalities for i) high-performance access to satellite imagery and other data sources such as statistics or topographic data, ii) state-of-the-art pre-processing, analysis, and visualization techniques, iii) customized development and dissemination of algorithms, products and services, and iv) networking and communication. This contribution introduces the main facts about the TEP Urban platform, including a description of the general objectives, the platform systems design and functionalities, and the available portfolio of products and services that can directly serve the global provision of indicators for SDG targets, in particular related to SDG 11.

From mixed to separate collection of solid waste: benefits for the town of Zavidovići (Bosnia and Herzegovina).

PubMed

Vaccari, Mentore; Di Bella, Veronica; Vitali, Francesco; Collivignarelli, Carlo

2013-02-01

In Bosnia and Herzegovina only 50% of the municipalities have a well-organized service for (mixed) waste collection and disposal. Illegal dumping is very common, in particular in rural areas, which are not regularly served by any service of collection. This situation leads to serious risks for public health and has dangerous environmental impacts. In Zavidovići the municipality is trying to meet high standards in the delivery of services of waste collection, but is constrained by scarce financial and technical resources. Different scenarios for the implementation of a system of separate collection in Zavidovići were elaborated in order to provide a useful tool for decision making by comparing costs and environmental & economic benefits of each scenario. Six scenarios were considered, based on different recovery rates for plastic, paper & cardboard, and metals. Benefits resulting from the implementation of each of the proposed scenarios are compared in terms of savings of landfill volume and costs. The study concludes that the adoption of a system of separate collection could generate positive impacts on all the stakeholders involved in the solid waste management sector in Zavidovići and could contribute to the compliance of European standards in many Central and Eastern European countries as established by a number of national environmental protection strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Generation of continuous-wave 194 nm laser for mercury ion optical frequency standard

NASA Astrophysics Data System (ADS)

Zou, Hongxin; Wu, Yue; Chen, Guozhu; Shen, Yong; Liu, Qu; Precision measurement; atomic clock Team

2015-05-01

194 nm continuous-wave (CW) laser is an essential part in mercury ion optical frequency standard. The continuous-wave tunable radiation sources in the deep ultraviolet (DUV) region of the spectrum is also serviceable in high-resolution spectroscopy with many atomic and molecular lines. We introduce a scheme to generate continuous-wave 194 nm radiation with SFM in a Beta Barium Borate (BBO) crystal here. The two source beams are at 718 nm and 266 nm, respectively. Due to the property of BBO, critical phase matching (CPM) is implemented. One bow-tie cavity is used to resonantly enhance the 718 nm beam while the 266 nm makes a single pass, which makes the configuration easy to implement. Considering the walk-off effect in CPM, the cavity mode is designed to be elliptical so that the conversion efficiency can be promoted. Since the 266 nm radiation is generated by a 532 nm laser through SHG in a BBO crystal with a large walk-off angle, the output mode is quite non-Gaussian. To improve mode matching, we shaped the 266 nm beam into Gaussian modes with a cylindrical lens and iris diaphragm. As a result, 2.05 mW 194 nm radiation can be generated. As we know, this is the highest power for 194 nm CW laser using SFM in BBO with just single resonance. The work is supported by the National Natural Science Foundation of China (Grant No. 91436103 and No. 11204374).

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

PubMed Central

2014-01-01

Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda.

PubMed

Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan

2014-04-02

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. PACTR201311000681314.

Care for Child Development: an intervention in support of responsive caregiving and early child development.

PubMed

Lucas, J E; Richter, L M; Daelmans, B

2018-01-01

An estimated 43% of children younger than 5 years of age are at elevated risk of failing to achieve their human potential. In response, the World Health Organization and UNICEF developed Care for Child Development (CCD), based on the science of child development, to improve sensitive and responsive caregiving and promote the psychosocial development of young children. In 2015, the World Health Organization and UNICEF identified sites where CCD has been implemented and sustained. The sites were surveyed, and responses were followed up by phone interviews. Project reports provided information on additional sites, and a review of published studies was undertaken to document the effectiveness of CCD for improving child and family outcomes, as well as its feasibility for implementation in resource-constrained communities. The inventory found that CCD had been integrated into existing services in diverse sectors in 19 countries and 23 sites, including child survival, health, nutrition, infant day care, early education, family and child protection and services for children with disabilities. Published and unpublished evaluations have found that CCD interventions can improve child development, growth and health, as well as responsive caregiving. It has also been reported to reduce maternal depression, a known risk factor for poor pregnancy outcomes and poor child health, growth and development. Although CCD has expanded beyond initial implementation sites, only three countries reported having national policy support for integrating CCD into health or other services. Strong interest exists in many countries to move beyond child survival to protect and support optimal child development. The United Nations Sustainable Development Goals depend on children realizing their potential to build healthy and emotionally, cognitively and socially competent future generations. More studies are needed to guide the integration of the CCD approach under different conditions. Nevertheless, the time is right to provide for the scale-up of CCD as part of services for families and children. © 2017 The Authors. Child: Care, Health and Development Published by John Wiley & Sons Ltd.

Implementing ecosystem management in public agencies: lessons from the U.S. Bureau of Land Management and the Forest Service.

PubMed

Koontz, Tomas M; Bodine, Jennifer

2008-02-01

Ecosystem management was formally adopted over a decade ago by many U.S. natural resource agencies, including the Forest Service and the Bureau of Land Management. This approach calls for management based on stakeholder collaboration; interagency cooperation; integration of scientific, social, and economic information; preservation of ecological processes; and adaptive management. Results of previous studies indicate differences in the extent to which particular components of ecosystem management would be implemented within the U.S. Forest Service and the Bureau of Land Management and suggest a number of barriers thought to impede implementation. Drawing on survey and interview data from agency personnel and stakeholders, we compared levels of ecosystem-management implementation in the Forest Service and Bureau of Land Management and identified the most important barriers to implementation. Agency personnel perceived similarly high levels of implementation on many ecosystem-management components, whereas stakeholders perceived lower levels. Agencies were most challenged by implementation of preservation of ecological processes, adaptive management, and integration of social and economic information, whereas the most significant barriers to implementation were political, cultural, and legal.

Implementation of Web 2.0 services in academic, medical and research libraries: a scoping review.

PubMed

Gardois, Paolo; Colombi, Nicoletta; Grillo, Gaetano; Villanacci, Maria C

2012-06-01

Academic, medical and research libraries frequently implement Web 2.0 services for users. Several reports notwithstanding, characteristics and effectiveness of services are unclear. To find out: the Web 2.0 services implemented by medical, academic and research libraries; study designs, measures and types of data used in included articles to evaluate effectiveness; whether the identified body of literature is amenable to a systematic review of results. Scoping review mapping the literature on the topic. Searches were performed in 19 databases. research articles in English, Italian, German, French and Spanish (publication date ≥ 2006) about Web 2.0 services for final users implemented by academic, medical and research libraries. Reviewers' agreement was measured by Cohen's kappa. From a data set of 6461 articles, 255 (4%) were coded and analysed. Conferencing/chat/instant messaging, blogging, podcasts, social networking, wikis and aggregators were frequently examined. Services were mainly targeted at general academic users of English-speaking countries. Data prohibit a reliable estimate of the relative frequency of implemented Web 2.0 services. Case studies were the prevalent design. Most articles evaluated different outcomes using diverse assessment methodologies. A systematic review is recommended to assess the effectiveness of such services. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

Mobile 3d Mapping with a Low-Cost Uav System

NASA Astrophysics Data System (ADS)

Neitzel, F.; Klonowski, J.

2011-09-01

In this contribution it is shown how an UAV system can be built at low costs. The components of the system, the equipment as well as the control software are presented. Furthermore an implemented programme for photogrammetric flight planning and its execution are described. The main focus of this contribution is on the generation of 3D point clouds from digital imagery. For this web services and free software solutions are presented which automatically generate 3D point clouds from arbitrary image configurations. Possibilities of georeferencing are described whereas the achieved accuracy has been determined. The presented workflow is finally used for the acquisition of 3D geodata. On the example of a landfill survey it is shown that marketable products can be derived using a low-cost UAV.

Some Programs Should Not Run on Laptops - Providing Programmatic Access to Applications Via Web Services

NASA Astrophysics Data System (ADS)

Gupta, V.; Gupta, N.; Gupta, S.; Field, E.; Maechling, P.

2003-12-01

Modern laptop computers, and personal computers, can provide capabilities that are, in many ways, comparable to workstations or departmental servers. However, this doesn't mean we should run all computations on our local computers. We have identified several situations in which it preferable to implement our seismological application programs in a distributed, server-based, computing model. In this model, application programs on the user's laptop, or local computer, invoke programs that run on an organizational server, and the results are returned to the invoking system. Situations in which a server-based architecture may be preferred include: (a) a program is written in a language, or written for an operating environment, that is unsupported on the local computer, (b) software libraries or utilities required to execute a program are not available on the users computer, (c) a computational program is physically too large, or computationally too expensive, to run on a users computer, (d) a user community wants to enforce a consistent method of performing a computation by standardizing on a single implementation of a program, and (e) the computational program may require current information, that is not available to all client computers. Until recently, distributed, server-based, computational capabilities were implemented using client/server architectures. In these architectures, client programs were often written in the same language, and they executed in the same computing environment, as the servers. Recently, a new distributed computational model, called Web Services, has been developed. Web Services are based on Internet standards such as XML, SOAP, WDSL, and UDDI. Web Services offer the promise of platform, and language, independent distributed computing. To investigate this new computational model, and to provide useful services to the SCEC Community, we have implemented several computational and utility programs using a Web Service architecture. We have hosted these Web Services as a part of the SCEC Community Modeling Environment (SCEC/CME) ITR Project (http://www.scec.org/cme). We have implemented Web Services for several of the reasons sited previously. For example, we implemented a FORTRAN-based Earthquake Rupture Forecast (ERF) as a Web Service for use by client computers that don't support a FORTRAN runtime environment. We implemented a Generic Mapping Tool (GMT) Web Service for use by systems that don't have local access to GMT. We implemented a Hazard Map Calculator Web Service to execute Hazard calculations that are too computationally intensive to run on a local system. We implemented a Coordinate Conversion Web Service to enforce a standard and consistent method for converting between UTM and Lat/Lon. Our experience developing these services indicates both strengths and weakness in current Web Service technology. Client programs that utilize Web Services typically need network access, a significant disadvantage at times. Programs with simple input and output parameters were the easiest to implement as Web Services, while programs with complex parameter-types required a significant amount of additional development. We also noted that Web services are very data-oriented, and adapting object-oriented software into the Web Service model proved problematic. Also, the Web Service approach of converting data types into XML format for network transmission has significant inefficiencies for some data sets.

New EUROPRACTICE microsystem design and foundry services

NASA Astrophysics Data System (ADS)

Salomon, Patric R.; Beernaert, Dirk; Turner, Rob

2000-08-01

The microsystems market for MST is predicted to grow to 38 billion dollars by the year 2002, with systems containing these components generating even higher revenues and growth. One of the barriers to successful exploitation of this technology has been the lack of access to industrial foundries capable of producing certified microsystems devices in commercial quantities. To overcome this problem, the European Commission has started the EUROPRACTICE program in 1996 with the installation of manufacturing clusters and demonstration activities to provide access to microsystems foundry services for European small and medium sized companies (SMEs). Since 1996, there has been a shift form providing 'broad technology offers' and 'raising awareness fro microsystem capabilities' to 'direct support of design needs' and 'focused services' which allow SMEs to use even complex microsystems technologies to implement their products, The third phase of EUROPRACTICE has just been launched, and contains 5 Manufacturing Clusters, 12 Designs Houses, and 7 Competence Centers, each working in different application/technology areas. The EUROPRACTICE program will be presented together with a detail description of the capabilities of the participants and information on how to access their services.

Towards local implementation of Dutch health policy guidelines: a concept-mapping approach.

PubMed

Kuunders, Theo J M; van Bon-Martens, Marja J H; van de Goor, Ien A M; Paulussen, Theo G W M; van Oers, Hans A M

2017-02-22

To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful implementation of the guideline were identified. Differences and similarities in perceptions of these characteristics between RHSs and developers were explored. Separate concept mapping procedures were executed in two RHSs, one with representatives from partner local health organizations and municipalities, the second with RHS members only. A third map was conducted with the developers of the guideline. All mapping procedures followed the same design of generating statements up to interpretation of results with participants. Concept mapping, as a practical implementation tool, will be discussed in the context of international research literature on guideline implementation in public health. Guideline developers consider implementation successful when substantive components (health issues) of the guidelines, content are visible in local policy practice. RHSs, local organizations and municipalities view the implementation process itself within and between organizations as more relevant, and state that usability of the guideline for municipal policy and commitment by officials and municipal managers are critical targets for successful implementation. Between the RHSs, differences in implementation targets were smaller than between RHSs and guideline developers. For successful implementation, RHSs tend to focus on process targets while developers focus more on the thematic contents of the guideline. Implications of these different orientations for implementation strategies are dealt with in the discussion. © The Author 2017. Published by Oxford University Press.

Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis.

PubMed

Breland, Jessica Y; Asch, Steven M; Slightam, Cindie; Wong, Ava; Zulman, Donna M

2016-03-01

Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH. Interviewees included facility leadership and clinical staff who were involved in a pilot Intensive Management Patient Aligned Care Team (ImPACT) intervention for high-need, high-cost VA PCMH patents. We classified implementation factors in the literature review and qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). The literature review (n=9 studies) and analyses of interviews (n=15) revealed key implementation factors in three CFIR domains. First, the Inner Setting (i.e., the organizational and PCMH environment), mostly enabled implementation through a culture of innovation, good networks and communication, and positive tension for change. Second, Characteristics of Individuals, including creativity, flexibility, and interpersonal skills, allowed program staff to augment existing PCMH services. Finally, certain Intervention Characteristics (e.g., adaptability) enabled implementation, while others (e.g., complexity) generated implementation barriers. Resources and structural features common to PCMHs can facilitate implementation of intensive outpatient programs, but program success is also dependent on staff creativity and flexibility, and intervention adaptations to meet patient and organizational needs. Established PCMHs likely provide resources and environments that permit accelerated implementation of intensive outpatient programs. V. Published by Elsevier Inc.

Price Transparency in the Online Age.

PubMed

Kaplan, Jonathan L; Mills, Parker H

2016-05-01

Plastic surgeons are sometimes hesitant to provide their pricing information online, due to several concerns. However, if implemented right, price transparency can be used as a lead generation tool that provides consumers with the pricing information they want and gives the physician the consumer's contact information for follow-up. This study took place during the author's first year in private practice in a new city. An interactive price transparency platform (ie, cost estimator) was integrated into his website, allowing consumers to submit a "wishlist" of procedures to check pricing on these procedures of interest. However, the consumer must submit their contact information to receive the desired breakdown of costs that are tailored based on the author's medical fees. During that first year, without any advertising expenditure, the author's website received 412 wishlists from 208 unique consumers. Consumers (17.8%) that submitted a wishlist came in for a consultation and 62% of those booked a procedure. The average value of a booked procedure was over US $4000 and cumulatively, all of the leads from this one lead source in that first year generated over US $92,000 in revenue. When compared with non-price-aware patients, price-aware patients were 41% more likely to book a procedure. Price transparency led to greater efficiency and reduced consultations that ended in "sticker shock." When prudently integrated into a medical practice, price transparency can be a great lead generation source for patients that are (1) paying out of pocket for medically necessary services due to a high-deductible health plan or (2) paying for services not typically covered by insurance, such as cosmetic services.

Developing next-generation telehealth tools and technologies: patients, systems, and data perspectives.

PubMed

Ackerman, Michael J; Filart, Rosemarie; Burgess, Lawrence P; Lee, Insup; Poropatich, Ronald K

2010-01-01

The major goals of telemedicine today are to develop next-generation telehealth tools and technologies to enhance healthcare delivery to medically underserved populations using telecommunication technology, to increase access to medical specialty services while decreasing healthcare costs, and to provide training of healthcare providers, clinical trainees, and students in health-related fields. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers. In the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization are critical pieces to the process. Next-generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity. To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service. Toward that end, our group addressed three overarching questions: (1) What are the high-impact topics? (2) What are the barriers to progress? and (3) What roles can the National Institutes of Health and its various institutes and centers play in fostering the future development of telehealth?

A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions.

PubMed

Owczarzak, Jill; Phillips, Sarah D; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna

2016-06-01

The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally generated solutions. In this study, we used the concept of "common factors," or broad constructs shared by most evidence-based HIV prevention interventions, to train service providers to develop their own programs. We recruited eight Ukrainian HIV prevention organizations from regions with HIV epidemics concentrated among people who inject drugs. We trained staff to identify HIV risk behaviors and determinants, construct behavior change logic models, and develop and manualize an intervention. We systematically reviewed each manual to assess intervention format and content and determine whether the program met intervention criteria as taught during training. All agencies developed programs that reflected common factors of effective behavior change HIV prevention interventions. Each agency's program targeted a unique population that reflected local HIV epidemiology. All programs incorporated diverse pedagogical strategies that focused on skill-building, goal-setting, communication, and empowerment. Agencies struggled to limit information dissemination and the overall scope and length of their programs. We conclude that training service providers to develop their own programs based on common elements of effective behavior change interventions can potentially transform existing processes of program development, implementation, and capacity building. Expanding this model will require committed training and support resources. © 2015 Society for Public Health Education.

Global Framework for Climate Services (GFCS)

NASA Astrophysics Data System (ADS)

Lúcio, F.

2012-04-01

Climate information at global, regional and national levels and in timeframes ranging from the past, present and future climate is fundamental for planning, sustainable development and to help organizations, countries and individuals adopt appropriate strategies to adapt to climate variability and change. Based on this recognition, in 2009, the Heads of States and Governments, Ministers and Heads of Delegation representing more than 150 countries, 34 United Nations Organizations and 36 Governmental and non-Governmental international organizations, and more than 2500 experts present at the Third World Climate Conference (WCC - 3) unanimously agreed to develop the Global Framework for Climate Services (GFCS) to strengthen the production, availability, delivery and application of science-based climate prediction and services. They requested that a taskforce of high-level independent advisors be appointed to prepare a report, including recommendations on the proposed elements of the Framework and the next steps for its implementation. The high-level taskforce produced a report which was endorsed by the Sixteeth World Meteorological Congress XVI in May 2011. A process for the development of the implementation plan and the governance structure of the Global Framework for Climate Services (GFCS) is well under way being led by the World Meteorological Organization within the UN system. This process involves consultations that engage a broad range of stakeholders including governments, UN and international agencies, regional organizations and specific communities of practitioners. These consultations are being conducted to facilitate discussions of key issues related to the production, availability, delivery and application of climate services in the four priority sectors of the framework (agriculture, water, health and disaster risk reduction) so that the implementation plan of the Framework is a true reflection of the aspirations of stakeholders. The GFCS is envisaged as a set of international arrangements that will coordinate the activities and build on existing efforts to provide climate services that are truly focused on meeting user needs. It will be implemented through the development of five main components: 1) User Interface Platform — to provide ways for climate service users and providers to interact and improve the effectiveness of the Framework and its climate services 2) Climate Services Information System — to produce and distribute climate data and information according to the needs of users and to agreed standards 3) Observations and Monitoring - to develop agreements and standards for collecting and generating necessary climate data 4) Research, Modeling and Prediction section — to harness science capabilities and results to meet the needs of climate services 5) Capacity Building — to support the systematic development of the institutions, infrastructure and human resources needed for effective production of climate services and their application. Putting the GFCS in place will require unprecedented collaboration among agencies and across political, functional and disciplinary boundaries, and a global mobilization of effort. This communication will provide information on benefits and the process for the development of the GFCS as well as potential entry points for stakeholders to participate. In addition, it will highlight some of the research, modelling and prediction opportunities that will require intra-disciplinary science action.

The Quality Improvement Environment: Results of the 2016 AAHPM/HPNA Membership Needs Assessment Survey.

PubMed

Lindley, Lisa C; Rotella, Joseph D; Ast, Katherine; Matzo, Marianne; Kamal, Arif H

2017-11-01

The American Academy of Hospice and Palliative Medicine (AAHPM) and Hospice and Palliative Nurses Association (HPNA) convened the Measuring What Matters (MWM) initiative in 2013, which recommended 10 quality performance measures; yet, little is known about the quality improvement (QI) environment and implementation of the MWM among hospices and palliative care services. The objective of this study was to describe the findings of the 2016 AAHPM/HPNA Needs Assessment survey exploring the QI environment among hospice and palliative care services. An online survey was distributed to approximately 16,500 AAHPM and HPNA members, and other hospice and palliative care organizations were invited to respond. Summary data and individual write-in responses were collated and analyzed. Data analysis included generating descriptive statistics and analyzing individual write-in responses for additional information and themes. More than 1000 responses were received. Most organizations had a designated QI leader and used an electronic medical record. Less than 50% of systems had fields for palliative care information. The top three MWM measures collected through an electronic medical record were pain treatment (66%), screening for physical symptoms (55%), and comprehensive assessment (54%). The most common barrier to implementing QI was time constraint. Most respondents had received no training and education in how to implement QI. The 2016 AAHPM/HPNA Needs Assessment Survey provided important information about the QI systems and measurement environment within hospice and palliative care services. Survey insights can aid AAHPM/HPNA in developing resources to empower hospice and palliative care clinicians to make QIs that matter for their patients and families. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Controllable Grid Interface for Testing Ancillary Service Controls and Fault Performance of Utility-Scale Wind Power Generation: Preprint

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

Gevorgian, Vahan; Koralewicz, Przemyslaw; Wallen, Robb

The rapid expansion of wind power has led many transmission system operators to demand modern wind power plants to comply with strict interconnection requirements. Such requirements involve various aspects of wind power plant operation, including fault ride-through and power quality performance as well as the provision of ancillary services to enhance grid reliability. During recent years, the National Renewable Energy Laboratory (NREL) of the U.S. Department of Energy has developed a new, groundbreaking testing apparatus and methodology to test and demonstrate many existing and future advanced controls for wind generation (and other renewable generation technologies) on the multimegawatt scale andmore » medium-voltage levels. This paper describes the capabilities and control features of NREL's 7-MVA power electronic grid simulator (also called a controllable grid interface, or CGI) that enables testing many active and reactive power control features of modern wind turbine generators -- including inertial response, primary and secondary frequency responses, and voltage regulation -- under a controlled, medium-voltage grid environment. In particular, this paper focuses on the specifics of testing the balanced and unbalanced fault ride-through characteristics of wind turbine generators under simulated strong and weak medium-voltage grid conditions. In addition, this paper provides insights on the power hardware-in-the-loop feature implemented in the CGI to emulate (in real time) the conditions that might exist in various types of electric power systems under normal operations and/or contingency scenarios. Using actual test examples and simulation results, this paper describes the value of CGI as an ultimate modeling validation tool for all types of 'grid-friendly' controls by wind generation.« less

NCC Simulation Model: Simulating the operations of the network control center, phase 2

NASA Technical Reports Server (NTRS)

Benjamin, Norman M.; Paul, Arthur S.; Gill, Tepper L.

1992-01-01

The simulation of the network control center (NCC) is in the second phase of development. This phase seeks to further develop the work performed in phase one. Phase one concentrated on the computer systems and interconnecting network. The focus of phase two will be the implementation of the network message dialogues and the resources controlled by the NCC. These resources are requested, initiated, monitored and analyzed via network messages. In the NCC network messages are presented in the form of packets that are routed across the network. These packets are generated, encoded, decoded and processed by the network host processors that generate and service the message traffic on the network that connects these hosts. As a result, the message traffic is used to characterize the work done by the NCC and the connected network. Phase one of the model development represented the NCC as a network of bi-directional single server queues and message generating sources. The generators represented the external segment processors. The served based queues represented the host processors. The NCC model consists of the internal and external processors which generate message traffic on the network that links these hosts. To fully realize the objective of phase two it is necessary to identify and model the processes in each internal processor. These processes live in the operating system of the internal host computers and handle tasks such as high speed message exchanging, ISN and NFE interface, event monitoring, network monitoring, and message logging. Inter process communication is achieved through the operating system facilities. The overall performance of the host is determined by its ability to service messages generated by both internal and external processors.

High temporal resolution mapping of seismic noise sources using heterogeneous supercomputers

NASA Astrophysics Data System (ADS)

Gokhberg, Alexey; Ermert, Laura; Paitz, Patrick; Fichtner, Andreas

2017-04-01

Time- and space-dependent distribution of seismic noise sources is becoming a key ingredient of modern real-time monitoring of various geo-systems. Significant interest in seismic noise source maps with high temporal resolution (days) is expected to come from a number of domains, including natural resources exploration, analysis of active earthquake fault zones and volcanoes, as well as geothermal and hydrocarbon reservoir monitoring. Currently, knowledge of noise sources is insufficient for high-resolution subsurface monitoring applications. Near-real-time seismic data, as well as advanced imaging methods to constrain seismic noise sources have recently become available. These methods are based on the massive cross-correlation of seismic noise records from all available seismic stations in the region of interest and are therefore very computationally intensive. Heterogeneous massively parallel supercomputing systems introduced in the recent years combine conventional multi-core CPU with GPU accelerators and provide an opportunity for manifold increase and computing performance. Therefore, these systems represent an efficient platform for implementation of a noise source mapping solution. We present the first results of an ongoing research project conducted in collaboration with the Swiss National Supercomputing Centre (CSCS). The project aims at building a service that provides seismic noise source maps for Central Europe with high temporal resolution (days to few weeks depending on frequency and data availability). The service is hosted on the CSCS computing infrastructure; all computationally intensive processing is performed on the massively parallel heterogeneous supercomputer "Piz Daint". The solution architecture is based on the Application-as-a-Service concept in order to provide the interested external researchers the regular access to the noise source maps. The solution architecture includes the following sub-systems: (1) data acquisition responsible for collecting, on a periodic basis, raw seismic records from the European seismic networks, (2) high-performance noise source mapping application responsible for generation of source maps using cross-correlation of seismic records, (3) back-end infrastructure for the coordination of various tasks and computations, (4) front-end Web interface providing the service to the end-users and (5) data repository. The noise mapping application is composed of four principal modules: (1) pre-processing of raw data, (2) massive cross-correlation, (3) post-processing of correlation data based on computation of logarithmic energy ratio and (4) generation of source maps from post-processed data. Implementation of the solution posed various challenges, in particular, selection of data sources and transfer protocols, automation and monitoring of daily data downloads, ensuring the required data processing performance, design of a general service oriented architecture for coordination of various sub-systems, and engineering an appropriate data storage solution. The present pilot version of the service implements noise source maps for Switzerland. Extension of the solution to Central Europe is planned for the next project phase.

Implementing an online pharmaceutical service using design science research.

PubMed

Lapão, Luís Velez; da Silva, Miguel Mira; Gregório, João

2017-03-27

The rising prevalence of chronic diseases is pressing health systems to introduce reforms. Primary healthcare and multidisciplinary models have been suggested as approaches to deal with this challenge, with new roles for nurses and pharmacists being advocated. More recently, implementing healthcare based on information systems and technologies (e.g. eHealth) has been proposed as a way to improve health services. However, implementing online pharmaceutical services, including their adoption by pharmacists and patients, is still an open research question. In this paper we present ePharmacare, a new online pharmaceutical service implemented using Design Science Research. The Design Science Research Methodology (DSRM) was chosen to implement this online service for chronic diseases management. In the paper, DSRM's different activities are explained, from the definition of the problem to the evaluation of the artifact. During the design and development activities, surveys, observations, focus groups, and eye-tracking glasses were used to validate pharmacists' and patients' requirements. During the demonstration and evaluation activities the new service was used with real-world pharmacists and patients. The results show the contribution of DSRM in the implementation of online services for pharmacies. We found that pharmacists spend only 50% of their time interacting with patients, uncovering a clear opportunity to implement online pharmaceutical care services. On the other hand, patients that regularly visit the same pharmacy recognize the value in patient follow-up demanding to use channels such as the Internet for their pharmacy interactions. Limitations were identified regarding the high workload of pharmacists, but particularly their lack of know-how and experience in dealing with information systems (IST) for the provision of pharmaceutical services. This paper summarizes a research project in which an online pharmaceutical service was proposed, designed, developed, demonstrated and evaluated using DSRM. The main barriers for pharmacists' adoption of online pharmaceutical services provision were the lack of time, time management and information systems usage skills, as well as a precise role definition within pharmacies. These problems can be addressed with proper training and services reorganization, two proposals to be investigated in future works.

Utilizing Service Learning in a College-Level Human Sexuality Course

ERIC Educational Resources Information Center

Jenkins, Dusty D.

2017-01-01

Implementing service learning into college courses has been shown to have positive benefits for both students and community members; however, service learning has not been largely evaluated in the literature on human sexuality courses. Thus, the purpose of the current study was to design, implement, and evaluate a service learning project in a…

47 CFR 400.4 - Application requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... proposed to be funded for the implementation and operation of Phase II E-911 services or migration to an IP... telecommunications services in the implementation and delivery of Phase II E-911 services or for migration to an IP...-911 services or for migration to an IP-enabled emergency network. (2) Project budget. A project budget...

47 CFR 400.4 - Application requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... proposed to be funded for the implementation and operation of Phase II E-911 services or migration to an IP... telecommunications services in the implementation and delivery of Phase II E-911 services or for migration to an IP...-911 services or for migration to an IP-enabled emergency network. (2) Project budget. A project budget...

75 FR 24862 - Removing Regulations Implementing the Fish and Wildlife Conservation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-06

... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service 50 CFR Part 83 [Docket No. FWS-R9-WSR-2010... and Wildlife Conservation Act AGENCY: Fish and Wildlife Service, Interior. ACTION: Proposed rule. SUMMARY: We, the U.S. Fish and Wildlife Service (Service), propose to remove our regulations implementing...

75 FR 51420 - Removing Regulations Implementing the Fish and Wildlife Conservation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service 50 CFR Part 83 [Docket No. FWS-R9-WSR-2010... and Wildlife Conservation Act AGENCY: Fish and Wildlife Service, Interior. ACTION: Final rule. SUMMARY: We, the U.S. Fish and Wildlife Service (Service), are removing our regulations implementing the Fish...

Promoting Community-Based Services: Implications for Program Design, Implementation, and Public Policy.

ERIC Educational Resources Information Center

Powers, Michael D.

1986-01-01

Program design, implementation, and public policy issues are discussed for five urban community-based programs for the developmentally disabled: (1) direct services in intermediate care facilities; (2) a High Risk Infant project; (3) group home consultative services; (4) training for support services to adoptive families; (5) a national…

The SysMan monitoring service and its management environment

NASA Astrophysics Data System (ADS)

Debski, Andrzej; Janas, Ekkehard

1996-06-01

Management of modern information systems is becoming more and more complex. There is a growing need for powerful, flexible and affordable management tools to assist system managers in maintaining such systems. It is at the same time evident that effective management should integrate network management, system management and application management in a uniform way. Object oriented OSI management architecture with its four basic modelling concepts (information, organization, communication and functional models) together with widely accepted distribution platforms such as ANSA/CORBA, constitutes a reliable and modern framework for the implementation of a management toolset. This paper focuses on the presentation of concepts and implementation results of an object oriented management toolset developed and implemented within the framework of the ESPRIT project 7026 SysMan. An overview is given of the implemented SysMan management services including the System Management Service, Monitoring Service, Network Management Service, Knowledge Service, Domain and Policy Service, and the User Interface. Special attention is paid to the Monitoring Service which incorporates the architectural key entity responsible for event management. Its architecture and building components, especially filters, are emphasized and presented in detail.

Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy.

PubMed

Kendall, Elizabeth; Barnett, Leda

2015-01-01

To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being. We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians. Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health. Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.

Process-oriented integration and coordination of healthcare services across organizational boundaries.

PubMed

Tello-Leal, Edgar; Chiotti, Omar; Villarreal, Pablo David

2012-12-01

The paper presents a methodology that follows a top-down approach based on a Model-Driven Architecture for integrating and coordinating healthcare services through cross-organizational processes to enable organizations providing high quality healthcare services and continuous process improvements. The methodology provides a modeling language that enables organizations conceptualizing an integration agreement, and identifying and designing cross-organizational process models. These models are used for the automatic generation of: the private view of processes each organization should perform to fulfill its role in cross-organizational processes, and Colored Petri Net specifications to implement these processes. A multi-agent system platform provides agents able to interpret Colored Petri-Nets to enable the communication between the Healthcare Information Systems for executing the cross-organizational processes. Clinical documents are defined using the HL7 Clinical Document Architecture. This methodology guarantees that important requirements for healthcare services integration and coordination are fulfilled: interoperability between heterogeneous Healthcare Information Systems; ability to cope with changes in cross-organizational processes; guarantee of alignment between the integrated healthcare service solution defined at the organizational level and the solution defined at technological level; and the distributed execution of cross-organizational processes keeping the organizations autonomy.

Implementation of Evidence-Based Employment Services in Specialty Mental Health

PubMed Central

Hamilton, Alison B; Cohen, Amy N; Glover, Dawn L; Whelan, Fiona; Chemerinski, Eran; McNagny, Kirk P; Mullins, Deborah; Reist, Christopher; Schubert, Max; Young, Alexander S

2013-01-01

Objective. Study a quality improvement approach for implementing evidence-based employment services at specialty mental health clinics. Data Sources/Study Setting. Semistructured interviews with clinicians and administrators before, during, and after implementation. Qualitative field notes, structured baseline and follow-up interviews with patients, semistructured interviews with patients after implementation, and administrative data. Study Design. Site-level controlled trial at four implementation and four control sites. Hybrid implementation–effectiveness study with mixed methods intervention evaluation design. Data Collection/Extraction Methods. Site visits, in-person and telephone interviews, patient surveys, patient self-assessment. A total of 801 patients completed baseline surveys and 53 clinicians and other clinical key stakeholders completed longitudinal qualitative interviews. Principal Findings. At baseline, sites varied in the availability, utilization, and quality of supported employment. Each site needed quality improvement for this service, though for differing reasons, with some needing development of the service itself and others needing increased service capacity. Improvements in knowledge, attitudes, beliefs, and referral behaviors were evident in mid- and postimplementation interviews, though some barriers persisted. Half of patients expressed an interest in working at baseline. Patients at implementation sites were 2.3 times more likely to receive employment services during the study year. Those who had a service visit were more likely to be employed at follow-up than those who did not. Conclusions. Studies of implementation and effectiveness require mixed methods to both enhance implementation in real time and provide context for interpretation of complex results. In this study, a quality improvement approach resulted in superior patient-level outcomes and improved clinician knowledge, attitudes, and behaviors, in the context of substantial variation among sites. PMID:24138608

An operational model for mainstreaming ecosystem services for implementation

PubMed Central

Cowling, Richard M.; Egoh, Benis; Knight, Andrew T.; O'Farrell, Patrick J.; Reyers, Belinda; Rouget, Mathieu; Roux, Dirk J.; Welz, Adam; Wilhelm-Rechman, Angelika

2008-01-01

Research on ecosystem services has grown markedly in recent years. However, few studies are embedded in a social process designed to ensure effective management of ecosystem services. Most research has focused only on biophysical and valuation assessments of putative services. As a mission-oriented discipline, ecosystem service research should be user-inspired and user-useful, which will require that researchers respond to stakeholder needs from the outset and collaborate with them in strategy development and implementation. Here we provide a pragmatic operational model for achieving the safeguarding of ecosystem services. The model comprises three phases: assessment, planning, and management. Outcomes of social, biophysical, and valuation assessments are used to identify opportunities and constraints for implementation. The latter then are transformed into user-friendly products to identify, with stakeholders, strategic objectives for implementation (the planning phase). The management phase undertakes and coordinates actions that achieve the protection of ecosystem services and ensure the flow of these services to beneficiaries. This outcome is achieved via mainstreaming, or incorporating the safeguarding of ecosystem services into the policies and practices of sectors that deal with land- and water-use planning. Management needs to be adaptive and should be institutionalized in a suite of learning organizations that are representative of the sectors that are concerned with decision-making and planning. By following the phases of our operational model, projects for safeguarding ecosystem services are likely to empower stakeholders to implement effective on-the-ground management that will achieve resilience of the corresponding social-ecological systems. PMID:18621695

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

Enterprising health: creating the conditions for entrepreneurial behaviour as a strategy for effective and sustainable change in health services.

PubMed

Exton, Rosemary

2010-01-01

This paper seeks to investigate conditions under which entrepreneurs emerge as agents of effective and sustainable change in UK National Health Service Trusts. The research synthesises literature on changing regulatory structures ("post-bureaucracy") and entrepreneurial behaviour to understand how individual identity construction is informed both by context and by individual attributes. Thematic analysis of interview data involving managers from 11 NHS Trusts, including detailed analysis of six transcripts, focuses on regulatory processes, the emergence of entrepreneurial behaviour and outcome variations in workplace innovation and improvement. This study identifies co-existing modes of regulation, which interact with individual behaviour, generating strategies differentiated as entrepreneurial or conformist. Four ideal types are identified: organisational entrepreneurship, resisted or dissonant entrepreneurship, conformity, and symbolic entrepreneurship. Analysis reinforces those literature findings, which suggest that the interaction of regulatory structures and the identity work of individuals influence the emergence of entrepreneurial behaviour and the effectiveness of change. The ability to achieve effective and sustainable outcomes varies considerably even between NHS Trusts faced with comparable challenges in implementing nationally prescribed targets. This variance is explained in terms of the organisation's ability to generate the structures, processes, individual competence and motivation which enable employees at all levels to act entrepreneurially with the ability and legitimacy to achieve strategic goals by working creatively in the spaces between formal organisational structures. The study identifies specific conditions, which stimulate the emergence of entrepreneurs as agents of effective and sustainable change in the NHS, identifying factors that policymakers should consider when implementing change.

Spaceflight Operations Services Grid (SOSG) Prototype Implementation and Feasibility Study

NASA Technical Reports Server (NTRS)

Bradford, Robert N.; Thigpen, William W.; Lisotta, Anthony J.; Redman, Sandra

2004-01-01

Science Operations Services Grid is focusing on building a prototype grid-based environment that incorporates existing and new spaceflight services to enable current and future NASA programs with cost savings and new and evolvable methods to conduct science in a distributed environment. The Science Operations Services Grid (SOSG) will provide a distributed environment for widely disparate organizations to conduct their systems and processes in a more efficient and cost effective manner. These organizations include those that: 1) engage in space-based science and operations, 2) develop space-based systems and processes, and 3) conduct scientific research, bringing together disparate scientific disciplines like geology and oceanography to create new information. In addition educational outreach will be significantly enhanced by providing to schools the same tools used by NASA with the ability of the schools to actively participate on many levels in the science generated by NASA from space and on the ground. The services range from voice, video and telemetry processing and display to data mining, high level processing and visualization tools all accessible from a single portal. In this environment, users would not require high end systems or processes at their home locations to use these services. Also, the user would need to know minimal details about the applications in order to utilize the services. In addition, security at all levels is an underlying goal of the project. The Science Operations Services Grid will focus on four tools that are currently used by the ISS Payload community along with nine more that are new to the community. Under the prototype four Grid virtual organizations PO) will be developed to represent four types of users. They are a Payload (experimenters) VO, a Flight Controllers VO, an Engineering and Science Collaborators VO and an Education and Public Outreach VO. The User-based services will be implemented to replicate the operational voice, video, telemetry and commanding systems. Once the User-based services are in place, they will be analyzed to establish feasibility for Grid enabling. If feasible then each User-based service will be Grid enabled. The remaining non-Grid services if not already Web enabled will be so enabled. In the end, four portals will be developed one for each VO. Each portal will contain the appropriate User-based services required for that VO to operate.

Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study.

PubMed

Cottrell, Michelle A; Hill, Anne J; O'Leary, Shaun P; Raymer, Maree E; Russell, Trevor G

2017-12-01

The Neurosurgical & Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service (N/OPSC&MDS) originated as a complementary, non-surgical pathway for patients referred to public neurosurgical and orthopaedic specialist services. Patient access to the N/OPSC&MDS could potentially be improved with the implementation of telerehabilitation as an additional method of service delivery. To evaluate service provider's views on (1) current barriers to patients' accessing N/OPSC & MD services, and (2) the implementation of telerehabilitation within the N/OPSC&MDS. Qualitative descriptive study design. Healthcare providers (n = 26) were recruited from six N/OPSC&MD services located throughout Queensland, Australia. Semi-structured interviews were conducted to explore service providers' views with respect to existing barriers to patients accessing the N/OPSC&MDS, and if telerehabilitation could be feasibly adopted to address current barriers. Template analysis resulted in six themes: (1) barriers to some patients' accessing current N/OPSC&MD services are complex & multifaceted; (2) telerehabilitation could improve patient access to appropriate management for their musculoskeletal condition; (3) telerehabilitation may have limitations when compared to face-to-face healthcare; (4) the delivery of telerehabilitation needs to be flexible; (5) perceived barriers, and (6) facilitators to the successful implementation of telerehabilitation within the N/OPSC&MDS. This study represents a critical step in determining the readiness of service providers for the implementation of telerehabilitation within the N/OPSC&MDS. Although cautious, service providers are overall accepting of the implementation of telerehabilitation, acknowledging that it could eliminate several current barriers, subsequently achieving more equitable access to the service. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A framework for community ownership of a text messaging programme to improve adherence to antiretroviral therapy and client-provider communication: a mixed methods study.

PubMed

Mbuagbaw, Lawrence; Bonono-Momnougui, Renee-Cecile; Thabane, Lehana; Kouanfack, Charles; Smieja, Marek; Ongolo-Zogo, Pierre

2014-09-26

Mobile phone text messaging has been shown to improve adherence to antiretroviral therapy and to improve communication between patients and health care workers. It is unclear which strategies are most appropriate for scaling up text messaging programmes. We sought to investigate acceptability and readiness for ownership (community members designing, sending and receiving text messages) of a text message programme among a community of clients living with human immunodeficiency virus (HIV) in Yaoundé, Cameroon and to develop a framework for implementation. We used the mixed-methods sequential exploratory design. In the qualitative strand we conducted 7 focus group discussions (57 participants) to elicit themes related to acceptability and readiness. In the quantitative strand we explored the generalizability of these themes in a survey of 420 clients. Qualitative and quantitative data were merged to generate meta-inferences. Both qualitative and quantitative strands showed high levels of acceptability and readiness despite low rates of participation in other community-led projects. In the qualitative strand, compared to the quantitative strand, more potential service users were willing to pay for a text messaging service, preferred participation of health personnel in managing the project and preferred that the project be based in the hospital rather than in the community. Some of the limitations identified to implementing a community-owned project were lack of management skills in the community, financial, technical and literacy challenges. Participants who were willing to pay were more likely to find the project acceptable and expressed positive feelings about community readiness to own a text messaging project. Community ownership of a text messaging programme is acceptable to the community of clients at the Yaoundé Central Hospital. Our framework for implementation includes components for community members who take on roles as services users (demonstrating clear benefits, allowing a trial period and ensuring high levels of confidentiality) or service providers (training in project management and securing sustainable funding). Such a project can be evaluated using participation rate, clinical outcomes, satisfaction with the service, cost and feedback from users.

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

PubMed

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

2010-05-28

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

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy.

PubMed

Egeland, Karina Myhren; Ruud, Torleif; Ogden, Terje; Färdig, Rickard; Lindstrøm, Jonas Christoffer; Heiervang, Kristin Sverdvik

2017-01-01

The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014.

77 FR 749 - General Services Administration Acquisition Regulation; Implementation of Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-06

... Acquisition Regulation; Implementation of Information Technology Security Provision AGENCY: Office of... orders that include information technology (IT) supplies, services and systems. DATES: Effective Date... 6, 2012 that include information technology (IT) supplies, services and systems with security...

Component, Context, and Manufacturing Model Library (C2M2L)

DTIC Science & Technology

2012-11-01

123 5.1 MML Population and Web Service Interface...104 Table 41. Relevant Questions with Associated Web Services...the models, and implementing web services that provide semantically aware programmatic access to the models, including implementing the MS&T

76 FR 34886 - General Services Administration Acquisition Regulation; Implementation of Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... Acquisition Regulation; Implementation of Information Technology Security Provision AGENCY: Office of... information technology (IT) supplies, services and systems with security requirements. DATES: Effective Date... effective date that include information technology (IT) supplies, services and systems with security...

Implementation of electronic medical records

PubMed Central

Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

2011-01-01

Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

Modern design of a fast front-end computer

NASA Astrophysics Data System (ADS)

Šoštarić, Z.; Anic̈ić, D.; Sekolec, L.; Su, J.

1994-12-01

Front-end computers (FEC) at Paul Scherrer Institut provide access to accelerator CAMAC-based sensors and actuators by way of a local area network. In the scope of the new generation FEC project, a front-end is regarded as a collection of services. The functionality of one such service is described in terms of Yourdon's environment, behaviour, processor and task models. The computational model (software representation of the environment) of the service is defined separately, using the information model of the Shlaer-Mellor method, and Sather OO language. In parallel with the analysis and later with the design, a suite of test programmes was developed to evaluate the feasibility of different computing platforms for the project and a set of rapid prototypes was produced to resolve different implementation issues. The past and future aspects of the project and its driving forces are presented. Justification of the choice of methodology, platform and requirement, is given. We conclude with a description of the present state, priorities and limitations of our project.

An Approach for the Assessment of System Upset Resilience

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2013-01-01

This report describes an approach for the assessment of upset resilience that is applicable to systems in general, including safety-critical, real-time systems. For this work, resilience is defined as the ability to preserve and restore service availability and integrity under stated conditions of configuration, functional inputs and environmental conditions. To enable a quantitative approach, we define novel system service degradation metrics and propose a new mathematical definition of resilience. These behavioral-level metrics are based on the fundamental service classification criteria of correctness, detectability, symmetry and persistence. This approach consists of a Monte-Carlo-based stimulus injection experiment, on a physical implementation or an error-propagation model of a system, to generate a system response set that can be characterized in terms of dimensional error metrics and integrated to form an overall measure of resilience. We expect this approach to be helpful in gaining insight into the error containment and repair capabilities of systems for a wide range of conditions.

TTCN-3 Based Conformance Testing of Mobile Broadcast Business Management System in 3G Networks

NASA Astrophysics Data System (ADS)

Wang, Zhiliang; Yin, Xia; Xiang, Yang; Zhu, Ruiping; Gao, Shirui; Wu, Xin; Liu, Shijian; Gao, Song; Zhou, Li; Li, Peng

Mobile broadcast service is one of the emerging most important new services in 3G networks. To better operate and manage mobile broadcast services, mobile broadcast business management system (MBBMS) should be designed and developed. Such a system, with its distributed nature, complicated XML data and security mechanism, faces many challenges in testing technology. In this paper, we study the conformance testing methodology of MBBMS, and design and implement a MBBMS protocol conformance testing tool based on TTCN-3, a standardized test description language that can be used in black-box testing of reactive and distributed system. In this methodology and testing tool, we present a semi-automatic XML test data generation method of TTCN-3 test suite and use HMSC model to help the design of test suite. In addition, we also propose an integrated testing method for hierarchical MBBMS security architecture. This testing tool has been used in industrial level’s testing.

Development and implementation of (Q)SAR modeling within the CHARMMing web-user interface.

PubMed

Weidlich, Iwona E; Pevzner, Yuri; Miller, Benjamin T; Filippov, Igor V; Woodcock, H Lee; Brooks, Bernard R

2015-01-05

Recent availability of large publicly accessible databases of chemical compounds and their biological activities (PubChem, ChEMBL) has inspired us to develop a web-based tool for structure activity relationship and quantitative structure activity relationship modeling to add to the services provided by CHARMMing (www.charmming.org). This new module implements some of the most recent advances in modern machine learning algorithms-Random Forest, Support Vector Machine, Stochastic Gradient Descent, Gradient Tree Boosting, so forth. A user can import training data from Pubchem Bioassay data collections directly from our interface or upload his or her own SD files which contain structures and activity information to create new models (either categorical or numerical). A user can then track the model generation process and run models on new data to predict activity. © 2014 Wiley Periodicals, Inc.

Development and usability testing of a web-based decision support for users and health professionals in psychiatric services.

PubMed

Grim, Katarina; Rosenberg, David; Svedberg, Petra; Schön, Ulla-Karin

2017-09-01

Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Implementation of Supplemental Education Services: 2009-10. Implementation Insights. E&R Report No. 11.05

ERIC Educational Resources Information Center

Paeplow, Colleen

2011-01-01

This report, the second of three reports examining Supplemental Education Services (SES) within WCPSS, focused on the implementation of SES, and the degree to which short-term and intermediate goals were met. In 2009-10, the SES program was largely implemented with fidelity, with some areas needing refinement related to communication and…

The case for implementing activity based costing.

PubMed

Monge, Paul H; Bolinger-Perez, Nicole; Boysen, Kent

2012-01-01

ABC identifies profitable volumes to give managers information to better manage volumes. Managers must balance the demand for service while maintaining a reasonable profit margin. Disparate systems work extremely well for their intended purposes, but they do not communicate with one another. The strength of the data they hold individually may be leveraged when implementing ABC methodology. Mayo Clinic in Rochester, Minnesota implemented a pilot of ABC to evaluate CT services where there is a high volume, multiple service location for cost comparison, variety of patient acuity and service mix, and large capital investments.The goal was to reveal the actual cost of CT services at the procedural level.

Virtual Tools to Broaden Participation in the Earth and Space Sciences through Geolead (Geoscience Learning, Engagement And Development)

NASA Astrophysics Data System (ADS)

Asher, P. M.; Holm Adamec, B.; Furukawa, H.; Morris, A. R.; Haacker, R.; Kaplan, M.; Lewis, G. B.; Velasco, E.; Brey, J. A.

2014-12-01

Professional societies, along with federal agencies, national research centers and laboratories, academic institutions, and private industry, all play a key role in educating the next generation of Earth, ocean, atmospheric, and space scientists by offering programs and opportunities that attract students to the field, engage and retain them by supporting them through their formal education, and provide training for a career in this field. Research indicates that multiple engagement opportunities, such as mentoring, internships, participation in research, and learning communities, among other interventions, increase student success. This is particularly true for first-generation students and those who are members of underrepresented minority populations. However, it is often difficult to provide such a variety of programs at a significant scale, especially for geographically isolated students and those whose schools have fewer resources. To enable this, the American Geophysical Union (AGU) is convening a coalition of organizations to co-design and implement a concept called Geoscience Learning, Engagement And Development (GeoLEAD). GeoLEAD will provide a virtual platform as well as a collaborative infrastructure to help engage, retain, and prepare two- and four-year-college undergraduate Earth, ocean, atmospheric, and space science students (including those students who are interested in becoming majors) for the workforce. It will centralize access to the vast array of already existing programs and services that are currently scattered across multiple organizations, support the development of new services and programs, and simplify the search process by recommending bundles of programs and services based on the students' profiles and interests. This presentation will highlight the research that led to the development of the GeoLEAD concept, including studies of the ways in which undergraduates use online resources for their education. Additionally, other virtual resources for students that are in the development or implementation stage, such as an online poster competition and a virtual student conference, will be discussed.

Evaluation of computerized health management information system for primary health care in rural India

PubMed Central

2010-01-01

Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

Regulatory Policy and Markets for Energy Storage in North America

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

Kintner-Meyer, Michael CW

2014-05-14

The last 5 years have been one of the most exciting times for the energy storage industry. We have seen significant advancements in the regulatory process to make accommodations for valuing and monetizing energy storage for what it provides to the grid. The most impactful regulatory decision for the energy storage industry has come from California, where the California Public Utilities Commission issued a decision that mandates procurement requirements of 1.325 GW for energy storage to 3 investor-own utilities in 4 stages: in 2014, 2016, 2018, and 2020. Furthermore, at the Federal level, FERC’s Order 755, requires the transmission operatorsmore » to develop pay for performance tariffs for ancillary services. This has had direct impact on the market design of US competitive wholesale markets and the monetization of fast responding grid assets. While this order is technology neutral, it clearly plays into the fast-responding capability of energy storage technologies. Today PJM, CAISO, MISO, NYISO, and NE-ISO have implemented Order 755 and offer new tariff for regulation services based on pay-for-performance principles. Furthermore, FERC Order 784, issued in July 2013 requires transmission providers to consider speed and accuracy in determining the requirements for ancillary services. In November 2013, FERC issued Order 972, which revises the small generator interconnection agreement which declares energy storage as a power source. This order puts energy storage on par with existing generators. This paper will discuss the implementation of FERC’s Pay for Performance Regulation order at all ISOs in the U.S. under FERC regulatory authority (this excludes ERCOT). Also discussed will be the market impacts and overall impacts on the NERC regulation performance indexes. The paper will end with a discussion on the California and Ontario, Canada procurement mandates and the opportunity that it may present to the energy storage industry.« less

New Generation of Broadcasting Satellite Systems: New Markets and Business Developments

NASA Astrophysics Data System (ADS)

Perrot, Bruno; Michel, Cyril; Villaret, Stéfanie

2002-01-01

Since the deployment of the first Digital Broadcasting Satellite Systems, European satellite operators and service providers have been faced with the continuously increasing demand for Digital Broadcasting Services. Their success is built on the availability of the MPEG and DVB standards. Undoubtedly, conventional digital television broadcasting is today the `Killer' application. Various service providers already offer multimedia applications through DVB-S systems based upon the `Push' technology. Although these services do not currently represent the core business for broadcasting satellite operators, their percentage is increasing. `Push' technology services include Data Carousel, Webcasting, Turbo Internet, File casting and so on. Such technology can support the implementation of different emerging multimedia services scenarios from Newsgroups, Network collaborative learning, and tele-medicine, to others that may be invented in the near future. The penetration rate of multi-channel television reception is still increasing. Broadcasting satellites benefit both from the development of new, more segmented and sophisticated offers and from the development of Internet services. Satellite is likely to enter these new markets at different levels of the value chain: Even if the satellite has demonstrated its capacity to fully serve the television, combinations with other networks may be necessary to address the new markets: at the consumer premises, Internet-related services will require a return path; at the backbone level, satellite becomes a component of a full telecommunications solution. This article focuses on the European market and proposes:

Accessibility and implementation in UK services of an effective depression relapse prevention programme – mindfulness-based cognitive therapy (MBCT): ASPIRE study protocol

PubMed Central

2014-01-01

Background Mindfulness-based cognitive therapy (MBCT) is a cost-effective psychosocial prevention programme that helps people with recurrent depression stay well in the long term. It was singled out in the 2009 National Institute for Health and Clinical Excellence (NICE) Depression Guideline as a key priority for implementation. Despite good evidence and guideline recommendations, its roll-out and accessibility across the UK appears to be limited and inequitably distributed. The study aims to describe the current state of MBCT accessibility and implementation across the UK, develop an explanatory framework of what is hindering and facilitating its progress in different areas, and develop an Implementation Plan and related resources to promote better and more equitable availability and use of MBCT within the UK National Health Service. Methods/Design This project is a two-phase qualitative, exploratory and explanatory research study, using an interview survey and in-depth case studies theoretically underpinned by the Promoting Action on Implementation in Health Services (PARIHS) framework. Interviews will be conducted with stakeholders involved in commissioning, managing and implementing MBCT services in each of the four UK countries, and will include areas where MBCT services are being implemented successfully and where implementation is not working well. In-depth case studies will be undertaken on a range of MBCT services to develop a detailed understanding of the barriers and facilitators to implementation. Guided by the study’s conceptual framework, data will be synthesized across Phase 1 and Phase 2 to develop a fit for purpose implementation plan. Discussion Promoting the uptake of evidence-based treatments into routine practice and understanding what influences these processes has the potential to support the adoption and spread of nationally recommended interventions like MBCT. This study could inform a larger scale implementation trial and feed into future implementation of MBCT with other long-term conditions and associated co-morbidities. It could also inform the implementation of interventions that are acceptable and effective, but are not widely accessible or implemented. PMID:24884603

Medical education today: globalising with quality.

PubMed

Shahabudin, S H

2005-08-01

With globalization education has become a tradable service governed by the rules and regulations of GATS and worth trillions of dollars. International standards are rapidly being developed to facilitate cross border supply of services. In medical education, the WFME has produced International Guidelines on Quality in Medical Education which has a regional equivalent in the WHO Western Pacific Region, and the IIME has defined the minimum essential requirements of standards in medical education in seven core competences. Malaysia, having an explicit policy of making education a sector for revenue generation, has put in place regulatory frameworks and incentives to make the country a centre of educational excellence. Within the ambit of this national aspiration, medical education has grown phenomenally in the last decade. Standards and procedures for accreditation of medical schools in line with the world standards have been developed and implemented and policies are enforced to facilitate compliance to the standards. The ultimate goal is for medical schools to be self-accredited. In striving towards self-accreditation medical schools should be innovative in making changes in the three requirements of medical education. These are the intellectual and social imperatives and strategies for effective implementation.

Accreditation and training on internal dosimetry in a laboratory network in Brazil: an increasing demand.

PubMed

Dantas, B M; Dantas, A L A; Acar, M E D; Cardoso, J C S; Julião, L M Q C; Lima, M F; Taddei, M H T; Arine, D R; Alonso, T; Ramos, M A P; Fajgelj, A

2011-03-01

In recent years, Brazilian Nuclear Programme has been reviewed and updated by government authorities in face of the demand for energy supply and its associated environmental constraints. The immediate impact of new national programmes and projects in nuclear field is the increase in the number of exposed personnel and the consequent need for reliable dosimetry services in the country. Several Technical Documents related to internal dosimetry have been released by the International Atomic Energy Agency and International Commission on Radiological Protection. However, standard bioassay procedures and methodologies for bioassay data interpretation are still under discussion and, in some cases, both in routine and emergency internal monitoring, procedures can vary from one laboratory to another and responses may differ markedly among Dosimetry Laboratories. Thus, it may be difficult to interpret and use bioassay data generated from different laboratories of a network. The main goal of this work is to implement a National Network of Laboratories aimed to provide reliable internal monitoring services in Brazil. The establishment of harmonised in vivo and in vitro radioanalytical techniques, dose assessment methods and the implementation of the ISO/IEC 17025 requirements will result in the recognition of technical competence of the network.

Estimating the potential health impact and costs of implementing a local policy for food procurement to reduce the consumption of sodium in the county of Los Angeles.

PubMed

Gase, Lauren N; Kuo, Tony; Dunet, Diane; Schmidt, Steven M; Simon, Paul A; Fielding, Jonathan E

2011-08-01

We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions' potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations. Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629,724 in direct health care costs. Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow.

[Role of the independent microbiology laboratory in supporting infection control programs in small to mid-sized hospitals].

PubMed

Yanagisawa, Hideji

2009-05-01

With the revision of the Medical Service Law in 2006 by the Japanese Ministry of Health, Labour and Welfare (MHLW), all healthcare institutions are now required to implement a healthcare risk management program including infection control program. At a national level, an infection control surveillance program (JANIS) was implemented in July 2007. Regular weekly, monthly, and yearly infection control surveillance reports from independent microbiology laboratories can make significant contributions to infection control programs in small to mid-sized hospitals; furthermore, such programs are consistent with the framework of the MHLW's objective of strengthening risk management in healthcare institutions. Against the backdrop of current efforts to improve risk management, independent laboratories can make a significant contribution. Independent laboratories must play a role beyond merely receiving and processing specimens for microbiological examination. In addition to generating results for patients, hospital epidemiological data that contribute to local infection control programs must be a value-added component of the service. A major obstacle for independent laboratories to make a significant contribution to risk management is the current reimbursement system, which makes it economically impossible for independent laboratories to support infection control programs in healthcare institutions.

How equitable are community health worker programmes and which programme features influence equity of community health worker services? A systematic review.

PubMed

McCollum, Rosalind; Gomez, Woedem; Theobald, Sally; Taegtmeyer, Miriam

2016-05-20

Community health workers (CHWs) are uniquely placed to link communities with the health system, playing a role in improving the reach of health systems and bringing health services closer to hard-to-reach and marginalised groups. A systematic review was conducted to determine the extent of equity of CHW programmes and to identify intervention design factors which influence equity of health outcomes. In accordance with our published protocol, we systematically searched eight databases from 2004 to 2014 for quantitative and qualitative studies which assessed access, utilisation, quality or community empowerment following introduction of a CHW programme according to equity stratifiers (place of residence, gender, socio-economic position and disability). Thirty four papers met inclusion criteria. A thematic framework was applied and data extracted and managed, prior to charting and thematic analysis. To our knowledge this is the first systematic review that describes the extent of equity within CHW programmes and identifies CHW intervention design features which influence equity. CHW programmes were found to promote equity of access and utilisation for community health by reducing inequities relating to place of residence, gender, education and socio-economic position. CHWs can also contribute towards more equitable uptake of referrals at health facility level. There was no clear evidence for equitable quality of services provided by CHWs and limited information regarding the role of the CHW in generating community empowerment to respond to social determinants of health. Factors promoting greater equity of CHW services include recruitment of most poor community members as CHWs, close proximity of services to households, pre-existing social relationship with CHW, provision of home-based services, free service delivery, targeting of poor households, strengthened referral to facility, sensitisation and mobilisation of community. However, if CHW programmes are not well planned some of the barriers faced by clients at health facility level can replicate at community level. CHWs promote equitable access to health promotion, disease prevention and use of curative services at household level. However, care must be taken by policymakers and implementers to take into account factors which can influence the equity of services during planning and implementation of CHW programmes.

Provider-identified barriers and facilitators to implementing a supported employment program in spinal cord injury.

PubMed

Cotner, Bridget A; Ottomanelli, Lisa; O'Connor, Danielle R; Trainor, John K

2018-06-01

In a 5-year study, individual placement and support (IPS) significantly increased employment rate of United States Veterans with spinal cord injury (SCI), a historically underemployed population. In a follow-up study, data on barriers and facilitators to IPS implementation were identified. Over 24 months of implementation, 82 key medical and vocational staff underwent semi-structured interviews (n = 130). Interviews were digitally recorded and qualitatively analyzed (ATLAS.ti v0.7) using a constant comparative method to generate themes. Some barriers to implementation occurred throughout the study, such as Veterans' lack of motivation and providers' difficulty integrating vocational and medical rehabilitation. Other barriers emerged at specific stages, for example, early barriers included a large geographic service area and a large patient caseload, and late barriers included need for staff education. Facilitators were mostly constant throughout implementation and included leadership support and successful integration of vocational staff into the medical care team. Implementation strategies need to be adjusted as implementation progresses and matures. The strategies that succeeded in this setting, which were situated in a real-world context of providing IPS as a part of SCI medical care, may inform implementation of IPS for other populations with physical disabilities. Implications for Rehabilitation Key facilitators to IPS in SCI implementation are integrating vocational staff with expertise in IPS and SCI on clinical rehabilitation teams and providing leadership support. Ongoing barriers to IPS in SCI include patient specific and program administration factors such as caseload size and staffing patterns. Varying implementation strategies are needed to address barriers as they arise and facilitate successful implementation.

HIV policy and implementation: a national policy review and an implementation case study of a rural area of northern Malawi.

PubMed

Dasgupta, Aisha N Z; Wringe, Alison; Crampin, Amelia C; Chisambo, Christina; Koole, Olivier; Makombe, Simon; Sungani, Charles; Todd, Jim; Church, Kathryn

2016-09-01

Malawi is a global leader in the design and implementation of progressive HIV policies. However, there continues to be substantial attrition of people living with HIV across the "cascade" of HIV services from diagnosis to treatment, and program outcomes could improve further. Ability to successfully implement national HIV policy, especially in rural areas, may have an impact on consistency of service uptake. We reviewed Malawian policies and guidelines published between 2003 and 2013 relating to accessibility of adult HIV testing, prevention of mother-to-child transmission and HIV care and treatment services using a policy extraction tool, with gaps completed through key informant interviews. A health facility survey was conducted in six facilities serving the population of a demographic surveillance site in rural northern Malawi to investigate service-level policy implementation. Survey data were analyzed using descriptive statistics. Policy implementation was assessed by comparing policy content and facility practice using pre-defined indicators covering service access: quality of care, service coordination and patient tracking, patient support, and medical management. ART was rolled out in Malawi in 2004 and became available in the study area in 2005. In most areas, practices in the surveyed health facilities complied with or exceeded national policy, including those designed to promote rapid initiation onto treatment, such as free services and task-shifting for treatment initiation. However, policy and/or practice were/was lacking in certain areas, in particular those strategies to promote retention in HIV care (e.g., adherence monitoring and home-based care). In some instances, though, facilities implemented alternative progressive practices aimed at improving quality of care and encouraging adherence. While Malawi has formulated a range of progressive policies aiming to promote rapid initiation onto ART, increased investment in policy implementation strategies and quality service delivery, in particular to promote long-term retention on treatment may improve outcomes further.

A randomised controlled trial of an intervention to facilitate the implementation of healthy eating and physical activity policies and practices in childcare services

PubMed Central

Jones, Jannah; Wolfenden, Luke; Wyse, Rebecca; Finch, Meghan; Yoong, Sze Lin; Dodds, Pennie; Pond, Nicole; Gillham, Karen; Freund, Megan; McElduff, Patrick; Wye, Paula; Wiggers, John

2014-01-01

Introduction Childhood overweight and obesity tracks into adulthood, increasing the risk of developing future chronic disease. Implementing initiatives promoting healthy eating and physical activity in childcare settings has been identified as a priority to prevent excessive child weight gain. Despite this, few trials have been conducted to assess the effectiveness of interventions to support population-wide implementation of such initiatives. The aim of this study is to assess the effectiveness of a multicomponent intervention in increasing the implementation of healthy eating and physical activity policies and practices by centre-based childcare services. Methods and analysis The study will employ a parallel group randomised controlled trial design. A sample of 128 childcare services in the Hunter region of New South Wales, Australia, will be recruited to participate in the trial. 64 services will be randomly allocated to a 12-month implementation intervention. The remaining 64 services will be allocated to a usual care control group. The intervention will consist of a number of strategies to facilitate childcare service implementation of healthy eating and physical activity policies and practices. Intervention strategies will include implementation support staff, securing executive support, consensus processes, staff training, academic detailing visits, performance monitoring and feedback, tools and resources, and a communications strategy. The primary outcome of the trial will be the prevalence of services implementing all healthy eating and physical activity policies and practices targeted by the intervention. To assess the effectiveness of the intervention, telephone surveys with nominated supervisors and room leaders of childcare services will be conducted at baseline and immediately postintervention. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. Trial registration number Australian Clinical Trials Registry ACTRN12612000927820. PMID:24742978

Service Learning in Policy and Practice: A Study of Service Learning across Three Universities

ERIC Educational Resources Information Center

Ahmed, Zahra G.

2010-01-01

This dissertation studies the creation and implementation of service learning policy and the implications of these programs for democratic citizenship and political participation. The project focuses on service learning centers at three universities in the Los Angeles area, framing the creation and implementation of these campus-wide centers as an…

Service Learning: A Promising Strategy for Connecting Future Teachers to the Lives of Diverse Children and Their Families

ERIC Educational Resources Information Center

Able, Harriet; Ghulamani, Hatice; Mallous, Ritsa; Glazier, Jocelyn

2014-01-01

This article provides a description of service learning implemented in a course entitled "Working with Socioculturally Diverse Families" for teacher education candidates (preK-grade 5). Students participated in 30 hours of service learning in which they provided support and service to diverse mentor families and implemented family events…

Implementation of Service Learning and Civic Engagement for Students of Computer Information Systems through a Course Project at the Hashemite University

ERIC Educational Resources Information Center

Al-Khasawneh, Ahmad; Hammad, Bashar K.

2015-01-01

Service learning methodologies provide students of information systems with the opportunity to create and implement systems in real-world, public service-oriented social contexts. This paper presents a case study which involves integrating a service learning project into an undergraduate Computer Information Systems course entitled…

Implementation of Service Learning and Civic Engagement for Computer Information Systems Students through a Course Project at the Hashemite University

ERIC Educational Resources Information Center

Al-Khasawneh, Ahmad; Hammad, Bashar K.

2013-01-01

Service learning methodologies provide information systems students with the opportunity to create and implement systems in real-world, public service-oriented social contexts. This paper presents a case study of integrating a service learning project into an undergraduate Computer Information Systems course titled "Information Systems"…

Forest Service Global Change Research Strategy, 2009-2019 Implementation Plan

Treesearch

Allen Solomon; Richard A. Birdsey; Linda A. Joyce

2010-01-01

In keeping with the research goals of the U.S. Global Change Research Program, the climate change strategy of the U.S. Department of Agriculture (USDA), and the climate change framework of the Forest Service, this Forest Service Global Change Research Strategy, 2009-2019 Implementation Plan (hereafter called the Research Plan), was written by Forest Service Research...

Cost calculator methods for estimating casework time in child welfare services: A promising approach for use in implementation of evidence-based practices and other service innovations.

PubMed

Holmes, Lisa; Landsverk, John; Ward, Harriet; Rolls-Reutz, Jennifer; Saldana, Lisa; Wulczyn, Fred; Chamberlain, Patricia

2014-04-01

Estimating costs in child welfare services is critical as new service models are incorporated into routine practice. This paper describes a unit costing estimation system developed in England (cost calculator) together with a pilot test of its utility in the United States where unit costs are routinely available for health services but not for child welfare services. The cost calculator approach uses a unified conceptual model that focuses on eight core child welfare processes. Comparison of these core processes in England and in four counties in the United States suggests that the underlying child welfare processes generated from England were perceived as very similar by child welfare staff in California county systems with some exceptions in the review and legal processes. Overall, the adaptation of the cost calculator for use in the United States child welfare systems appears promising. The paper also compares the cost calculator approach to the workload approach widely used in the United States and concludes that there are distinct differences between the two approaches with some possible advantages to the use of the cost calculator approach, especially in the use of this method for estimating child welfare costs in relation to the incorporation of evidence-based interventions into routine practice.

Are family-oriented interventions in Portuguese genetics services a remote possibility? Professionals' views on a multifamily intervention for cancer susceptibility families.

PubMed

Mendes, Alvaro; Paneque, Milena; Sousa, Liliana

2012-10-01

This article examines genetics healthcare professionals' opinions about a multifamily psychoeducational programme for hereditary cancer susceptibility families, implemented at a Portuguese genetics service. Their views on how a family-oriented approach is envisioned to be incorporated in Portuguese genetic counselling services are also reported. Six focus groups and three individual interviews were undertaken comprising 30 professionals working in the provision of genetic counselling and genetic counsellor trainees. Participants were given a page-summary describing the intervention and asked to comment the strengths and limitations of the multifamily intervention. All interviews were fully transcribed and analysed using the constant comparison method. The qualitative analysis generated data comprising four thematic categories in relation to the professionals' views: (a) usefulness of the programme; (b) programme's methodological and practical obstacles; (c) genetics services constraints; and (d) suggestions for improving the programme and further family-oriented interventions. We reflect on the reported views examining the intervention, and on how current constraints of genetic services limit the provision of psychosocial support for cancer susceptibility families. The implications of these findings regarding the purpose of genetic counselling are discussed. Results may sensitise stakeholders and policy makers for the need to deliver family-based services in cancer genetic counselling, with adequate planning and collaborative involvement of different professionals.

A price- and-time-slot-negotiation mechanism for Cloud service reservations.

PubMed

Son, Seokho; Sim, Kwang Mong

2012-06-01

When making reservations for Cloud services, consumers and providers need to establish service-level agreements through negotiation. Whereas it is essential for both a consumer and a provider to reach an agreement on the price of a service and when to use the service, to date, there is little or no negotiation support for both price and time-slot negotiations (PTNs) for Cloud service reservations. This paper presents a multi-issue negotiation mechanism to facilitate the following: 1) PTNs between Cloud agents and 2) tradeoff between price and time-slot utilities. Unlike many existing negotiation mechanisms in which a negotiation agent can only make one proposal at a time, agents in this work are designed to concurrently make multiple proposals in a negotiation round that generate the same aggregated utility, differing only in terms of individual price and time-slot utilities. Another novelty of this work is formulating a novel time-slot utility function that characterizes preferences for different time slots. These ideas are implemented in an agent-based Cloud testbed. Using the testbed, experiments were carried out to compare this work with related approaches. Empirical results show that PTN agents reach faster agreements and achieve higher utilities than other related approaches. A case study was carried out to demonstrate the application of the PTN mechanism for pricing Cloud resources.

Technical and Organizational Lessons Learned From More Than One Decade of the International GNSS Service Global Tracking Network

NASA Astrophysics Data System (ADS)

Moore, A. W.

2007-12-01

The International GNSS Service (IGS) is a voluntary collaboration of more than 200 worldwide agencies that pool resources to generate precise GPS and GLONASS products. The foundation of the IGS is a global network of 385 permanent, continuous, geodetic-quality stations independently operated by about 100 agencies. The IGS Central Bureau develops minimum functional requirements and operational standards that enable the individual stations' data to be used coherently in global analyses, but the IGS remains vendor neutral, leaving procurement decisions and implementation details to the individual agencies. The IGS network is hence quite heterogeneous in instrumentation, station management strategies, and culture; these diversities bring both strengths and challenges in coordination. This presentation will detail the IGS's approaches, successes, and opportunities for improvement in coordinating and monitoring the collaborative network.

Shipboard fisheries management terminals

NASA Technical Reports Server (NTRS)

Nagler, R. G.; Sager, E. V.

1980-01-01

The needs of the National Marine Fisheries Service (NMGS), National Weather Service, and the U.S. Coast Guard for locational, biological, and environmental data were assessed. The fisheries conservation zones and the yellowfin tuna jurisdiction of the NMFS operates observer programs on foreign and domestic fishing vessels. Data input terminal and data transfer and processing technology are reviewed to establish available capability. A matrix of implementation options is generated to identify the benefits of each option, and preliminary cost estimates are made. Recommendations are made for incremental application of available off the shelf hardware to obtain improved performance and benefits within a well bounded cost. Terminal recommendations are made for three interdependent shipboard units emphasizing: (1) the determination of location and fishing activity; (2) hand held data inputting and formatting in the fishing work areas; and (3) data manipulation, merging, and editing.

Implementing a continuum of evidence-based psychosocial interventions for people with severe mental illness: part 1-review of major initiatives and implementation strategies.

PubMed

Menear, Matthew; Briand, Catherine

2014-04-01

Providing comprehensive care to people with severe mental illness (SMI) involves moving beyond pharmacological treatment and ensuring access to a wide range of evidence-based psychosocial services. Numerous initiatives carried out in North America and internationally have promoted the widespread adoption of such services. Objectives of this rapid review were 3-fold: to identify these implementation initiatives, to describe the implementation strategies used to promote the uptake of psychosocial services, and to identify key issues related to the implementation of a broad range of services. Part 1 presents findings for objectives 1 and 2 of the review. Searches were carried out in MEDLINE and PsycINFO for reports published between 1990 and 2012 using key words related to SMI, psychosocial practices, and implementation. Contacts with experts and reference list and reverse citation searches were also conducted. Fifty-five articles were retained that identified more than a dozen major North American and international implementation initiatives. Initiative leaders employed diverse strategies at the planning, execution, and evaluation stages of the implementation process. Stakeholder meetings, training, ongoing consultation, and quality or fidelity monitoring were strategies consistently adopted across most initiatives, whereas theory-based approaches and organizational- and system-level strategies were less frequently described. Insights from the initiatives identified in this review can help guide future efforts to implement a broad range of psychosocial services for people with SMI. However, such efforts will also need to be informed by more rigorous, theory-based studies of implementation processes and outcomes.

Bridging the gap between the science and service of HIV prevention: transferring effective research-based HIV prevention interventions to community AIDS service providers.

PubMed Central

Kelly, J A; Somlai, A M; DiFranceisco, W J; Otto-Salaj, L L; McAuliffe, T L; Hackl, K L; Heckman, T G; Holtgrave, D R; Rompa, D

2000-01-01

OBJECTIVES: AIDS service organizations (ASOs) rarely have access to the information needed to implement research-based HIV prevention interventions for their clients. We compared the effectiveness of 3 dissemination strategies for transferring HIV prevention models from the research arena to community providers of HIV prevention services. METHODS: Interviews were conducted with the directors of 74 ASOs to assess current HIV prevention services. ASOs were randomized to programs that provided (1) technical assistance manuals describing how to implement research-based HIV prevention interventions, (2) manuals plus a staff training workshop on how to conduct the implementation, or (3) manuals, the training workshop, and follow-up telephone consultation calls. Follow-up interviews determined whether the intervention model had been adopted. RESULTS: The dissemination package that provided ASOs with implementation manuals, staff training workshops, and follow-up consultation resulted in more frequent adoption and use of the research-based HIV prevention intervention for gay men, women, and other client populations. CONCLUSIONS: Strategies are needed to quickly transfer research-based HIV prevention methods to community providers of HIV prevention services. Active collaboration between researchers and service agencies results in more successful program adoption than distribution of implementation packages alone. PMID:10897186

Minority ethnic community participation in needs assessment and service development in primary care: perceptions of Pakistani and Bangladeshi people about psychological distress.

PubMed

Kai, Joe; Hedges, Clive

1999-03-01

OBJECTIVES: To promote community participation in exploring perceptions of psychological distress amongst Pakistani and Bangladeshi people, in order to develop appropriate services. DESIGN: Training and facilitation of resident community members (as community project workers), to define and conduct qualitative research involving semistructured interviews in their own communities, informing primary care led commissioning and service decision making. Setting A socio-economically disadvantaged inner-city locality in the UK. Participants One-hundred and four South Asian people (49 of Pakistani and 55 of Bangladeshi origin), interviewed by 13 resident community members. RESULTS: All community project workers completed training leading to a National Vocational Qualification, and successfully executed the research. Most study respondents located their main sources of stress within pervasive experience of racism and socio-economic disadvantage. They were positive about 'talking' and neutral listening as helpful, but sought strategies beyond non-directive counselling services that embraced practical welfare advice and social support. The roles of primary health care professionals were believed to be restricted to physical ill health rather than personal distress. The importance of professionals' sex, age, ethnicity and social status were emphasized as affecting open communication. Practical recommendations for the re-orientation and provision of services were generated and implemented in response to the findings, through dialogue with a primary care commissioning group, Health and Local Authority, and voluntary agencies. CONCLUSIONS: The work illustrates the feasibility and value of a community participation approach to research and service development in addressing a challenging and neglected area of minority ethnic health need. It offers one model for generating responsive service change in the context of current health policy in the UK, whilst also imparting skills and empowering community members. The study findings emphasize the need to recognize the social contexts in which distress is experienced and have implications for effective responses.

76 FR 6381 - Fee-Generating Cases

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services...) proposes to amend the Legal Services Corporation's regulation on fee-generating cases to clarify that it... Counsel, Office of Legal Affairs, Legal Services Corporation, 3333 K Street, NW., Washington, DC 20007...

Operational research as implementation science: definitions, challenges and research priorities.

PubMed

Monks, Thomas

2016-06-06

Operational research (OR) is the discipline of using models, either quantitative or qualitative, to aid decision-making in complex implementation problems. The methods of OR have been used in healthcare since the 1950s in diverse areas such as emergency medicine and the interface between acute and community care; hospital performance; scheduling and management of patient home visits; scheduling of patient appointments; and many other complex implementation problems of an operational or logistical nature. To date, there has been limited debate about the role that operational research should take within implementation science. I detail three such roles for OR all grounded in upfront system thinking: structuring implementation problems, prospective evaluation of improvement interventions, and strategic reconfiguration. Case studies from mental health, emergency medicine, and stroke care are used to illustrate each role. I then describe the challenges for applied OR within implementation science at the organisational, interventional, and disciplinary levels. Two key challenges include the difficulty faced in achieving a position of mutual understanding between implementation scientists and research users and a stark lack of evaluation of OR interventions. To address these challenges, I propose a research agenda to evaluate applied OR through the lens of implementation science, the liberation of OR from the specialist research and consultancy environment, and co-design of models with service users. Operational research is a mature discipline that has developed a significant volume of methodology to improve health services. OR offers implementation scientists the opportunity to do more upfront system thinking before committing resources or taking risks. OR has three roles within implementation science: structuring an implementation problem, prospective evaluation of implementation problems, and a tool for strategic reconfiguration of health services. Challenges facing OR as implementation science include limited evidence and evaluation of impact, limited service user involvement, a lack of managerial awareness, effective communication between research users and OR modellers, and availability of healthcare data. To progress the science, a focus is needed in three key areas: evaluation of OR interventions, embedding the knowledge of OR in health services, and educating OR modellers about the aims and benefits of service user involvement.

Adolescents with Type 1 Diabetes: transition between diabetes services.

PubMed

Visentin, Kate; Koch, Tina; Kralik, Debbie

2006-06-01

The research aimed to develop a sustainable and coordinated approach to facilitating the transition between diabetes services for adolescents. The objectives were to: (1) involve key diabetes health delivery stakeholders in expressing their concerns and issues about current service delivery and ways to improve same, and (2) reveal from the perspective of the adolescents living with Type 1 Diabetes their experiences surrounding the process of transition. This paper presents research that sought to identify the major concerns and issues that stakeholders had about transition and to reveal the experience of transition for the adolescent with Type 1 Diabetes. Key representatives from seven public diabetes services in Adelaide, South Australia worked collaboratively to answer the objectives of this inquiry. Approach. Interview data were generated and analysed using a response focus framework provided by fourth generation evaluation research. In this study, the focus was on common concerns, claims and issues raised by health care professionals (n = 21) and adolescents (n = 10) aged between 15 and 18 years about transferring from children's to adult diabetes services. Data revealed education and dietetic advice was reactive rather than proactive and that the paediatric model of care is philosophically and practically different to the adult model of diabetes care. Three phases of transition were identified: preparation, formal transition and evaluation. Our findings indicated that these stages of transition were not being fully implemented in health units. The project findings have set the scene to establish a multidisciplinary working party to work collaboratively across agencies to develop effective transition pathways. The role of diabetes nurse educators and dietitians in South Australia is under-used throughout the transition process. Diabetes nurse educators are in an ideal position to prepare, coordinate and evaluate transitional processes.

Economic grand rounds: the price is right? Changes in the quantity of services used and prices paid in response to parity.

PubMed

Goldman, Howard H; Barry, Colleen L; Normand, Sharon-Lise T; Azzone, Vanessa; Busch, Alisa B; Huskamp, Haiden A

2012-02-01

The impact of parity coverage on the quantity of behavioral health services used by enrollees and on the prices of these services was examined in a set of Federal Employees Health Benefit (FEHB) Program plans. After parity implementation, the quantity of services used in the FEHB plans declined in five service categories, compared with plans that did not have parity coverage. The decline was significant for all service types except inpatient care. Because a previous study of the FEHB Program found that total spending on behavioral health services did not increase after parity implementation, it can be inferred that average prices must have increased over the period. The finding of a decline in service use and increase in prices provides an empirical window on what might be expected after implementation of the federal parity law and the parity requirement under the health care reform law.

Temporal Informative Analysis in Smart-ICU Monitoring: M-HealthCare Perspective.

PubMed

Bhatia, Munish; Sood, Sandeep K

2016-08-01

The rapid introduction of Internet of Things (IoT) Technology has boosted the service deliverance aspects of health sector in terms of m-health, and remote patient monitoring. IoT Technology is not only capable of sensing the acute details of sensitive events from wider perspectives, but it also provides a means to deliver services in time sensitive and efficient manner. Henceforth, IoT Technology has been efficiently adopted in different fields of the healthcare domain. In this paper, a framework for IoT based patient monitoring in Intensive Care Unit (ICU) is presented to enhance the deliverance of curative services. Though ICUs remained a center of attraction for high quality care among researchers, still number of studies have depicted the vulnerability to a patient's life during ICU stay. The work presented in this study addresses such concerns in terms of efficient monitoring of various events (and anomalies) with temporal associations, followed by time sensitive alert generation procedure. In order to validate the system, it was deployed in 3 ICU room facilities for 30 days in which nearly 81 patients were monitored during their ICU stay. The results obtained after implementation depicts that IoT equipped ICUs are more efficient in monitoring sensitive events as compared to manual monitoring and traditional Tele-ICU monitoring. Moreover, the adopted methodology for alert generation with information presentation further enhances the utility of the system.

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics

PubMed Central

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A.

2015-01-01

Background and Objectives: In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007–2012). Approach: Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. Results: The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. Conclusion: The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. PMID:26742118

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.

PubMed

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A; Gill, Kathryn

2015-11-01

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012). Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. Copyright © 2015 Longwoods Publishing.

The Implementation of a Service-Learning Component in an Organic Chemistry Laboratory Course

ERIC Educational Resources Information Center

Glover, Sarah R.; Sewry, Joyce D.; Bromley, Candice L.; Davies-Coleman, Michael T.; Hlengwa, Amanda

2013-01-01

avenues for the implementation of service-learning into their curricula. A second-year undergraduate organic chemistry laboratory experiment, in which the undergraduate students make azo dyes, can provide a vehicle for a service-learning module in which university undergraduate…

Acute HIV infection (AHI): Trained Service Linkage Workers and fourth-generation Assay Significantly Shorten Time to Antiretroviral Therapy Initiation.

PubMed Central

Smith, Daniel; Gao, Qianmiao; Miao, Hongyu; Gutierrez, Oswaldo; Martinez, Cecilio; Vigil, Karen; Utay, Netanya S; Arduino, Roberto

2017-01-01

Abstract Background Identification and early initiation of antiretroviral therapy (ART) during acute HIV infection (AHI) can preserve the immune system, reduce HIV reservoir size, and prevent transmission. We aimed to characterize patients with symptomatic AHI and their linkage/retention to care in a county clinic. Methods Retrospective chart review of 60 patients diagnosed with AHI from 7/2012 to 4/2017 at two county hospitals emergency departments in Houston, TX. We compared the interval between diagnosis and initiation of ART before and after implementation of an AHI protocol in 11/2014 comprised of trained service linkage workers and use of the fourth-generation Ag/Ab combination assay as newly recommended by the CDC in 6/2014. AHI was defined as 1) detectable HIV RNA or reactive fourth-generation Ag/Ab combination assay with non-reactive HIV-1 antibody, 2) reactive third-generation Ab assay and negative/indeterminate Western blot (WB), or 3) positive WB that is negative for p31 band. CDC and DHHS definitions were used for linkage to and retention to care respectively. Results 10 patients were diagnosed prior to AHI protocol (25-month period) and 50 after (31-month period). 92% established care with 78% retention. Median age 34 years (IQR 25–42), with 78% men, 58% Hispanic, 36% Black non-Hispanic, 50% men having sex with men. Presenting symptoms include fever 78%, chills 47%, malaise/fatigue 47%, nausea 38%, sore throat 37%, and headache 37%. Physical exam findings include rash 20%, pharyngeal edema/erythema 14%, cervical lymphadenopathy 8%, and thrush 7%. Baseline median CD4+ T cell count was 205 cells/µL (IQR 123–350), median HIV RNA 4.75 x 106 copies/mL (IQR 1.1–10.0 x 106). 56% had leukopenia, 47% thrombocytopenia, 37% syphilis, 12% aseptic meningitis and 8% K103N mutation. Median time to ART initiation decreased from 17 days (IQR 11.75–23.5) to 7 days (IQR 4.0–13.25) after protocol implementation (P = 0.011). Conclusion Employing trained service linkage workers and the new CDC testing algorithm significantly decreased time to initiating ART, which may improve long-term outcomes in these patients. However, 14% of patients were lost to follow-up, highlighting the need for a strategy to maintain engagement of care. Disclosures All authors: No reported disclosures.

A TMS320-based modem for the aeronautical-satellite core data service

NASA Astrophysics Data System (ADS)

Moher, Michael L.; Lodge, John H.

The International Civil Aviation Organization (ICAO) Future Air Navigation Systems (FANS) committee, the Airlines Electronics Engineering Committee (AEEC), and Inmarsat have been developing standards for an aeronautical satellite communications service. These standards encompass a satellite communications system architecture to provide comprehensive aeronautical communications services. Incorporated into the architecture is a core service capability, providing only low rate data communications, which all service providers and all aircraft earth terminals are required to support. In this paper an implementation of the physical layer of this standard for the low data rate core service is described. This is a completely digital modem (up to a low intermediate frequency). The implementation uses a single TMS320C25 chip for the transmit baseband functions of scrambling, encoding, interleaving, block formatting and modulation. The receiver baseband unit uses a dual processor configuration to implement the functions of demodulation, synchronization, de-interleaving, decoding and de-scrambling. The hardware requirements, the software structure and the algorithms of this implementation are described.

Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

PubMed

Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

2012-02-01

Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

Mixed Methods for Implementation Research: Application to Evidence-Based Practice Implementation and Staff Turnover in Community Based Organizations Providing Child Welfare Services

PubMed Central

Aarons, Gregory A.; Fettes, Danielle L.; Sommerfeld, David H.; Palinkas, Lawrence

2013-01-01

Many public sector services systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well-suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This paper describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. We integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research. PMID:22146861

Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

PubMed

Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

2015-09-01

The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

32 CFR 321.14 - DSS implementation policies.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) PRIVACY PROGRAM DEFENSE SECURITY SERVICE PRIVACY PROGRAM § 321.14 DSS implementation policies. (a) General... matters of particular concern to the Defense Security Service. (b) Privacy Act rules application. Any... 32 National Defense 2 2014-07-01 2014-07-01 false DSS implementation policies. 321.14 Section 321...

32 CFR 321.14 - DSS implementation policies.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) PRIVACY PROGRAM DEFENSE SECURITY SERVICE PRIVACY PROGRAM § 321.14 DSS implementation policies. (a) General... matters of particular concern to the Defense Security Service. (b) Privacy Act rules application. Any... 32 National Defense 2 2013-07-01 2013-07-01 false DSS implementation policies. 321.14 Section 321...

32 CFR 321.14 - DSS implementation policies.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) PRIVACY PROGRAM DEFENSE SECURITY SERVICE PRIVACY PROGRAM § 321.14 DSS implementation policies. (a) General... matters of particular concern to the Defense Security Service. (b) Privacy Act rules application. Any... 32 National Defense 2 2012-07-01 2012-07-01 false DSS implementation policies. 321.14 Section 321...

76 FR 5203 - Draft Environmental Impact Statement, Stehekin River Corridor Implementation Plan, North Cascades...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... Statement, Stehekin River Corridor Implementation Plan, North Cascades National Park Service Complex; Chelan... public comment period. SUMMARY: The National Park Service, in cooperation with the Federal Highway Administration, has prepared a combined Stehekin River Corridor Implementation Plan, Lake Chelan National...

78 FR 52777 - Implementation of the Revised International Guiding Principles for Biomedical Research Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Implementation of the... Institutes of Health (NIH) is providing guidance to Public Health Service (PHS) awardee institutions on implementation of the revised International Guiding Principles for Biomedical Research Involving Animals...

The Case for Home-Grown, Sustainable, Next Generation Library Services

ERIC Educational Resources Information Center

Haefele, Chad

2011-01-01

While libraries offer next generation public services such as mobile access and e-books, these services are often neither home-grown nor sustainable. Libraries have a history of lending and services built on a simple model: they purchase an item and then provide it to the community. Unfortunately, the latest generation of services offered by…

Modeling health impact of global health programs implemented by Population Services International

PubMed Central

2013-01-01

Background Global health implementing organizations benefit most from health impact estimation models that isolate the individual effects of distributed products and services - a feature not typically found in intervention impact models, but which allow comparisons across interventions and intervention settings. Population Services International (PSI), a social marketing organization, has developed a set of impact models covering seven health program areas, which translate product/service distribution data into impact estimates. Each model's primary output is the number of disability-adjusted life-years (DALYs) averted by an intervention within a specific country and population context. This paper aims to describe the structure and inputs for two types of DALYs averted models, considering the benefits and limitations of this methodology. Methods PSI employs two modeling approaches for estimating health impact: a macro approach for most interventions and a micro approach for HIV, tuberculosis (TB), and behavior change communication (BCC) interventions. Within each intervention country context, the macro approach determines the coverage that one product/service unit provides a population in person-years, whereas the micro approach estimates an individual's risk of infection with and without the product/service unit. The models use these estimations to generate per unit DALYs averted coefficients for each intervention. When multiplied by program output data, these coefficients predict the total number of DALYs averted by an intervention in a country. Results Model outputs are presented by country for two examples: Water Chlorination DALYs Averted Model, a macro model, and the HIV Condom DALYs Averted Model for heterosexual transmission, a micro model. Health impact estimates measured in DALYs averted for PSI interventions on a global level are also presented. Conclusions The DALYs averted models offer implementing organizations practical measurement solutions for understanding an intervention's contribution to improving health. These models calculate health impact estimates that reflect the scale and diversity of program operations and intervention settings, and that enable comparisons across health areas and countries. Challenges remain in accounting for intervention synergies, attributing impact to a single organization, and sourcing and updating model inputs. Nevertheless, these models demonstrate how DALYs averted can be viably used by the global health community as a metric for predicting intervention impact using standard program output data. PMID:23902668

Design and implementation of handheld and desktop software for the structured reporting of hepatic masses using the LI-RADS schema.

PubMed

Clark, Toshimasa J; McNeeley, Michael F; Maki, Jeffrey H

2014-04-01

The Liver Imaging Reporting and Data System (LI-RADS) can enhance communication between radiologists and clinicians if applied consistently. We identified an institutional need to improve liver imaging report standardization and developed handheld and desktop software to serve this purpose. We developed two complementary applications that implement the LI-RADS schema. A mobile application for iOS devices written in the Objective-C language allows for rapid characterization of hepatic observations under a variety of circumstances. A desktop application written in the Java language allows for comprehensive observation characterization and standardized report text generation. We chose the applications' languages and feature sets based on the computing resources of target platforms, anticipated usage scenarios, and ease of application installation, deployment, and updating. Our primary results are the publication of the core source code implementing the LI-RADS algorithm and the availability of the applications for use worldwide via our website, http://www.liradsapp.com/. The Java application is free open-source software that can be integrated into nearly any vendor's reporting system. The iOS application is distributed through Apple's iTunes App Store. Observation categorizations of both programs have been manually validated to be correct. The iOS application has been used to characterize liver tumors during multidisciplinary conferences of our institution, and several faculty members, fellows, and residents have adopted the generated text of Java application into their diagnostic reports. Although these two applications were developed for the specific reporting requirements of our liver tumor service, we intend to apply this development model to other diseases as well. Through semiautomated structured report generation and observation characterization, we aim to improve patient care while increasing radiologist efficiency. Published by Elsevier Inc.

Patient care outcomes of a tobacco use registry in an academic family practice.

PubMed

Ripley-Moffitt, Carol; Neutze, Dana; Gwynne, Mark; Goldstein, Adam O

2015-01-01

While the potential benefit of a chronic disease registry for tobacco use is great, outcome reports have not been generated. We examined the effect of implementing a tobacco use registry, including a decision support tool, on treatment outcomes within an academic family medicine clinic. A chart review of 200 patients who smoked and attended the clinic before and after registry implementation assessed the number of patients with clinic notes documenting (1) counseling for tobacco use, (2) recommendations for cessation medication, (3) a set quit date, (4) referrals to the on-site Nicotine Dependence Program (NDP) and/or QuitlineNC, and (5) pneumococcal vaccine. Data from the NDP, QuitlineNC, and clinic billing records before and after implementation compared the number of clinic-generated QuitlineNC fax referrals, new scheduled appointments for the NDP, and visits coded for tobacco counseling reimbursement. Significant increases in documentation occurred across most chart review variables. Significant increases in the number of clinic-generated fax referrals to QuitlineNC (from 27 to 96), initial scheduled appointments for the NDP (from 84 to 148), and coding for tobacco counseling (from 101 to 287) also occurred when compared with total patient visits during the same time periods. Patient attendance at the NDP (52%) and acceptance of QuitlineNC services (31%) remained constant. The tobacco use registry's decision support tool increased evidenced-based tobacco use treatment (referrals, medications, and counseling) for patients at an academic family medicine clinic. This novel tool offers standardized care for all patients who use tobacco, ensuring improved access to effective tobacco use counseling and medication treatments. © Copyright 2015 by the American Board of Family Medicine.

Planning and Implementing total Quality Management in an Air Force Service Organization: A Case Study

DTIC Science & Technology

1988-09-01

Quality Management (TQM). Documentation of such implementation methods can provide useful crossfeed to other services organizations attempting similiar efforts. The following research questions were addressed to present the case in a useful context for interpretation: (1) What is TQM and how will it be implemented in AFALC; (2) How can the quality of service organizations be improved and what techniques may be useful for this purpose; (3) How does the environment at AFALC differ from most Air Force organizations implementing TQM and what obstacles must it overcome; (4) How

Implementation and de-implementation: two sides of the same coin?

PubMed

van Bodegom-Vos, Leti; Davidoff, Frank; Marang-van de Mheen, Perla J

2017-06-01

Avoiding low value care received increasing attention in many countries, as with the Choosing Wisely campaign and other initiatives to abandon care that wastes resources or delivers no benefit to patients. While an extensive literature characterises approaches to implementing evidence-based care, we have limited understanding of the process of de-implementation, such as abandoning existing low value practices. To learn more about the differences between implementation and de-implementation, we explored the literature and analysed data from two published studies (one implementation and one de-implementation) by the same orthopaedic surgeons. We defined 'leaders' as those orthopaedic surgeons who implemented, or de-implemented, the target processes of care and laggards as those who did not. Our findings suggest that leaders in implementation share some characteristics with leaders in de-implementation when comparing them with laggards, such as more open to new evidence, younger and less time in clinical practice. However, leaders in de-implementation and implementation differed in some other characteristics and were not the same persons. Thus, leading in implementation or de-implementation may depend to some degree on the type of intervention rather than entirely reflecting personal characteristics. De-implementation seemed to be hampered by motivational factors such as department priorities, and economic and political factors such as cost-benefit considerations in care delivery, whereas organisational factors were associated only with implementation. The only barrier or facilitator common to both implementation and de-implementation consisted of outcome expectancy (ie, the perceived net benefit to patients). Future studies need to test the hypotheses generated from this study and improve our understanding of differences between the processes of implementation and de-implementation in the people who are most likely to lead (or resist) these efforts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Sea state indices for a coastal strait

NASA Astrophysics Data System (ADS)

Gemmrich, Johannes; Dewey, Richard

2017-04-01

The Strait of Georgia at the west coast of Canada is an enclosed coastal strait, about 250km long and 25 to 50 km wide, with great socio-economic importance. Regular freighter traffic, ferry services, commercial and sport fisheries, and recreational boating, makes the area one of the busiest marine areas in the world. Waves in SoG are generally small, with the median value of the significant wave height Hs=0.3m. However, strong outflows off the mountainous terrain can generate significant wave heights Hs > 2.5m, with high spatial and temporal variability. In addition, strong tidal currents and the Fraser River outflow generate localized regions of steep and breaking waves that are of particular concern. We have implemented the Wavewatch III model at 500m-resolution, forced by Environment Canada's high resolution atmospheric model winds and currents from the UBC NEMO implementation of the Salish Sea. The final output combines GIS layers of the predicted wave field (Hs, dominant wave length and direction), the modeled wind field and currents, observed currents from a set of CODAR systems, and a sea state index that highlights regions of potentially steep and dangerous waves.

Providing Internet Access to High-Resolution Lunar Images

NASA Technical Reports Server (NTRS)

Plesea, Lucian

2008-01-01

The OnMoon server is a computer program that provides Internet access to high-resolution Lunar images, maps, and elevation data, all suitable for use in geographical information system (GIS) software for generating images, maps, and computational models of the Moon. The OnMoon server implements the Open Geospatial Consortium (OGC) Web Map Service (WMS) server protocol and supports Moon-specific extensions. Unlike other Internet map servers that provide Lunar data using an Earth coordinate system, the OnMoon server supports encoding of data in Moon-specific coordinate systems. The OnMoon server offers access to most of the available high-resolution Lunar image and elevation data. This server can generate image and map files in the tagged image file format (TIFF) or the Joint Photographic Experts Group (JPEG), 8- or 16-bit Portable Network Graphics (PNG), or Keyhole Markup Language (KML) format. Image control is provided by use of the OGC Style Layer Descriptor (SLD) protocol. Full-precision spectral arithmetic processing is also available, by use of a custom SLD extension. This server can dynamically add shaded relief based on the Lunar elevation to any image layer. This server also implements tiled WMS protocol and super-overlay KML for high-performance client application programs.

Providing Internet Access to High-Resolution Mars Images

NASA Technical Reports Server (NTRS)

Plesea, Lucian

2008-01-01

The OnMars server is a computer program that provides Internet access to high-resolution Mars images, maps, and elevation data, all suitable for use in geographical information system (GIS) software for generating images, maps, and computational models of Mars. The OnMars server is an implementation of the Open Geospatial Consortium (OGC) Web Map Service (WMS) server. Unlike other Mars Internet map servers that provide Martian data using an Earth coordinate system, the OnMars WMS server supports encoding of data in Mars-specific coordinate systems. The OnMars server offers access to most of the available high-resolution Martian image and elevation data, including an 8-meter-per-pixel uncontrolled mosaic of most of the Mars Global Surveyor (MGS) Mars Observer Camera Narrow Angle (MOCNA) image collection, which is not available elsewhere. This server can generate image and map files in the tagged image file format (TIFF), Joint Photographic Experts Group (JPEG), 8- or 16-bit Portable Network Graphics (PNG), or Keyhole Markup Language (KML) format. Image control is provided by use of the OGC Style Layer Descriptor (SLD) protocol. The OnMars server also implements tiled WMS protocol and super-overlay KML for high-performance client application programs.

Web Services Security - Implementation and Evaluation Issues

NASA Astrophysics Data System (ADS)

Pimenidis, Elias; Georgiadis, Christos K.; Bako, Peter; Zorkadis, Vassilis

Web services development is a key theme in the utilization the commercial exploitation of the semantic web. Paramount to the development and offering of such services is the issue of security features and they way these are applied in instituting trust amongst participants and recipients of the service. Implementing such security features is a major challenge to developers as they need to balance these with performance and interoperability requirements. Being able to evaluate the level of security offered is a desirable feature for any prospective participant. The authors attempt to address the issues of security requirements and evaluation criteria, while they discuss the challenges of security implementation through a simple web service application case.

TAPRegExt: a VOResource Schema Extension for Describing TAP Services Version 1.0

NASA Astrophysics Data System (ADS)

Demleitner, Markus; Dowler, Patrick; Plante, Ray; Rixon, Guy; Taylor, Mark; Demleitner, Markus

2012-08-01

This document describes an XML encoding standard for metadata about services implementing the table access protocol TAP [TAP], referred to as TAPRegExt. Instance documents are part of the service's registry record or can be obtained from the service itself. They deliver information to both humans and software on the languages, output formats, and upload methods supported by the service, as well as data models implemented by the exposed tables, optional language features, and certain limits enforced by the service.

Primary Pre-Service Teachers' Perspectives on Constructivism and Its Implementation in the Schools

ERIC Educational Resources Information Center

Savas Basturk

2016-01-01

The aim of this study was to determine pre-service teachers' perspectives on constructivism and its implementation in schools. In order to do this, a semi-structured interview was conducted with 12 primary pre-service teachers from the grades 2, 3, and 4. Four pre-service teachers were voluntarily selected from each grade for interview. Each…

Implementing a New Cloud Computing Library Management Service: A Symbiotic Approach

ERIC Educational Resources Information Center

Dula, Michael; Jacobsen, Lynne; Ferguson, Tyler; Ross, Rob

2012-01-01

This article presents the story of how Pepperdine University migrated its library management functions to the cloud using what is now known as OCLC's WorldShare Management Services (WMS). The story of implementing this new service is told from two vantage points: (1) that of the library; and (2) that of the service provider. The authors were the…